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Just received ATOs medical questionnaire. What happens next?
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# 1
blackcloud
Old 14-07-2012, 5:16 PM
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Default Just received ATOs medical questionnaire. What happens next?

Just received the Medical questionnaire from Atos. What happens after I fill it in and send it back to them? Do they look at it and decide whether to keep me on ESA in the support group or could they request me to goto a medical appointment? Or could they upon receiving the medical questionnaire stop my benefits without sending me for a medical? How long do you think the process could be from the point of me sending off the questionnaire? I dont understand why I have been sent a questionaire now as on my last letter from the DWP it says "your case is due to come up for review on the 5/9/12"


Can you still appeal ESA, if they declare you fit for work and they put you on a smaller amount until your appeal is heard? What would the smaller amount be called? It use to be income support if someone was on Incapacity Benefit and they were declared fit for work and they appealed?

Any help appreciated.

Last edited by blackcloud; 14-07-2012 at 5:26 PM.
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# 2
atrixblue.-MFR-.
Old 14-07-2012, 6:13 PM
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ESA can review you case at any point the date they give is just a indicator that anytime before this date they will send a letter for more info.

ESA50 is a medical questionarre that if you do not fill in will stop your benefits or if they dont recieve it.

the point to point of you handing it over and them getting about a decision based on your answers will be 4-8weeks.

supply any report that is beneficial to your condition and descriptor for ESA support group.

Atos will not look at your past award they only look forward to the ESA50, be sure to include you current benefit level in the more info box especially of you won at tribunal. what they will award is anymans guess. you maybe called for a medical, they may call upon your GP/specialist for a report/they may place you in LCW WRAG, or have a face to face to be placed into WRAG.

upon an appeal, you will be entitled to reduced rate (appeal rate) ESA.

currently the appeal waiting times are 12-18 months to get to tribunal, i have appealed a decising to place me in LCW WRAG, after sending off the letter, it has taken them three months to tell me they have recieved my letter and will review My case for reconsidderation before it goes on to the tribunal services they will let me know in due course whether the decision can be overturned.
I make spelling mistakes, its not intentional, its a condition I have please afford people who have these conditions some respect and not single out their posts for correcting mistakes.
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# 3
blackcloud
Old 14-07-2012, 6:34 PM
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Atrix, thanks so much for that. Very helpful. A couple more questions if you maybe?

1) Can I ask you, if I do fail the medical and I appeal, do you mean I would still receive ESA but at the appeal rate?

2) If so what is the appeal rate?

3) Is it possible once I have sent off my ESA50 they could send me a letter saying I have been taken off ESA even without a Medical?

4) What is LCW WRAG?

5) What is WRAG?

6) When I send in the ESA50 can I send evidence of my Support plan from my Care worker and letters that prove I have appointments with the hospital? If so, do they have to be originals or can they be photocopies?
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Muttleythefrog
Old 14-07-2012, 6:44 PM
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The process of reassessment may take a couple of months so this could all well be happening roughly in line with the date in september given last time.

The process is fairly simple. You return completed ESA50 form (might be worth using pdf version available online if you have a printer - save efforts next time and easier to correct mistakes)... send any supporting medical evidence you have. ATOS HCP reviews the form and any other evidence available to them to determine if face to face medical necessary or if GP report (ESA113 form) will suffice or if already sufficient facts to provide advice. THis should take a matter of weeks.. not too long. If they conduct face to face medical they'll send the resulting ESA85 medical report to DWP as their advice on the Work Capability Assessment along with the other paperwork.. otherwise they'll send an ESA85A single page report that provides their advice on the WCA. The DWP decision maker may take weeks to months to give decision and that decision is usually in line with the ATOS HC advice.

If you fail the WCA you could appeal and continue to get assessment rate ESA usually under the cover of sicknotes until the appeal is dealt with. If you get placed in the WRAG you could appeal to get placed back into the Support Group.
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# 5
Muttleythefrog
Old 14-07-2012, 6:50 PM
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Quote:
Originally Posted by blackcloud View Post
Atrix, thanks so much for that. Very helpful. A couple more questions if you maybe?

1) Can I ask you, if I do fail the medical and I appeal, do you mean I would still receive ESA but at the appeal rate? Assessment rate, yes, usually you'll need to provide continual sick notes.

2) If so what is the appeal rate? Refer assessment rate for ESA. http://www.direct.gov.uk/en/moneytaxandbenefits/benefitstaxcreditsandothersupport/illorinjured/dg_171896

3) Is it possible once I have sent off my ESA50 they could send me a letter saying I have been taken off ESA even without a Medical? You may not get a face to face medical as part of the WCA... so probably yes. The DWP make the decision ultimately.

4) What is LCW WRAG? Limited Capability for Work is the terminology used to describe the level of disability that meets WRAG criteria. It's Limited Capability for Work Related Activity for Support Group.

5) What is WRAG? Work Related Activity Group.... the 'lower' of the two main phase ESA groups... the 'higher' being Support Group.

6) When I send in the ESA50 can I send evidence of my Support plan from my Care worker and letters that prove I have appointments with the hospital? If so, do they have to be originals or can they be photocopies?
Yes you could send those with the ESA50. I'd strongly advise not sending originals of any evidence unless demanded as they could go astray. Evidence is best if it is closer to the highlighting that descriptors (statements of disability that help qualify for the benefit) apply to you. If I were you I'd try to make a good case for your current Support Group criteria continuing to be met if applicable... but I've a horrible feeling you may not know what Support Group descriptor(s) gave you your entitlement as the last assessment.
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# 6
blackcloud
Old 14-07-2012, 7:07 PM
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Muttley, thanks

Quote:
3) Is it possible once I have sent off my ESA50 they could send me a letter saying I have been taken off ESA even without a Medical? You may not get a face to face medical as part of the WCA... so probably yes. The DWP make the decision ultimately.
So after sending in the ESA50 they could take me off ESA even without sending me for a medical? Is that common?
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# 7
Muttleythefrog
Old 14-07-2012, 7:08 PM
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Quote:
Originally Posted by blackcloud View Post
Muttley, thanks


So after sending in the ESA50 they could take me off ESA even without sending me for a medical? Is that common?
Not sure (data probably doesn't exist).. but given you're currently in the Support Group it would probably be quite unusual to not even be found to meet WRAG criteria at reassessment unless you've had a notable improvement in health.
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# 8
atrixblue.-MFR-.
Old 14-07-2012, 9:19 PM
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Quote:
Originally Posted by blackcloud View Post
Muttley, thanks



So after sending in the ESA50 they could take me off ESA even without sending me for a medical? Is that common?
its best not to sit and dwell on the unlikely.

they would have to have reasonable grounds as to cease your benefit whilst the ESA50 is being dealt with.

in your case i doubt they would do cease entitlement alltogether its highly unlikey a support group claimant gets rejected for esa after a ESA50 review.
I make spelling mistakes, its not intentional, its a condition I have please afford people who have these conditions some respect and not single out their posts for correcting mistakes.
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# 9
Cpt.Scarlet
Old 14-07-2012, 10:19 PM
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Quote:
Originally Posted by blackcloud View Post
3) Is it possible once I have sent off my ESA50 they could send me a letter saying I have been taken off ESA even without a Medical?
They cannot (legally) find you Fit for Work without holding a medical, although they can if you fail to attend.
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# 10
Muttleythefrog
Old 14-07-2012, 11:12 PM
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Quote:
Originally Posted by blackcloud View Post
Muttley, thanks



So after sending in the ESA50 they could take me off ESA even without sending me for a medical? Is that common?
Correction to above advice as per Scarlet... I should have checked. I don't think they can find you fit for work without a face to face medical (except where you fail to engage such).. they could reach either of the other 2 decisions WRAG or Support Group without one.
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# 11
blackcloud
Old 15-07-2012, 12:11 AM
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Thanks everyone, a couple more questions if you dont mind,

1) is it possible to extend the time you have for submitting the ESA50? Just in case I can not get the evidence in time?

2) OK so they can not Legally find me fit for work without me having a medical?

3) If I did fail the medical I could go back onto ESA at the basic rate while waiting for the appeal, would I still be on the contribution based ESA as I am on now and as I was on for the first few months of my initial claim of ESA before being put into the support group?

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# 12
Cpt.Scarlet
Old 15-07-2012, 12:22 AM
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No, the legislation does not allow for an extension.

Unless you have it in writing from the DWP, not ATOS, the period cannot be extended, you can return it late, but you risk your claim being closed, this is appealable, but it can take months to resolve, and there's no guarantee you would win.
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Old 15-07-2012, 12:34 AM
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Quote:
Originally Posted by blackcloud View Post
Thanks everyone, a couple more questions if you dont mind,

1) is it possible to extend the time you have for submitting the ESA50? Just in case I can not get the evidence in time?

2) OK so they can not Legally find me fit for work without me having a medical?

3) If I did fail the medical I could go back onto ESA at the basic rate while waiting for the appeal, would I still be on the contribution based ESA as I am on now and as I was on for the first few months of my initial claim of ESA before being put into the support group?
Fill in the form as fully as you can and if you cannot get your "evidence in time" make a note on the form that it will follow on. The most important part it to get that form into them on time. Take a copy of the form for your records too.
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Muttleythefrog
Old 15-07-2012, 12:37 AM
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1. No... but there's nothing to stop you submitting the evidence in due course... at medical if asked to attend one or to DWP thereafter.. or later if you end up challenging the decision in appeal or reconsideration.

2.Yes

3. Yes I believe so.

Try not to think too much about all the what ifs. Focus on the descriptors, completing the form and getting into play any supporting medical evidence if you can. There's a decent chance you'll be returned to the Support Group and a decent chance you won't have to face a medical... although from reading the above someone might conclude you desperately want one..lol
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blackcloud
Old 15-07-2012, 2:00 AM
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Mutley,

2) OK so they can not Legally find me fit for work without me having a medical?

Your answer is "correct" yes?

Ohh no I dont want one, just like to know exactly everything.
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Muttleythefrog
Old 15-07-2012, 3:14 AM
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Quote:
Originally Posted by blackcloud View Post
Mutley,

2) OK so they can not Legally find me fit for work without me having a medical?

Your answer is "correct" yes?

Ohh no I dont want one, just like to know exactly everything.
Yes... the process is set up so that they try to identify if LCW or LCWRA can be identified ASAP... for those with terminal illness it should be able to be done fairly quickly for example... medical will be ordered when evidence available isn't sufficient to conclude opinion LCW or LCWRA applies. That's how I'd look at things. So the advice is to get as much information in up front to reduce their scope for opinion and error.... and of course reduce chances of requirement for medical.

If you've got access to a printer you might prefer to take a copy of the pdf version of the ESA50 form and print that out when completed. Completion on computer obviously means correcting errors is easy but it also might save you efforts in the future when reassessed. http://www.direct.gov.uk/prod_consum.../dg_195544.pdf

Did you get your board money sorted with your mother? I knew your name rang a bell from somewhere...lol... you were in dispute with mother weren't you?
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# 17
grummps
Old 15-07-2012, 8:51 AM
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Quote:
Originally Posted by atrixblue.-MFR-. View Post
, i have appealed a decising to place me in LCW WRAG, after sending off the letter, it has taken them three months to tell me they have recieved my letter and will review My case for reconsidderation before it goes on to the tribunal services they will let me know in due course whether the decision can be overturned.
Isn't it the case that in order to stop appeals that have little or no chance of success (made because it is a far easier life on ESA than JSA), the assessment rate will now not be paid for all appeals pending a reconsideration?

Thus making the point that failing the ESA assessment should automatically mean a JSA claim instead whilst waiting for the appeal to be heard.
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Muttleythefrog
Old 15-07-2012, 2:12 PM
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Isn't it the case that in order to stop appeals that have little or no chance of success (made because it is a far easier life on ESA than JSA), the assessment rate will now not be paid for all appeals pending a reconsideration?

Thus making the point that failing the ESA assessment should automatically mean a JSA claim instead whilst waiting for the appeal to be heard.
Not sure what the position is regarding this.. don't think the legislation has been passed into law or if it even got that far. The idea was that they'd draw a distinction between automatic reconsideration and the rest of the 'appeal process'... forcing the claimant to wait indefinitely for a mandatory reconsideration and then if unsuccessful they'd have to appeal directly the the tribunals service. ESA payments would only be paid while appealing in relation to tribunals service. i.e. the reconsideration element would no longer be regarded as part of the appeals process during which claimants would continue to be eligible to get ESA payments.
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Old 15-07-2012, 2:29 PM
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Not sure what the position is regarding this.. don't think the legislation has been passed into law or if it even got that far.
As I understand it - the primary legislation - the welfare reform bill - was passed some time ago.
This contains powers to allow mandatory reconsideration.
Recently the courts and tribunals service has had a consultation into this.
As far as I'm aware, this has not yet had any conclusions drawn from this consultation.
I assume (from notes in the consultation request) that the government are holding off putting through the secondary legislation until this consultation is finished.
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# 20
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Old 17-07-2012, 7:04 PM
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As I understand it - the primary legislation - the welfare reform bill - was passed some time ago.
This contains powers to allow mandatory reconsideration.
Recently the courts and tribunals service has had a consultation into this.
As far as I'm aware, this has not yet had any conclusions drawn from this consultation.
I assume (from notes in the consultation request) that the government are holding off putting through the secondary legislation until this consultation is finished.
It's a shame that it is taking so long to implement.

It would stop all of the 'chancers' making spurious appeals to avoid having to claim JSA.

Those that have nothing to worry about would then be prepared to wait for the reconsideration process to be completed as they know that their appeal has merit.

Mind you, I would be very interested to find out how many cases would actually be reversed at the reconsideration stage. It would be an indicator that maybe poor initial decision making is taking place. There should be very few cases that are overturned on reconsideration if enough care and time is taken to get the right decision in the first place.
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