failed ESA medical because husband hasnt attempted to commit suicide!

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  • pmlindyloo
    pmlindyloo Posts: 13,049 Forumite
    Name Dropper First Anniversary First Post
    QUOTE

    You have mental health problems and report occasional suicidal thoughts but you have not acted on these and have no fixed plan or intent.
    You have no psychiatric input and have had no hospital admissions for a number of years." (he has previously been sectioned for a number of months for trying to commit suicide!)

    This is where medical evidence is a must - was the letter about his being sectioned sent as evidence? If so then this can be used in the appeal to refute the assessor's findings. Or if it wasn't sent then it needs to be.
  • Alice_Holt
    Alice_Holt Posts: 5,946 Forumite
    First Anniversary Name Dropper First Post
    edited 8 April 2017 at 11:55AM
    You should still be able to take the appeal to the Tribunal Service:
    This is the form:
    https://formfinder.hmctsformfinder.justice.gov.uk/sscs001-eng.pdf
    You need to send it with the MRN attached within 1 month of the date of the MRN.

    As you now have successfully re-applied for ESA, the tribunal's decision will be time limited.
    It will consider the period between the date the DWP declined the first ESA renewal claim and the date the current ESA award was granted. If the tribunal allows your appeal you will get a backpayment for this period only. In other words, the period during which ESA was not in payment.
    However, I'm not clear from your post how long this period was. So I would second NeilCr's suggestion that you visit your local CAB.
    https://www.citizensadvice.org.uk/about-us/how-we-provide-advice/advice/
    Take all the paperwork with you.
    The tribunal will look at your husband's condition at the date of the decision to disallow the initial ESA claim.

    Here are useful guides to appeals:
    http://www.advicenow.org.uk/guides/how-win-pip-appeal (It relates to PIP, but the appeal process is virtually the same).
    http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-appeals
    https://www.leicester.gov.uk/media/182136/employment-and-support-allowance-appeals-guide.pdf
    https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/while-youre-getting-esa/challenging-an-esa-decision/

    You may need to think carefully about a further appeal if the DWP place him in the WRAG group for his current ESA claim (especially if the tribunal places your husband back into the SG for the backdate period), Get advice from the CAB on this.

    Here are the Support Group descriptors:
    http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1353-support-group-descriptors
    Your husband could also be assigned to the SG on Regulation 35 -
    http://www.cpag.org.uk/content/making-exception
    - If if participation in the WRAG activities would mean there was a substantial risk to the claimants mental or physical health (or to others).

    Edit: I would strongly suggest that the OP ignores any (mis)information posted by rockingbilly.
    See these threads - http://forums.moneysavingexpert.com/showthread.php?t=5626671
    and http://forums.moneysavingexpert.com/showthread.php?t=5617003.

    Medical evidence is very important evidence, and often determines the success or otherwise at tribunal.
    The How to win a PIP appeal is useful on getting medical evidence from the GP relating to the descriptors.
    All relevant evidence is helpful - carers, family, friends, CPN, other health professionals.
    The key to a successful outcome at tribunal is to produce the evidence, so that on the balance of probabilities given all the evidence in front of them the tribunal panel will allow the appeal.
    The verbal evidence of the appellant is also very important - so preparation, knowing how you score the necessary points, and examples to back that up really help.

    Good luck.
    Alice Holt Forest situated some 4 miles south of Farnham forms the most northerly gateway to the South Downs National Park.
  • jaylee3
    jaylee3 Posts: 2,127 Forumite
    Combo Breaker First Post
    I am a little bit confused OP. So has your husband now been accepted for ESA then?

    Also, I voted no to the poll, because although there are many genuine cases of mental health issues, and depression etc, there are also many that swing the lead, and don't actually have that much wrong with them. Many of the latter most likely had a time when they were quite low and depressed and were written off work long-term with depression, but instead of returning when they got a bit better, they just stayed off. I think in many cases, they got so used to being at home, that they didn't want to go back to work.

    This is understandable, but too many people are off work with depression who really could work. As has been said (on here quite often,) depression is the new 'bad back.' I mean, pre mid 1990's, no-one was ever off work with depression, (no-one I knew anyway,) and I don't recall there ever being any benefits for it.

    So the DWP need to ensure that anyone who is claiming the benefit is entitled to it. With illnesses you can't see (IYSWIM,) it can be hard to prove anything; and it's especially hard if the person has not been to the doctors for several years, or had any meds, or seen a specialist etc...

    I am sure your husband is a genuine case, and I am sorry he is suffering, and I know some of these assessors (and the company they represent like ATOS for example,) have behaved badly in the past, but at the same time, I don't think on this occasion, that the assessor has done anything wrong.

    I wish you and your husband well. Sounds like he is quite poorly.
    (•_•)
    )o o)╯
    /___\
  • IAmWales
    IAmWales Posts: 2,024 Forumite
    pmlindyloo wrote: »
    QUOTE

    You have mental health problems and report occasional suicidal thoughts but you have not acted on these and have no fixed plan or intent.
    You have no psychiatric input and have had no hospital admissions for a number of years." (he has previously been sectioned for a number of months for trying to commit suicide!)

    This is where medical evidence is a must - was the letter about his being sectioned sent as evidence? If so then this can be used in the appeal to refute the assessor's findings. Or if it wasn't sent then it needs to be.

    The date of the section is important here. If it was a number of years ago then it could be indicative of an ongoing condition, but would not be directly relevant to his current condition without further evidence.

    I do agree that medical evidence is key. A detailed GP letter would be helpful, but a letter from a psychiatrist or other mental health professional would be even more so. Thousands of people claim ESA for mental health conditions without need for appeal, and key to these claims is supporting evidence.
  • theartfullodger
    theartfullodger Posts: 14,586 Forumite
    Name Dropper First Anniversary First Post
    edited 8 April 2017 at 11:26AM
    paragon909 wrote: »
    One can't apologies for being a sad pathetic troll. Am not sure the OP has time to worry about a space or a joint word!
    A somewhat intemperate response to a perfectly calm, polite post: From a "paragon"?

    Surely with benefit applications/appeals etc one key thing is to be very careful to get all information provided correct, and attention to detail matters: If the assessors have any way of wriggling out of an award because of a slightly sloppily worded form they will: These things matter! (Sadly..)

    Having said that, "escape goat" is a more charming wording...
    scapegoat.jpg
    (dear Holman Hunt's painting...)
    https://en.wikipedia.org/wiki/The_Scapegoat_(painting)
  • jaylee3
    jaylee3 Posts: 2,127 Forumite
    Combo Breaker First Post
    IAmWales wrote: »
    The date of the section is important here. If it was a number of years ago then it could be indicative of an ongoing condition, but would not be directly relevant to his current condition without further evidence.

    I do agree that medical evidence is key. A detailed GP letter would be helpful, but a letter from a psychiatrist or other mental health professional would be even more so. Thousands of people claim ESA for mental health conditions without need for appeal, and key to these claims is supporting evidence.

    100% agree with this. Particularly the second paragraph.

    A friend of mine has a chronic illness (diagnosed about 10 years ago,) and is on a number of meds. She has blood tests every other month to monitor her blood to ensure the meds are not affecting her blood and internal organs. In addition, she attends a clinic every 4 months where a specialist monitors her condition, and twice a year she goes to hospital for X-rays to see if the condition is deteriorating (which it is slowly.) The doctors and the specialists have seen strong and obvious signs of her condition, and it has been recorded on her medical file many times, most recently only 8-10 weeks ago.

    She was asked to reapply for ESA last year, she filled in the form, and received a letter a few weeks later, asking her to attend an assessment. The lady who saw her, (who was an ex nurse who specialised in my friend's condition,) said 'you have a file 2 inches deep here, and you have clearly been suffering with this for many years; I don't even know why you were called in.'

    Then she asked her a couple of very basic questions, and then said 'OK, that's it, I am sorry you were dragged in when there was no need, there won't be any problems...' And 2 weeks later, she got the letter through saying she was remaining on ESA in the Support Group.

    So yes indeed, the evidence, the continued visits to the specialists and the doctors, and being on so many meds helped her enormously. If there has been nothing for a number of years, it's not surprising that the DWP and assessors etc think there may be very little wrong. Not saying there is nothing wrong with the OP's husband of course, just that it's easy to understand why they think this way if someone has zero evidence (or very little) of an illness.

    And as has been said, getting evidence of a mental illness or depression is very hard. Never, or hardly ever seeing specialists and not having any meds and rarely seeing the doctor is not going to go in anyone's favour.
    (•_•)
    )o o)╯
    /___\
  • jaylee3
    jaylee3 Posts: 2,127 Forumite
    Combo Breaker First Post
    I thought the response from paragon was a bit harsh too.

    Have to say the OP putting 'escape goat' instead of scapegoat did make me chuckle. :D I mean that in a nice way, I'm not being horrible OP! :)

    Reminds me of a few weeks ago; someone was talking about keeping their puppy out of the upstairs, and someone suggested getting a baby gate, and they put baby goat instead. :D

    Something to do with their phone auto-correcting wrongly or something! :p
    (•_•)
    )o o)╯
    /___\
  • SingleSue
    SingleSue Posts: 11,699 Forumite
    Name Dropper Photogenic First Post First Anniversary
    jaylee3 wrote: »

    As has been said (on here quite often,) depression is the new 'bad back.' I mean, pre mid 1990's, no-one was ever off work with depression, (no-one I knew anyway,) and I don't recall there ever being any benefits for it.

    I was, way back in early 1994 (ok just before mid 1990's). Didn't claim any benefits apart from sick pay from work though. I eventually gave up work as I was in no fit state to be there and I felt guilty costing them money through sick pay. I returned to work at a different company when I felt well enough to go back to work ( over 6 months later).

    Still didn't claim anything though (more from ignorance than design) and as a result, we lost our house.
    We made it! All three boys have graduated, it's been hard work but it shows there is a possibility of a chance of normal (ish) life after a diagnosis (or two) of ASD. It's not been the easiest route but I am so glad I ignored everything and everyone and did my own therapies with them.
    Eldests' EDS diagnosis 4.5.10, mine 13.1.11 eekk - now having fun and games as a wheelchair user.
  • Tolly_T
    Tolly_T Posts: 120 Forumite
    Unfortunately a GP is not normally in a knowledgeable position to give a report into how patients cope with life. There are descriptors that make up both ESA and PIP - how on earth could a GP make any comment on these if he/she has not witnessed them on a daily basis?

    This is said so often but I don't agree. How can an assessor for ESA or PIP give a report into how patients cope with life if they haven't witnessed them on a daily basis? I'd trust a report from a GP who has known the patient for many years and probably spoken to them many times about the problems that they have over and above an assessor or an OT who is only likely to meet them briefly to conduct an assessment.

    With mental health problems trust has to come into it. My GP does ask about several things that would be relevant to PIP when she's assessing me. There are signs specific to me and how depression affects me and my GP has got to know me over many years and knows these signs. There isn't a blood test to confirm that I am suffering with depression and other mental illnesses, the diagnoses were based on what I told my GP or psychiatrist. My GP, or previously my psychiatrist, could write a very good report supporting me but it would still based on what I told them in the first place. This is true for many physical problems too, particularly where pain causes the difficulty - no-one else can experience that pain so the GP has to believe what they're being told in order to try to treat it.
  • Tolly_T
    Tolly_T Posts: 120 Forumite
    jaylee3 wrote: »
    too many people are off work with depression who really could work. As has been said (on here quite often,) depression is the new 'bad back.' I mean, pre mid 1990's, no-one was ever off work with depression, (no-one I knew anyway,) and I don't recall there ever being any benefits for it.

    They probably didn't call it depression back then. I remember as a child (long before mid 1990's sadly) being told that a family friend had had a breakdown. She was locked up and lost her job. She suddenly disappeared from the workplace and was probably whispered about and lots of jokes would have been made at her expense but I doubt there would have been much understanding. I assume she was on benefits when she came out as she didn't go back to work and she lived alone. I expect there were plenty of people who thought she could go back to work when she got a bit better but it's unlikely they had much of an idea about how she was affected. She was diagnosed with depression.

    Just because people weren't open about depression doesn't mean it didn't exist. There is still so little understanding of depression. The effect on concentration, memory, motivation etc. is often ignored. People say they're depressed when they're actually sad. It's incredibly difficult to work when your concentration and memory has been affected so badly. Many people would be unsafe to work in that state because of the nature of their jobs.

    It sounds like it was clear the the OP's husband was obviously ill - the JC staff wouldn't allow him to claim JSA because they thought he wasn't well enough to work. There is a lot of discussion about how the assessment needs to be able to pick up fraudulent claimants. Lets turn this around and think about why the system fails to recognise genuine claimants. They don't trust what claimants say because some of them might lying (many aren't), GPs reports are ignored because they aren't with the claimant day to day (neither is the assessor but their opinion is valid for some reason), lack of a psychiatrist and medication is taken as an indication that the claimants problems are minimal even though many people don't take medication because it doesn't work, so they're likely to be more severely affected than a person who is taking medication and getting some benefit from it. What can a person with a severe mental illness, but without a psychiatrist, provide to prove that they are unable to work?

    I think it's terrible that the OP's husband who has suicidal thoughts was turned down because he hadn't recently attempted suicide. I was suicidal during my PIP claim and did act on those feelings but because I wanted to die I didn't go to hospital so there was no evidence and I got no points on PIP for reasons connected to mental illness. This is probably again because people could just claim to be suicidal when they aren't. I'm trying to get away from thinking about the fraudulent claimant though, what does the genuine claimant do to prove that they are severely affected?
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