failed ATOS medical, please help, next steps..

Bamber19

dustinjames wrote: »

can someone please help with the last part of my last post please.
i want to get the letters written this weekend to post on monday.

and i have recieved the appeal form in post today. BUT have NOT recieved my medical report yet.

thankyou

The letter shouldn't be long and repetative, that's the best start.

Simply state that you wish to appeal as the decsion made is wrong and you do not believe your circumstances were fully taken into account. State that you have conditions that impact on your capability for work and that these are detailed in your medical report.

However, you really need to see the report from ATOS to be able to say what you disagree with. When you get it the first place to look is probably the typical day as this paints a picture of the applicant and a lot of conclusions can, and will be, drawn from it.

dustinjames

Bamber19 wrote: »

The letter shouldn't be long and repetative, that's the best start.

Simply state that you wish to appeal as the decsion made is wrong and you do not believe your circumstances were fully taken into account. State that you have conditions that impact on your capability for work and that these are detailed in your medical report.

However, you really need to see the report from ATOS to be able to say what you disagree with. When you get it the first place to look is probably the typical day as this paints a picture of the applicant and a lot of conclusions can, and will be, drawn from it.

thanks.
no its not the appeal letter im talking about. ive got a few weeks left to do that.

im talking about the letter to jobcentre asking them to reconsider their decision. not sure how basic or detailed this needs to be.
not sure if i should wait for the detailed medical report before sending this.

so i think ill say please reconsider, as i have a new doctor report which ill include, and also say atos did not read my questionnaire properly and complain about that too.

cit_k

dustinjames wrote: »

thanks.
no its not the appeal letter im talking about. ive got a few weeks left to do that.

im talking about the letter to jobcentre asking them to reconsider their decision. not sure how basic or detailed this needs to be.
not sure if i should wait for the detailed medical report before sending this.

so i think ill say please reconsider, as i have a new doctor report which ill include, and also say atos did not read my questionnaire properly and complain about that too.

The decision maker can only reconsider aspects of the case you mention specifically, so instead of saying for example they did not read my report properly, go into detail showing which bits you can prove they did not read properly, and back it up with as much explanation / evidence as you can.

dustinjames

went to CAB. They have confused me further.
The guy told me to do something which was slightly diff to what ive read here. He said this initial stage is NOT the tribunal thing, its just an appeal, and he said no need to go through the detailed medical report and pointing out all things i disagree with, he said just write a sentence or two on gl24, send it in, and the appeal will be done in about 2 months or less, just a few weeks, he said its an internal procedure and if they stick with decision, THEN it can go to tribunal and THEN i can dispute all the things in medical report.

But others told me to go through the report and list all things i disagree with NOW, making a multi page appeal/gl24.

The complaint i sent to ATOS, they have sent me a letter saying they will investigate it.

CAB told me that if i lose the appeal, i may have to pay back the ESA money. Is this true? Has this happened to anyone?
would you be require to pay back ALL ESA payment from the very beginning, or just from when they stopped it and you appealed? this sounds like a nightmare, hearing this makes me want to forget about ESA and maybe go on JSA. How can they expect you to pay back ESA payments...

Now im not sure how to fill out gl24, quick short and simple, or very detailed with many notes.

Also when the appeal is in, i guess the DWP will say you are entitled this x amount of money while appealing, it could be less than assessment rate i hear, so then i tell this new rate to housing benefit, correct? no point telling housing benefit now as i do not know what my next rate will be.
I once was in a transition from one benefit to another, and i informed them straight away and the payments were stopped as i could not prove the new benefit paperwork and learnt my lesson that only inform of changes when they are all provable and sendable with documents.

So the appeal process is NOT the tribunal process? these are two distinct diff stages? if i fail the appeal, can i apply for ESA again : i know they say you have to wait 6 months, is it 6 months from original decision or 6months from the appeal hearing?

the one month deadline to get appeal in.
say if my decision letter is dated 20th may. but it says they have stopped ESA from 15th may. Does my month deadline to get appeal in, begin from 15th may or 20th may?

thankyou

Cpt.Scarlet

OK, when you appeal, the first thing that hapens is that the DWP carry out a Reconsideration, this means that a new decision maker will review the original evidence and any new evidence that you might submit, this process normally takes 8-10 weeks.

If the DM does not overturn the decision, and they usually do not, then everything is sent to the Tribunal Service for an appeal to be heard.

If you appeal, then you will not be required to repay any money, whatever the decision, and you will be entitled to receive the assessment rate while you wait.

You can re-claim ESA six months after the date of the Decision letter, even if your appeal has not been heard at that time, although there would be no point doing so unless your condition has deteriorated.

It is the date of the decision letter that matters, not when your ESA was stopped.

cit_k

dustinjames wrote: »

went to CAB. They have confused me further.
The guy told me to do something which was slightly diff to what ive read here. He said this initial stage is NOT the tribunal thing, its just an appeal,

[its called a reconsideration, they have to reconsider the case, and if they dont find in your favour then it goes to appeal, but they can only reconsider based on facts/evidence, so just saying you disagree is kinda pointless, hence why its best to say what you disagree with and why at this point if possible.]

dustinjames wrote: »

and he said no need to go through the detailed medical report and pointing out all things i disagree with, he said just write a sentence or two on gl24, send it in, and the appeal will be done in about 2 months or less, just a few weeks, he said its an internal procedure and if they stick with decision, THEN it can go to tribunal and THEN i can dispute all the things in medical report.

But others told me to go through the report and list all things i disagree with NOW, making a multi page appeal/gl24.

You can do that, but they will agree with their original decision, unless something massively sticks out as evidently wrong at a glance.
Yes, at tribunal you can also dispute what ever you need to dispute, but you can also do it now.
Reconsiderations are not commonly found in favour of the claimaint, but it can and sometimes does happen if you can supply enough reasons why it should be done.

dustinjames wrote: »

The complaint i sent to ATOS, they have sent me a letter saying they will investigate it.

Most likely atos will ask the assessor, his or her version will vary from yours and they will disbelieve you and beleive the assessor, unless you have a way of proving your case.

dustinjames wrote: »

CAB told me that if i lose the appeal, i may have to pay back the ESA money. Is this true? Has this happened to anyone?

Go back to the CAB [and or write a letter] and ask to speak to a manager, report the idiot who told you the above, as they should not be allowed any where near a CAB again, its totally untrue, and harmful advice. No money needs to be paid back if you lose. Never has been the case, and there are no known plans for it to be the case.

dustinjames wrote: »

Now im not sure how to fill out gl24, quick short and simple, or very detailed with many notes.

The important thing is to make sure you get it in within the month allowed, that is the overiding thing you must do.
You are not limited to what you put in that letter, you can supply more evidence/information later for the tribunal, so do not delay, get what you can now, and submit it, anything else can be submitted later.

dustinjames wrote: »

Also when the appeal is in, i guess the DWP will say you are entitled this x amount of money while appealing, it could be less than assessment rate i hear, so then i tell this new rate to housing benefit, correct? no point telling housing benefit now as i do not know what my next rate will be.
I once was in a transition from one benefit to another, and i informed them straight away and the payments were stopped as i could not prove the new benefit paperwork and learnt my lesson that only inform of changes when they are all provable and sendable with documents.

You should be paid at assessment rate whilst appealing.
You need to inform housing benefit you are appealing.
It is a risk of course, but failing to inform them of a change of circumstances can be regarded as fraud, so best to keep them informed. If in doubt, speak to a welfare rights advisor on that issue.

dustinjames

update.
so i wrote to the jobcentre asking for them to reconsider decision, they did NOT reply back to this letter. (i sent futher medical report along with this).

So then i made the offical gl24 appeal with an accompanying explanation.
They replied to this, saying they will look at it again.
But do i need to send in the futher medical info again? i sent it with First letter i have mentioned above.

I am back on assessment phase ESA.

The complaint i made to ATOS about:
1) assessor not reading my medical report i took with me
2) not reading my questionnaire, and admitting it to me.

The letter from atos acknowledges my complaint.
They say any further evidence has to be made to Decision Maker.
DM is the jobcentre?
ATOS aplogised for the assessor not reading my medical evidence.
Letter says the examiner says they DO read questionnaires and DO read further notes the interviewee brings.

Letter goes on to say a manager has looked at the report the examiner made and after reviewing the report and my questionnaire, they agree that it appears that the questionnaire has not been read and had it been, the report would have focused on my specific issues, and that the ESA50 had not been referred to in my report. And its says ATOS doesnt feel my report has been completed in accordance with their standards.

It says the deificiences will be made aware to the DM handling the claim.

Do you guys think i should send a copy of this atos letter to the DM?

thankyou

Muttleythefrog

dustinjames wrote: »

update.
so i wrote to the jobcentre asking for them to reconsider decision, they did NOT reply back to this letter. (i sent futher medical report along with this).

So then i made the offical gl24 appeal with an accompanying explanation.
They replied to this, saying they will look at it again.
But do i need to send in the futher medical info again? i sent it with First letter i have mentioned above.

I am back on assessment phase ESA.

The complaint i made to ATOS about:
1) assessor not reading my medical report i took with me
2) not reading my questionnaire, and admitting it to me.

The letter from atos acknowledges my complaint.
They say any further evidence has to be made to Decision Maker.
DM is the jobcentre?
ATOS aplogised for the assessor not reading my medical evidence.
Letter says the examiner says they DO read questionnaires and DO read further notes the interviewee brings.

Letter goes on to say a manager has looked at the report the examiner made and after reviewing the report and my questionnaire, they agree that it appears that the questionnaire has not been read and had it been, the report would have focused on my specific issues, and that the ESA50 had not been referred to in my report. And its says ATOS doesnt feel my report has been completed in accordance with their standards.

It says the deificiences will be made aware to the DM handling the claim.

Do you guys think i should send a copy of this atos letter to the DM?

thankyou

Provided they received the evidence when you first requested reconsideration (although what happened regarding that reconsideration is... up in the air it seems.. and rather irrelevant now since you have appealed and so they'll reconsider by default before referring on to tribunal for appeal) then it should form part of the evidence used for the decision they're making. It could have gone astray though... especially in light of fact your reconsideration seemed to go awry.

(Well done regarding ATOS... outstanding job. In my case the HCP hadn't read my ESA50 - said so... and possibly because they weren't the planned HCP meant to do my assessment and the fact I also went to great effort to fill it in.. answers were extremely long. I didn't complain as got into Support Group and had DLA battles to deal with. There was no reference to my ESA50 form at all in the medical report)

However... this document from ATOS... the fact you also are concerned that it may not get to the DM at the DWP makes me conclude that it might be worth you getting your evidence submitted for reconsideration and this ATOS letter copied and sent to the DM.... and then hopefully there can be no failure to have these documents and consider them.

The DM... address. Oh gosh... hopefully someone will confirm address. Probably it is the BDC applicable to your area (the one sending you letters)... but get this verified.

Seems you've had a really torrid experience. Medical was not carried out according to the rules, decision was therefore baseless.. and DWP has given you incorrect information judging from previous posts in the thread. With any luck you might one day get fairly assessed for ESA.

cit_k

WPN wrote: »

There is still a large assumption that Decision Makers spend 2 hours per case looking at evidence, pass it on to another Decision Maker for another 2 hours to confirm, get a solicitor to overlook it etc. and then make the decision

The reality is, soon as its a fail its a fail.

I think its a conspiracy how the majority (from what I have heard on forums, not sure about overall cases) of people who failed the test scored 0 points. Not, 8, not 3, not even 1... but 0!! It as if its all fixed 8-) If so many people are failing with zero points, and if the tests were genuine, they should all be prosecuted. The truth they just want to force everyone on to JSA. Make sure you appeal!

A full time Decision Maker is required to complete, on average, 12 cases per day.

(source)

Assuming 9 to 5 with 1 hour lunch, thats 7 hours in a working day

That means they are expected to do on average one roughly every just over half an hour or so. (taking into account toilet breaks etc)

Not very long per decision really.

Cpt.Scarlet

cit_k wrote: »

(source)

Assuming 9 to 5 with 1 hour lunch, thats 7 hours in a working day

That means they are expected to do on average one roughly every just over half an hour or so. (taking into account toilet breaks etc)

Not very long per decision really.

12 claims in a 7 hour day is 35mins each!