Confused about ESA

ToNik

Hiya thanks so much for you're imput!
Nothing that is wrong with him could or should effect his driving skills.

cit_k

ToNik wrote: »

However yesterday he had another Atos medical and the guy as good as told him he failed because he can drive and will only score the same points as last time.

So my question is even if the tribunal change the previous decision will he still get ESA stopped as the next medical is going to fail him again ?? Does he then appeal again??

He also said if he fails the tribunal he wont be able to appeal the new medical decision as my husband shouldnt of been entitled to it for the last year. Is that true ??

Thanks for reading and I hope someone can help.

You need to write a strongly worded complaint to the DWP AND ATOS, and the GMC or NMWC (depending if it was a nurse or doctor).

They are not allowed to discuss possible outcome, scoring / points at ALL.

Nor are they allowed to enter into any discussion about benefit issues (ie eligibliity/appeals etc).

ToNik

I didnt realise they were not allowed to discuss it, I will certainly put a letter in as this has done my husband no favours. Thank you for your help everyone

cit_k

ToNik wrote: »

I didnt realise they were not allowed to discuss it, I will certainly put a letter in as this has done my husband no favours. Thank you for your help everyone

This may help with your complaints to them all, taken direct from the ESA handbook for assessors, their bible so to speak

3.1.4.1
Conclusion of the examination
After the interview and examination, the claimant should be invited to ask any questions regarding the procedure. It is appropriate to advise that the Department for Work and Pensions office will be in touch with the claimant as soon as possible but a specific period of time in which this will happen should not be given.
No indication should be given of the likely outcome of the claim.
The claimant should be told that the decision will not be made by you, but by a Decision Maker.

also from that same section is

Do not enter into discussions about entitlement to other benefits. The claimant should be encouraged to approach the staff in their local Benefits Office for further information.
Do not enter into any debate about the details of Employment and Support Allowance or respond to criticisms of the administrative process.

Both are direct proof you can quote to DWP/ATOS/GMC etc that the assessor was in breach of both those rules, both indicating the likely outcome, and discussing benefit policy/admin process.

ATOS/DWP complaint because they are responsible for it, GMC (general medical council for a doctor, or NMWC Nursing and midwifery council for a nurse) so you can complain the assessor acted in breach of the rules they were meant to operate under, which is pretty unethical behaviour, and requires investigation.

Muttleythefrog

Let us know the ouctome of that letter/complaint. Because I agree with cit_k that this was truly shocking behaviour - I mean I could to some degree understand if an ATOS HCP (Healthcare prof.) wanted to reassure a claimant by offering advice they shouldn't... but this was nasty, untrue and entirely outwith their responsibilities. Ironically, from reading last night, the information they did reveal regarding the outcome being 'same as last time' would appear to actually be favourable since it probably can't trigger a new WCA while awaiting appeal (no change in condition).

I'd request a copy of the latest medical report from the DWP.... at very least to see if this issue of being able to drive is being used to downscore on apparently unexpected descriptors. (They can be quite 'deviant' in terms of extrapolating facts. e.g. I had remote assistance from a friend in completing my form (via email). Fact obtained - I have many friends (patently untrue). Conclusion good social functioning). But the report may reveal other failures by the HCP.

cit_k

Muttleythefrog wrote: »

Ironically, from reading last night, the information they did reveal regarding the outcome being 'same as last time' would appear to actually be favourable since it probably can't trigger a new WCA while awaiting appeal (no change in condition).

I missed that bit, how did he know they failed last time, and how did they know what points they got last time?

The DWP/ATOS is on record as stating ATOS are not informed of the outcome of any decision.

So, unless you told them, something is really wrong here.

ToNik

Hi , thanks once agin for your help. We didnt tell him we failed but it was the same person we saw last time and he some how knew we had our appeal in a few weeks time. I will include this in the letter, have started drafting it now

Lady_strange

The medical assesors are renowned for lieing about what a patient can and can't do. Request a copy of the medical assesment to be sent to you. and then you can use it in your appeal, to argue what they say you husband can and can't do.

ToNik

Hi again

I sent a letter off to DWP and yesterday had a vague response saying they will look into my complaint but can assure me the Dr's are very reliable and it is very unusual for Atos employees to discuss cases with individuals.

Today we had a further letter explaining he got 9 points and the full ESA is stopped but the appeal rate would continue till after the appeal?
I rang to find out what was going on, after much faffing I got an answer and it is very bizarre. They seem to think in May this year my husband married a woman called Miss Donald Duck (seriously!) and when he rang to inform them of circ change from single to married (we started the orginal claim as married couple) it some how triggered a new claim, with income based ESA payed at full rate into her account. We have been recieving £14 fortnightly into husbands account.
So I guess that explains the second medical.... feel bad for wasting all your time and 'assuring' you there was definatly no second claim.

Muttleythefrog

Dear me..lol...you'd think if they got information a claimant was marrying a Miss Donald Duck it would trigger a fraud investigation not a new application! Should be able to get assessment rate of ESA during waiting for appeal (usually are required to continue providing 'sicknotes' during this period).

But I have to be honest... the circumstances of your claim(s) now seem beyond anything other than DWP explanation. It seems DWP staff have a pretty bad relationship with the 'system' regarding ESA and there's plenty evidence even just in threads on this site that the two don't operate with any correlation and undermine each other. I just hope that in your case they've undone any confusions and that you are appealing the original decision with clarity and that any further medical was ordered in error.

I can't explain the £14 payments...lol... unelss you don;t get the full amount of basic rate ESA. In fact I just hope in the end some sense is made of all this. Wouldn't it be incredible if a new WCA was instructed by a computer system and included a medical and was done so because somehow that system somehow found your husband to be marrying a Miss Donald Duck and having a marital status change from married to married.

Here's my guess... and I do say guess. Some moron at the DWP entered his claim details in incorrectly as single status. Subsequently they realised he was married but they didn't know who to. Some further moron at the DWP therefore entered Miss Donald Duck because it was the first name that came into their head that someone would recognise as made up and changed him to married status. That moron set her details up incorrectly and started paying her ESA, although to where would be quite a mystery since her bank details would also have to be made up. The ESA system triggered a re-assessment because this was now a joint claiim. No idiot spotted this and your husband went through half the WCA again before they realised the serious errors. They can't explain to you exactly what has happened because several people would get into serious trouble. Of course I could be completely wrong... but this seems the most logical explanation for the known facts. Welcome to planet Mars..lol

Unfortunately though you have appeared to have been victim to totally inappropriate behaviour by the HCP that did the second medical that probably should have never occurred. Be interesting to see what they do about the complaint.