ESA medical- who passes?

purplehearts066

Yes, the system is often unfair, and i'm so sorry she's had to go through this.

Although there are some (very limited) conditons that excuse you from the medical examination, generally the assessors are looking at the effect of your illness/disability on your ability to work, rather than the what illnesses/disabilities you have. So, someone with a minor illness could be awarded ESA if they could prove the descriptors applied to them, and someone with a severe illness/disability could be denied ESA because the assessor does not consider that they meet the descriptors.

Apparently, the success rate at appeal is very good - averaging around 40% although that rate does vary depending on where you live. So it is absolutely worth fighting it, and continuing to fight it.
Does she have anyone to help her with her appeal, such as a support worker, community nurse, CAB worker? Could she get some legal advice perhaps? In my city, there are a few community legal firms, funded partly by grants and partly by legal aid that offer advice and representation regarding welfare issues, debt issues etc. Has she contacted any disability charities? She could really do with some good, solid advice and someone to fight her case. Losing benefits and going through the appeal system is stressful, upsetting and very hard work for someone who is genuinely ill but some of this could be eased if she had someone to take on her case.

I was recently awarded ESA without the need for a medical after filling in my ESA50. To be honest, it was a surprise to me, from the stories I've heard I was expecting to be denied it. I have a history of mental health problems, which got worse after my son died recently. but I have been feeling better recently (although I do still have problems and am on medication still) and I was totally honest about this on my form (I was moved over to ESA from IB - the assessment was triggered early because I called up to tell them I had been feeling better and was looking for work). And to my shock, I was awarded ESA two weeks ago - at this point I'd been offered a job and was waiting for my CRB check and I'm actually starting work again on Wednesday. There does seem to a be a lot of inconsistency in how ESA is awarded.
Best of luck

jonty1970

menher wrote: »

That's not entirely correct is it?

It's not that they cost too much, more a case of the fact that they are non producive!

ESA and DLA are more than JSA.
The more ill people thrown off the those and onto JSA saves money.

If you are too sick to work, you have to have benefits to live!
For an awful lot of people, they never get better, so will cost more!

the changes are to save money and people are being made worse with the stress of these forms and being found fit for work!

Muttleythefrog

menher wrote: »

But those claiming ESA but found fully fit for work should be claiming JSA and looking for a job that could make them productive. It has nothing to do with saving money, it's all about motivating those that seek to have a quiet life claiming sickness benefit instead of being productive.

Choosing to carry on claiming ESA at the appeal rate to avoid looking for a job is immoral for those that are unlikely to win at the Tribunal.

However there are some (40% at last count) that should never have failed the ESA test and should be financially supported. The other 60%, as I have said should be looking to be a productive member of society instead of joining the 'roundabout' of a new ESA claim!

Problem is, and people keep popping up in these threads as examples, that despite failing to qualify for ESA main phase rightly or wrongly, at appeal or otherwise, some would struggle to meet their obligations regarding JSA. So they end up in a situation of fraudulently claiming JSA or genuinely claiming ESA assessment rate with the backing of their doctor. (This problem has been raised in threads where people have gone to make their claim for JSA after being advised to do so following failed WCA... then are told that they shouldn't be applying for JSA because of their medical problems... so then they seek 3rd party advice because they need to claim something to survive). For those that do the latter, reclaim ESA, (or former) you'll get a mix of those who want to work and don't want to work. In a recent thread the benefits of being on ESA assessment over JSA in practical terms was highlighted in terms of someone's desperate desire to work again. The JSA regime would almost certainly happily push them into a job that they wouldn't be able to maintain.. while on ESA they'd be afforded that freedom to get a suitable job that could keep them off benefits for the long term and benefit their health.

purplehearts066

That is true - I think a good point that has been made is that fitness to work is not the same thing as readiness to work.

Having spent maybe 5, 10 or even more years on sickness benefits, someone is likely to struggle to meet the strenuous jobseeking demands of JSA. They are likely to have lost their confidence, have no skills or outdated skills, have poor interviewing skills, be unused to the routine of working life... and unless they were claiming fraudulently they will still have health problems or disabilities which act as a further barrier to gaining employment and working and may mean they have problems with energy, concentration levels, dexterity etc

In theory, I think ESA was a great idea - especially the work related activity group.
I know that as someone who has mental health problems, working helps my energy levels, my confidence and my self esteem - it enables me to socialize, gives me a reason to get up in the morning and gives me a sense of purpose and achievement. So I think it is socially as well as financially irresponsible of us to park people on the sick and leave them there indefinitely.
The problem is, so few people are actually being put into the work related activity group, perhaps because of problems with the descriptors. I think there should be something similar for people who have been on sickness benefits long term but do not meet the requirements of ESA - to help get them ready for work again and ease them back into jobseeking and working life.

mardatha

Ok many thanks for all help here. The initial refusal was over 6 months ago so she should now have the option of a new claim.
She did have a guy from the CAB with her but I don't know how much help he was.
She was superfit and a very hard worker until the sudden heart attack out of the blue at age 41. She would like a wee job but needs to be careful of people with coughs and colds etc, a cold or flu would be very serious for her. So I will see her tomorrow and pass this on, thank you.

dark_lady

mardatha wrote: »

Ok many thanks for all help here. The initial refusal was over 6 months ago so she should now have the option of a new claim.
She did have a guy from the CAB with her but I don't know how much help he was.
She was superfit and a very hard worker until the sudden heart attack out of the blue at age 41. She would like a wee job but needs to be careful of people with coughs and colds etc, a cold or flu would be very serious for her. So I will see her tomorrow and pass this on, thank you.

And this could be a problem because a lot of people go into work with coughs and colds because they are frightened of losing their jobs. And also because they cant afford to lose three days money before the SSP kicks in. Then if there is an employee with other health problems they are then put at risk when their colleague comes into work ill.
This is something that wont have crossed the minds of some of the benefit bashers on this site unfortunately.

mardatha

Ok update is she is just going to the doc next week and telling him the story and asking him to sign her off as fit to work. So she can claim JSA because she needs money to live on. She can hardly get her breath on the phone and is coughing like mad. I feel so sad and angry but it seems to be the only way forward. She can't face re-applying as it will be like round and round the mulberry bush and she will just be refused again. TY for all kind help.

sleepless_saver

When she goes to sign on, she should explain that certain sorts of work are not suitable because of the risks to her health e.g. lots of contact with the public, or because of the amount of physical exertion needed and ensure that this is properly recorded

She would have good justification for refusing work if it would cause significant harm to her health, but best to make this clear upfront.

The problem is that otherwise she may be offered work which would pose a health risk to her, and be penalised if she does not apply for it.

wombles_forever

Hi, if she does go for the JSA option then when she signs on tell her to ask to be referred to the Disability Employment Advisor. They are there to help with any issues that her capability to work may cause and will save her being put through the normal JSA rigmarole every time she signs on.

In my experience they are very helpful and understand your limitations a lot more than the normal advisors. Hope this helps and hope all goes well,

Muttleythefrog

mardatha wrote: »

Ok update is she is just going to the doc next week and telling him the story and asking him to sign her off as fit to work. So she can claim JSA because she needs money to live on. She can hardly get her breath on the phone and is coughing like mad. I feel so sad and angry but it seems to be the only way forward. She can't face re-applying as it will be like round and round the mulberry bush and she will just be refused again. TY for all kind help.

If technically she feels she wouldn't qualify for ESA main phase then this might be a decent decision (although GP signing her as fit for work probably won't be necessary). If however she should qualify for ESA (based on honest assessment of the descriptors) then it may well not be a good decision. It's hard to predict and say. But the fact she has CAB supporting her might be the best place to turn to advise... they should have a good idea whether she should qualify for ESA or not. Good luck!

Sleepless raises good points above. The main concern regarding JSA would have to be the demands placed on her and their expectations of suitable work.