ESA Medical Assessment - Anxiety Disorder Questions

evolution200

Hi. I got a couple of really helpful replies here earlier regarding my ESA being backdated, so thought I’d bother you all again and ask for some further advice.

I have my ATOS Medical Assessment on 21 November, after claiming ESA from 9 July this year.

My Medical Certificates from my doctor currently give ‘Generalised Anxiety Disorder’ as the reason for me being unfit for work.

I’ve been looking into the ‘Limited Capability for Work Descriptors’ that I think will relate to my condition, and I think the main one will be ‘Coping with social engagement due to cognitive impairment or mental disorder’. To score 15 points, it says that ‘Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual’.

I feel that this applies to me, but my question is.....

Do they just ask something like, ‘is social contact always precluded due to difficulty relating to others, or does it cause significant distress’, or do they phrase it differently, ask for examples etc?

I’m just getting myself worked up wondering what they will ask, will they give an example situation and ask me to describe what I would do in that particular situation?

Sorry for the long rambling post. It’s taken me a while to type, trying to get the question clear in my own head as I went along. I know I’ve got until the 21st to try and calm down but it’s just worrying me a lot.

Many thanks for reading.

rogerblack

The questions they ask have no relation to the descriptors.
For example - if you do the washing up, they may say you can stand up for half an hour.
Or if you walk the dog, they may assume you walk 200m without no problems.
The answers they put down for each of the descriptors have little relation to your answers.
This is not completely unfair - it's designed so that they use the responses you give to work out the answer to each descriptor.
In the best case, the Health Care Professional uses your words from various questions to justify their answers to each of the descriptors.
(this was the case for me, largely).
In the worst case - it's as if they threw dice.

evolution200

Ah, I see. That's really helpful. I think it's the fear of the unknown that is making me panicky, so knowing what sort of questions they will ask helps me. Thanks for replying

Cpt.Scarlet

You need to read the relevant section in the WCA Handbook, page 107 onwards.

http://www.dwp.gov.uk/docs/wca-handbook.pdf

missmontana

Have you not been prescribed anything for your anxiety? I'm just starting on beta blockers, they seem to be helping.

From previous accounts on here, they even take into consideration the fact that you turn up at the assessment centre!

evolution200

missmontana wrote: »

Have you not been prescribed anything for your anxiety? I'm just starting on beta blockers, they seem to be helping.

From previous accounts on here, they even take into consideration the fact that you turn up at the assessment centre!

I'm on Citalopram which seems to be helping quite a bit.

One thing I've read (on a few forums) is that if I turn up for the assessment alone, I will receive 0 points for the social anxiety questions. Apparently, by making your own way there, you prove that you don't have any anxiety in a social situation!

It's just unbelievable. I've requested a home visit, but am waiting to hear if I'll get one or not.

bobajob_1966

evolution200 wrote: »

I'm on Citalopram which seems to be helping quite a bit.

One thing I've read (on a few forums) is that if I turn up for the assessment alone, I will receive 0 points for the social anxiety questions. Apparently, by making your own way there, you prove that you don't have any anxiety in a social situation!

It's just unbelievable. I've requested a home visit, but am waiting to hear if I'll get one or not.

You need to stop believing everything you read on the internet! Having said that, I doubt you would score 15 points on the one section if you are able to use public transport without assistance.

To get a home visit you will need to submit evidence of the need from your GP.

Muttleythefrog

evolution200 wrote: »

Ah, I see. That's really helpful. I think it's the fear of the unknown that is making me panicky, so knowing what sort of questions they will ask helps me. Thanks for replying

You've had good advice.... but you need to be absolutely aware that if you're claiming for MH reasons then your medical will feature a lot of observed behaviours being recorded (even though you may find the medical being conducted by someone who spends the majority of the medical banging on their keyboard looking at the monitor using the 'special' software they have for the medical). If a situation like the medical would ordinarily cause you to sweat, shake, fidget, exhibit poor rapport, have difficulties or panic then the last thing you want to do is try to conceal that. (Many people with MH problems.. including myself.. not only try to conceal symptoms.. but actively go out of our way to conceal and distract from them... unfortunately that isn't helpful to giving an impression of your ability to cope or to a novice (you may be seen by a nurse for example) regarding what health problems you have).

I would advise requesting a copy of your medical report a couple of days after medical... from the DWP (number at top of your DWP ESA letters). This will give you warning of what decision may be reached (although no guarantees as the medical report may not be the only evidence used to take decision at DWP). The actual decision could take many weeks.

Questions will likely be indirect. Unfortunately this leaves the door open for misleading extrapolation. For example you may be asked what TV programmes you enjoy watching (this may be to find out if you can concentrate for long periods of time.. or sit down comfortably for periods etc).. you may be asked what hobbies you engage in (this will be to get facts on things perhaps relating to physical movements or cognition). They'll then use the observed behaviour and facts obtained to justify the descriptors they choose (if any) in each section regarding WRAG and if any Support Gp descriptors apply or special circumstances.

The medical begins the moment the the person conducting the medical comes to meet you in the waiting area... this gives opportunity to observe ability to walk (to assessment room) if relevant and you may be asked questions like 'did you have a nice trip here' (particularly relevant to you if you are claiming to have social anxiety related issues). You may experience 'good cop/bad cop' tactics to obtain facts - nice polite and friendly to see if that makes you relax and divulge information helpful to them filling in the medical report details on the PC.. bad cop if they don't get success playing nice. A good question for them to ask is 'what do you do in the daytime' - your activities could reveal many facts that they could use to form opinion on appropriate descriptors... and give a general impression of whether you have a serious health problem affecting you. Another question they could ask is 'what do you do regarding grocery shopping'... probably to find out if you can go shopping regularly in public.. or perhaps have to evade going out and use online supermarket... which may raise facts relevant to social functioning.

Any supporting medical evidence you can take could be helpful to present when there if not already submitted... the person who conducts your medical almost certainly will not be a MH specialist so even a diagnosis written down by a medical pro would persuade them against concluding you may have no MH related disabilities/conditions of note.

I don't know if this link is any help.. it certainly is for DLA... it is the DWPs list of medical ailments and how the DWP may view them in terms of day to day effects.. you can look up anxiety... Generalised Anxiety Disorder is covered... I'll give the link that takes you straight to that (2nd one)

http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/

http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/anxiety-disorders/clinical-features/clinical-features-gad-ad.shtml

Good luck!

Muttleythefrog

Actually... got my medical report here... I'll give you a sample of it. I was claiming on the basis of MH problems including anxiety. The descriptors were changed earlier this year... so apologies if this relates to changes ones.... but I hope it is of some value.

---

Activity 21 Dealing with Other People

DPe Is Unaware of impact of own behaviour to the extent that (i) has difficulty.. blah blah blah. (this is the selected discriptor - as determined by the HCP doing the medical)

Social Interaction - Supporting Medical Evidence

Prominent Features of Functional Ability Relevant to Daily Living

Client states that:
Leads a structured regimented lifestyle
Does not like to have visitors at home
Finds it fascinating to read about serial killers
At times feels powerful and invincible and goes out at 3am (with hammer in carrier bag)
Has been referred to MH services. Letter from psychiatrist seen. Awaiting psychology assessments.

Relevant Features of Clinical Examination

Abnormal Findings:
Behaviour
Was restless
Seemed agitated
Poor rapport (may indicate poor social function)

Relevant Normal Findings:
Appearance
Well kempt
Did not appear to be trembling
Increased sweating was not apparent
Behaviour
Did not make rocking movements (rocking may indicate anxiety)
Speech
Spoke at normal volume
Mood
Behaved normally

Summary of Functional Ability
Mental state examination suggests the client's MH problem causes moderate disability with their interaction with others and awareness of others, which is consistent with the condition history and typical day history.

---

lulugirl

Muttleythefrog wrote: »

Actually... got my medical report here... I'll give you a sample of it. I was claiming on the basis of MH problems including anxiety. The descriptors were changed earlier this year... so apologies if this relates to changes ones.... but I hope it is of some value.

---

Activity 21 Dealing with Other People

DPe Is Unaware of impact of own behaviour to the extent that (i) has difficulty.. blah blah blah. (this is the selected discriptor - as determined by the HCP doing the medical)

Social Interaction - Supporting Medical Evidence

Prominent Features of Functional Ability Relevant to Daily Living

Client states that:
Leads a structured regimented lifestyle
Does not like to have visitors at home
Finds it fascinating to read about serial killers
At times feels powerful and invincible and goes out at 3am (with hammer in carrier bag)
Has been referred to MH services. Letter from psychiatrist seen. Awaiting psychology assessments.

Relevant Features of Clinical Examination

Abnormal Findings:
Behaviour
Was restless
Seemed agitated
Poor rapport (may indicate poor social function)

Relevant Normal Findings:
Appearance
Well kempt
Did not appear to be trembling
Increased sweating was not apparent
Behaviour
Did not make rocking movements (rocking may indicate anxiety)
Speech
Spoke at normal volume
Mood
Behaved normally

Summary of Functional Ability
Mental state examination suggests the client's MH problem causes moderate disability with their interaction with others and awareness of others, which is consistent with the condition history and typical day history.

---

Wow thanks so much for posting that, I have my medical very soon for mental health including anxiety. I am a wreck every day thinking about it. Did they give deatils & the relevence to you for every descriptor? Would you mind inboxing me more. Just thinking the more prepared I am the better I will cope

Muttleythefrog

lulugirl wrote: »

Wow thanks so much for posting that, I have my medical very soon for mental health including anxiety. I am a wreck every day thinking about it. Did they give deatils & the relevence to you for every descriptor? Would you mind inboxing me more. Just thinking the more prepared I am the better I will cope

No problem. Hopefully this helps. The computer software they use takes them through each section of descriptors... from which they have to choose one or none... it probably prompts many of the questions asked too.. and ultimately creates the actual report. In most cases that's likely to be 'None of the above'... as for example the physical descriptors may well not apply at all if you're claiming for MH reasons. The facts obtained are repeatedly used... the software regurgitates the 'relevant' facts/observations for each section such as Social Interaction. In reality not that many facts are obtained... in my case most relating to day to day activity investigation and observations of my behaviour and appearance. As you can probably see from the above... there isn't any obvious relationship between the descriptor chosen and the facts obtained... the assessment is open to a lot of subjectivity and error.

Remember on your last point... as stated in my prior (prior to the one you replied to) post above... make sure you don't cope too well...lol. If you suffer anxiety they will be prompted to look at whether you are showing classic symptoms of things like anxiety.. sweating.. shaking etc. They aren't there to make a diagnosis and they probably wouldn't be qualified to make one anyway... but they will look to see if they can corroborate claimed MH problems. For depression things like lack of facial expression, tone of voice, lack of eye contact, speed of speech may be things they look for as classical symptoms... presentation too... if you're dressed scruffily with manky hair that may be indicative of the self neglect associated with severe depression.

The example above was from the Social Interaction section which had 2 'activities' (I should warn that I had my medical prior to the spring changes in descriptors)... Propriety of Behaviour with Other People and Dealing with Other people... for Propriety of Behaviour with Other People "None of the above apply" was recorded (i.e. no descriptor was selected by the HCP) and that relied on the same facts as above.

A prognosis is also recorded in the medical... typically a duration of time before you can be considered as potentially able to return to work.. 3 months to 2 years typically. This would probably drive re-assessment scheduling.

It's important to remember that the resulting medical report, whilst it gives the descriptors the HCP thinks appropriate, is not the actual result of your Work Capability Assessment. There has been much criticism that the DWP decision makers were effectively rubber stamping the opinion of the ATOS HCP... i.e. taking their report as gospel and effectively regarding it as the WCA decision... this may be less so the case now since the problems with report accuracy are well known and additional evidence is more actively sought from claimant.