ESA question.

durbledurble

Hi - please help as I am panicking a bit.
I have been asked to help a family member fill in an ESA50 form. This in itself shouldn't be a problem but trying to explain it to her is!

She has serious mental health issues and I doubt very much she will be asked to attend a medical. I have an excellent letter from her CPN confirming her problems.

The trouble is I don't quite get the pass/fail aspect and the more I read on here the more confused I get.

She is, amongst other things, high functioning Aspergers and a large amount of time is spent with her explaining things over and over until I get tied in knots and very frustrated.

If someone attends a WCA and is found fit to return to work - is that a pass or a fail?
I see it as 'passing' ie being fit to work but 'failing' to remain on Incap but her primary carer is explaining it to me the other way around - that is, he maintains that 'failing' the WCA will result in her being found fit to work and placed on JSA.


(I am only filling in the form as the principal carer is semi-literate)

Is there anyone who can help me explain this or is it possibly better to fill in the forms without her knowledge and hope she doesn't have to attend an assessment?

MrsManda

It may be helpful to stop thinking in terms of pass or fail before you tie yourself in knots.

The ESA50 form is used to gather information to see if the claimant meets the criteria for ESA or is found fit for work.

A number of descriptors are used with each one relating to a certain number of points. You can read these descriptors and the points associated by downloading the Guide to Work Capability Assessment here:
http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/@disabled/documents/digitalasset/dg_177366.pdf

Under most circumstances the claimant needs to gain 15 points in order to qualify for ESA. Details of how this works in practice can also be found in the document linked above.

If you can get your relative to understand that you are filling out a form on her behalf then it may be better to leave it at that and fill it out. There's a section at the end of the form to say that you've filled it out rather than the claimant.

It may be helpful before filling it in to write a diary for a few days (or get the primary carer to do so if they're with the claimant more often) - it doesn't have to be detailed but could help you make sure you don't leave anything out. Don't worry about trying to fit everything into the boxes, add extra pieces of paper if you need more space. The more detail you put in the easier it will be for the decision maker to make a decision.

HTH

durbledurble

Thank you MrsManda for taking the time to answer.

I need to know how to phrase the possible outcome if we do tell her about it because her carer likes to contradict everything I say causing more turmoil and distress and I'm not really up to date with the whole Atos procedure.

I'm hoping and praying that the medical evidence and supporting letters will mean she doesn't have to undergo the assessment at all. She hasn't left her home in months for a start!

The form looks pretty straight forward which is a good start - I think I will fill it in on her behalf and say so on the form.

MrsManda

It's a judgement her carer and yourself will have to make but it may be worth not trying to explain possible outcomes but just saying that her benefit is being reassessed so to help you are filling out a form.

Put in as much detail as possible and make sure her GP as well as any specialists she sees are up to date with her problems and know that you are filling out the ESA50 form so that if they're asked to give further information they already know it's coming and know the situation.

durbledurble

Just noticed the thanks button!


Sadly her now live-in carer and I do not seem to be able to get along at all! if i suggest filling in the form without telling my cousin he will lecture me on her rights to know about what is going on and accuse me of 'abuse'.

I am really at my wits end about the situation - he is even restricting when I can visit her in her own home.

Muttleythefrog

durbledurble wrote: »

Thank you MrsManda for taking the time to answer.

I need to know how to phrase the possible outcome if we do tell her about it because her carer likes to contradict everything I say causing more turmoil and distress and I'm not really up to date with the whole Atos procedure.

I'm hoping and praying that the medical evidence and supporting letters will mean she doesn't have to undergo the assessment at all. She hasn't left her home in months for a start!

The form looks pretty straight forward which is a good start - I think I will fill it in on her behalf and say so on the form.

The best way to explain is to say eligibility for (main phase of) ESA is tested by a Work Capability Assessment. That WCA can comprise a range of fact finding efforts made by the DWP and their medical advisers at a company called ATOS Healthcare. The fact finding efforts can include things like requesting customer (or their rep) complete ESA50 form (very common), requesting medical evidence from people involved in the care/treatment of the claimant (not common), other evidence supplied by claimant (increasingly common) or other evidence available from other claims (probably common for claims transferring from the likes of Incapacity Benefit) and the largely dreaded face to face medical by ATOS HC (common) that results in a computer software driven report. Using all the available evidence a decision is taken by a DWP Decision Maker as to outcome of the WCA.

Usual terminology is to describe the claimant as having failed the WCA if they're found 'fit for work' - they'd be typically expected to appeal against this decision or seek alternative benefit. If they pass the WCA then they will be found to have limited capability for work and placed in the Work Related Activity Group (WRAG) OR they will be found to have limited capability for work related activity (and work) and placed in the Support Group (SG).

WRAG is typically qualified for by scoring 15 or more points against the descriptors (disabling effects) in the Limited Capability for Work 'test'. Support Group is typically qualified for by at least one of the descriptors in the Limited Capability for Work Related Activity test being found to apply to the claimant. Support Group is generally described as the group for those most seriously disabled and WRAG as the group for those who may be able to return to work in due course. (In neither group are you required to look for work or take work.. in WRAG you may be required to engage in 'work related activities').

Good luck!

rogerblack

In addition, I would recommend searching for specialised forums on beefburgers, or any other conditions she's suffering from, and seek information on their experiences with ESA applications.
Sometimes the best approaches to the answering the questions can be unexpected.

durbledurble

Muttleythefrog wrote: »

The best way to explain is to say eligibility for (main phase of) ESA is tested by a Work Capability Assessment. That WCA can comprise a range of fact finding efforts made by the DWP and their medical advisers at a company called ATOS Healthcare. The fact finding efforts can include things like requesting customer (or their rep) complete ESA50 form (very common), requesting medical evidence from people involved in the care/treatment of the claimant (not common), other evidence supplied by claimant (increasingly common) or other evidence available from other claims (probably common for claims transferring from the likes of Incapacity Benefit) and the largely dreaded face to face medical by ATOS HC (common) that results in a computer software driven report. Using all the available evidence a decision is taken by a DWP Decision Maker as to outcome of the WCA.

Usual terminology is to describe the claimant as having failed the WCA if they're found 'fit for work' - they'd be typically expected to appeal against this decision or seek alternative benefit. If they pass the WCA then they will be found to have limited capability for work and placed in the Work Related Activity Group (WRAG) OR they will be found to have limited capability for work related activity (and work) and placed in the Support Group (SG).

WRAG is typically qualified for by scoring 15 or more points against the descriptors (disabling effects) in the Limited Capability for Work 'test'. Support Group is typically qualified for by at least one of the descriptors in the Limited Capability for Work Related Activity test being found to apply to the claimant. Support Group is generally described as the group for those most seriously disabled and WRAG as the group for those who may be able to return to work in due course. (In neither group are you required to look for work or take work.. in WRAG you may be required to engage in 'work related activities').

Good luck!

Its all the abbreviations that confuse me - its like a foreign language and I can't understand why this WCA isn't done by the people who have treated her and kept her stable for the last goodness knows how many years.

Also I can't get my head around whether you have 'passed' or 'failed' but that's by the by really - I don't know who's side Atos is on!

Thank you though. I have completed the ESA50 and am sending it off tonight along with the evidence. (Keeping copies of everything and sending recorded delivery) I haven't told my cousin anything yet -no point in rocking her boat.

durbledurble

rogerblack wrote: »

In addition, I would recommend searching for specialised forums on beefburgers, or any other conditions she's suffering from, and seek information on their experiences with ESA applications.
Sometimes the best approaches to the answering the questions can be unexpected.

I didn't get you at first (beefburgers threw me!)

The trouble I have is that there is so much information on the internet - horribly, horribly negative and frightening to be quite honest - and my cousin doesn't fit conveniently into any of the boxes!


Oh I get it now - beefburgers/Aspergers!!
Haha:rotfl::rotfl:

Thank you Roger!