ESA - WRAG to Support Group

zippy1969

My friend has now got a letter from her GP. It lists each of the 'Support Group' descriptors and then the GP's comments as to how she fits each one.

He's then made the following statement:

Miss xxxxxxxxxxx requires a reconsideration of her ESA group placement. The information given here should form the basis of the reconsideration. Miss xxxxxxxxxx has been a patient of the surgery for many years and we are more able to assess her state of mental health. She has a history of mental health issues, OCD, anxiety, suicidal depression etc. Miss xxxxxxxxxx wants to return to work at some point, but needs to be able to do this at her own pace and in her own time without being unduly pressured. If she is moved to the ‘Support Group’, this will allow her the time and space to consider her options when she feels well enough to do so. I can confirm also the recent interventions of the mental health crisis team and her ongoing attendance at weekly group psychotherapy, which she has now been attending for over a year. I also confirm her current medication of 200mg xxxxxxxxxx daily (max dose) and 160mg xxxxxxxxxx as required.


Quite a result I would say:)

Muttleythefrog

zippy1969 wrote: »

My friend has now got a letter from her GP. It lists each of the 'Support Group' descriptors and then the GP's comments as to how she fits each one.

He's then made the following statement:

Miss xxxxxxxxxxx requires a reconsideration of her ESA group placement. The information given here should form the basis of the reconsideration. Miss xxxxxxxxxx has been a patient of the surgery for many years and we are more able to assess her state of mental health. She has a history of mental health issues, OCD, anxiety, suicidal depression etc. Miss xxxxxxxxxx wants to return to work at some point, but needs to be able to do this at her own pace and in her own time without being unduly pressured. If she is moved to the ‘Support Group’, this will allow her the time and space to consider her options when she feels well enough to do so. I can confirm also the recent interventions of the mental health crisis team and her ongoing attendance at weekly group psychotherapy, which she has now been attending for over a year. I also confirm her current medication of 200mg xxxxxxxxxx daily (max dose) and 160mg xxxxxxxxxx as required.


Quite a result I would say:)

Be interesting to see what happens. I presume this (a copy of... keep original!) will be getting sent back with completed ESA50 for the reassessment. Let us know the outcome... be interesting to see if ATOS decide a feace to face medical is in order.. they can take a decision not to and would normally request GP complete ESA113 form I think if they went that route. But they already are going to get solid advice from GP..lol.

zippy1969

Muttleythefrog wrote: »

Be interesting to see what happens. I presume this (a copy of... keep original!) will be getting sent back with completed ESA50 for the reassessment. Let us know the outcome... be interesting to see if ATOS decide a feace to face medical is in order.. they can take a decision not to and would normally request GP complete ESA113 form I think if they went that route. But they already are going to get solid advice from GP..lol.

Yes, a copy of this is going with the ESA50. When we collected the letter yesterday we were told another letter was coming and this arrived today. In a nutshell, my friend couldn't get the GP she wanted to see initially and so saw someone else. She then got to see her regular GP who prepared the report. However, the other letter is from the first GP she saw. This letter basically states that she is not able to cope with the ESA assessment process. The GP has also stated "it concerns me to think how she will cope with employment." It also states that my friend attended the surgery "in desperation and with heightened anxiety."

So she is going to send a copy of this letter too.

I'm not sure the DWP can ignore such compelling and specific medical advice from two seperate GP's? Indeed, there is direct correlation between the descriptors and the information both GP's have put forward. If the DWP did ignore the evidence, and my friend appealed the group she is placed in, surely any appeals panel with sense would see she should be in the 'Support Group?'

Adereterial

zippy1969 wrote: »

I'm not sure the DWP can ignore such compelling and specific medical advice from two seperate GP's? Indeed, there is direct correlation between the descriptors and the information both GP's have put forward. If the DWP did ignore the evidence, and my friend appealed the group she is placed in, surely any appeals panel with sense would see she should be in the 'Support Group?'

A GP's evidence is less weighty than a specialist consultant or, in the case of mental health conditions, a psychiatrist or psychologist. If she's not seeing a specialist for a condition then the Decision Maker may consider that the evidence is not sufficiently weighty to justify Support Group, as it is not a specialist opinion. GPs are not qualified to properly deal with severe conditions - if she were that severe then it's a reasonable expectation that consultant opinion would have been sought. If it has been, she should provide this evidence.

Also, looking at the quote above, the wording isn't exactly helpful to her. 'If required to change her routine' invokes the potential for uncontrolled behaviour but it does not guarantee it. To fulfill the Support Group criteria she must, now, be experiencing a loss of mental control. Not just have the potential for it if her routine is changed.

zippy1969

Adereterial wrote: »

Also, looking at the quote above, the wording isn't exactly helpful to her. 'If required to change her routine' invokes the potential for uncontrolled behaviour but it does not guarantee it. To fulfill the Support Group criteria she must, now, be experiencing a loss of mental control. Not just have the potential for it if her routine is changed.

This was just a quote from the report covering one of the descriptors. The GP has given evidence saying she meets five...but only one has to be met for 'Support Group' placement I believe?

Descriptor number 12 covers change to routine and her GP has referenced this descriptor in the report too:

12. Coping with change

Cannot cope with any change, due to cognitive impairment or mental disorder, to the extent that day to day life cannot be managed.

Anyway, the whole pack of information has been sent and has been received by the DWP so we'll see how things turn out?

zippy1969

Just an update on this.

It's now been eight weeks since we sent in my friends ESA50 and the evidence supporting her move from the WRAG to the SG. She hasn't heard a thing. I did phone on her behalf about four weeks ago and was just told that the information had gone to ATOS and that a decision would be forthcoming. Still nothing though.

So now I have prepared a GL24 appeal for her. Once more I've enclosed all the GP reports and all the information that was sent with the ESA50, along with evidence that the ESA50 was received, via the Recorded Delivery receipt and Post Office 'track and trace' website.

The appeal is basically challenging the lack of a decision. She's asked to be put in the 'SG' and yet no correspondence has been received following her submission of ESA50 and supporting evidence.

Cpt.Scarlet

You can't appeal against a decision that hasn't been made, all you can do is make a complaint.

Muttleythefrog

As above... don't make things even more confused than they are..this is the DWP you're dealing with who couldn't untangle a shoelace... give them spaghetti and you will be left to untangle it for them at great efforts quite likely. From my understanding of above this is a routine reassessment and your friend is currently in WRAG following 'successful' reconsideration last time. ATOS HC will be consulted for to do what they need to do (which may include requiring a face to face medical) and then return opinion (ESA85/ESA85A) to the DWP to take decision. A couple of months is quite normal for these things to still be in progress. Hold your appeal against the decision (for Support Group) until at least an undesired decision has been made.

What it may be worth doing is contacting the local ATOS HC assessment centre or ATOS HC via email to try to find out their position regarding progress... they won't likely tell you much but what they do say could be quite revealing... e.g. 'we've written to your GP for more information' or 'we've closed our file'. Try using email address [EMAIL="customer-relations@atoshealthcare.com"]customer-relations@atoshealthcare.com[/EMAIL] giving name, address, date you sent them ESA50 and most important of all NI number and ask if they've received ESA50 and what is happening next.

zippy1969

My friend got a letter from ATOS today. She's been called in for a medical assessment. The letter says to take any GP letters/reports etc...so these will basically be the ones we already sent to ATOS with the ESA50!

I rang ATOS to ask for the assessment to be recorded so now have to wait for a new date. I explained that my friend was awarded zero points when she originally applied for ESA but that this was overturned after a reconsideration based on evidence supplied by her GP. I was told that this will be taken into consideration at the new assessment.

This all seems crazy. She'll go for the assessment and if she gets zero points again, we'll just submit the latest GP letters that were already sent to ATOS but this time to the DWP themselves. They'll reconsider and she'll get the award again. If the assessment results in her continuing to get ESA, the decision will be mostly based on the evidence supplied by her GP...that they've already had! If she gets put into the WRAG again, she'll just appeal...again with the report from her GP that clearly lists the SG descriptors and explains why she meets them.

This whole 'assessment' is a waste of time...and just causes my friend undue stress, anxiety and depression. Putting her through this is not helping her at all.

Muttleythefrog

zippy1969 wrote: »

My friend got a letter from ATOS today. She's been called in for a medical assessment. The letter says to take any GP letters/reports etc...so these will basically be the ones we already sent to ATOS with the ESA50!

I rang ATOS to ask for the assessment to be recorded so now have to wait for a new date. I explained that my friend was awarded zero points when she originally applied for ESA but that this was overturned after a reconsideration based on evidence supplied by her GP. I was told that this will be taken into consideration at the new assessment.

This all seems crazy. She'll go for the assessment and if she gets zero points again, we'll just submit the latest GP letters that were already sent to ATOS but this time to the DWP themselves. They'll reconsider and she'll get the award again. If the assessment results in her continuing to get ESA, the decision will be mostly based on the evidence supplied by her GP...that they've already had! If she gets put into the WRAG again, she'll just appeal...again with the report from her GP that clearly lists the SG descriptors and explains why she meets them.

This whole 'assessment' is a waste of time...and just causes my friend undue stress, anxiety and depression. Putting her through this is not helping her at all.

Yeah.. it can end in a vicious roller coaster... ESA certainly hasn't been designed nor is administrated with the customer base in clear view.. for many claimants it is simply going to prevent them looking forward or improving in health. I'm not getting treatment.. the NHS doesn't have any to offer me and for 20 years I've been continually getting worse... and I have no ambition to get better... so reassessing me every year or so is just a waste of time and money... it just further reduces my capability.

Regarding recording... be aware many seem to be having problems since apparently only 11 machines are available for the entire country. There is no legal right as I understand to have it recorded... I'd strongly advise therefore if you could make provision to secretly audio-record.. that recording also being a covert one will not have you signed up to any restrictive declarations regarding use of it that ATOS HC probably insist on.

Hopefully the outcome will be Support Group. The HCP at ATOS HC should have the ESA50 and evidence already supplied with it... they're meant to have studied that evidence in advance of the medical (although some clearly do not). I would take a copy of evidence along just in case... and if she can force some focus onto the GP document in relation to Support Group descriptors that could be useful. If things don't go as planned.. well appeal will offer option... not ideal.. but probably a more reasoned opinion.