Concerns About ESA Review

Saetana

My husband currently receives higher rate Income Support due to long-term sickness and his review has finally come around - we have received the form to fill in about capability for work. Will they get information from his doctor as well as the form says to include any supporting medical information - we don't have hardly any of this as most stuff goes straight to the doctor, all we have kept are all his letters for hospital and consultant appointments.

My husband has chronic pancreatitis and wakes up feeling sick every single day, something his consultant and doctor have yet to find a treatment for (he is due to go for more tests soon). He is really worried that ATOS are not qualified to assess this kind of condition as being sick does not make him incapable of lifting an empty cardboard box. He also has osteoarthritis in both knees, lower back problems and suffers with clinical depression - some of these conditions are fluctuating and, again, we are concerned these "healthcare professionals" - the term used in the letter (are they really doctors at all?) are not qualified to assess multiple conditions like this. The stress is making him worse and I am really concerned about him sinking into another bout of serious depression (currently mostly under control with medication).

I've heard of people with even more serious conditions being found fit to work, can anyone explain the process a little better for me please?

Anubis_2

Muttley is the one who is best to explain, hopefully he will see this soon If not a few others can help you.

rogerblack

Saetana wrote: »

He is really worried that ATOS are not qualified to assess this kind of condition as being sick does not make him incapable of lifting an empty cardboard box.

There is a misunderstanding as to what HCPs do.
It is not a conventional medical.

It does not assess the persons illness, or fitness for work at all.
It does not assess how employable you are.

All it does is to determine if you meet the various legal tests as outlined in http://www.dwp.gov.uk/docs/m-06-11.pdf

If you do not meet these specific tests, you can only get ESA in very limited cases, or if there is a severe risk to health if not found unfit for work.

Read and understand the above criteria.

They may or may not choose to contact your doctor.
You can request copies of your medical notes from your doctor for a modest fee.
This may be useful.

Muttleythefrog

Anubis wrote: »

Muttley is the one who is best to explain, hopefully he will see this soon If not a few others can help you.

Roger is even better..lol

Muttleythefrog

Saetana wrote: »

My husband currently receives higher rate Income Support due to long-term sickness and his review has finally come around - we have received the form to fill in about capability for work. Will they get information from his doctor as well as the form says to include any supporting medical information - we don't have hardly any of this as most stuff goes straight to the doctor, all we have kept are all his letters for hospital and consultant appointments.

My husband has chronic pancreatitis and wakes up feeling sick every single day, something his consultant and doctor have yet to find a treatment for (he is due to go for more tests soon). He is really worried that ATOS are not qualified to assess this kind of condition as being sick does not make him incapable of lifting an empty cardboard box. He also has osteoarthritis in both knees, lower back problems and suffers with clinical depression - some of these conditions are fluctuating and, again, we are concerned these "healthcare professionals" - the term used in the letter (are they really doctors at all?) are not qualified to assess multiple conditions like this. The stress is making him worse and I am really concerned about him sinking into another bout of serious depression (currently mostly under control with medication).

I've heard of people with even more serious conditions being found fit to work, can anyone explain the process a little better for me please?

I would advise from now on trying to get copies of all medical correspondence before I forget... you never know when it could come in handy.

Presumably you've got the ESA50 form. If you have access to a printer you might prefer to complete an electronic version.. easier to correct things and may well save lots of duplicated efforts in future as assessment is typically regular. http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/@money/documents/digitalasset/dg_195544.pdf

Roger gives link above for descriptors for ESA... the qualifying criteria. Understand and keep it in sight when completing the ESA50 as the ESA50 form doesn't always prompt for appropriate information.

When ATOS HC receive your ESA50 form back along with any supporting evidence then it should be reviewed to determine if they've got sufficient evidence to provide advice to the DWP on entitlement. If not then they may decide to contact GP with an ESA113 form which requests further facts. But more likely than contacting GP they would arrange a face to face medical for factfinding. ATOS will provide advice or medical report to DWP who are ultimately responsible for the decision on entitlement.

The HCPs can come from a variety of backgrounds... nurses are common... there are GPs etc and possibly physiotherapists. The argument is that these assessments are not regular medical assessments but disability assessments... and that's how they get around the 'suitably qualified' issue. I'm not convinced quite frankly but such is life. It's important if he is asked to attend medical that he doesn't play down his problems. The medical is driven by software (hence many problems reported) and the HCP will spend most of the medical typing... rather unfortunate because they will record physical observations regarding things like facial expressions and whether trembling is evident. The questions will typically surround day to day activity to generate facts that'll be used to determine if any descriptors apply. Experiences of the face to face medical vary enormously... and mine varied enormously in the one medical I had..lol. Experience of the medical and the resulting medical report can even conflict... I'd advise if attending medical to shortly afterwards request a copy of the resulting medical report (ESA85) from DWP as not only will it be revealing it'll quite likely effectively be rubber stamped by the DWP as their decision weeks later.

Ellejmorgan

I've got spinal problems which affect my legs, arms and neck..also arthritis
I'm in the WRAG, which was a good result as i'm on income related ESA..

opus33

Saetana wrote: »

My husband has chronic pancreatitis and wakes up feeling sick every single day, something his consultant and doctor have yet to find a treatment for (he is due to go for more tests soon). He is really worried that ATOS are not qualified to assess this kind of condition.

He also has osteoarthritis in both knees, lower back problems and suffers with clinical depression - some of these conditions are fluctuating.

I've heard of people with even more serious conditions being found fit to work, can anyone explain the process a little better for me please?

CP and AP over CP, are not well know conditions.
Experience tells me that most 'medics' know what it is, but will probably have never come across it. Most understand it to mean 'pain in the pancreas'.
Consequently, they will have very little knowledge of how dibilitating the condition and symptoms are.

At last count, very few people who suffer will be accepted onto ESA. CP & AP over AP are classified by the DWP as something similar to constipation!!

No one that I know has ever managed to get any level of DLA for this disease as the needs are unusual.

Daily sickness is just one of the easiest to control symptoms. Most sufferers find this not to be a problem - they are prescribed anti-sickness medication, which is routinely given to cancer patients undergoing treatment and not the common stuff you can pick up at the chemist for travel sickness. The drugs are a lot more potent and issued on prescription only. Generally up to 5 tabs a day.

CP is a progressive disease and the symptoms start to pile on as time goes on. There is no cure for the disease, only radical and dangerous surgery, the process being exactly the same as someone who has pancreatic cancer. All you can have is medication to tone down the severity of the symptoms. Most people become addicted to Opiates.

Quite honestly I could count on two hands how many hospitals in this country have a specialised department.

Claiming ESA for that disease is basically a non starter.

You have more of a chance with osteoarthritis and depression to get you through the assessment. I would point out that depression is also a complication caused by CP.

When you say 'other serious conditions' I think you are down playing CP. CP is a very serious condition, an attack can so easilly be fatal and from memory CP sufferers are more likely to die of pancreatic cancer than anything else.
As a statistic, sufferers only have a 50/50 chance of surviving beyond seven years after the first attack of AP. And that info can also be found in the DWP A to Z of medical conditions!

Good luck. If you want more info on CP or want to chat to other suffers, let me know.

Saetana

Thanks very much for the advice everyone.

As regards the nausea, his doctor has tried him on numerous anti-nausea tablets, none of which have helped at all. The nausea is a massive problem, the only saving grace being that he is rarely actually sick (usually nothing to bring up). His consultant is planning more tests as he is a little mystified about the continued nausea, it may even be the case that the nausea is not connected to the problems with his pancreas, another endoscopy needs to be done which is an awful procedure - he spent over ten minutes retching with a camera down his throat.

I will be attending any interview with ASOS with my husband for the first time - he has gone alone in the past but has a tendency to play down his problems, something that would not be a good idea in this case.

I cannot believe they do not seek information from GPs as a matter of course, that is totally ridiculous! I am very concerned that the ASOS people will have no understanding of his condition - so many people have been declared supposedly fit to work despite serious conditions, a neigbour's sister has a hip replacement, bad osteoarthritis in both knees and is 59 and she has been told she needs to find a job. She said "who will come and help me get out of bed on my bad days?". They apparently looked at her dumbstruck.

I will push this claim as far as necessary, as I understand it around 80% of all appeals have been successful. I'll contact our local MP, the newspapers and anyone else I can think of if they should decide he is fit to work. My husband also wondered whether he could just keep putting sick notes in from the doctor (who would happily provide them, he has been our GP for 10 years) if he is declared fit to work, does anyone know if that would help?

This is so annoying - my husband worked for 25 years before being signed off sick and would love to be fit enough to return to work, they pick on the sick and disabled and all the flash bankers who caused the financial crisis are still coining it in. He only gets higher rate income support (rent and council tax benefit also) as he doesn't quite qualify for DLA, being sick rather than disabled makes claiming any additional benefits very difficult.

skintmacflint

For more info on how the descriptors are supposed to be assessed google - ESA WCA handbook and take link to dwp.gov.uk link.

If curious about the computer logic tick box system which drives the assessment and will be keeping the assessor busy during any assessment google - ATOS computer programme manula (LIMA).

If your husband's declared fit to work after assessment, you'll start down the lengthy appeal/tribunal route. He'll need to submit sick notes from GP for the time it takes until the appeal/tribunal is held.

If the decision isn't overturned at Tribunal don't think they accept sick notes for same condition unless something else has developed or the condition has deteriorated in some way .

It's a flawed system from start to finish. I don't agree with a private company carrying out this process. ATOS get paid for each assessment but have no financial penalty applied for all the incorrect decisions they've made which are later overturned at Tribunal. If ATOS had to pay the cost of the Tribunals (estimated at £50 million) they'd be more inclined to ensure they carried them out correctly, instead of doing conveyor belt assessments.

Muttleythefrog

Saetana wrote: »

Thanks very much for the advice everyone.

As regards the nausea, his doctor has tried him on numerous anti-nausea tablets, none of which have helped at all. The nausea is a massive problem, the only saving grace being that he is rarely actually sick (usually nothing to bring up). His consultant is planning more tests as he is a little mystified about the continued nausea, it may even be the case that the nausea is not connected to the problems with his pancreas, another endoscopy needs to be done which is an awful procedure - he spent over ten minutes retching with a camera down his throat.

I will be attending any interview with ASOS with my husband for the first time - he has gone alone in the past but has a tendency to play down his problems, something that would not be a good idea in this case.

I cannot believe they do not seek information from GPs as a matter of course, that is totally ridiculous! I am very concerned that the ASOS people will have no understanding of his condition - so many people have been declared supposedly fit to work despite serious conditions, a neigbour's sister has a hip replacement, bad osteoarthritis in both knees and is 59 and she has been told she needs to find a job. She said "who will come and help me get out of bed on my bad days?". They apparently looked at her dumbstruck.

I will push this claim as far as necessary, as I understand it around 80% of all appeals have been successful. I'll contact our local MP, the newspapers and anyone else I can think of if they should decide he is fit to work. My husband also wondered whether he could just keep putting sick notes in from the doctor (who would happily provide them, he has been our GP for 10 years) if he is declared fit to work, does anyone know if that would help?

This is so annoying - my husband worked for 25 years before being signed off sick and would love to be fit enough to return to work, they pick on the sick and disabled and all the flash bankers who caused the financial crisis are still coining it in. He only gets higher rate income support (rent and council tax benefit also) as he doesn't quite qualify for DLA, being sick rather than disabled makes claiming any additional benefits very difficult.

Appeal success rate at tribunal is about 40%... it will no doubt significantly vary depending upon representation (having legal support or being present to give oral evidence both would cause a trend of better success). I don't have figures in my head regarding reconsiderations that in many cases will overturn a decision before independent tribunal.

Just to clarify it is ATOS.. ATOS Healthcare. A division of a global giant based in France I believe that is essentially an IT firm.

If he fails the Work Capability Assessment he can appeal and usually continue to get assessment rate ESA while under cover of sicknotes. Otherwise sicknotes are only useful for assessment phase (approx initial 3 months for new claims). When you are given a WCA then you are being assessed for the main phase of the benefit (which has the two groups WRAG and Support Gp)... a GP sicknote is effectively redundant as the WCA tests for something different.. limitations in capability for work and work related activity.

Saetana

Sorry, I did know it was ATOS, I was a little worked up when I made that last post. We are going to get a copy of his medical records given its not definite that the DWP will bother to contact his doctor. Since he had a heart attack 4.5 years ago his health has deteriorated, given he has 5-6 separate medical issues that affect his ability to work I just hope he will get enough points between them to pass.