partners failed ATOS medical & appeal question

donny909

Short story, partner claims for me to she gets IS\IB, also in receipt of housing\council tax benefits as well as child benefit for our daughter. My patner had the ATOS medical and fails it getting zero points when last time she also failed, it went to a tribunal and she was awarded several points more than needed.

The medical report back as per usual states she is fine yet she is not and selected editing of the findings of the medical seems to have been used to make the decision to award zero points while ignoring each and every point that would have awarded her points to pass the medical in her favour.

Also come to light is that prior to the medical a request was appaprently sent out directly to the doctors (IS confirmed this) for her medical information to be used as part of the medical information gathering process but this request went un-answered and they (whoever "they" was?)had no responce. But not sure if it would have been ATOS\IS or IB who would have requested this information. When contacting the doctors they stated that they have received no request at any time for any information and if they had they would have responed to that request and also contacted my partner to state that the information is subject to a processing fee that would be due.

Funny that, as the medical information would have confirmed my partners health issues and shown what points she was awarded via medical information used in the tribunal some 2 years ago is just as valid if not worse in some areas to get more points this time round.

This and the seemingly familiar habbit of ATOS to vastly edit information took at the medical to ensure a person gets awarded zero point is the basis of the appeal.

For example the report states my partner was able to get up and down from a chair twice unaided during the medical. So that entire section of the medical by default gave her zero points because of that single sentence. Missing from that information and pointed out in the appeal is that while getting up from and sitting back down in the chair unaided twice during the medical is that on each time she had to hold onto both sides\arm rests of the chair to support herself and to help her to get up from the chair at all and had to breath harder to do this task each time. The entire medical report back for my partner was typical of the above example in that they have effectivly edited the details of the medical to ensure zero points awarded. Well that and the fact they never (again) covered the mental health issues section of the medical.

Anyways, in the meantime should the original benefit be re-instated during the appeal and likely tribunal thats likely to be won as there is no chance of circumstances since the last won tribunal?. Because IS\IB are giving 3 differing information 1 is saying she has to now put in a new joint JSA (or whatever) claim while the appeal\tribunal process progresses while another says she just has to get a sicknote of the doctor for now and the original benefit gets reinstated but at a reduced rate untill a final decision is reached and accepted by either side?.

Any advice at all really as it's really annoying the way ATOS are getting worse and worse over these medicals, are editing and missing out details when doing the medicals to the point where what they provide to the decisiom makers is total lies and telling lies about requesting medical information that would have certainly ment she would have passed.

Cpt.Scarlet

They should be elligible for the ESA assessment rate until the appeal is heard, they will need to provide Fit Notes throughout this period.

andrea_louise

Hi Donny,

Not an awful lot of advice I can give here, If you still have the paperwork from the previous tribunal, use that as the basis for this one, but do note that the descriptors changed last March.

Good luck.

coin_operated_girl

This is what happened to me around about a year and a half ago. I was on IB, called for a medical assessment where I was found fit for work. I spoke to someone at the DWP as I was pretty naieve about this kind of thing and was told that I could appeal and whilst the appeal is going on I would have to claim JSA. I did a bit of research and found that this was incorrect and that you could claim ESA at the assessment rate- so thats what I did. Shortly after going on to ESA I was called for another medical assessment. Yet again I was found fit for work. I put in an appeal against this as well and was told that I can stay on ESA at the assessment rate until it goes to a tribunal. So I had both an IB and an ESA appeal going on at the same time. You need to send in sick notes whilst you are on ESA at the assessment rate. It took a whole year for my appeals to be heard- although the ESA appeal was put in 2-3 months after the IB appeal, on the day of the tribunal they said that they will do the IB one first and then if they find me fit for work they will do the ESA appeal (as the descriptors are slightly different) so I don't have to come back for the ESA tribunal. Over the course of the year I did a lot of research and a (now) ex put in so much hard work as well so I was armed with a whole host of reasons why I believe I was not fit for work. I had a big folder of stuff with me for the tribunal and was ready for a battle, but I didn't even need to open the folder and they basically said straight away that I was unfit for work and since I scored enough points they would backdate my IB as that was more money than ESA. When I got my backdated money, it was a fair bit less then what I expected it to be. I sat down, did the calculations and then sent a letter to the DWP to say that I think they underpaid me and sent them my calculations to show why I thought that. They originally paid me about £1,800 but after my letter they paid me another £1,300!

I expect you and your partner will be put through a similar thing. If you win the appeal, when they backdate the benefits, please take the time to check whether they have paid you the correct amount. I almost didn't bother checking, and had they paid me say £2,200 then I don't think I would have checked as I was expecting around £2,500 just from a very rough calculation I did a while before, but £1,800 was a bit too much under what I was expecting. I can't help but think that they have gotten away with underpaying a LOT of people.

Muttleythefrog

Sadly your experience regarding the medical is a commonly reported one. So next step is to probably appeal in writing (GL24 form from DWP can be used) and get medical certificate so as to be able to get assessment rate ESA while appealing. It sounds like ATOS HC might have sent an ESA113 form to GP for completion.. it either went missing or information is defective on what occurred.

If you appeal, focus on the descriptors... try to get supporting medical evidence. DWP will first carry out an automatic reconsideration to see if they can change decision.. I'd be tempted to make some factual challenge of the ATOS medical report especially if it can be fundamentally undermined such as to make the DWP think it is totally unreliable.

Good luck!

epitome

If you appeal, make sure you point out that it was the same last time and you won on appeal, so what has changed? It may be overturned on reconsideration before appeal.

donny909

Thanks for the replies, things are progressing if a little slow and are now on the ESA assesement rate that will be payed and backdated when they get the sick-note.

Some great advice, prehaps I should have come on here a little before my partner sent the appeal form in as we night have been able to add additional information in the appeal form.

andrea_louise wrote: »

Hi Donny,

Not an awful lot of advice I can give here, If you still have the paperwork from the previous tribunal, use that as the basis for this one, but do note that the descriptors changed last March.

Good luck.

We have actually moved since the last tribunal and have no clue where the last tribunal papers are, assumingly IS\IB have a copy on record, should this not have been provided to ATOS to point out issues that won her the tribunal 2 years ago?.

Muttleythefrog wrote: »

Sadly your experience regarding the medical is a commonly reported one. So next step is to probably appeal in writing (GL24 form from DWP can be used) and get medical certificate so as to be able to get assessment rate ESA while appealing. It sounds like ATOS HC might have sent an ESA113 form to GP for completion.. it either went missing or information is defective on what occurred.

If you appeal, focus on the descriptors... try to get supporting medical evidence. DWP will first carry out an automatic reconsideration to see if they can change decision.. I'd be tempted to make some factual challenge of the ATOS medical report especially if it can be fundamentally undermined such as to make the DWP think it is totally unreliable.

Good luck!

I think (because I spoke to IS or IB for my partner) it was the ESA113 form that IS mentioned when they were called. My partner had no prior knowledge of this request and that it had been sent out, the call to IS was the first we knew of such a request and had no prior request for permission about such a request to the doctors in advance to her memory for which I'd assume they would need to ask for?.

So as to why IS have stated they have a stated responce from ATOS stating a request went out (which to my partners memory she is unsure of if she was asked for permission for them to contact her doctor directly at all in the first place) and no responce was made is a bit of a mystery. I'd assume ATOS would not admit to having lied for whatever reason and in fact they never requested the information at all and in fact no form went out. Yet it helps there position for the medical and to award zero points each time to make out and claim it did.

These such issues have been pointed out in the appeal, prehaps ATOS will be asked to prove they sent the form out to the doctors as otherwise the entire medical process could be called into question if they did not try to obtain the medical information they are supposed to, claimed they did yet can be proved they did'nt.

epitome wrote: »

If you appeal, make sure you point out that it was the same last time and you won on appeal, so what has changed? It may be overturned on reconsideration before appeal.

As said, sadly I forgot to come on here for a little advice before my partner sent the appeal form off. But as I helped her with the appeal (because she has problems expressing herself and explaining things properly) and did point out as part of the appeal that the medical findings was pretty much the same as the last 1 and again explained the same flaws of selected editing of the facts and answers given (as well as missing out key elements of the medical like medical mental health alltogether yet it was made out that section was done) during the medical to give a false impression to the decision maker. Also in the appeal went that she then appealed her previous failed medical and that when it went to the tribunal she was awarded several points above what was required as they took into account the medical information and properly listened to all the facts and explanation of her various medical issues as was confirmed via her provided medical notes at the tribunal. It was also pointed out that the doctors had confirmed that no such request for medical information hade been received by her doctor at any time.

Since the appeal, she has been given the sick note, valid for 3 months. They done that on the basis of life long issues with walking and pains in her feet due to the way her bones grew in her feet when she was a child which often causes a lot of mobility and pain issues. So a medical note to say she in unfit to work on a lifelong issue on mobility issues due to her feet yet the medical found she has no such mobility problem?.

Also the doctors confirmed another twice, once by the secretery and again by the doctor themselfs that can look deeper into her records I assume that at no point has any medical information been requested by anyone at any time and that the last request was for a copy of her note for the previous tribunal.

It's been over 2 weeks since the appeal form went in now so just a waiting game untill we assume, but hope not if we have dis-credited ATOS enough untill we hear back.

epitome

You can follow up the appeal form with any evidence you want, whenever you want, you could get a letter from the doctor to say the conditions are the same as the last time she was found fit for work. i,e, nothing has changed so should win on appeal again.

Muttleythefrog

Just a couple of points to make Op.. given last reply. Assume nothing regarding evidence used in the process... when ATOS are contacted to do what they need to do I would assume absolutely nothing is supplied to them... so if you get ESA50 form to fill in then put in everything necessary and add any supporting evidence you want considered. It is probably unlikely ATOS would see previous tribunal decision paperwork unless you supply it. Treat the process as placing the burden of proof on yourself... and a path of minimal resistence and complexity used by your 'opponents'.

ATOS HC wouldn't inform that they're seeking information from GP via ESA113 unless enquiries are made to them... I would think they'll typically have permissions to seek such info from completion of ESA50 form. I was lucky to make email enquiry to ATOS and they said they'd written to GP and would give them 2 weeks to respond. It's unlikely that if ATOS HC have lied or things didn't go according to process that the matter will be pursued by any party unless you complain. The idea of contacting the GP is that it can offer opportunity to get into process, as far as ATOS are concerned, sufficient facts in order to provide advice on entitlement to DWP.. it seems to be something they will do where they consider a face to face medical can be avoided... if ESA113 is not forthcoming then they'll probably order such a medical.

Make sure appeal case is left in a state whereby you are making case for the various applicable descriptors applying... it's easy to get dragged into an ATOS attack when they've produced the key evidence which is a load of rubbish... discredit their report but ensure you make a positive case for entitlement.

With any luck a DWP auto-reconsideration might prove fruitful... you never know... that could take weeks to months. Make sure they have received appeal notification.