Does (C) ESA stop straight away if fail ATOS medical

jayk

Hi

Due to have medical shortly am on ESA contribution based. If I receive ) points will my ESA payments stop straight away. Very worried and not sure what to do if they stop. From reading posts and watching recent TV documetaries dont hold out much hope re passing medical.

Can I appeal- will I still receive payments during appeal time? Or if sign onto JSA - even though still unwell- will this be allowed.

Have been sending in sick certificates from day 1 of illness to DWP. Still on medication.

Have always been in work prior to illness and whole system is very confusing at times.

Thak you for any help.

Cpt.Scarlet

If you score less than 15 points then your payments will stop from the date on the decision letter you will receive.

You can appeal, and should receive the assessment rate. You will need to provide a a new Fit Note if you appeal.

JS477

Cpt.Scarlet wrote: »

If you score less than 15 points then your payments will stop from the date on the decision letter you will receive.

You can appeal, and should receive the assessment rate. You will need to provide a a new Fit Note if you appeal.

So if you fail the WCA and you wish to appeal you need to go back to your Dr and request a "Fit Note"? So what happens given the ever increasing times to hear appeals your "Fit Note" expires, do you have to keep going back to your Dr. to get a "Fit Note" until your appeal is hear?

Ta.

Muttleythefrog

JS477 wrote: »

So if you fail the WCA and you wish to appeal you need to go back to your Dr and request a "Fit Note"? So what happens given the ever increasing times to hear appeals your "Fit Note" expires, do you have to keep going back to your Dr. to get a "Fit Note" until your appeal is hear?

Ta.

Yes. 'Fit notes' giving continual cover are normally required as qualification to get assessment rate ESA during assessment phase and while awaiting appeal. As the DWP also takes time to process appeal tribunal results (some people suggesting 3 months shockingly lately!) you need to also provide them during this period to ensure continued payments.

Muttleythefrog

jayk wrote: »

Hi

Due to have medical shortly am on ESA contribution based. If I receive ) points will my ESA payments stop straight away. Very worried and not sure what to do if they stop. From reading posts and watching recent TV documetaries dont hold out much hope re passing medical.

Can I appeal- will I still receive payments during appeal time? Or if sign onto JSA - even though still unwell- will this be allowed.

Have been sending in sick certificates from day 1 of illness to DWP. Still on medication.

Have always been in work prior to illness and whole system is very confusing at times.

Thak you for any help.

As per Scarlet.. payments stop when DWP takes a negative decision on entitlement.. i.e. you failed the WCA... you sometimes might get warning.. but ESA admin is so poor some people find out to their horror when they check bank account. ATOS HC who provide medical services to the DWP in respect of the WCA (including face to face medicals) can't make the decision. They do however usually have their advice as good as rubber stamped. It is therefore advised that you request from the DWP the resulting medical report (an ESA85 medical report) shortly after medical that could give advanced notice of likely decision. Otherwise it's evidence you'll need anyway should the worst happen and you want to challenge a decision later made using it.

Refer above regarding fit notes.. these are typically required when claiming ESA but not in the main phase.. the main phase being where you are placed if you pass the WCA and are put into WRAG or Support group. It's improtant to note that this government has now passed legislation that means contribution based ESA payments are limited to one year in the WRAG. They are not limited in the Support Group. If you qualify for Income related ESA you can claim that indefinitely in either of the groups.

Focus on the descriptors... you probably have recently completed the ESA50 form and returned it. Get any supporting evidence you can.. if you haven't sent it with the ESA50 you could take it and present at medical. But ensure you have in mind what descriptors you thinkapply to you and therefore how you think you should qualify for the benefit. The face to face medical are hit and miss... you'll probably find much questioning quite indirect... asking you about typical day.. hobbies etc... do you watch TV... the idea is that they then use facts obtained from your replies to draw inferences and extrapolated conclusions about your capacity in relation to the descriptors. The medical is software driven.. the HCP will spend large amounts of time PC focussed and typing. Observations regarding demeanor, appearance, behaviour at medical will also probably be recorded.. and are particularly important if claiming to have mental health problems.

jayk

Thank you very much for replies and your very detailed response Mutley- very helpful and I feel more informed now. Am nervous re the medical. I hope I will eventually return to full health and find work again.

However not there yet and do need help.

Horseunderwater

As muttley stated - DWP will stop ESA right away if they get told that you do not qualify with a min 15 points. This can be for one descriptor or several different ones totalling upto a min 15. If you google ESA descriptors. it should come up with a link to Pseudo-living: ESA Descriptors blog spot. That lists very clearly what they all are, so I'd have a good read and see what applies to you. If for instance you have incontinence, tell them just how bad it really is. That is how you get through this. If you do it by using their terms and tell them how it (your problems and medications etc) affect your life, then you should pass the medical. You need to think like them.
That is part of the reason why I passed mine, but the other more obvious one is that I am disabled and very sick with an incurable illness, which the ATOS Dr saw and actually knew of. And my illness is rare. And do not be afraid to ask questions before the medical starts.