ESA refusal Blah!!

mazza111

As many of you know, my dd has been going through the process, but for those of you who don't know but can offer some advice, I'll go through it as briefly as possible.

DD started claiming ESA in around July last year. Was signed off with depression and mobile knees. Filled out ESA50 as required. Sent it off and heard nothing

Sent for medical, in August, didn't receive the appointment through.

Resent appointment for September. Attended ATOS medical and received 0 points. Heard this on Nov 1st.

October 31st had a bad break to her ankle. Was borderline for surgery but because of her HMS/EDS. They didn't want to operate as people with HMS take longer to heal. So spent 5.5 months in cast. First 2 months non weight bearing.

Appealed the decision and due to the leg break, asked their advice, said to go to appeal.

Received medical report that was full of lies and inaccuracies. They didn't even examine her knees or ankles. And only looked at her MH problems.

During this time we found a lot of mail in the street belonging to her, so asked DWP to send all mail to my postal address. Postie not doing job properly, complaints have gone to RM. And since this time her condition has deteriorated dramatically. To the state where she's working mega hard with her physio to keep herself out a wheelchair. Is needing surgery on both legs. Wears braces on her knees, wrists, has insoles for her shoes and is only allowed to wear high top trainers. She's waiting for wrist splints to be made with thumb supports. She really needs something for her shoulder too, but because of her psoriasis.... They make her sweaty and psoriasis worse, so ortho reluctant to go there.

Since this time she's been awarded HRM and LRC elements of DLA.

We went to tribunal about 3 months ago. It was adjourned waiting for more medical evidence.

DD received a letter in at her own address tonight at around 5pm, stating that as she didn't turn up for tribunal a decision had been made in her absence and they stuck with the 0 points. No letter had been received at her her or my address :wall: Although I've not had any other letters go missing, I can only assume that as she received this one at her address, the other one went to that address too and went astray.


Anyhoo, advice of where we go from here please. I know we could start another claim immediately because of worsening/different condition. But would she get any money in this time? Mutttttttttttttttley or Roger, advice pleaaaaaaaaaaaaase!!! I'm ready to get on the blower tomorrow on her behalf, but I'm struggling as to what's best way to approach it.

[Deleted User]

seems to be a catalogue of errors,i`d be tempted at this point to get her MP involved

atrixblue.-MFR-.

its past the 6 month in wich to re claim anyway, they can only look at claims at time of claim everything alse can and will be ignored.

so with the new developments in condition i would reclaim this would make the case stronger.

i know its alot of hassle in wich you have to rego through and possibly another medical.

use a new claim to include an abundance of medical evidence inc reports, dignosis, prognosis, treatments, im sure physio would be happy to help on a factual report perhaps take along a copy of the WCA handbook, for them to read through and see what descriptors she meets, and then make a report based on descriptors and also must state they have read and understand the ESA descriptors and know the criteria.

i would also involve your MP to see if he can monitor this new claim aswell but aslo detail the catalog of errors the have made, much i must say is down to RM wich the DWP cant be held responsable. so no way of going to higher tier tribunal because of error in law because you attended the first and a report was sent for request that report and other documents from the DWP, read through it its probably a GP i dont know what to put in this report as she isnt under my care for her ailments response.

you would need that report that the tribunal sent for, and read it then anything you wish to descuse with the GP i would do so-so you iron the kinks in the process.

now theres DLA in place, she has something to go on with the reports from that can be used with ESA, a tribunal notice of what was awarded and why (if DLA tribunal).

keep a diary from now till you make a new claim time how long things take to do in everyday life, the things she can do the things need helkp with and things she cant do then with the WCA handbook fill in the form.

mazza111

I understand your point about them not being responsible for RM's errors, but would it have gone missing if it was sent to my address as requested? Sorry, really peed off at this former colleague of mine, he's the laziest 4rs3 I've ever had the pleasure of working with. And I don't normally say this about posties as I believe the majority of them are really hard working. Everything else of her's has been coming to my address for about a year now without problem.

The 3 letters she should have received. One's gone missing and 2 have been posted thru letterbox by neighbours after being miss delivered. Don't get me wrong, any postie can do that.. but... it's just getting beyond a joke now. Sorry I'm ranting about them now.

Keep suggestions coming. I intend to go get her ready tomorrow morning and get her up to call them. Or I'll get the ok from her to speak to them, cos she gets all flustered talking to them.

Thnx guys sorry to rant. Just rather annoyed about the whole shennanigans. We've always said we'd have welcomed a fresh medical anyway btw, because of her worsening condition.

epitome

Did you also inform tribunal of change of postal address? Because they would not have known otherwise. Sounds like you didn't, because they sent the result letter to her address. The relationship between you and tribunal has nothing to do with ESA, so you have to keep tribunal informed of any changes aswell.

STEP 1 Phone tribunal (not ESA) to see if you can get a "set aside".

If yes, ESA will continue to pay on appeal until it is heard again. But you must act fast to get a "set aside letter" from tribunal....which you then forward on to ESA.... so as to not get a break in payments, but they would backdate to cover any break.

If not, appeal the appeal, and make a new claim starting from the day after the tribunal.

The tribunal will consider her condition as it was in Sept 11 any broken ankles since then will not be considered.

A new claim will pay her as it has been more than 6 months since Sept/Nov 2011.

mazza111

Thanks Epitome. Yes I did inform the tribunal service too and the first couple of letters came to my address. The refusal letter went to her address though. So think it's probably just a note that's on her papers as a separate postal address. Which has either been ignored or not been added properly, I don't know. I thought it strange that some letters come here and some go to her address. It's the same with hospital appointments. Some of them come here, some of them go there. Despite us telling them of the problems.

benefitbaby

You have one month to challenge the tribunal decision by trying to get it set-aside as epitome said or by requesting a statment of reasons to see if the tribunal panel made an error in law. I urge you to seek advice and good luck.

atrixblue.-MFR-.

to get a set aside, there would have to be good reason, postal confusion, is not a good enough reason, by setting aside you would be asking a higher tier tribunal to considder there has been errors in law by the judgement (making a decision without you is not error in law).

i would see this as a test case you know what to expect and things will be less stressfull this time round if another claim is made if it gets to that stage.

yes there will be a break in ESA whilst the new claim is processed and the last shut down but assessment rate will be back up and running again within a few weeks, inform housing benefit etc that they will be notified about the ESA stopping and tell them a new claim is being made and can the continue HB CTB on a nill income basis untill its processed so no arears with rent.

skintmacflint

mazza111 wrote: »

We went to tribunal about 3 months ago. It was adjourned waiting for more medical evidence.

Should you not have also received a copy of the additional medical evidence when it was sent back to them, , so when the readjourned Tribunal took place you'd also have the prior knowledge of it?

mazza111

skintmacflint wrote: »

Should you not have also received a copy of the additional medical evidence when it was sent back to them, , so when the readjourned Tribunal took place you'd also have the prior knowledge of it?

You know I didn't even think of that, but no we received no medical evidence either.

TBH I don't know whether to go ahead with the appeal or not or make a fresh claim due to the changing/worsening condition. As the letter was posted through her letterbox on Sunday evening, I've been a bit stuck in all honesty. I'll get on the blower today to the WRO and see where we go from here. Just want it sorted for the sake of the dd. Being under 25 she's been surviving on £56/week since taking ill. Recently been awarded dla so that's boosting it a bit, but it's being used for living expenses instead of care and mobility needs.

I'll update when I know more.

I just think rather than fight them constantly a fresh claim would probably put her in the right group, but then what's probable in my eyes isn't always the same with ATOS.

Muttleythefrog

Yeah.. some good advice above. May be able to argue error in law.. in procedural sense... to try to get the tribunal set aside and therefore a new one ordered. But that won't likely be a swift process and probably requires some decent legal expertise in this area... and it could all come to nothing. It's over 6 months since decision... and as you say her health has changed too... I'd be tempted to chalk up to experience and make new application. Opportunity then to get new medical evidence if necessary and potentially use the DLA award circumstances to her benefit.