ESA- was placed in WRAG, this has stopped, now appealing.

Poppie68

Im very suprised your GP has not tried you with amitripyline or something similar, it helps with IBS-D which you describe and obvioulsy it also works as an antidepressant.
Maybe worth a discussion with them.

Muttleythefrog

midjet666 wrote: »

I have already filled in the form for an appeal. I am waiting for the date now. I won't be able to go to court because mainly my anxiety attacks, although the diarrhoea will be a problem (I take imodium from time to time to attend hospital appointments, but am left in agony for the next few days because of the changes to my intestines so can't use it all the time.)

I put in the appeal back in about May or June I think, I'm not quite sure but the form was filled in before the 13 months so that's definitely going through.

I rang my doctors today and I've asked about viewing my files and was told that the doctor may withhold some from me that they deem would be too distressing. I thought by law I was entitled to see everything about me?

I've also contacted the hospital where I had the operation and I have to fill in a form asking to see my notes. It'll cost between £10 -£50 to get copies!!

Oh right.. you appealed back in June... sounds like they accepted a late appeal and duly did a reconsideration at DWP which didn't change decision. Your appeal hearing is therefore just a matter of time.

So... to sum up.... because we've been around the houses a bit here to be honest. You made a late appeal of a WRAG decision back in June. You've got a representative going to the tribunal the date for which I presume you haven't yet got but I would assume it could take a few months to get one. Your only hope of getting ESA payments would be support group decision as income related ESA payments are not on the table due to your working partner.

Okay... my advice can be clarified. Don't waste your efforts away from the descriptors. Medical evidence ideally is targetted... generic records.. and certainly old records may be on little to no value. You will only win your appeal if you convince (with the help of your representative) the tribunal panel that at least one support group descriptor applies to you... it is as simple as that. My advice is try to get medical evidence directly relating to your suffering problems relevant to the descriptors in question at around the time of the decision being appealed against (as tribunal can only consider how you were at around that time).

My firm advice would be to attend if you can but you seem to have ruled that out. My other advice is make sure your representative is going to do a decent job of communicating your relevant problems. You don't say who they are.. if they are a professional in this area (appealling ESA decision) then quite frankly I don't understand why you are here for advice... and if they are not a professional in the area then you need to arm them as best you can with medical evidence and/or good information (descriptor relevant) regarding your problems.

If the appeal fails.. remain on ESA getting zero monies and look to make a case for support group at next reassessment... I wonder if indeed you are due one... you're probably past the average time for getting one but again due to your apparent lack of knowledge of the previous decision there's little point me asking what prognosis was given then which will likely determine that reassessment timing. The issue regarding the DWP error stating you attended medical when you didn't.. forget that matter.. that was a distraction... if indeed it is true then the tribunal will notice no ATOS face to face medical report exists in the evidence... I'm assuming you would have noticed in the appeal paperwork if a medical report existed for a medical that never existed.

midjet666

Ok so I'll forget about getting the hospital records, I thought it would back up the fact that I have had problems with my intestines since when I was younger, my mistake.

It does show somewhere on my doctors notes that I was diagnosed with IBS but I'm not sure how they diagnosed it as I wasn't sent for tests which I'm sure you have to be?

I haven't been put on any medication for it, I'm going to ask to be though as my pains seem to be getting worse but that may be because stress plays it up more?

I'll be going to the doctors on friday along with my Mom, she seems to be able to get things across better than me, as you can see I do get muddled up and again this is part of the side effects from my medication. My memory is like a sieve!

I haven't got a professional to go for me, how do I go about getting one? Do I ask the CAB for a representative or a benefits advisor? I don't want to have someone who's new to the process (like someone practising for the CAB) and then they mess it up.

I was assessed the one time when I was 18, and then haven't been assessed since. I'm not sure why, they just took my written word rather than face to face assessments.

I've got the paperwork that they've sent me, which will be sent to the tribunal, the date of decision was 12 June, and the reconsideration 19 September, date appeal received 19 July.

This is what they said-
"On 6/6/12 Miss____ was examined by a health care professional of the medical services in connection with the Work Capabillities Assessment.

It says on one part Miss ____ continues to be accepted as having limited capability for work and is still entitled to ESA . The decision maker has also considered limited capability for work related activity.

Miss ___ 's capability for work related activity is not limited or any limitation is such that it is reasonable to require Miss ___ to undertake such activity. "

The that worries me is that my surname is spelt a certain way, and in the paperwork it's spelt a different way which is an easy mistake to make, but I'm wondering maybe they could have seen someone with the same first name and similar surname? I'm probably clutching at straws, but it states that they have seen me, when they haven't.

Muttleythefrog

Yes.. you need to switch focus regarding medical evidence... proving medical conditions won't do any harm... but this is all about the descriptors and their applicability at around the time of the decision you're appealing against.

Their claim to have had you examined by a HCP you say is untrue. If it is untrue then that should be clear from the fact there will be no corresponding medical report in the evidence... you should have it all in the appeal bundle of paperwork. If no such report exists then forget the matter.. it can be regarded as simple some admin error with no bearing on the appeal outcome. The tribunal will look at the evidence. You need to persuade the tribunal (via your rep) that you do have limited capability for work (this is shown by meeting at least one Support group descriptor).

Should you get professional support regarding appeal... it is at a late stage now.. someone may be able to bring things together and make a written submission for the tribunal to consider... lay out your case in clear terms (which I fear you may not have done and it is impossible to tell from what is written here) and potentially look at trying to get relevant supporting medical evidence.

In the bundle of papers regarding the appeal you should have an ESA85A document... there must be some advice from ATOS in relation to you... the ESA85A is what ATOS produce when they don't create a full medical report (ESA85). If you can find that document... does it have a prognosis on it.. that may indicate timing of reassessment which could end up being useful to know. The ESA85A will also probably give the descriptor(s) that were felt to apply to you.. quite probably explaining in full the 15 points you accrued to qualify for WRAG.

But I have to be honest with you.. you may benefit from someone knowledgeable about all this to help you. It's late in the day for that with appeal hearing looming... but yes perhaps CAB or welfare rights. The reason I suggest so is because my calculation from reading the above is that you are extremely poor at focussing on what is relevant and important, and that relates to both your appeal and your communication of information. You seem unable to shift background noise and as a result we're getting a wild orchestra of music.... as evidenced above.. probably most of the advice you've got has been based on false understanding.

midjet666

I understand what you mean about false understanding. I haven't got a clue what to do to be honest. I'm not an unintelligent person but I just do not understand this at all. I haven't received an ESA85A or anything of the sort. I rang up today and asked them to provide the reason for the 15 points and they said they would send it out for me.

My main problem is when I get stressed I do focus on the small unimportant things and this relates to everyday life aswell as this matter. I know which descriptors I can fit into and I'll be visiting the doctor on friday to talk about this and give them the letter requesting my information and I'll be asking for an antispasmodic for my stomach. The main evidence is at the GPs, but for a while I haven't been to the doctors about my problems as I just can't face going there or being referred to the hospital to see a specialist.

Muttleythefrog

midjet666 wrote: »

I understand what you mean about false understanding. I haven't got a clue what to do to be honest. I'm not an unintelligent person but I just do not understand this at all. I haven't received an ESA85A or anything of the sort. I rang up today and asked them to provide the reason for the 15 points and they said they would send it out for me.

My main problem is when I get stressed I do focus on the small unimportant things and this relates to everyday life aswell as this matter. I know which descriptors I can fit into and I'll be visiting the doctor on friday to talk about this and give them the letter requesting my information and I'll be asking for an antispasmodic for my stomach. The main evidence is at the GPs, but for a while I haven't been to the doctors about my problems as I just can't face going there or being referred to the hospital to see a specialist.

I don't understand why you haven't apparently been sent the paperwork which should include everything the appeal tribunal will see as evidence... that should include forms you filled in.. the DWPs argument, the evidence they used etc etc. Asking for the ESA85A (assuming one exists) is rather meaningless in that context... you or someone supporting you... needs to see all the evidence.. all the paperwork the tribunal will see. Your rep will need to read through the pack and take it with them to the tribunal.... is it possible they were sent it instead... does someone have legal capacity to act for you? I presume not... which just leaves me frustrated and wondering to be honest. I think you need to get hold of that paperwork... but I'm not sure if the tribunals service or DWP is nest to ask for that at this stage. I'm hoping someone else can advise on that before I lose my sanity..lol. Definitely use this appointment coming... you understand if they give you a letter or document it must ideally relate to those identified descriptors... make sure also it is made clear that the information/opinion relates to how you were at the time of the decision being appealed (a tribunal may otherwise refuse to look at it as it may not be applicable regarding your health at the appropriate time). If you can get such a letter from GP then it needs to be sent to the tribunals service to admit into evidence... it could be taken on the day if necessary by your rep... but as the tribunal is probably months away I'd send it in. I'd also be tempted to send a copy to the DWP and ask them if they'd like to reconsider their decision again..lol...cheeky but it might work if it is powerful evidence.

midjet666

I'm sorry it's my error, I've just double checked and I do have the ESA85A it says they have evidence from the ESA50, Med 3, previous report and consultant letter.
It says-
"The available evidence suggests that the client has a significant level of disability due to mental health, such that they would have limitied capability for work.
Psychiatrist letter confirms significant mental function difficulties
Appears to be using pads to contain the incontinence problems.
It carries on through the other reasons saying there's no evidence (like death in 6 months etc) then it says
The available evidence does not suggest there would be substantial mental or physical risk if the client were found capable of work related activity. Then it goes onto say
They are also unlikely to experience loss of control leading to extensive evacuation of the bowel or voiding of the bladder, requiring them to clean themselves and change clothing at least weekly. Then goes on to say
The available evidence does not suggest the client has a mental disorder or a cognitive impairment, such that they could not cope with any change to the extent that day to day life cannot be managed.

I feel that this is conflicting as the psychiatrist letter confirms significant mental function difficulties, but then they say there wouldn't be substantial mental risk etc and that the evidence doesn't suggest I wouldn't be able to cope day to day.

Do you agree? I've copied it word for word what has been said, maybe it's just me?

Muttleythefrog

Ah okay. So it sounds like in providing advice in the ESA85A (which the DWP probably relied on to make their decision) they used your ESA50 completed form.. sicknote from doctor... previous report (although which one will probably be a mystery best left unsolved) and a letter from your consultant.

They recommend you have limited capability for work (i.e. be found eligible for WRAG).. but from what you quote they don't actually state why...i.e. they don't declare the descriptor(s)? And what about prognosis is there anything like 'a return to work could be considered in x months'? These are important bits if they are there.

The psychiartist letter... which obviously I can't see and probably you should keep that way... you are getting distracted yet again. The descriptors are the only thing that matters... if your psychiatrist says you have significant mental function difficulties (and I suspect they do not use these words!) then this doesn't actually mean much at all. The ESA85A goes through things they considered could apply to you but they didn't find so... but for reason unknown either it fails to state what descriptor(s) were found to apply or you have failed to relay that information above (or I'm not reading properly).

Do I agree... I'm in no position to agree or disagree... but you ask regarding whether you would be at substantial risk... presumably your psychiatrist letter does not give information to confirm you do in such a way as to be persuasive with specific regard to the descriptor in question (probably that you pose substantial risk to your or someone else if found capable of work related activity). Your job is to convince a tribunal that they (the DWP) are wrong with respect to the descriptors you feel do apply to you. In considering whether they do apply to you and in getting evidence then you should reflect on precisely what the ESA85A does say... and in particular be careful regarding the continence descriptor... ATOS felt that your use of aids meant you did not qualify for the descriptor it would appear.

If you want to explore how the descriptors are applied.. how they test whether they apply or not.. then refer the WCA manual. This is the bible if you like on the WCA. http://www.dwp.gov.uk/docs/wca-handbook.pdf

nannytone_2

why arent you claiming income basrd ESA? do you have a partner that you live with?

Muttleythefrog

nannytone wrote: »

why arent you claiming income basrd ESA? do you have a partner that you live with?

She has a partner working full time... I'd assumed differently from the initial post.