ESA and Fit Note Problem

SJI85

Hi everyone,

I've recently began a claim for ESA.

I needed a fit note to cover me from the 8th of April. Unfortunately I wasn't able to get one until the 25th. During this time period I was depressed, finding it hard to motivate myself, abusing painkillers and the GP surgery was busy anyway. My GP refused to provide me with a note covering the previous two weeks as they hadn't seen me during this time. I was given a note to cover me for the four weeks after the 25th.

I accepted this and assumed I'd just miss out on those two weeks payment. However, despite having received a fit note from the 25th April, the DWP have suspended all payments until I get the missing medical evidence.

I feel this is unfair considering I have a well documented chronic medical conditions/disabilities (epilepsy, bipolar disorder, dyspraxia), and when I had attended my GP two months ago I did ask for a referral to local mental health services. It's the nature of the condition that motivation, getting things done, and leaving the house can be a problem.

Have anyone got any advice? Is it possible to still get my payments from the 25th, despite missing the previous fit note?

Thanks for reading.

DomRavioli

ESA is based on fitting a descriptor, not on diagnosis.

It is your responsibility to get a letter or MED3 to cover yourself for the period you want to claim. If you cannot get one, then you will have to contact ESA to advise them of this; they may close your claim down completely.

SJI85

DomRavioli wrote: »

ESA is based on fitting a descriptor, not on diagnosis.

Don't know what you mean by this.

The point I made about my diagnosis was not directed at ESA, which I understand is based on fitting a descriptor, but at my GP. Namely my GP refusing to backdate the sick note a week or two, despite knowing that I have chronic medical conditions. The illness isn't exactly new and I had been in recently to discuss a referral to local mental health services.

It is your responsibility to get a letter or MED3 to cover yourself for the period you want to claim. If you cannot get one, then you will have to contact ESA to advise them of this; they may close your claim

Yes, and I have informed them that I'm unable to provide the missing medical evidence. Though it still seems payments are suspended. I hoped they'd still pay ESA from the 25th of April (the date of the sick note)

northerntwo1

Your GP can't assess if you were fit for work if you didn't see them to present symptoms (although I've had months of sick notes and never even see my GP who just issues them). But if that's their opinion then it's what it is.

From the date you have a sick note I really can't understand why it's not going through as normal.

DomRavioli

SJI85 wrote: »

The point I made about my diagnosis was not directed at ESA, which I understand is based on fitting a descriptor, but at my GP. Namely my GP refusing to backdate the sick note a week or two, despite knowing that I have chronic medical conditions. The illness isn't exactly new and I had been in recently to discuss a referral to local mental health services. If your GP was unaware that you were ill, they aren't going to give you a sick note. It really is that simple, doesn't matter if it is chronic, life long, or whatever, if you don't tell them you're sick, they don't know you're sick. Most GP's deal with thousands of patients, and you're just a number on the EMIS system.



Yes, and I have informed them that I'm unable to provide the missing medical evidence. Though it still seems payments are suspended. I hoped they'd still pay ESA from the 25th of April (the date of the sick note)

Hi OP,

They will stay suspended until you either provide evidence or they make a decision on whether to accept it. You claimed before the 25th April, so they have to do their bit now; might be best off calling them directly for more advice as the only way I can see this progressing is either them changing your date, or getting proof of sickness. Either call your GP surgery for advice on how to get proof of illness for the dates you are missing, or call the ESA team and get some advice from them, as at the moment you are refusing to provide evidence (that is how they will see it, regardless of the situation) of illness by a clinician.

SJI85

northerntwo1 wrote: »

Your GP can't assess if you were fit for work if you didn't see them to present symptoms (although I've had months of sick notes and never even see my GP who just issues them). But if that's their opinion then it's what it is..

I believe (and correct me if I'm wrong) a GP can backdate a sick note if they feel it's medically justified, even if they didn't see the patient in time period. Obviously the GP I saw that day (first time I've seen her, and I'm still relatively new at the surgery) didn't feel it is. In fact, she was quite critical of my situation and believed I was "over-medicalising" things and assumed I was asking for medication which I'm not. But this was an unfair judgement. My current relapse is partly, though certainly not entirely, down to my complicated and unusual living situation. There are other issues, namely possible Asperger's which I've been waiting years for a proper assessment, and just general lack of support.

DomRavioli wrote: »

Hi OP,

They will stay suspended until you either provide evidence or they make a decision on whether to accept it. You claimed before the 25th April, so they have to do their bit now; might be best off calling them directly for more advice as the only way I can see this progressing is either them changing your date, or getting proof of sickness. Either call your GP surgery for advice on how to get proof of illness for the dates you are missing, or call the ESA team and get some advice from them, as at the moment you are refusing to provide evidence (that is how they will see it, regardless of the situation) of illness by a clinician.

Thanks. I have an appointment with a different GP tomorrow so was going to ask then. If they still can't provide the medical evidence I'll contact ESA again once I get home.

DomRavioli

SJI85 wrote: »

I believe (and correct me if I'm wrong) a GP can backdate a sick note if they feel it's medically justified, even if they didn't see the patient in time period. Obviously the GP I saw that day (first time I've seen her, and I'm still relatively new at the surgery) didn't feel it is. In fact, she was quite critical of my situation and believed I was "over-medicalising" things and assumed I was asking for medication which I'm not. But this was an unfair judgement. My current relapse is partly, though certainly not entirely, down to my complicated and unusual living situation. There are other issues, namely possible Asperger's which I've been waiting years for a proper assessment, and just general lack of support. If they felt it was justified, you would have had it backdated - hence my original comments. I wouldn't go in with that attitude to your GP, it will get you nowhere. You haven't been diagnosed with "aspergers" so it isn't relevant at all; from your OP you have mental health issues, so perhaps concentrate on getting yourself stable before thinking you have more issues?



Thanks. I have an appointment with a different GP tomorrow so was going to ask then. If they still can't provide the medical evidence I'll contact ESA again once I get home. I suggest you ring them now to inform that you are going to the GP surgery tomorrow, as if there is little or no contact they may close your claim.

Hi OP,

Don't hold out too much hope with a different GP; I don't want to sound condescending, but unless you have a really good reason, they usually won't do it. Could you not have got a telephone consultation or a home visit when you were ill and unable to attend the surgery? Do you have a CPN or social worker?

SJI85

DomRavioli wrote: »

Hi OP,

Don't hold out too much hope with a different GP; I don't want to sound condescending, but unless you have a really good reason, they usually won't do it.

I don't. It's just worth asking before contacting ESA again, that's all. The primary reason for attending the appointment is to chase up my referral (again), get a prescription and get a new fit note.

Could you not have got a telephone consultation or a home visit when you were ill and unable to attend the surgery?

Not sure if they'd have agreed to be honest.

It's not just the depression, apathy and anxiety. It's also a general malaise and difficulty organising myself and getting things done. Ultimately I only blame myself, I just naively thought they'd still pay me from the 25th.

Do you have a CPN or social worker?

No and no. When I say I have no support, I really mean it

Firstly, I admit that even if I even have bipolar (I have been diagnosed with bipolar II, but personally I think of it more as an unspecified mood disorder) it is at the mild end of the spectrum. It's just that because of dyspraxia/possible Asperger's, and an assault I experienced in when 16, things are complex.

I haven't accessed any NHS mental health services since 2009, and most of what I did experience before 2009 was very poor indeed (misdiagnosis, only seeing inexperienced staff-grade Psychiatrists who would refuse to refer me to CBT despite the recommendation of a private neuropsychologist, and even despite the fact their own boss, a consultant, previously tried to refer me). When returning to university a lot of support I received was from university (plus academic support through DSA) rather than NHS. But that was OK, as it got me through and meant I eventually finished my degree. Then the first year after graduating things were going relatively well and I was living with my parents. It's only been this last eight months or so that things have gone downhill, and I'm not already in the care of LMHS. So I'm still waiting on the referral, which I requested in January but still don't have a first appt despite the GP chasing it up again four weeks ago.

Because this is another concern - that I can't provide any real medical evidence for my ESA claim.

So no, I don't have a CPN or Social Worker and never have.

DomRavioli

Hi again OP,

They would have done you at least a telephone consultation - if you're unable to get to the surgery, they will do a home visit (most practices anyway), and if they can't they usually do a phone consultation.

Might be worth asking your GP for a referral to the CMHT (community mental health team) - that seems to open a few doors for people, or you may wish to talk to your local MIND branch if you have one; my local MIND has free CBT with around a 6 week referral time.

You can also go direct to IAPT (Improving access to psychological therapies) and ask for CBT, you'd need to get the number from your GP surgery, or get your GP to refer you.

You don't have to go through it alone, and I do hope the GP you see tomorrow makes life a little easier for you

I've also been in your shoes, and you do get through it. I was misdiagnosed in 2004, noone (not even my GP knew) knew of the diagnosis till 2010 - and just this year I've had it removed from my record, as I don't have it.

It can be very hard to make sense of a hellish system, but once you are in, there are pathways. If you get stuck, PALS may help with treatment options.

tomtontom

The rules on this have changed - it is not possible to provide a backdated fit note where no consultation has occurred during that period. A consultation can be by phone or with another medical professional. If this has not happened the most the GP can do is write comments on the fit note to the effect that they believe you were unfit for work during the relevant period, and this is usually sufficient for benefit purposes.

northerntwo1's case differs from that of the OP because they see another clinician during the relevant period.