ESA Issues

CuriouslyGeorge182

Hi all, I applied for ESA in November 2013 due to widespread pain, chronic fatigue, chronic asthma, irritable bowel syndrome, GERD, unilateral migraines, hiatus hernia and other issues.!

I filled out a very thorough ESA50 using Fightbacks notes and sent additional evidence.!

I also quoted regs 29 and 35 in my ESA50 and requested a home visit and for it to be recorded.!

Since then I've been referred to Physiotherapists, Rheumatologist and a Respiratory Consultant. Also, since then, I've been diagnosed with Fibromyalgia and COPD.!

As I hadn't heard anything for months, I contacted my MP at the beginning of August who contacted the DWP. The DWP fobbed me off as they said if I had additional medical evidence to send it to ATOS.!

I made a complaint to ATOS and a Customer Relations manager emailed me and since then I've sent them letters from Gastroentorologists, a Neurologist, my Respiratory Consultant and my Rheumatologist. Also my Respiratory Consultant done me a supporting stating I have very limited ability to do physical work and perform physical tasks, this was also emailed to ATOS.

Also I was told they recently contacted my GP so I contacted my practice and was told by the practice manager that they had sent back a ESA113 and it was sent back on time, however a GP who I've never seen about my medical problems filled it in, I've informed the DWP and ATOS about this and made an official complaint to the practice manager.!

I got a glimpse of the ESA113 when seeing my Asthma Nurse recently but only saw one part of it. It stated I have COPD, Asthma and Fibromyalgia although missed out IBS, cognitive problems, Chronic Fatigue, tingling, pins and needles, twitching, migraines and swallowing issues, hiatus hernia and GERD.!

However, I've sent ATOS proof of all the above problems and conditions from consultants to show I do suffer from all those symptoms and conditions so I hope they don't ignore the things missing on the ESA113.

The ESA113 was sent back a few weeks ago, been emailing some more evidence and received another fob off letter saying I'm not a priority as I'm getting assessment rate benefits, that's a joke when I've been waiting for 10 months.!

I'm still waiting so I contacted my MP again this week who has emailed ATOS and he said waiting 10 months to see if I need an assessment is a very long time.!

Is the ESA113 always requested? I'm baffled as to why it took them 9 months to request one?!

I'd like some opinions on all of this.!

Thank you for reading.

TELLIT01

Basically ATOS is in a complete mess and their main interest is getting to the end of the contract. Long, long waits for assessment are unfortunately the norm.

rogerblack

Several issues.
First - you are not registered with a GP, but a surgery. Any GP at that practice can fill in the form.

richard9991

Another thing is doesn't really matter which GP does the report because they will be doing it from your medical records on their computer so will see what every GP including hospital consultants have said

CuriouslyGeorge182

Thanks for the info, much appreciated. However my issue is despite it being done from medical records, information is missing.

Also on one part of the ESA113, it asks about sitting, standing, walking, reaching and other issues, how is a GP that i've never seen before supposed to answer correctly because if he states I'm ok to do all those things then he isn't being accurate and if it affected my assessment then I'd lodge an appeal and that form would be one of my grounds for doing so.

I had to make an official complaint to the practice manager because of this, although i've emailed consultants letters to cover myself just incase ATOS try saying i haven't got this or that because it's not listed on the form.

lakes17

I got a glimpse of the ESA113 when seeing my Asthma Nurse recently but only saw one part of it. It stated I have COPD, Asthma and Fibromyalgia although missed out IBS, cognitive problems, Chronic Fatigue, tingling, pins and needles, twitching, migraines and swallowing issues, hiatus hernia and GERD.!


As you only caught a glimpse of the ESA113 and only saw 1 part of it - is it not possible that the conditions you think were missing were actually there?


Also as other posters have already stated it is irrelevant which GP writes the report. If you feel that certain aspects have been missed out then that is because they don't appear on your medical records. And this would still apply if the GP who you had seen wrote the report.

CuriouslyGeorge182

lakes17 wrote: »

I got a glimpse of the ESA113 when seeing my Asthma Nurse recently but only saw one part of it. It stated I have COPD, Asthma and Fibromyalgia although missed out IBS, cognitive problems, Chronic Fatigue, tingling, pins and needles, twitching, migraines and swallowing issues, hiatus hernia and GERD.!


As you only caught a glimpse of the ESA113 and only saw 1 part of it - is it not possible that the conditions you think were missing were actually there?


Also as other posters have already stated it is irrelevant which GP writes the report. If you feel that certain aspects have been missed out then that is because they don't appear on your medical records. And this would still apply if the GP who you had seen wrote the report.

Hi, I've seen the first part of the form where it states about my conditions and quite a few things are missing.

Also, the information should be on the medical records because all the consultants letters are sent to the GP, if there are things missing then that's the fault of the surgery. It needs to be corrected though. I plan to change surgery within the next few weeks because if seems to be one mistake after another over the last few months with medications, prescriptions etc so I think it's for the best.

Hopefully sending consultants letters overrides some of the ESA113 as they can't deny things that i've been diagnosed with by consultants.

lakes17

I hope everything goes well for you and you get everything sorted speedily to your satisfaction

epitome

Hello George

I'm sorry to say that I don't see that you have any serious problem here.

ATOS is snowed under and you might be waiting until February 2015 for your assessment and considering ATOS is losing the contract soon (October 2014?), you might be waiting a whole lot longer than that if the DWP can't get the chageover to the new contract provider to run smoothly... we don't even know who the new providor will be yet.

You are being paid assessment rate and that does mean you are not a priority, the cases who are a priority are those who are waiting without any ESA payments at all £0.00 a week - imagine that, the law says they have to wait without payment and that is exactly what they do for up to 6 months or more without any payment.


Your ESA113 may be incomplete but you have sent all the evidence of your other conditions. - good, your whole approach to this assessment has been brilliant you are taking all the positive steps that you need to in order to get a positive outcome or an easier appeal should the worst come to the worst.

After your ATOS report is finished and sent to the DWP you can ask the DWP for a copy of your whole ESA55 bundle.
The ESA55 bundle contains:
your ESA50
all your submitted medical evidence that ATOS used in their decision
your Doctors letter/ESA113
And the ATOS report (ESA80)

If you don't like the DWP decision you can ask for a
Verbal explanation
and Written Statement of Reasons

and you can write a letter requesting a Mandatory Reconsideration stating where you think ATOS and the DWP got it wrong.

In short, you will have to wait until you have your face to face assessment before you can make any more progress on this (and if ATOS is going to pass you you may not get an assessment), and then you will have to wait for a DWP decision.

You could phone and ask ATOS now "Is my case past pre-board check yet?"

"Pre board check" is when they decide whether or not they want to see you face to face or not. Basically, if you need to be seen face to face you will have a longer wait.

Luckily your second MPs letter was to the right department - ATOS, your waiting has nothing to do with the DWP.

CuriouslyGeorge182

Thanks for your message Epitome.

Received an email today from ATOS saying:-

"I can confirm that a Health Care Professional (HCP) reviewed the available evidence and advice was provided to the Department for Work and Pensions (DWP) on 19th September 2014 that you meet the criteria for the Support Group for Employment and Support Allowance (ESA). Your file is in the process of being returned to the DWP and you will not be required to attend a Work Capability Assessment at this time.

Atos Healthcare is contracted to provide independent medical advice to the DWP. However, the DWP may choose to accept or reject this advice. Ultimately, the decision on benefit entitlement and whether or not a customer is entitled to benefit and is placed in a group rests with the Decision Maker at the DWP. The DWP will contact you in due course."

epitome

Right, give it 2 weeks then phone DWP for confirmation the notes say
"ESA55 received passed to DM"

When you phone, you want to ask them if they see that note, if after 2 weeks that note is not there, then you need a callback from BC to confirm they are working on the ESA55.

If the note is there, then give them at least 6 weeks from the date the note was entered before becoming impatient with them.