Need help from any medical /legal experts regarding ESA fraud

NeilCr

steveactual wrote: »

Ok thanks, I will definitely contact my MP and see what he says. As for the MR decision, does anyone know where I would specifically send this? Do I just send it to the standard ESA address or would their be a department within the ESA that it should go to?

Google is your friend

https://www.gov.uk/government/organisations/department-for-work-pensions/about/complaints-procedure

nannytone_2

steveactual wrote: »

It does sound like your condition was a lot worse than mine and it is admirable that you worked full time! I personally don't think you should have been expected to work with that limiting condition but that's a different debate I guess!


However, my understanding of the ESA criteria and the 15 point requirement is that I would have easily qualified under the mobility section.


Either way, regardless of whether I am fit for work or not, the HCP is required to judge it based on facts and not fraudulent claims about my condition.

you do realise that if you can physically move a manual wheelchair ( regardless of whether you do or not) this would lose you points from the mobilising section?

sangie595

steveactual wrote: »

I've actually made a claim for PIP a few days ago, so I will see how that goes. I imagine they wont want to give me very much but as my condition is quite limiting, I should be entitled to something.


As for the hip replacement, it is definitely an option in the long term.


I need to pursue this first though because as I've said, regardless of my capability for work, they should not be able to get away with fraud.

I think that you may have missed an essential point here. It isn't regardless of your capability for work. Even if you were to be able to show that the report was incorrect, that doesn't mean you will get the benefit. Your consultant doesn't choose who is fit to work and who isn't. It isn't their decision. I very much doubt that some osteoarthritis that leaves you fit enough to use public transport is going to be assessed as "incapable of work". Assuming that you have to depend on NHS waiting lists, it could take several months to get to surgery if you started today. During which time it is entirely possible that you will be deemed fit for work and end up having to deal with benefits as such. Far better to stay to address your medical position as well- not least because you will presumably wish to get back to work and off benefits anyway.

sangie595

nannytone wrote: »

you do realise that if you can physically move a manual wheelchair ( regardless of whether you do or not) this would lose you points from the mobilising section?

I don't think the OP is in a wheelchair. They talked about catching the bus, and I can't see any reference to wheelchairs, although I may have missed it. I know that technically buses can take wheelchairs, but it isn't that easy in practice. Not around here anyway.

Tolly_T

I think that's the point that nannytone was making - the actual use of a wheelchair isn't important. ESA considers a claimants ability to use a wheelchair even if they don't use one. If the assessor decides they would be able to use a manual wheelchair, so no problems with their arms that would prevent the claimant propelling it, or heart or lung problems that would make it impossible etc. then points will be lost on the mobilising section.

nannytone_2

sangie595 wrote: »

I don't think the OP is in a wheelchair. They talked about catching the bus, and I can't see any reference to wheelchairs, although I may have missed it. I know that technically buses can take wheelchairs, but it isn't that easy in practice. Not around here anyway.

when it comes to mobilising, the ESA assessment will consider IF you would be able to use a manual wheelchair.

unless there are breathing or upper limb issues it is quite possible that they would consider the OP capable of mobilising using a manual wheelchair.

it is irrelevant whether they actually use one or not.

that is why i mentioned a whelchair

FBaby

The consultant informed me that it was unlikely at this age that I'd be given a hip replacement but agreed that I shouldn't have to look for work with this limiting condition so I went onto ESA a year ago.

The irony is that if your consultant said this exactly like that, it is them you should be suing for age discrimination!

But my gut feeling is that it's not what he said at all, more likely that you condition is not serious enough to warrant the surgery yet, and this would be the same reason why the outcome of your assessment is that they believe you are fit for work.

If I'm wrong though and your consultant is refusing to do surgery on you purely because of your age, then shift your energy to challenge him.

steveactual

I think we are getting off topic here ... the point of this thread isn't to debate my suitability for work. Some of the replies seemed more concerned with the criteria for awarding ESA and not the fact that a HCP has committed fraud. I will repeat this again; his medical report has claimed things that are medically impossible given my condition. The actual decision itself, regardless of whether it was right or wrong, was taken based on a fraudulent report. Therefore at the very least, this fraudulent report should be declared invalid and the WCA done again. I was entitled to a fair WCA and a decision should have been made on my actual condition and not the lies told by the HCP.

steveactual

Also, as some seem more concerned with debating my suitability for ESA rather than fraud at high level, here is what I understand to be the mobility criteria for ESA;


(ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion.
6 Points

(b) Cannot, for the majority of the time, remain at a work station, either:
(i) standing unassisted by another person (even if free to move around); or (ii) sitting (even in an adjustable chair) for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion.
9 Points

I can mobilise about 150 metres before the pain and discomfort becomes too much. 6 points.


I cannot sit in any sort of chair (that would include a wheelchair) for more than around 15 minutes without severe discomfort. For perspective, I spend ALL of my seated time at home in a horizontal position either on the sofa or bed. Anytime I am forced to sit in a chair for an extended time such as 20 or 30 minutes, I will not even be able to walk properly once I stand up. 9 Points.


At the assessment, the HCP claimed he saw me sat 'in a hardback chair for 30 minutes'. This is wildly untrue. He saw me sat for approx.15 minutes and my Oyster card history is proof that the assessment didn't even last 30 minutes!. Another lie he made up.

nannytone_2

steveactual wrote: »

Also, as some seem more concerned with debating my suitability for ESA rather than fraud at high level, here is what I understand to be the mobility criteria for ESA;


(ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion.
6 Points

(b) Cannot, for the majority of the time, remain at a work station, either:
(i) standing unassisted by another person (even if free to move around); or (ii) sitting (even in an adjustable chair) for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion.
9 Points

I can mobilise about 150 metres before the pain and discomfort becomes too much. 6 points.


I cannot sit in any sort of chair (that would include a wheelchair) for more than around 15 minutes without severe discomfort. For perspective, I spend ALL of my seated time at home in a horizontal position either on the sofa or bed. Anytime I am forced to sit in a chair for an extended time such as 20 or 30 minutes, I will not even be able to walk properly once I stand up. 9 Points.

' fraud at a high level' ? you really need to get a grip and is a bit of perspective here.

yes, it does seem that you have had poor service regarding the ESA assessment, but calling it fraud is more than a little ridiculous.
you have every right to, and should complain, but to talk of legal action is just plain silly.

you are not inderstandin what 'repeatedly mobilise' means.
it isn't just about walking. they will look at your ability to use a manual wheelchair and if your only health issue is 1 bad hip then they would probably deem you able to mobilise using a manual wheelchair and so you would gain NO points for this section