Need help from any medical /legal experts regarding ESA fraud

sangie595

steveactual wrote: »

I appreciate your response but you need to understand that this isn't a case of me making wild accusations. He examined a hip joint that is fused together with no cartilage, a joint that cannot even bend slightly, and then went and wrote in his report that it can 'bend fully'. He even tried to claim the joints flexion is the same as the right, which is ridiculously untrue. There can be no excuse or that level of incompetence.

I think the point people are trying to make is that nobody is going to charge this person with fraud, no matter what you say. So devoting your energy to attempting to punish this person for what you believe they did is a waste of time because they are not going to be punished. If you insist that you are unfit for work of any kind then your focus is better spent on getting the decision reviewed, not on punishing the person who did the original assessment. Ranting about fraud and criminal intent simply makes you sound insane. Which does not help your case.

steveactual

sangie595 wrote: »

I think the point people are trying to make is that nobody is going to charge this person with fraud, no matter what you say. So devoting your energy to attempting to punish this person for what you believe they did is a waste of time because they are not going to be punished. If you insist that you are unfit for work of any kind then your focus is better spent on getting the decision reviewed, not on punishing the person who did the original assessment. Ranting about fraud and criminal intent simply makes you sound insane. Which does not help your case.

Even if nothing comes of a fraud case, I have a strong case to take to the NMC because he provably lied about a claimants condition. You might find that acceptable but I do not, and I suspect you would have a different perspective if it was you.

dippy3103

steveactual wrote: »

Yes but that's a very basic description of fraud. If you look at the Fraud Act 2006, we can see there are two important subsections;


Section 2, Fraud by Misrepresentation


Section 4 Fraud by Abuse of Position


You might see all this as an overreaction but I suspect that thinking is why they get away with this and they can continue their cowboy operation.

There would need to be a criminal investigation- who do you envisage will do that? What are you saying they misrepresents?

steveactual

dippy3103 wrote: »

There would need to be a criminal investigation- who do you envisage will do that? What are you saying they misrepresents?

I don't claim to be an expert on fraud law, that was just what I was looking into. This is why my OP asked for anyone with legal experience to tell me what the legalities are when a medical professional is found to have made incorrect and damaging claims about an individual.


When people lie to get benefits, they get in trouble ... why doesn't it work the other way around?

LKRDN_Morgan

steveactual wrote: »

Even if nothing comes of a fraud case, I have a strong case to take to the NMC because he provably lied about a claimants condition. You might find that acceptable but I do not, and I suspect you would have a different perspective if it was you.

The HCP will have a union behind them. What will you have?

I understand you're angry but surely this is a case of pick your battles? Of course make a complaint direct to whoever employs the nurse (which is what you're supposed to do in the first instance) but talking about getting the NMC involved already is crazy.
If after an internal investigation concerns are raised surrounding the nurses ability to practice the employer is duty bound to refer on to the NMC. But you going direct to them will come across as nothing more than an angry patient with an axe to grind.

You think you're going to be the first person upset by a HCPs decision?

steveactual

LKRDN_Morgan wrote: »

The HCP will have a union behind them. What will you have?

I understand you're angry but surely this is a case of pick your battles? Of course make a complaint direct to whoever employs the nurse (which is what you're supposed to do in the first instance) but talking about getting the NMC involved already is crazy.
If after an internal investigation concerns are raised surrounding the nurses ability to practice the employer is duty bound to refer on to the NMC. But you going direct to them will come across as nothing more than an angry patient with an axe to grind.

You think you're going to be the first person upset by a HCPs decision?

So nurses can get away with knowingly providing factually wrong medical evidence because they have a union behind them to protect them? The problem here is I think many replying to this post just think I am angry about the decision and looking for someone to blame when the reality is that I would have considered reporting him even if they reversed the decision and awarded me ESA because he knowingly provided false information about my condition and ethically he shouldn't be allowed to do that. He did this to me so its reasonable to assume he has done this to other people, many much more vulnerable than myself. Its abhorrent.


More people need to make a stand against this sort of nonsense or things will never change.

dippy3103

steveactual wrote: »

I don't claim to be an expert on fraud law, that was just what I was looking into. This is why my OP asked for anyone with legal experience to tell me what the legalities are when a medical professional is found to have made incorrect and damaging claims about an individual.


When people lie to get benefits, they get in trouble ... why doesn't it work the other way around?

It could be done in theory.. but I think proving intent will be tricky. Plus did they believe they were honest on the form?

steveactual

dippy3103 wrote: »

It could be done in theory.. but I think proving intent will be tricky. Plus did they believe they were honest on the form?

I fully agree that it is difficult to prove some sort of intent but I don't see how he could claim to be honest. If any doctor or nurse examined my leg, they would instantly be able to say that it is unable to bend even slightly and I certainly could not squat to floor level. I don't know how he could argue otherwise when what he has claimed is physically impossible. Anyone with no medical knowledge could take one look and tell you that the left leg and right leg have very different functionality.


I am going to the doctors next week and will take the report to get a feel for what he thinks about what the HCP has written. This doctor has access to my MRI, documents from the Orthopaedic Consultant etc so he'll be in a good position to judge the contents of the report.

micky2phones

Hi, imo i think fraud is the wrong term here, because theres has been many cases of people being found fit for work following whats been written on their report after a medical.

Then after appealing a true view of thier illness etc different from their 1st medical are found.

Also i thought fraud was deception for finanical or personal gain

sangie595

steveactual wrote: »

Even if nothing comes of a fraud case, I have a strong case to take to the NMC because he provably lied about a claimants condition. You might find that acceptable but I do not, and I suspect you would have a different perspective if it was you.

That is pretty insulting. I could have given up working and decided to just claim benefits. But it would have been a fraud, to put it in your terms, because I am quite capable of working. There are plenty of job that I couldn't do, yes. But not the job that I do, and not lots of other jobs either. I need reasonable adjustments in the workplace - not public charity.

IF it were me I would have a perspective that involved being realistic, picking my battles more carefully, and focussing on what is important.

You are more than willing to continue to live with this condition in the "long term" when you do not have to live with it and your life can easily be improved - I am assuming, of course, that it is a bad as you say. It's better to pick a fight with a nurse that you will not win and which gives you no advantage than to pick one with the health service that you say has unlawfully denied you access to the treatment you require to live a full and productive life. Really? That's perspective?

You have the money to mount a private prosecution for fraud? - because the CPS will not take such a prosecution.

And if you check the NMC process, you are going to find that despite your personal feelings on the matter, there is no way on earth they are going to launch an investigation into a single compliant or incident which falls significantly short of catastrophic - they are very clear on this point.

You are tilting at windmills. And, again assuming that you really are unfit for any kind of work, wasting your time on the windmills when that time is better spent overturning the decision and getting treatment for your condition. Arthritis of this type is the most successful surgical procedure currently in practice. Despite being major surgery it is quick, easy, and has excellent prognoses. Don't you get it? You could be better!

How many people with disabilities, given the good chance of an outcome somewhere between excellent and "cured" wouldn't jump at it and fight for it? I only wish my other conditions were as easy - not that that is stopping me getting the best support and treatment I can. If you think that pursuing this nurse is the most important thing you can do, you really need to reconsider your priorities. It won't make you better. It won't get you the benefits you say you should be entitled to.