Esa medical summary

sporty1

Hi advice if possible please, my hubby who is 50 as been in support group for last 5 years due to musculoskeletal problem, which causes him pain discomfort, he has had this problem for over 25 years. O at end march he had his ESA review, today e received the summary , he has been put in the WRAG group with 24 points coming from his depression anxiety mental state... they have given him no points whatsoever for his degenerative spondylithesisis & musculoskeleton problem which causes him pain discomfort walking sitting bending etc
..The nurse that did the medical states he can get up and down stairs using double hand rail which is correct but does not state he is in pain discomfort and it takes him a while todo so !
..She also says he can get in and out if a vehicle as a passenger to get to appointments " yes he can with the help and assistance of my self !
.she also states he can sit for about 30 mins before he has to get up and reposition, NO it's less than that
.. She said in the assessment room he rose unaided after 29 mins then re sat down after 20 seconds stood on the spot ... he didn't stand unaided he used chair to rise and his stick !
.. He walked 20 metres into the room with his stick ( yes he did slowly and in discomfort , but she has failed to mention all this ,
She makes it seem as though he did all these activities without pain and discomfort which he clearly didn't she could see he was in pain,
Amongst other things to many to list ��
Basically he was in the assessment 29 mins she cut it short and he was not asked to do any physical exam, ( bearing in mind his appointment was 1.10pm but was only called in at 2,35 as they was running late, to me I think she was trying to catch up with her appointment !
Observed behaviour " client repositioned regularly throuougt assessment !
Ok so it says in middle if the form Exeptional ciecumstan Non functional Descriptors, "" The non-functional descriptors were not considered for this case as curtailment applied !!
What does that mean does anyone know
Also days score from physical activity
Mobilising activity 1 healthcare outcome We 0 points
Standing sitting activity 2 .outcome Sd 0 points
Teaching activity 3 outcome Rd 0 points
Picking up moving activity 4 outcome Pd 0 points
Basically all that physical assessment section 0 points , he wasn't even asked to do anything as she stopped the medical shirt as she said I won't ask you to do anything as I can clearly see your in pain and distressed
We have asked for a mandatory appeal as we feel he should of been given points for his mobility moving around sitting etc as he has difficulty his condition is degenerative it's not just disappeared, these people cause more stress and anxiety, any advise please Thanks ..

Bananas123

hello,

sometimes, they take the !!!!.............. absolute !!!!.....................

(i think you got a !!!!!!!! HCP)

---

HCP's aren't really vetted.... and some of them eagerly discriminate against claimants to obtain "blood money" for themselves (seriously).

(it's far far quicker and easier to discriminate and lie, and you also get paid more!!)

(100% of them, objectively in my experience)),

---

what you need to do is phone for mandatory reconsideration...

and then i am pretty sure your husband will get back into the support group by tribunal if not earlier....

(they withold the health report from you untill the end).

i could moan about the !!!!!!!s all day!... although my !!!!!!! hcp did give me 5 literal more minutes then yours gave your husband.........

---

don't worry though, saint peter will have them!!

Alice_Holt

I would suggest seeing if your local CAB / advice agency can help with the appeal.
https://www.citizensadvice.org.uk/about-us/how-we-provide-advice/advice/

After the MR (which is usually declined by the DWP), you can continue your appeal to the tribunal service (TS).

This is the form to take the appeal on to the Tribunal Service:
https://formfinder.hmctsformfinder.justice.gov.uk/sscs001-eng.pdf
You need to send it with the MRN attached within 1 month of the date of the MRN.

The tribunal will look at your husband's condition at the date of the decision to disallow ESA claim.

Here are useful guides to appeals:
http://www.advicenow.org.uk/guides/how-win-pip-appeal (It relates to PIP, but the appeal process is virtually the same).
http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-appeals
https://www.leicester.gov.uk/media/182136/employment-and-support-allowance-appeals-guide.pdf
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/while-youre-getting-esa/challenging-an-esa-decision

Here are the ESA descriptors:
http://www.benefitsandwork.co.uk/employment-and-support-allowance/start-the-esa-test

And the Support Group descriptors:
http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1353-support-group-descriptors
Your husband could also be given ESA on Reg 29 or assigned to the SG on Regulation 35 -
http://www.cpag.org.uk/content/making-exception
- If if participation in the WRAG activities would mean there was a substantial risk to the claimants mental or physical health (or to others).


Medical evidence is very important evidence, and often determines the success or otherwise at tribunal.
The How to win a PIP appeal is useful on getting medical evidence from the GP relating to the descriptors.
All relevant evidence is helpful - carers, family, friends, CPN, other health professionals.
The key to a successful outcome at tribunal is to produce the evidence, so that on the balance of probabilities given all the evidence in front of them the tribunal panel will allow the appeal.
The verbal evidence of the appellant is also very important - so preparation is important (i.e. keeping a diary)

Good luck.

Bananas123

hello,

sorry to clarify post #2.

> you don't need medical knowlege (just common sense) : IF your husband was in the support group for chronic degenerative problems previously, it doesn't take a "genuis" to work out:

that if a HCP says your husband has got "better" (...from "chronic degenerative problems") i.e. "problems that don't get better".

> then it's quite obvious, they are talking !!!!!!!!.

---

as he was already support grouped previously, and is not better, then they should support group him again, obviously.

---

the only problem, would be IF he was awarded tooo many points last time, and this time was accurate.

this is from my personal experience, at tribunal, 2 different judges on two different occasions.

(the judge both times, ruled with "common sense" as opposed to "!!!!!!!!")

regards

sporty1

Thank for replies so
Far in the scoring sheet what does
In the Atos healthcare professional column
outcome / score section Colum
Under outcome in each activity there is what I assume abbreviations
Wc Sc Rd Pd Me Vd Spd Hd Cc Fc
Anyone know what these mean ? x

sporty1

we are currently putting together what we disagree with on the decision that was made going over the comments the HCP Nurse made there is one that is made that says....

the details and scope of a physical examination were explained to the client, including advise not to perform any movements causing pain and discomfort, the client gave consent for the process to proceed ?

does anyone know in simple terms what this means above what the hcp nurse has wrote under "medical examination findings section"

just to clarify my husband was told in the assessment by her ,
"I wont ask you to do any physical activities as I can clearly see you are in pain"

poppy12345

sporty1 wrote: »

we are currently putting together what we disagree with on the decision that was made going over the comments the HCP Nurse made there is one that is made that says....

the details and scope of a physical examination were explained to the client, including advise not to perform any movements causing pain and discomfort, the client gave consent for the process to proceed ?

does anyone know in simple terms what this means above what the hcp nurse has wrote under "medical examination findings section"

just to clarify my husband was told in the assessment by her ,
"I wont ask you to do any physical activities as I can clearly see you are in pain"

I read it as, your husband gave his consent to a physical examination even though he was adviced not to perform any movements that caused pain and discomfort.

Alice_Holt

Your appeal will be to get your husband placed back into the Support Group of ESA.

On what grounds was he placed into the SG before this latest assessment?
Is he in receipt of DLA or PIP?
Have you made contact with your local CAB?

I think you need to concentrate on the Support Group descriptors:
http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1353-support-group-descriptors
Your husband could also be put into the SG on Regulation 35 -
http://www.cpag.org.uk/content/making-exception
- If if participation in the WRAG activities would mean there was a substantial risk to the claimants mental or physical health (or to others).

Have you looked through these carefully?
Do exceptional circumstances (Regulation 35) apply?
What descriptor would you be able to get persuasive medical evidence for, and put a convincing case for, at tribunal?

If your hubby has been in the support group for last 5 years due to musculoskeletal problems, which causes him pain and discomfort, Does this apply -
1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used.
Cannot either
(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

You wrote " he was not asked to do any physical exam........Ok so it says in middle if the form Exeptional ciecumstan Non functional Descriptors, "" The non-functional descriptors were not considered for this case as curtailment applied !!"

So it appears as if the HCP did not consider the physical functions nor Reg 35 - did you explain the physical problems on the ESA form?
It looks to me that the HCP having awarded the points to enable your husband to be placed in the WRAG, in effect stopped the examination there and failed to consider if any of the SG physical descriptors applied.

I would suggest you concentrate on the SG criteria and don't get too bogged down in the details of the flawed assessment report (particularly as, it seems, the HCP didn't consider if any of the SG physical descriptors applied).

sporty1

Alice_Holt wrote: »

Your appeal will be to get your husband placed back into the Support Group of ESA.

On what grounds was he placed into the SG before this latest assessment?
Is he in receipt of DLA or PIP?
Have you made contact with your local CAB?

I think you need to concentrate on the Support Group descriptors:
http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1353-support-group-descriptors
Your husband could also be put into the SG on Regulation 35 -
http://www.cpag.org.uk/content/making-exception
- If if participation in the WRAG activities would mean there was a substantial risk to the claimants mental or physical health (or to others).

Have you looked through these carefully?
Do exceptional circumstances (Regulation 35) apply?
What descriptor would you be able to get persuasive medical evidence for, and put a convincing case for, at tribunal?

If your hubby has been in the support group for last 5 years due to musculoskeletal problems, which causes him pain and discomfort, Does this apply -
1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used.
Cannot either
(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

You wrote " he was not asked to do any physical exam........Ok so it says in middle if the form Exeptional ciecumstan Non functional Descriptors, "" The non-functional descriptors were not considered for this case as curtailment applied !!"

So it appears as if the HCP did not consider the physical functions nor Reg 35 - did you explain the physical problems on the ESA form?
It looks to me that the HCP having awarded the points to enable your husband to be placed in the WRAG, in effect stopped the examination there and failed to consider if any of the SG physical descriptors applied.

I would suggest you concentrate on the SG criteria and don't get too bogged down in the details of the flawed assessment report (particularly as, it seems, the HCP didn't consider if any of the SG physical descriptors applied).

Yes these apply to my my hubby

Cannot either
(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion
This was wrote in the form and also he was put in SG last time regarding these issues .... yes he claims DLA too

sporty1

My husband was awarded at this assessment also 24 points these are made up of
Coping with change 6 points
Getting bout 9 points
Coping socially 9 points
These all fall in the score for mental congenitive and intellectual function assessment, but last time he was assessed he got 0 points for these but scored points for the physical , does anyone think with not receiving 0 points for physical it could be overturned , the advice you have given us so far we are taking on board

Alice_Holt

sporty1 wrote: »

Yes these apply to my my hubby

Cannot either
(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion
This was wrote in the form and also he was put in SG last time regarding these issues .... yes he claims DLA too

So the basis of your appeal is:

He was previously in the SG;
His condition has not improved since being placed in the SG and this assessment;
The assessment was curtailed, did not consider fully his physical abilities, so was not performed adequately;

He is in receipt of high rate DLA mobility (?? I'm assuming this is the case ??), and therefore has been assessed as unable or virtually unable to walk; Again, his condition has not subsequently improved.

He cannot reliably use a manual wheelchair to repeatedly self propel 50m because of upper body and arm weakness (?? I'm assuming this is the case ??).

Get a letter from your GP confirming he cannot repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion. Enclose this letter with your submission, along with other supporting medical evidence and evidence from family members, etc to confirm this.

Opt for an oral tribunal hearing, and have examples ready to talk about to the panel (i.e. distance to local shop / bus stop / etc, how many times your husband has to stop, how far / time he can walk before having to stop due to pain, after effects following walking, use of motorised scooter, examples of upper body weakness (why he can't self-propel),....etc)