Nightmare ESA Reassessment

Noodles2020

Good morning all,

I'm just looking for some advice with my husbands ESA reassessment. He is currently in the support group. The ESA50 was returned after i completed it on behalf of my husband. When he was last assessed they eventually sent him an appointment letter for a face-to-face and we contacted Maximus to explain how this was not possible due to my husbands mental health and how much distress it would cause. They said that the case would be reviewed and a few hours later told me the appointment was cancelled and he would not need to go. However, this time we decided to contact Maximus in advance to try and avoid that situation completely. It seems last time they ESA50 wasn't actually looked at properly so this was one of the main reasons for contact because everything in it explains in detail how it affects my husbands daily life, nothing has really changed since the last assessment when they cancelled the face-to-face, this time they have told me that i must get further medical evidence from the doctor, this is nothing new or extra than we sent with the last reassessment.

The issue we have is this is a new GP, our previous one closed down and they don't know my husband as well as the previous one. I have always dealt with everything over the phone for him. Not only is this difficult to get a letter they also have a £30 charge which i don't have spare at the moment. The lady from Maximus has told me that plenty of people find it hard to come to the assessments but they do, I can fully understand many people have issues but surely each case should be looked at individually? I sent maximus a letter i had from his old GP which is 2 years old ( used for last assessment ) and they have told me that they cannot accept it and will not pass it on to be reviewed because its older than 6 months, Now i wasn't aware that this could not be accepted if its older than 6 months. Its becoming a losing battle now and they have told me by default a face-to-face assessment letter will automatically be sent out. I really don't know what to do, it will not be possible for him to attend the face-2-face and it seems we are pretty much going to lose his ESA. I'm just baffled with how nothing has changed and last time it went smoothly and after contacting them they reviewed the file and did a paper based review but this time after the exact same situation they are being awkward about it. I've tried to explain how much distress this is causing my husband and what its doing to him but they will not acknowledge that. Just wondering if anyone here may have some advise on what more i could possibly do. It seems we are in a bit of a trap and with his mental health the way it is we will be punished for it.

Thank you.

pmlindyloo

Has your husband seen any medical professionals since his last ESA assessment? If he has you should be able to ask for reports (free of charge) from the doctor which you can send to Maximus.
If your husband has had no contact with any medical professional then I think it might be helpful if you can arrange a home visit from the 'new' doctor and 'go from there'.
I realise that many people with mental health problems do not visit their doctor very often but it may even be that there are new treatments/medication which could help. of course I have no details of your husband's illness so apologise if this is not relevant.
It is not, in my opinion, unrealistic for up to date information to be asked for by Maximus unless a condition is terminal or likely to deteriorate in the future.  I hope this doesn't offend you.
Reassessments for ESA are to find out if there have been any change of circumstances and this inevitably means that you usually need medical evidence to back this up.
It may be that you are going to have to find the £30 for a letter saying that your husband is unable to attend a face to face assessment.

Noodles2020

pmlindyloo said:

Has your husband seen any medical professionals since his last ESA assessment? If he has you should be able to ask for reports (free of charge) from the doctor which you can send to Maximus.
If your husband has had no contact with any medical professional then I think it might be helpful if you can arrange a home visit from the 'new' doctor and 'go from there'.
I realise that many people with mental health problems do not visit their doctor very often but it may even be that there are new treatments/medication which could help. of course I have no details of your husband's illness so apologise if this is not relevant.
It is not, in my opinion, unrealistic for up to date information to be asked for by Maximus unless a condition is terminal or likely to deteriorate in the future.  I hope this doesn't offend you.
Reassessments for ESA are to find out if there have been any change of circumstances and this inevitably means that you usually need medical evidence to back this up.
It may be that you are going to have to find the £30 for a letter saying that your husband is unable to attend a face to face assessment.

Hello

Thank you for the reply.

He hasn't seen a medical professional since the last assessment. This is all due to his anxiety and panic attacks which he has been really struggling with. I have further spoken with Maximus today and they have told me that they can not accept any evidence / letters etc.. That is 2 years old, even though i've explained there is no difference in conditions since the last assessment. I am just baffled how we can go from such an easy assessment 2 years ago to this. We sent the exact same staff as last time, and when they sent that appointment letter all we did was contact them and they reviewed the case again and cancelled the appointment and sent a report to the DWP and he remained in the support group. I have contacted my husbands surgery to deal with this further but they are extremely busy and it takes a while to get anything done. Maximus have told me that an appointment letter will arrive by default and i really don't know where to go from there.

One of the reasons that my husband is terrified to go there again is down to them with a past assessment. We went for one which was audio recorded and they report was full of inaccurate information. We raised a complaint about this and it was looked into and they found that the report was not accurate and the DWP eventually reserved the decision. I have also asked them about the cover letter i wrote, i feel i obviously know my husband better than anyone else and i've explained how his conditions affect his everyday life and what descriptors he meets to remain in the support group. They have come back to me and told me that my letter is not evidence and only letters from a GP or from treating physicians only. I don't know what's changed in 2 years but obviously whatever i say is meaningless to his reassessment now.

pmlindyloo

I know you are feeling very despondent about this but do try not to take it personally. The DWP deal with thousands of ESA assessments and 'to them' your husband is 'merely' a claimant.  
Unfortunately there are some people who claim fraudulently and the DWP have a legal requirement to make sure that all claimants are genuine.
You know your husband and expect them to accept your word about his mental health problems. But if you think logically this cannot be sufficient. There usually has to be medical evidence and evidence from two years ago is deemed to be 'not up to date'.  Obviously some people with mental health problems do improve over time and it is the DWP's job to find out if this has happened, usually through a face to face assessment.
In some cases the medical evidence is so strong that a face to face is not needed.  This seems to be what happened at your husband's last assessment.
Two years later they will usually expect further medical evidence.
Keep 'pestering' your doctor.

poppy12345

I have to agree with pmlindyloo here. If it means that you have to pay £30 for a letter then i'd advise you to do this or request his medical records from his GP to see if there's anything in there you can use. If the reason he won't or can't attend is purely because of the lies that were told the last time he had a face to face assessment then this may not help have a paper based assessment.

I'm not sure how true this is but it seems like those that have had a previous paper based assessment, then the next one is usually a face to face. 

Mental health can change and a lot can happen in 2 years.

Noodles2020

pmlindyloo said:

I know you are feeling very despondent about this but do try not to take it personally. The DWP deal with thousands of ESA assessments and 'to them' your husband is 'merely' a claimant.  
Unfortunately there are some people who claim fraudulently and the DWP have a legal requirement to make sure that all claimants are genuine.
You know your husband and expect them to accept your word about his mental health problems. But if you think logically this cannot be sufficient. There usually has to be medical evidence and evidence from two years ago is deemed to be 'not up to date'.  Obviously some people with mental health problems do improve over time and it is the DWP's job to find out if this has happened, usually through a face to face assessment.
In some cases the medical evidence is so strong that a face to face is not needed.  This seems to be what happened at your husband's last assessment.
Two years later they will usually expect further medical evidence.
Keep 'pestering' your doctor.

That is pretty much the issue we are in at the moment, The doctors surgery we are registered at is overwhelmingly busy and so far appointments are showing 24th March. I tried to put everything into his ESA50 and how everything affects him, we even had to use separate paper that we gave that much detail, after these talks with Maximus they haven't even mentioned the ESA50 even after i have brought it up in conversations, it seems like a meaningless form.

The last assessment was similar, we filed out the ESA50 with pretty much the exact same info, sent of off and waited. We got a letter for an appointment and i contacted them to say that it would not be possible for him to attend. They said they would review it and then we get the surprise that they have done a paper based review. There was no extra evidence sent, no contact to the GP.. nothing. It seems we have reached deadlock, there is nothing in place for those with mental health that have limited contact with their own gp due to mental health.

Noodles2020

poppy12345 said:

I have to agree with pmlindyloo here. If it means that you have to pay £30 for a letter then i'd advise you to do this or request his medical records from his GP to see if there's anything in there you can use. If the reason he won't or can't attend is purely because of the lies that were told the last time he had a face to face assessment then this may not help have a paper based assessment.

I'm not sure how true this is but it seems like those that have had a previous paper based assessment, then the next one is usually a face to face. 

Mental health can change and a lot can happen in 2 years.

That's just one of the reasons that add to the fear of having the assessment again. But its mostly down to the engaging with other people side of things, He doesn't even speak to any family members any more. Doesn't leave the house either.

tacpot12

You should ask the doctor if there is any possibility of them reducing their charge as you have no money. 

In future, you need to save money for this. It’s a small charge for the work involved, and your husband needs to be assessed.

Noodles2020

tacpot12 said:

You should ask the doctor if there is any possibility of them reducing their charge as you have no money. 

In future, you need to save money for this. It’s a small charge for the work involved, and your husband needs to be assessed.

I have been in contact with the doctors, they had first said they need to speak to my husband and after listening to the issues they have arranged for this to be done over the phone. That's a bit of a relief as it means he doesn't have to go to the surgery. They have also mentioned that they will go over the form with him, Maximus mentioned an ESA113 form and i'm assuming this is what the doctors is talking about. I don't know much about this or if this is a good or bad thing. if someone could clarify.

Thank you.

coachman12

tacpot12 said:

You should ask the doctor if there is any possibility of them reducing their charge as you have no money. 

In future, you need to save money for this. It’s a small charge for the work involved, and your husband needs to be assessed.
_________________________________________________________
I agree with all tacpot advises. And I would go even further. Your husband must be very ill in view of all you describe, and you both have my sympathy in having to deal with DWP and their agents. Such serious illness surely means that your husband is under the care of a consultant psychiatrist. A letter from a consultant , especially a recent one, would carry 100 times more weight with DWP than any useless letter from a GP. Has your husband ever seen a psychiatrist, who may now be able to see  him again and come to the rescue with a letter setting out the full and up-to-date position for DWP and their agents.
If he has never seen a consultant psychiatrist, he should now do so. Even the disliked DWP have a job to do that requires a recent assessment and diagnosis/prognosis of your husband's condition. And a consultant's letter would carry much weight with DWP.
Ideally, I would advise that you phone your surgery and get a referral for your husband to see a consultant as a private patient. You could accompany him. In such a case, being seen privately, you are very much more likely to get a letter which will means something important to DWP. But, as you cannot afford £30 for a letter ( which surprises me when ESA Support Group rates are about £500 pcm), from a GP ( which count for little with DWP), you are unlikely to be able to afford the consultant's fee of £150+. 
I think you have to rethink your priorities. If it were my problem I would think the health of  husband comes first, and ESA comes second. And that means an up-to-date assessment by a consultant ( more than a GP, especially one who has not seen him) and then the question of ESA becomes much clearer. You will find it very difficult to keep relying on your husband not being seen by a professional for some years and still receiving ESA payments. Someone needs to assess his health and provide diagnosis and prognosis and then DWP will have something concrete to go on, and ESA will be so much easier to maintain. DWP will not keep on and on paying ESA without up-to-date professional assessment and opinion, and that is understandable. I have a disabled friend who receives ESA and previously a relative who suffered severe mental health problems for many years so I sympathise with your plight, but the final answer lies in seeking the very best medical/psychological help-----and in my relative's case that was a wonderful consultant psychiatrist who, with the help of psychologists and mental health nurses under his auspices, helped enormously, including in convincing DWP of the need for IB/ESA while it was necessary.

Noodles2020

coachman12 said:

tacpot12 said:

You should ask the doctor if there is any possibility of them reducing their charge as you have no money. 

In future, you need to save money for this. It’s a small charge for the work involved, and your husband needs to be assessed.
_________________________________________________________
I agree with all tacpot advises. And I would go even further. Your husband must be very ill in view of all you describe, and you both have my sympathy in having to deal with DWP and their agents. Such serious illness surely means that your husband is under the care of a consultant psychiatrist. A letter from a consultant , especially a recent one, would carry 100 times more weight with DWP than any useless letter from a GP. Has your husband ever seen a psychiatrist, who may now be able to see  him again and come to the rescue with a letter setting out the full and up-to-date position for DWP and their agents.
If he has never seen a consultant psychiatrist, he should now do so. Even the disliked DWP have a job to do that requires a recent assessment and diagnosis/prognosis of your husband's condition. And a consultant's letter would carry much weight with DWP.
Ideally, I would advise that you phone your surgery and get a referral for your husband to see a consultant as a private patient. You could accompany him. In such a case, being seen privately, you are very much more likely to get a letter which will means something important to DWP. But, as you cannot afford £30 for a letter ( which surprises me when ESA Support Group rates are about £500 pcm), from a GP ( which count for little with DWP), you are unlikely to be able to afford the consultant's fee of £150+. 
I think you have to rethink your priorities. If it were my problem I would think the health of  husband comes first, and ESA comes second. And that means an up-to-date assessment by a consultant ( more than a GP, especially one who has not seen him) and then the question of ESA becomes much clearer. You will find it very difficult to keep relying on your husband not being seen by a professional for some years and still receiving ESA payments. Someone needs to assess his health and provide diagnosis and prognosis and then DWP will have something concrete to go on, and ESA will be so much easier to maintain. DWP will not keep on and on paying ESA without up-to-date professional assessment and opinion, and that is understandable. I have a disabled friend who receives ESA and previously a relative who suffered severe mental health problems for many years so I sympathise with your plight, but the final answer lies in seeking the very best medical/psychological help-----and in my relative's case that was a wonderful consultant psychiatrist who, with the help of psychologists and mental health nurses under his auspices, helped enormously, including in convincing DWP of the need for IB/ESA while it was necessary.

Thank you,

He has always had mental health issues, the main focus of it has been going out and not being able to engage with others. Even his own family. Over time it gradually got worse and he hasn't ever seen a psychologist. I should clarify, the £30 payment is affordable but its come at the wrong time to have it there and ready to use. I've been trying to deal with this as quickly as possible to try and eliminate the stress. I haven't looked into the option of a private mental health visit that you mentioned, i've not been aware of this. I want to help him as much as i can to get the confidence back in himself to try and live a better life than feeling too anxious and scared to even leave the house. I'll stand by him no matter what but as you say his health comes first.