ATOS medical/home visit or transport advice please

Tulip09 · 26 November 2010 at 7:49PM

Thanks for all your replies. I have no problem doing a medical at all and dont think i would be exempt, its just at £400 to get there its out of my reach financially and I would be pretty ill and not guarenteed to get there at all. I am sure the hospitial & GP will give me a letter so hopefully that will be enough for them to give me an appointment nearer to me or at home. I havent had any experience with Atos yet but i am hoping it wont be as bad as people say. Thanks once again for you replies

ankspon · 26 November 2010 at 7:54PM

oldestrocker wrote: »

Hi, Have you checked if your illness falls in one of the 5 categories that define either you should not have a medical to yes you do?

What are the 5 categories?

oldestrocker · 26 November 2010 at 11:21PM

Hi, here is the list. Yes I know it refers to DLA, but the intention was for the 05 Reform Bill to include it also for the new ESA benefit.

I have put this argument to ATOS already and am waiting a reply. I have also asked my MP to intervene as I feel that they can't use one set of guidelines to not test or do a home visit for DLA, yet for the same condition expect you to travel and be called in for a medical for ESA.

You will note that those conditions would put you in the Support Group without a medical - well they should!!!

So just waiting for clarification on all of this.

1. c/o: DWP Atos Healthcare Medical Services Contract

Medical Conditions and Categories

For the purposes of administrative scrutiny of cases to determine suitability for inclusion in the DLA in Medical Examination Centre project, 5 categories of case have been devised:
In 2005 the Welfare Reform Bill, which introduced the Employment and Support Allowance (ESA), had not yet been enacted hence the reference to the Disability Living Allowance (DLA).

1. Unsuitable for calling to a Medical Examination Centre.
2. Reference to Medical Advisor required for advice.
3. Tentatively invite to Medical Examination Centre.
4. Invite to Medical Examination Centre.
5. Any other Diagnosis.

For each category a list is attached.
1. Unsuitable for calling to a Medical Examination Centre.
Age >75 years

Age <12 years

Both Blind and Deaf
Registered Blind (needs to be seen in own environment)
Cases accepted under the Special Rules defining Terminal illness.
Alzheimers
Amputation of both legs
Asperger's
Autistic Spectrum Disorder / Autism
Cerebral Palsy
Dementia
Hemiplegia
Huntingdon's Chorea
Korsakoffs Psychosis
Macmillan Nurse attending.
Motor Neurone Disease
On oxygen
Paraplegia
Quadraplegia
Renal Dialysis
Severe Mental Impairment
Severe Learning Difficulty
!!!!!! Diplegia
Tetraplegia
Total Parenteral Nutrition
Unstable Angina
Wernicke's Encephalopathy

2. Reference to Medical Advisor required for advice.
AIDS
Astrocytoma
Bone Marrow Transplant
Brittle Bone Disease
Cancer
Cystic Fibrosis
Dermatomyositis
Glioma
Guillane-Barre Syndrome
Hodgkin's Lymphoma
Leukaemia
Liver Failure
Mental Retardation
Mental Subnormality
Multiple Sclerosis
Muscular Dystrophy
Non Hodgkin's Lmphoma
On Morphine / MST
Osteogenesis Imperfecta
Parkinson's Disease
Poliomyelitis
Polymyasitis
Registered partially sighted
Respiratory Failure
Rheumatoid Arthritis
Schizoaffective Disorder
Schizophrenia
SLE
Spinal Injury
Systemic Lupus Erythematosis
Scleroderma
5evere Depression
Thallassaemia

3. Tentatively invite to Medical Examination Centre.
Agoraphobia (offer taxi)
Anorexia Nervosa
Ataxia
Bipalar Affective Disorder / Bipolar Disease Manic Depression
Burns
Cardiomyopathy
Cerebrovascular Accident / CVA
Cerebrovascular Disease
CFS
Chronic Fatigue Syndrome
Crohn's Disease
Diabetic Neuropathy
Eating Disorder
Fibromyalgia
Haemopphilia
Heart Transplant
Hemiparesis
Learning Difficulties
Leg Ulcers
Myalgic Encephalomyelitis / ME
Obsessive Compulsive Disorder
Peripheral Neuropathy
Phobic Anxiety
Sickle Cell Anaemia
Social Phobia
Spina Bifida
Stroke
Subarachnoid Haemorrage / SAH
Ulcerative Colitis
Varicose Ulcers
4. Invite to Medical Examination Centre.
Alcohol Dependence
Anaemia
Angina
Ankylosing Spondylitis
Anxiety
Arrythmia
Asthma
Atrial Fibrillation
Back Pain
Bronchiectasis
Bulimia Nervosa
Cardiac Arrythmia
Cervical Spondylosis
Chronic Bronchitis
Chronic Obstructive Airways Disease
Chronic Obstructive Pulmonary Disease
COPD
Coronary Artery Disease
Coronary Heart Disease
Depression
Dermatitis
Diabetes
Diverticular Disease
Diverticulitis
Dizziness
Down's Syndrome
Drug Dependence
Eczema
Endometriosis
Epilepsy
Hearing Impairment
Hernia
HIV
Hypertension
Hyperthyroidism
Hypathyroidism
Hysterectomy
Incontinence
Ischaemic Heart Disease
Irritable Bowel Syndrome / IBS
Joint Pain
Kyphosis
Kyphoscoliosis
Labyrinthitis
Liver Transplant
Lumbar Spondylosis
Meniere's Disease
Migraine
Myasthenia Gravis
Neck Pain
Osteoarthritis
Osteoporosis
Overactive Thyroid
Panic Attacks
Pelvic Inflammatory Disease
Peripheral Vascular Disease
Personality Disorder
Prolapsed Intervertebral Disc
Psoriasis
"Registered Alcoholic"
Renal Transplant
Rheumatic Heart Disease
Scoliosis
Slipped Disc
Underactive Thyroid
Valvular Heart Disease
Varicose Veins
Visual Impairment
5. Any other Diagnosis.
Not listed above should be referred to a Medical Adviser for advice

Indie_Kid · 26 November 2010 at 11:25PM

davidhwdn wrote: »

What are the 5 categories?

From Benefits and Work:

You are exempt if:

You are terminally ill and your death can reasonably be expected within 6 months.
You are receiving, or recovering from receiving, intravenous, intraperitoneal or intrathecal chemotherapy.
You have a notifiable disease or have been in contact with someone with a notifiable disease.
You are a pregnant woman and there is a serious risk of damage to your health or to the health of your unborn child if you do not refrain from work.
You are a pregnant woman entitled to maternity allowance.
You are a pregnant woman within 6 weeks of your expected confinement date or 14 days after the date of your confinement where you don’t have any entitlement to maternity allowance or statutory maternity pay.

oldestrocker · 26 November 2010 at 11:31PM

cit_k wrote: »

Im not convinced that list applies to ESA, it may, but it only definately applied(or applies) to DLA. Unless someone can find a legislative link to ESA it cannot be relied up for ESA purposes in my opinion.

ESA is meant to go by a pre-board check, where they pre-run lima with evidence from the esa forms and produce a esa85a form which states if a medical is needed (on flimsy evidence like there is no evidence on the ESA form, even when their was)

I agree with what they are doing which isn't the same as what they should be doing.

I have a copy of the 05 Welfare Bill and whilst the intention was that Category 1 was/should form the basis of an automatic transfer into the Support Group without a medical, but as there were so many changes before it was enacted, for some reason it was omitted. Having looked further into this in all of the changes that took place, this particular part was always accepted as being part of the backbone of the new Act. Whether it was left out in error, or they believed that there was no need for it to be included as it already existed for DLA - nobody knows.

Either way I have challenged ATOS & DWP for them to show me that it isn't included. I have set out that I intend to take legal action against them as they have worsened my condition by making me go to a medical and breached the DDA. (whether they have is here nor there - I just want them to confirm that they are not using this list for ESA but do so for DLA) Then I question why is it right to demand under penalty someone who is on permanent oxygen to attend for an ESA assessment but NOT want to carry out a medical for DLA purposes?

cit_k · 27 November 2010 at 12:17AM

oldestrocker wrote: »

I agree with what they are doing which isn't the same as what they should be doing.

I have a copy of the 05 Welfare Bill and whilst the intention was that Category 1 was/should form the basis of an automatic transfer into the Support Group without a medical, but as there were so many changes before it was enacted, for some reason it was omitted. Having looked further into this in all of the changes that took place, this particular part was always accepted as being part of the backbone of the new Act. Whether it was left out in error, or they believed that there was no need for it to be included as it already existed for DLA - nobody knows.

Either way I have challenged ATOS & DWP for them to show me that it isn't included. I have set out that I intend to take legal action against them as they have worsened my condition by making me go to a medical and breached the DDA. (whether they have is here nor there - I just want them to confirm that they are not using this list for ESA but do so for DLA) Then I question why is it right to demand under penalty someone who is on permanent oxygen to attend for an ESA assessment but NOT want to carry out a medical for DLA purposes?

If you have not done so already, I would suggest asking for a copy of the ESA85A form which is produced by the pre-board check.

This is different from the normal medical report, its the report that is given to the decision maker to recommend if you need a medical.

It has to justify why you are being called for an assessment, you may find it does not really contain any such justification, mine just said they were unable to advise on the evidence held.... (despite the fact they should have had enough evidence In my opinion, and the fact I know they never even read the form...)

If the DWP give you any grief (ie claim no such thing exists) then I can dig out the relavent info for you to quote to them.

speedfreek1000 · 27 November 2010 at 11:46AM

thanks for that cit ESA85A form eh? I think that I'll request one as it could be interesting :beer:

The booking process is an absolute mess.

I included with my ESA50 a letter from my doctor and another from my councillor supporting my request for a home visit.

Guess what? Neither was read and I was issued an appointment to attend a centre!

When I rang to challenge I was told ...

You need to send us a letter from you doctor.

Sent with ESA50 said I :rotfl:

Erm erm erm.... we'll call you back!

Cue 40+ days of them trying to 1st find, then recall my file from the ether. 2 attempts by me to fight for a rebook of the appointment as they still hadn't found it a couple of days before the 1st appointment date.

The 1st rebook amazingly chose the exact same date and time as the original appointment :rotfl:

Oh the fun I had over the course of 13 phone calls trying to sort this out.

Snippets of utter ATOS incompetence include.

We called you back sir! .... Does a 30 second call saying we are still looking into it count? .... silence .... No I didn't think so!

We can't rebook it sir as it has already been rebooked! .... see above

Eventually as I was persistent they offered a pre paid taxi there and back.

Which I accepted as I was loosing the plot somewhat due to the stress of it all and just wanted it over.

Things to note both ATOS and the DWP say will say we need to contact/liaise with the "Medical Services" department aka ATOS????

The number you are given to call to book the appointment with ATOS can not do anything else but book new or confirm existing appointments. You have to be very firm and persistent with these people as they will say/try anything to get you to give up here. Persistence will get you a new number for "Medical Services" who can actually re-arrange appointments and answer questions. This amazingly turns out to be the number for the ATOS assessment centre you've been assigned to (well it did in my case).

ankspon · 27 November 2010 at 3:53PM

oldestrocker wrote: »

Hi, here is the list. Yes I know it refers to DLA, but the intention was for the 05 Reform Bill to include it also for the new ESA benefit.

I have put this argument to ATOS already and am waiting a reply. I have also asked my MP to intervene as I feel that they can't use one set of guidelines to not test or do a home visit for DLA, yet for the same condition expect you to travel and be called in for a medical for ESA.

You will note that those conditions would put you in the Support Group without a medical - well they should!!!

So just waiting for clarification on all of this.

1. c/o: DWP Atos Healthcare Medical Services Contract

Medical Conditions and Categories

For the purposes of administrative scrutiny of cases to determine suitability for inclusion in the DLA in Medical Examination Centre project, 5 categories of case have been devised:
In 2005 the Welfare Reform Bill, which introduced the Employment and Support Allowance (ESA), had not yet been enacted hence the reference to the Disability Living Allowance (DLA).

1. Unsuitable for calling to a Medical Examination Centre.
2. Reference to Medical Advisor required for advice.
3. Tentatively invite to Medical Examination Centre.
4. Invite to Medical Examination Centre.
5. Any other Diagnosis.

For each category a list is attached.
1. Unsuitable for calling to a Medical Examination Centre.
Age >75 years

Age <12 years

Both Blind and Deaf
Registered Blind (needs to be seen in own environment)
Cases accepted under the Special Rules defining Terminal illness.
Alzheimers
Amputation of both legs
Asperger's
Autistic Spectrum Disorder / Autism
Cerebral Palsy
Dementia
Hemiplegia
Huntingdon's Chorea
Korsakoffs Psychosis
Macmillan Nurse attending.
Motor Neurone Disease
On oxygen
Paraplegia
Quadraplegia
Renal Dialysis
Severe Mental Impairment
Severe Learning Difficulty
!!!!!! Diplegia
Tetraplegia
Total Parenteral Nutrition
Unstable Angina
Wernicke's Encephalopathy

2. Reference to Medical Advisor required for advice.
AIDS
Astrocytoma
Bone Marrow Transplant
Brittle Bone Disease
Cancer
Cystic Fibrosis
Dermatomyositis
Glioma
Guillane-Barre Syndrome
Hodgkin's Lymphoma
Leukaemia
Liver Failure
Mental Retardation
Mental Subnormality
Multiple Sclerosis
Muscular Dystrophy
Non Hodgkin's Lmphoma
On Morphine / MST
Osteogenesis Imperfecta
Parkinson's Disease
Poliomyelitis
Polymyasitis
Registered partially sighted
Respiratory Failure
Rheumatoid Arthritis
Schizoaffective Disorder
Schizophrenia
SLE
Spinal Injury
Systemic Lupus Erythematosis
Scleroderma
5evere Depression
Thallassaemia

3. Tentatively invite to Medical Examination Centre.
Agoraphobia (offer taxi)
Anorexia Nervosa
Ataxia
Bipalar Affective Disorder / Bipolar Disease Manic Depression
Burns
Cardiomyopathy
Cerebrovascular Accident / CVA
Cerebrovascular Disease
CFS
Chronic Fatigue Syndrome
Crohn's Disease
Diabetic Neuropathy
Eating Disorder
Fibromyalgia
Haemopphilia
Heart Transplant
Hemiparesis
Learning Difficulties
Leg Ulcers
Myalgic Encephalomyelitis / ME
Obsessive Compulsive Disorder
Peripheral Neuropathy
Phobic Anxiety
Sickle Cell Anaemia
Social Phobia
Spina Bifida
Stroke
Subarachnoid Haemorrage / SAH
Ulcerative Colitis
Varicose Ulcers
4. Invite to Medical Examination Centre.
Alcohol Dependence
Anaemia
Angina
Ankylosing Spondylitis
Anxiety
Arrythmia
Asthma
Atrial Fibrillation
Back Pain
Bronchiectasis
Bulimia Nervosa
Cardiac Arrythmia
Cervical Spondylosis
Chronic Bronchitis
Chronic Obstructive Airways Disease
Chronic Obstructive Pulmonary Disease
COPD
Coronary Artery Disease
Coronary Heart Disease
Depression
Dermatitis
Diabetes
Diverticular Disease
Diverticulitis
Dizziness
Down's Syndrome
Drug Dependence
Eczema
Endometriosis
Epilepsy
Hearing Impairment
Hernia
HIV
Hypertension
Hyperthyroidism
Hypathyroidism
Hysterectomy
Incontinence
Ischaemic Heart Disease
Irritable Bowel Syndrome / IBS
Joint Pain
Kyphosis
Kyphoscoliosis
Labyrinthitis
Liver Transplant
Lumbar Spondylosis
Meniere's Disease
Migraine
Myasthenia Gravis
Neck Pain
Osteoarthritis
Osteoporosis
Overactive Thyroid
Panic Attacks
Pelvic Inflammatory Disease
Peripheral Vascular Disease
Personality Disorder
Prolapsed Intervertebral Disc
Psoriasis
"Registered Alcoholic"
Renal Transplant
Rheumatic Heart Disease
Scoliosis
Slipped Disc
Underactive Thyroid
Valvular Heart Disease
Varicose Veins
Visual Impairment
5. Any other Diagnosis.
Not listed above should be referred to a Medical Adviser for advice

What happens if i come under category 2,3 and 4

oldestrocker · 27 November 2010 at 9:13PM

Hi,
Cat 2 is where your case would fall somewhere in between not having to be called for a medical to possibly might be called. They should review your case and make a considered and valued judgement call.
Cat3 is similar, in that you should have a medical but there is a small chance that it might not happen depending on your case
Cat4 is - you will have an appointment to attend the medical centre for a medical
Cat5 is the same as Cat2, except that your medical condition isn't quoted.

ankspon · 28 November 2010 at 12:44PM

So i'm still not clear if i should or should not be called for a medical

ATOS medical/home visit or transport advice please - Page 2

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ATOS medical/home visit or transport advice please

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