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Need help from any medical /legal experts regarding ESA fraud
Comments
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steveactual wrote: »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.
No of course I don't think that. But you don't have (and never will have) proof that he knowingly falsified the report. Short of holding a gun to his head it's never going to happen.
The better option would be to complain on the grounds that he lacks the skills to be in his current role (if he has got you as wrong as you say he has) At least then you won't come off like some raving lunatic throwing around accusations of fraud. His employer would be your first port of call.0 -
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.
I take a lot of what you say on board, it makes a lot of sense and I will absolutely be focusing on getting this resolved with the DWP first and foremost, and then go from there. As for the NMC, what is the point of them having a complaints procedure that individuals can report wrong doing if they don't take it seriously? Its like what you are saying here is, you are just one guy who cant win against the system so just let it go.
This is why HCP's do what they do, because they are safe in the knowledge that no matter what, they are protected and can get away with saying virtually anything about a claimant. If people like me don't even try to fight this, then nothing will ever change. I know we aren't here to discuss the ESA process but it does need a huge overhaul and the only way it will ever change is if people shout LOUDLY when an injustice has occurred.0 -
I think op should follow the procedures as above. You have been treated very unfairly and I for one don't blame you for appearing a little stressed. Im sure if op gets this issue (which is after all her immediate concern ) she may well then post in the relevant section and let everybody have a go at diagnosing her and declaring just "how able bodied she actually is". Until then maybe it is best just to answer her question....random I know.
As for why do the HCP's lie....Who know's/ There is PLENTY of evidence of this though. This has led to claimants asking for their meetings to be recorded....Just think of that. You have a situation where someone who's own GP has declared them unfit then has to be "interviewed" by someone they don't actually trust....And as above with very good reason.
Yes we hear all about the poor GP's getting bullied by their clients to sign them off sick - Well surely then the problem lies with the GP ? If you can't handle the heat .....ect ect ect.
But you are also having HCP's refuting the opinions of consultants.....How can this be ? Are we saying that these claimants not only bullied their GP into signing them off but they also bullied their GP to referring them to a consultant who they then in turn bullied into giving them a report that states that they are unfit or whatever....There is zero common sense in ALL of this. The whole thing has been approached all wrong.
Rather than a fit note or whatever they are called I would rather see a situation where a doctor could say sign someone off from manual work or office work or pressure environments ect ect, This would then mean a patient may well not be able to do X but can continue to look for jobs doing Y (Unless not appropriate due to nature of illness) - you could still give this group extra cash on top of jsa. But the real change imho would be for this to be based on the GP's and consultants or relevant professionals reports, If it is found that some GP is giving out a huge amount of sick notes then review the patients and monitor the GP....IMHO if a GP gives a sick note out just to get someone out of his room then he is failing his patient, the tax payer, his employer.....and even himself in that the job he/she is supposed to be doing.0 -
I think op should follow the procedures as above. You have been treated very unfairly and I for one don't blame you for appearing a little stressed. Im sure if op gets this issue (which is after all her immediate concern ) she may well then post in the relevant section and let everybody have a go at diagnosing her and declaring just "how able bodied she actually is". Until then maybe it is best just to answer her question....random I know.
As for why do the HCP's lie....Who know's/ There is PLENTY of evidence of this though. This has led to claimants asking for their meetings to be recorded....Just think of that. You have a situation where someone who's own GP has declared them unfit then has to be "interviewed" by someone they don't actually trust....And as above with very good reason.
Yes we hear all about the poor GP's getting bullied by their clients to sign them off sick - Well surely then the problem lies with the GP ? If you can't handle the heat .....ect ect ect.
But you are also having HCP's refuting the opinions of consultants.....How can this be ? Are we saying that these claimants not only bullied their GP into signing them off but they also bullied their GP to referring them to a consultant who they then in turn bullied into giving them a report that states that they are unfit or whatever....There is zero common sense in ALL of this. The whole thing has been approached all wrong.
Rather than a fit note or whatever they are called I would rather see a situation where a doctor could say sign someone off from manual work or office work or pressure environments ect ect, This would then mean a patient may well not be able to do X but can continue to look for jobs doing Y (Unless not appropriate due to nature of illness) - you could still give this group extra cash on top of jsa. But the real change imho would be for this to be based on the GP's and consultants or relevant professionals reports, If it is found that some GP is giving out a huge amount of sick notes then review the patients and monitor the GP....IMHO if a GP gives a sick note out just to get someone out of his room then he is failing his patient, the tax payer, his employer.....and even himself in that the job he/she is supposed to be doing.
Its HE by the way, not SHE haha, but you do make a lot of sense when it comes to the status of the ESA system.
I wish I had thought to record the assessment on my phone then I could have easily proven all his other lies. Just to give another example of one of the lies; the first page of the report contains information about when the assessment started and ended. He states it started at 09:34 (which is correct) and claims it ended at 10:07. The assessment actually ended at 10:00 and my Oyster card history proves when I got on the bus. You might wonder why adding 7 minutes on is relevant to much? Well by adding this time on, he could claim that he saw me 'sat in a chair with a hardback for 30 minutes', which means he doesn't have to award any points for that part of the mobility section, when in reality, I was in the room for 26 minutes. Lets also bare in mind that at least 7-10 minutes of the assessment was observing me stood up (upper limb movements etc) and then looking at the mobility of my leg while on the bed. This means that he saw me sat for a total of 15 minutes (in two separate sittings) so he has doubled the time. Again, maybe not enough to get the man convinced of anything but proof that he is a liar and extremely unethical. How can you justify doubling times? How is that not a deliberate act of lying? There are many more examples but I've more than made my point.0 -
I'm sorry, but whilst I am far from being an expert on the subject of ESA, it is clear that you do not understand what the system is supposed to do or how it should function. I do accept that it may not always work to the standard one would hope - but your suggestions are impractical and would be totally opposed by GP's and consultants.I think op should follow the procedures as above. You have been treated very unfairly and I for one don't blame you for appearing a little stressed. Im sure if op gets this issue (which is after all her immediate concern ) she may well then post in the relevant section and let everybody have a go at diagnosing her and declaring just "how able bodied she actually is". Until then maybe it is best just to answer her question....random I know. Absolutely nobody has done this - you need to reread the thread. What everyone is saying is that there is no possibility that the OP is going to successfully mount a prosecution for fraud against this person. Attempting to prove a criminal act against this person isn't going to happen. It therefore gets the OP no further forward.
As for why do the HCP's lie....Who know's/ There is PLENTY of evidence of this though. This has led to claimants asking for their meetings to be recorded....Just think of that. You have a situation where someone who's own GP has declared them unfit then has to be "interviewed" by someone they don't actually trust....And as above with very good reason. Whether they lie is not necessarily proven - there is a difference between lying and having a difference of opinion. A GP has a totally different role and does not have the level of occupational health experience to assess whether someone might be unfit for ANY work. You need to remember that boards like this tend to garner stories of when the system goes wrong (and every system can go wrong) rather than when it goes right. There is PLENTY of evidence that HCP's do not lie - every time people get the answer they want or agree with. When they do not that is not evidence that the HCP is lying.
Yes we hear all about the poor GP's getting bullied by their clients to sign them off sick - Well surely then the problem lies with the GP ? If you can't handle the heat .....ect ect ect.
But you are also having HCP's refuting the opinions of consultants.....How can this be ? Are we saying that these claimants not only bullied their GP into signing them off but they also bullied their GP to referring them to a consultant who they then in turn bullied into giving them a report that states that they are unfit or whatever....There is zero common sense in ALL of this. The whole thing has been approached all wrong.
Rather than a fit note or whatever they are called I would rather see a situation where a doctor could say sign someone off from manual work or office work or pressure environments ect ect, This would then mean a patient may well not be able to do X but can continue to look for jobs doing Y (Unless not appropriate due to nature of illness) - you could still give this group extra cash on top of jsa. But the real change imho would be for this to be based on the GP's and consultants or relevant professionals reports, Neither GP's nor consultants would support this. Their job is to treat their patients. It is not to, nor are they qualified to, make occupational assessments of this sort. They also would not support making such decisions on behalf of the DWP because that would get in the way of their duty to their patients
If it is found that some GP is giving out a huge amount of sick notes then review the patients and monitor the GP....IMHO if a GP gives a sick note out just to get someone out of his room then he is failing his patient, the tax payer, his employer.....and even himself in that the job he/she is supposed to be doing.Whether or not GP's do this or not is not the issue - the issue is that it is not and should not be their job to decide whether someone should be eligible for benefits; and they are not qualified to make general occupational assessments. A lot of them are female too. And mostly GP's are not employed either - they are self-employed and contract to the NHS.
There really isn't any good argument for expecting GP's or consultants responsible for personal health care to become occupational health professionals as well, or to work on behalf of the DWP. That does not mean that the system for assessing our of work sickness benefits could not be improved, but that really isn't the point here. The point is that the OP wants to indict a HCP for fraud. And if proposing to spend a great deal of time and effort trying to do so. That won't happen. And it won't either get them their benefit nor will it help them recover from their condition. In real life you have to pick your battles.0 -
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.
You would think that but the NMC took no further action against the nurse who reported that I walked up a flight of stairs during a PIP assessment, I'm a paraplegic.0 -
What you are failing to accept is that the assessor didn't lie, YOU believe that she did and that is a massive distinction. As it stands it is nothing more than your opinion against hers so your first action should be to look as whether you can gather evidence, that is evidence that she lied rather than that she doesn't agree with you.
And there lies your problem, proving that someone lied, and then that they did so for the purpose of causing harm is a very tedious and often impossible mission. Every day innocent people don't get justice because they can't evidence the above.
Your case as you describe it here is as weak as it gets.0 -
What you are failing to accept is that the assessor didn't lie, YOU believe that she did and that is a massive distinction. As it stands it is nothing more than your opinion against hers so your first action should be to look as whether you can gather evidence, that is evidence that she lied rather than that she doesn't agree with you.
And there lies your problem, proving that someone lied, and then that they did so for the purpose of causing harm is a very tedious and often impossible mission. Every day innocent people don't get justice because they can't evidence the above.
Your case as you describe it here is as weak as it gets.
With the greatest of respect, who are you to say HE didn't lie? I am not sure why you cant seem to grasp that this individual examined my leg and then wrote extremely wrong information about it on the form. Saying someone can fully bend their left hip and squat to the floor is a lie, it isn't his opinion. If I said it was October, you would tell me I was incorrect, but what if I said it was my opinion? Does that make it ok? NO. You cannot justify saying whatever you like about a person just because you are in a Medical Capacity. Also, you'll notice I explained a few posts back that this individual doubled the length of time that he saw me sat in his chair, again, that's not his opinion because we have seen that I have absolute proof of when I left the assessment and got back on the bus.
I question your motivation for defending someone who has so obviously lied.0 -
I have to agree with Sangie and others offering similar feedback. I have been very seriously unwell for the last year and had two assessments (still working). No-one would regard them as pleasant, for sure. But it is the NCM's medical opinion that has been provided, not necessarily a set-in-stone fact.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.
As a previous poster said, a NCM can be struck-off for deliberate falsification of records. Some have been struck-off for much less. Would they honestly risk all their professional education, training, experience and career (for the rest of their working lives) for something like this? What exactly would they stand to gain by their actions? What conspiracy or fraud against you do you believe them to be perpetrating?0 -
RuthnJasper wrote: »I have to agree with Sangie and others offering similar feedback. I have been very seriously unwell for the last year and had two assessments (still working). No-one would regard them as pleasant, for sure. But it is the NCM's medical opinion that has been provided, not necessarily a set-in-stone fact.
As a previous poster said, a NCM can be struck-off for deliberate falsification of records. Some have been struck-off for much less. Would they honestly risk all their professional education, training, experience and career (for the rest of their working lives) for something like this? What exactly would they stand to gain by their actions? What conspiracy or fraud against you do you believe them to be perpetrating?
So if you examined my leg and saw that it could not bend at all, not even slightly, and you went back to your report and said that it could, even going as far as to say you observed me crouching to the floor, when you never even asked me to do that, you think that's ok? To make up the actual degrees that the leg can bend and rotate even though you never actually measured them and know that they cant do what you claim, that would be ok?
I am stunned how some here think this is acceptably justifiable as an 'opinion'. It isn't. Its intentional lies. As for why they do it? They know that they will get away with it because they are backed up by their employer and the NMC. Untouchable.
I might not get anywhere with my case, but I am damn sure going to try. I don't know about other people but I was brought up with better morals and ethics than that, and I wont allow him to lie about me.0
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