Denied both ESA & DLA....

Moderators: perseus, *Lisa*, FluppyPuffy

Denied both ESA & DLA....

Postby darkcyde » Sat Apr 14, 2012 11:49 am

Hi

Quick background.....was diagnosed with severe FM in January this year after being off work since Oct 2011, am on Amitriplyene (which doesnt do anything except give me bad side effects), regular codine and tramadol. I can hardly walk, I'm dizzy and foggy especially in the morning due to meds, I can hardly move, I need help getting around the house, getting off the toilet, getting in about out of the bath, my hands shake and hurt, etc, etc.....I'm sure everyone can relate.

To top everything off, I was made redundant last month....my boss took the opportunity as in May I qualify for redundancy pay, this month my Professional Qualification expires whens means several thousand in retraining fees for him to pay, so cheaper to offload me now rather than later. I have no grounds for appeal as it's a very small firm, and redundancy would be me or someone else....as I'm off sick he can pick me otherwise he would be left with no workforce.

I've applied for DLA and ESA simultaneously to get some money coming in, as my wife is on maternity leave and only receiving SMP (twin boys born in November).

My ESA has been denied due to lack of contributions (self employed up to April 2010, business failed in recession and there are outstanding monies due to HMRC) so I've been told to apply for income related ESA whilst my wife is working zero hours. I've not received a penny since applying for the ESA, so no assessment period payments whatsoever!

My DLA has been denied also....they have the GP report, I have received a ESA50 Limited Capability for Work questionaiire a couple of days ago but not had time to complete and return yet, but they have point blank turned me down without evening waiting for an ATOS assessment!!

For example, I told them that my wife has to help me in about out of the bath, and on and off the toilet as my limbs do not have the strength to take my body weight. I tolf them that I need help getting up and down stairs. They said at your own speed you can safely use a bath or shower, get up and down stairs, move about ,etc, etc. Basically, they have denied every single thing I said without even seeing me for an assessment!

Is this a standard response and they are challenging me to appeal or what?? My GP is VERY supportive, and has had a lot of experience with benefit claim procedures. He said for example, if they ask him how well do I get on and off the toilet, he will answer that he cannot assess that as he has not witnessed this activity. Sounds like they have taken his inability to assess me as I can do it on my own! I've also seen a Specialist and continue to do so every three months.

I was already suffering from depression (for which I cannot take any meds as they will clash with what I'm already taking) and am undertaking counselling.....I didn't feel suicidal before reading these letter, but I sure as hell do now! The only income we have is my wives SMP at £128 a week, housing benefit has gone down after 13 weeks as we 'have a house larger than we need, so 13 weeks a grace period to move into something more suitable'. I can't even think about moving house right now let alone afford deposits and moving costs!! Our house is 2 beds with a box room that you can't even fit a bed into, but it's classified as 3 bedrooms and there are 4 in our family.

I really don't know what to do....I have a pile of DLA and ESA paperwork in front of me that might as well all be written in another language!

Please, can someone advise me where to go from here??
Diagnosed : ME/FM, CFS,CPS, IBS, ADHD : Medications : Mirtazapine 45mg, Paracetamol 4gram a day, Omeprazole 40mg, Dompperidone 30mg, Morphine (tabs) 120mg, Morphine (liquid) 100mg twice a day
darkcyde
UKFM Member
 
Posts: 140
Joined: Fri Jan 27, 2012 5:17 pm

Re: Denied both ESA & DLA....

Postby wiscolet » Sat Apr 14, 2012 12:33 pm

Oh what a dreadful situation :evil: i hate what they are doing to the sick and vulnerable, please please contact your mp immediatly and the benefits advice people at your local town hall, contact your local radio station, your gp,your regional tv news,local newspaper, write to the tabloids, anyone that will listen, the truly sick and less able seem to have no voice anymore due to malingeres and the savage benefits cuts and there are more to come, also contact the dissability rights organisation and the court of human rights if you have to! keep us informed.
wiscolet
UKFM Newbie
 
Posts: 6
Joined: Fri Feb 19, 2010 8:28 am

Re: Denied both ESA & DLA....

Postby denys » Sat Apr 14, 2012 12:48 pm

Hi firstly inform them of your intent to appeal, citing the innaccuracies in the refusal letter. Get in touch with the likes of CAB, DIAL etc and ask for help with the process, get your GP to write a letter stating his support and then unfortuantely wait for the tribunal to happen and you could use this time to do as the other poster has suggested :fingerscrossed: and :goodluck1:
Denys

As a Public Moderator of this forum my opinions/views expressed are personal and are no more valid than those of other members and not necessarily those of UKFibromyalgia.
User avatar
denys
UKFM Veteran
 
Posts: 11901
Joined: Tue Feb 09, 2010 10:05 pm

Re: Denied both ESA & DLA....

Postby Ldyalb » Sat Apr 14, 2012 12:51 pm

Most people are turned down for DLA first time round. I have been too, and got similar responses 'at your own speed you can do XYZ' - it's all lies. I'm appealing this decision.

viewtopic.php?f=11&t=12519

This is a link to a list of useful sites, you may well find them useful.

Wrt DLA. I would seek advice from a specialist organisation such as the CAB, Welfare Rights or DIAL. You need to inform the DWP in writing that you wish to appeal within one month of the date on the refusal letter. You need to enclose form GL24 which can be downloaded from here: http://www.direct.gov.uk/en/Diol1/DoItOnline/DG_4017514 or picked up from your local Job Centre. You don't have to go into loads of detail why you are appealing in the initial letter, just outline some brief reasons, state that the list is not exhaustive and that you will send more specific detail at a later date, once you have spoken to your advisor.

When you appeal your DLA decision this will trigger a reconsideration. This means that all your original forms will be sent to a different decision maker. That decision maker will then either agree that no award should be made, or will make you an award. Some people on here have been awarded DLA at the reconsideration stage. If you still get a no the DWP will write to you explaining why it's a no, and will tell you that they have forwarded your details to the tribunals service.

Wrt ESA. I think you may need to call the DWP up again and make a fresh claim, state you wish to appeal for income based as you have not paid enough NI, and your wife is on Maternity Leave so not earning. I would seek advice about this also as I'm not sure why they haven't been paying you at the assessment rate. Most likely because you're not eligible for contributions based, so hopefully ringing up and making a new claim for income based will trigger the assessment rate payments.

:goodluck1:
'Think of all the beauty still left around you and be happy' - Anne Frank

TMJ, RLS, HMS, Fibro, Dyspraxia - ASD + Dyscalculia overlap, Eczema + Rosacea + suspected Psoriatic Arthritis.

Being an Adult is nothing like it said in the brochure...!
User avatar
Ldyalb
UKFM Regular
 
Posts: 1667
Joined: Sat Nov 13, 2010 6:46 pm
Location: Lincolnshire

Re: Denied both ESA & DLA....

Postby helen w » Sat Apr 14, 2012 1:19 pm

Hi,I would like to offer you some hope. I was in a very similar position,minus the children.
I was made redundant because of my FM,ME and hand problems.
I am now in receipt of ESA and DLA after having to appeal for both. It has been a nightmare of form filling and reading but I was assisted by welfare rights who took a lot of the burden off my shoulders.
We all know stress makes our condition worse so any help you can get is worth its weight in gold.
As I have been on ESA for over 12 months my money is being stopped at the end of this month. They have told me I can claim job seekers allowance!!! When I told them I was not fit for work they said I was not entitled to it then!! I want to work but my body has other ideas!
I am now putting in an appeal to be put into the support group. I will keep you all posted.
This system stinks for us genuine people who have paid into the system for years and now need some financial help through no fault of our own. I think the government should read this site and all similar ones. They may learn something about REAL life. Can you tell I am angry!!!.
My advice to you would be to get in touch with welfare rights asap. You will get back pay when you win your appeal,which I know doesn't help you now but it will soon. It is wrong that we have to fight so hard but I am afraid there is no other choice. Let them take the burden for you. I would also follow the advice of the other reply and involve your MP and anyone else that will listen.
This site has helped me with my sanity and we are all here and rooting for you.
Keep us updated and good luck xxxx
helen w
UKFM Member
 
Posts: 32
Joined: Sun Feb 05, 2012 10:34 pm

Re: Denied both ESA & DLA....

Postby FluppyPuffy » Sat Apr 14, 2012 1:47 pm

:wave: :wave: darkcyde and :welcome: to the forum :mrgreen: :mrgreen:

I'm so sorry to hear what you're going thru with the benefits system, sadly it is happening to more and more people who desrve and need the help :facepalm: :facepalm:

You've been given some really good advice, so there isn't really much more that I can say, apart from a couple of little things. When I appealed the decision regarding ESA, I simply wrote a letter to them, as advised by the person who rang to let me know I had been placed in. For your appeals, make sure you ask them for a statement of reasons to be sent to you. This tells you about how they have reached their decision, and you can use it to pull apart the reasoning they claim to have used in deciding your fate.

There are various organisations who will be able to help and advise you with your appeals. Have a look and see if you have CAB, DIAL Welfare Rights in your area, or other similar places. A lot of councils also have a one~stop~shop type of place, who can advise you/direct you in the direction of people who may be able to help you.

There is a lot of info in the Benefits and Works part of the forum, so having a look in there may be helpful. There is also a lot of info on the other parts of the forum that you may find useful too.

Anything you're needing/wanting to know about, just ask and we'll try to help you with it :wave: :wave:
As a Public Moderator of this forum my opinions/views expressed are personal and are no more valid than those of other members and not necessarily those of UKFibromyalgia.

If your dog doesn't like someone, then you probably shouldn't either
User avatar
FluppyPuffy
SITE ADMIN
 
Posts: 12719
Joined: Mon Jun 08, 2009 11:25 am
Location: Living Life On The Edge.......Of The Norty Step!!!

Re: Denied both ESA & DLA....

Postby robert » Sat Apr 14, 2012 5:37 pm

myself and my husband have just been reading your post and we are amazed at how similar your story is and your symptoms are to my husband.there seems to be much fewer male sufferers also and its good to hear were not alone.weve had similar with dla and are appealing to tribunal.fm seems to not be recognised as a real condition,not understood and under-estimated by most.best wishes and :crazy: hope u find the strength to carry on the fight to receive what you are entitled to.x :crazy:
robert
UKFM Newbie
 
Posts: 2
Joined: Sat Apr 14, 2012 12:10 pm

Re: Denied both ESA & DLA....

Postby masonsbarms » Sat Apr 14, 2012 5:59 pm

so sorry to read how you have been treated and feel hope all sorts it out soon xx
masonsbarms
UKFM Regular
 
Posts: 1119
Joined: Wed Dec 28, 2011 8:14 am
Location: preston

Re: Denied both ESA & DLA....

Postby darkcyde » Sat Apr 14, 2012 10:26 pm

Wow, what an incredible response.....I was nearly in tears reading them, just knowing I'm not alone with this wall of negativity we get from these people who are meant to be helping us!

I've started writing a response to them in my lucid times of the days - I'm listing out each section of their letter, with my response and directing them to each page and section of my claim form where it outright contradicts what they are saying.

Before them FM fully took hold, I wasn't a genius but I could hold my own when it comes down to arguements....I had a near photographic memory....my wife hated it! ;-)

I think the mistake I made when filling the form in was where it sasid something like "if none of these answers best decribes the way you walk" for example "then please tell us in your own words in the box below" I used the box. I think because I didn't use their predefined answers, then my answer didn't fit in their categories so they've taken it as I can do that activity. For example, in the part where it asks how far you can walk before suffering extreme discomfort, I said I could walk up to 50 metres in about 5 minutes. They've taken that as I my walking is limited, but I am not unable or virtually unable to walk (their words). However, in their predefined answer boxes, they define less than 40 metres a minute as Very Slow....well, mine calculates at 10 metres a minute, yet they say my walking is fine! Also, they say that I don't need help to walk, yet I've answered a very direct question that asks do you need someone to help you walk!

I think I've hit the angry stage of emotions now! How do they expect us to live and work?!?

Regarding appeal vs tribunal, I gather it's best to go straight for requesting a tribunal then as this will automatically trigger a review of my claim? If I request a review then I'm essentially adding more time to the case as they will write to me undoubtedly saying it's denied again, then I would have to write back asking for tribunal I would imagine.

To the user, I think it was robert, who said they were in the same boat regarding the redundancy and everything else....I know exactly what is going through your mind....feelings of worthlessness, desperation, etc. It's awful I know! I used to be a gas engineer, and a damn good one even if I say so myself....I really had my finger on the pulse of boilers and could normally put my finger straight on the problem. To go from that, to wondering if you can get out of bed in the morning....its soul destroying!

I will come back and update everyone as soon as I know more....thanks everyone again, your messages have helped a huge amount!

xx
Diagnosed : ME/FM, CFS,CPS, IBS, ADHD : Medications : Mirtazapine 45mg, Paracetamol 4gram a day, Omeprazole 40mg, Dompperidone 30mg, Morphine (tabs) 120mg, Morphine (liquid) 100mg twice a day
darkcyde
UKFM Member
 
Posts: 140
Joined: Fri Jan 27, 2012 5:17 pm

Re: Denied both ESA & DLA....

Postby Ldyalb » Sun Apr 15, 2012 12:03 am

Regarding appeal vs tribunal, I gather it's best to go straight for requesting a tribunal then as this will automatically trigger a review of my claim? If I request a review then I'm essentially adding more time to the case as they will write to me undoubtedly saying it's denied again, then I would have to write back asking for tribunal I would imagine.


Correct, this will make things much quicker and easier for you.

Don't forget, you don't have to list every reason why initially. You can just briefly say something along the lines of:

"I believe that the Decision Maker has not fully taken into account the level of care and mobility needs that I have on a day to day basis, for example needing to have meals prepared and cooked for me, and being unable to navigate somewhere I have never been before by myself. Please note that the above is not an exhaustive list of reasons why I am appealing this decision.

Please find enclosed my completed GL24 appeal form. I will be seeking independent advice and support regarding this matter from the Citizens Advice Bureau. Once I have spoken to them I shall provide additional information to support my appeal. I shall also provide a list of reasons as to why I am appealing the decision once I have spoken to my Advisor"


Then you can send a more complex list of reasons why at a later date. If you can manage to send an exhaustive list initially then it's probably best to do so (I wouldn't specifically state that it's exhaustive, always leave room to add more at a later date). I didn't with mine and the review came pretty quickly and it was still a no. I do wonder whether I'd have had a more successful outcome if I'd already sent them the nitty gritty reasons why I'm appealing.

Hope that helps. Lots of us are going through this at the moment, not just us Fibro Folks, but people with all sorts of disabilities. You are not alone. Keep fighting!
'Think of all the beauty still left around you and be happy' - Anne Frank

TMJ, RLS, HMS, Fibro, Dyspraxia - ASD + Dyscalculia overlap, Eczema + Rosacea + suspected Psoriatic Arthritis.

Being an Adult is nothing like it said in the brochure...!
User avatar
Ldyalb
UKFM Regular
 
Posts: 1667
Joined: Sat Nov 13, 2010 6:46 pm
Location: Lincolnshire

Re: Denied both ESA & DLA....

Postby denys » Sun Apr 15, 2012 12:53 pm

:fingerscrossed: :fingerscrossed: and :goodluck1: hope it all gets sorted out quickly and properly for you :hugs: :hugs:
Denys

As a Public Moderator of this forum my opinions/views expressed are personal and are no more valid than those of other members and not necessarily those of UKFibromyalgia.
User avatar
denys
UKFM Veteran
 
Posts: 11901
Joined: Tue Feb 09, 2010 10:05 pm

Re: Denied both ESA & DLA....

Postby millymoodoo » Sun Apr 15, 2012 1:42 pm

Hi

I don't know if this is of any help to you, but when i recently applied for the mobility rate of DLA i included 5 typed pages of how my disability affected my daily life in detail. I sent copies of all tests i had, had done copies of all appointments and any other information that i had. I have several other problems besides the fm which include crohn's disease, diabetes, osteoporosis, high blood pressure, kidney stones, underactive thyroid so if you have other problems tell them initially. I was also denied any mobility so i appealed and at reconsideration was overtuned and i received a letter telling me that i would be getting higher rate mobility. I very nearly didn't send in my appeal as i couldn't cope with all the stress involved, but the way i saw it was i can always change to a paper hearing if need be. I am so pleased i made the decision to fight.

Go for it, it seems such a fight but believe me it is worth it!!! Good luck
Milly :shooting: xxx
Never look down on anyone unless you are helping them get up!!! When life hands you lemons, make lemonade!!! Everyday is a gift which is why we call it the present
User avatar
millymoodoo
UKFM Member
 
Posts: 499
Joined: Sat Jun 11, 2011 4:14 pm

Re: Denied both ESA & DLA....

Postby darkcyde » Mon Apr 16, 2012 10:01 am

Hi Milly - thanks for your advice!

Whats a paper hearing? I'm guessing that it's instead of a stand up in court or similar?

How do you change to this, or is there a qualifying scenario?

I must admit, I do find the idea of been scrutinised by god knows how many people in a court or similar situation extremely daunting, and I would probbably cop out on the actual day!
Diagnosed : ME/FM, CFS,CPS, IBS, ADHD : Medications : Mirtazapine 45mg, Paracetamol 4gram a day, Omeprazole 40mg, Dompperidone 30mg, Morphine (tabs) 120mg, Morphine (liquid) 100mg twice a day
darkcyde
UKFM Member
 
Posts: 140
Joined: Fri Jan 27, 2012 5:17 pm

Re: Denied both ESA & DLA....

Postby Ldyalb » Mon Apr 16, 2012 10:14 am

Basically when your forms come through from the tribunals service you can opt for a paper hearing or an oral hearing.

A paper hearing is when you don't attend, the Tribunal Panel (usually A Judge, Dr and a Benefits Law Solicitor I believe) will scrutinise your forms and decide whether or not to make an award. An oral hearing is one which you attend and can answer their questions about your disability/disabilities.

I wouldn't recommend the former. They have a lower success rate than oral hearings - by the time you get to tribunal your documents have already been scrutinised twice and no award has been made. By attending in person you increase your chances of an award. Up to 70% of people who have an oral hearing (acc. Benefits and Work site) will be made an award.

Best thing to do IMO is to say you'll attend in person. You can change your mind at a later date. If you do opt nearer the time not to attend, whether you can't cope mentally or are physically too ill to attend then I would make sure you give your exact reasons to the tribunal in writing. Explain that you're not physically able to leave the house that day/that you're having panic attacks and can't cope with the stress etc.
'Think of all the beauty still left around you and be happy' - Anne Frank

TMJ, RLS, HMS, Fibro, Dyspraxia - ASD + Dyscalculia overlap, Eczema + Rosacea + suspected Psoriatic Arthritis.

Being an Adult is nothing like it said in the brochure...!
User avatar
Ldyalb
UKFM Regular
 
Posts: 1667
Joined: Sat Nov 13, 2010 6:46 pm
Location: Lincolnshire

Re: Denied both ESA & DLA....

Postby FluppyPuffy » Mon Apr 16, 2012 10:15 am

A paper hearing is one where the panel make a decision based on what paperwork has been sent in to help with the appeal without you attending. The success rate for a paper hearing/where the appellant doesn't attend is lower than the success rate for for hearings where the appellant is present, so you really need to consider things carefully before deciding on the type you want.
As a Public Moderator of this forum my opinions/views expressed are personal and are no more valid than those of other members and not necessarily those of UKFibromyalgia.

If your dog doesn't like someone, then you probably shouldn't either
User avatar
FluppyPuffy
SITE ADMIN
 
Posts: 12719
Joined: Mon Jun 08, 2009 11:25 am
Location: Living Life On The Edge.......Of The Norty Step!!!

Next

Return to DWP, Working & Benefits

Who is online

Users browsing this forum: No registered users and 3 guests