ESA Turned down

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ESA Turned down

Postby bernpep » Thu Jul 18, 2013 8:13 am

Hi all

I am new to this site and have joined on behalf of my mum who does not have internet access. She is at the end of her tether with the whole ESA situation. She made a claim nearly two years ago which was turned down, she then appealed and it went to a tribunal which was thrown out. She was advised to make a second claim as according to outside sources she scores more than the 15 points required. She then made a second claim and is now undergoing the same process!! As I am sure anyone who has been through this will completely understand how stressful this is for mum.

In addition to fibromyalgia she has depression, hiatus hernia, recurrent vertigo, hypertension plus more. I cannot understand how they can keep turning this claim down when 95% of the time my mum can barely walk let alone go to work. They award it to people with depression alone yet are turning it down for more than just depression.

We have had numerous Dr's letters and done many trips to CAB for help and advice.

Please please please can anyone help us?? :too-upset: :too-upset:
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Re: ESA Turned down

Postby *Lisa* » Thu Jul 18, 2013 8:52 am

:welcome:

You say you asked advice from CAB were they the ones that filled out the form or did you complete the forms yourself?

What reasons did they give to throw the claim out? and to turn you down this time?

Its a very tricky form to fill.

You have to tick *NO* if you cannot reliably, repeatidly or safely do each task. So when looking on the forms and one question asks about grasping items and mentions *can you pick up a pound coin*

At first you think, well yes i can BUT can you repeatidly do this action :?: alot of fibros cannot as it cramps the hands up, causes pain / stiffens the fingers and so forth. Just an example there.

You need to quote each task to the ESA how you cannot do them reliably/safely and repeatidly for example....
I cannot pick up a pint of milk repeatidly or safely because .......................
and then to back it up. If i was to do the task repeatidly it would increase pain levals , spasm the muscle etc etc...

Again its the way you word things on the form like the dla.

Has your mum had a medical for an ESA claim?
As a Public Moderator & Admin 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...Lisa
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Re: ESA Turned down

Postby bernpep » Thu Jul 18, 2013 12:33 pm

Hi Lisa

Thank you so much for your reply :-)

My mum completed the form which I didn't see until a copy was returned when saying it had been refused. I had said to her that I think it has been turned down as she played things down rather than writing a truthful description of how day to day life is for her. She is one of those people who doesn't like others to think that she isn't copying. Repeatedly throughout the form she writes 'when I get a spasm (she suffers with back problems and has done for over 30 years after having an epidural knock her nerves when having my brother) I have written a letter to state that Mum gets confused and what I have put above and hope that this helps however I am incredibly sceptical.

When she went for the first medical I took her and at the time she was suffering badly from vertigo. We were placed in a room of own rather than waiting with other people. She was even advised to go home but she was scared it would affect her claim that she wouldn't. I more or less had to carry her into the room although stated on the initial 'no' she walked on her own which was a load of rubbish. The clinician even stated that there was no way she could live her life this way and this modern day she shouldn't be suffering the way she is yet this clinician declined the award!! Crazy if you ask me.

Like I say she is now going through this for a second time and once again the claim was declined after a medical :-( She now says that she wont go to the tribunal as they don't take on board what she says to them anyway so she feels she has lost already. The problem is if she doesn't get ESA she will have to go onto JSA and there is no way someone would employ her and the majority of the time she wouldn't even make it to sign on. Her pain is so unpredictable as I sure many will understand. Her GP is backing her up and agrees she cannot work but again it doesn't seem to be taken into consideration.

I just don't know how I can help her with the tribunal process. Again I took her to the previous one and she was just a wreck and being her usual 'play it down' self. Which I have explained to her wont help but its just in her nature.
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Re: ESA Turned down

Postby *Lisa* » Thu Jul 18, 2013 1:36 pm

A few things that may be of help

You can ask for a home visit for the medical as long as you GP writes to them to explain why which should be better for mum

As you say above when mum puts down *when i get a spasm* when i get one could mean anything :?: what she needs to do is write the form out as if she IS in spasm. This will come across more clearer in the forms to how things are when she is in one rather then *when* she gets them.

I know how she feels, my back locks up in spasms so much and there very painfull and dibilitating.

ANother thing is you can put another claim in for ESA and get the CAB to complete the forms. If your there with mum then she cannot play it down as you are there to explain how bad things are.

CAB know exactly what to say/how to say it and what can be put and what not.

Without seeing what your mum has written its hard for me to pin pointexactly where she has gone wrong and why the claim is not a success.

As soon as mum claims JSA if she feels she cannot face another tribunal, im sure jobcentre will advice her to try again for ESA as they know she has limited capabilities for work.

Another point is the person doing the medical is not the decision maker. After the medical they process all of the information that gets sent over the the decision maker to make the decision of the final outcome.

In your appeal and being a witness you will need to point out any errors from what you say about mum walking in alone. Another one to take on board is many people record the medical for evidance as so many lies are being put down effecting claims. You will need to ask permission first tho.

Its a good thing you wrote in support of your mum and that she gets confused but realisticly anyone who fills the form out for themselves (mstakes or not) automaticly get seen as able to complete a form and thus meaning having concentration, able to write, hold a pen and so having capabilities to work

Very confusing i know! always research as another thing ATOS like to do is catch you out by question like *do you watch TV?* this is to see if you can sit for longer and concentrate from more then 30mins :roll: and the list goes on!

We are very much up against the system and all its contridictions but i feel you will need to seek help next time on your forms.

If mum does decide to appeal/tribunal then ask CAB to represent you as they know the system.
As a Public Moderator & Admin 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...Lisa
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Re: ESA Turned down

Postby anonymouse » Thu Jul 18, 2013 2:49 pm

I really sympathise, the system is not fit for purpose, my ESA & DLA took three years each to get sorted!

You need to work out is she should be in the support group (limited capability for work related activity) or work related activity group (WRAG or limited capability for work). The points criteria for WRAG is listed here http://www.legislation.gov.uk/uksi/2013/379/schedule/2/madeand you need 15 points or more. To get in the support group (for more severe issues) you need to qualify under these rules here http://www.legislation.gov.uk/uksi/2013/379/schedule/3/made.

It is hard and if an ATOS medical has turned her down then you have a fight on your hands likely to be at your own cost. There are other rules if she would come to serious harm if she was not awarded ESA and special cancer rules and things I'm guessing are not applicable.

My advice is:
1) really get to know the criteria contained within those links.
2) work out what points you feel your entitled to, if its 15+ criteria or the support group then ask DWP for a full copy of your ATOS WCA, if this will delay your appeal time write and ask for an extension until 14 days after the date the WCA is sent and ask for written confirmation AND carry on here:
3) take your points list to CAB (some are amazing, some are amazingly useless)
4) take the points list to your GP and see if he will write a letter and agree to your points assessment (minimum) and any specialist you can
5) as most doctors will charge so get a quote from a GP and a specialist for a private consultation with a written report for submission to DWP for benefits. Then decide if you can afford it and justify the cost
6) ask your GP for a copy of all consultation letters from specialists or any other evidence you feel can add anything evidence wise to your points assessment, then send all of this to DWP with your appeal
7) tell any specialists to copy you into any reports to your GP
8) consider getting a witness statement from a carer, medical professional or if you have to, a family member.
9) construct a simple appeal based on the points, enclose any of the evidence listed AND go through the WCA report. Anything that is not true, accurate or did not occur needs listing in your appeal, if its major consider a complaint too. If possible you need to discredit this report if it is not accurate
10) list every symptom that causes her problems, when it started, how it effects her etc and remember your 14 day deadline (you can ask for extension but its V V hard to get so don't rely on it

Hopefully that makes sense, I didn't have much time so I've written it really really quickly so there will be spelling mistakes etc, I have not had time to read it through so if anyone spots a glaring untrue statement in that please point it out lol

Hope it helps, keep tough if you are legally entitled your legally entitled, don't be put off by those links being actual legislation, its on there to be available to the public because its the law :-) good luck!

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Fibro, Chronic Pain, Insomnia, Psoriasis, Migraines, Light & Hyper Sensitivity & Joint Subluxation but apart from that I am perfectly healthy & battling for ESA & DLA. - Twitter: my_fibromyalgia - Facebook: myfibromyalgia
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Re: ESA Turned down

Postby Tracie » Thu Jul 18, 2013 8:00 pm

request a home visit,also the person who does the assessment does not decide on if you keep ESA or go on JSA,request a report from dip about the medical once you have this go through it of what you disagree with and why and send it off,we had todo this with a friend of mine and they told her she can not work and she be ok,she was not ok and is now appealing this has gone on sice nov last year.
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