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ESA turned down after medical assessment

Discussion in 'Social Security / Disability Benefits' started by Debs2411, Feb 25, 2012.

  1. Debs2411

    Debs2411 Registered

    I have been on the lower rate of ESA since May 2011 whilst waiting for my medical assessment. I was called in for my medical on 11th January and was told at the interview that they had "lost" the 28 page questionnaire that it had taken me 2 weeks to complete!

    ATOS eventually sent my details to DWP on 7th February and I then received a 20 page booklet to complete "limited capacity for work".

    I have just received a letter telling me that I have only scored 6 points ( I need at least 15 to qualify for ESA) and quite frankly a lot of their reasons for not awarding points bear no relation to how my condition affects me on a day to day basis.

    I am now waiting to see my GP who will hopefully write me a letter of support so that I can ask DWP to reconsider their decision but have been warned by the Citizens Advice Bureau that I must be prepared to go to a first and second appeal.

    Has anybody else had to go through this process and does anybody know if I am entitled to continue receiving ESA whilst this is ongoing?

    Needless to say I feel pretty distressed right now. I explained at the medical what my daily life is like but one of the comments on the letter from DWP states that as the Healthcare Professional saw me walk 15 metres to the examination room and the examination showed some restrictions to upper and lower limbs due to stiffness and pain, their evidence suggests I would be able to mobilise more than 100 metres within a reasonable timescale! How can they suggest they have evidence that I could walk the extra 85 metres? Am I missing something here or are they just making it up as they go along? That is just one example of their logic.

    Any help on this would be very much appreciated.

  2. TracyJN

    TracyJN Registered

    Hi Debs,

    I just wanted to say how sorry I am that you are having to go through this. My advice would be to do exactly what the CAB advise as they are really very good when it comes to benefits.

    ATOS are a law unto themselves. I was very, very lucky that when I had my medical I saw a "real" doctor rather than someone only trained in "box ticking" and I think it helped a lot that he had an understanding of my conditions.

    Write a letter to the DWP detailing where you feel their reasons for not awarding points bear no relation to how your condition affects you on a day to day basis. Also explain how much stress this is putting you under and how that stress is affecting your health.

    I am sorry but I don't know if you will continue to receive ESA while it is ongoing but I am sure the CAB will be able to answer that question for you.

    Good luck.

  3. keebler

    keebler Moderator

    HI Debs,

    Sorry you are going threw all this.:hug:

    I am not much help to you. (live in the US)
    I just wanted to wish you good luck with all of this.:luck:
  4. Jessica1

    Jessica1 Moderator

    Hi Debs
    Although I'm from the UK I'm afraid I'm not much help as I have no experience with this to share with you. I'm with Tracy though, I think the CAB are your best bet and it's good that you're already in touch with an advisor.

    I hope you get on ok with this and that you're able to carry on with your claim for ESA. Will keep my fingers crossed for you :fingers:
    Best wishes,
  5. Debs2411

    Debs2411 Registered

    Thank you all for your replies.

    Since going to the CAB I have found a useful website about benefits and appeals. They recommend going straight for an appeal rather than asking DWP to reconsider their decision. This will speed up the process and I should be able to get the assessment rate of ESA until the appeal is heard.

    Am I allowed to post the website address on here as it may be helpful to others? It also covers DLA.

    Thank you for your good wishes. I will keep you informed.

    Debs x
  6. debatat

    debatat Moderator

    Yes, it would be useful if you posted the link, thank you.
  7. Debs2411

    Debs2411 Registered


    I've posted under "useful websites".

    Hope it can be of help to others.
  8. debatat

    debatat Moderator

    It appears the link doesn't work.
  9. wheeliefab

    wheeliefab Registered

    I think you often do have to appeal decisions. My Drs refered me to local council social services to help represent me for appeal as the whole stress of the assessment has made my health worse, so may be worth giving them a try
    I posted this link also under "usefull websites" as this detailed doc re ESA work capability assesment including what points you may "score" has been really useful to me .

    Remember not being able to do a "task"/thing on form repeatedly or reliably (eg due to pain/fatigue) should be counted as not being able to do a task.

    Also there are exceptional circumstances rules which basically say the assesment outcome should not be detrimental to your health.
    These special/ exceptional circumstances rules may apply to Lupus patients being put into the "work related activity group" of ESA if you do not generate enough "points on the form" to qualify automatically. (Eg the stress may cause more Lupus flares/ may have impacted upon your mental & physical health, working/ looking for work may prevent you paceing activities correctly/resting enough)

    I think you would need supportive Drs but the exceptional circumstances rule and may even allow people to be put in the "support group" if you can prove " there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work-related activity."
  10. wheeliefab

    wheeliefab Registered

    The link I posted sometimes fails it can be found on the direct gov web site
    under money,tax and benefits, Ill or injured benefits, then Employment and Support Allowance Introduction page - There is then a option to click on
    Employment and Support Allowance - Work Capability Assessment - This brings up the Work Capability Assesment page

    This is the link to the page directly and this link usually does not fail like the other link

    Once on the work capability assesment page a further link can be found at the bottom of the page (under Further details)

    eg page says
    Further details
    There is a very detailed guide to the Work Capability Assessment (ESA214) in PDF format. It is published by Jobcentre Plus and is aimed mainly at professionals, but you may find it useful. Because the information is detailed and technical, some of it can be quite hard to understand.

    See the link 'Guide to Employment and Support Allowance - the Work Capability Assessment ESA214'.

    Download 'A guide to ESA - the Work Capability Assessment ESA214' (PDF, 154K) Opens new window

    Just click on the PDF, 154K download link

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