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under surgeon sick note, called for medical

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7 years 6 months ago #170821 by julie
Hi, my husband had an accident just over a month ago, and had surgery on his knee for a torn quad. He has claimed ESA contribution based, and has had 3 weeks of payments. He has already had to fill in an ESA 50 and has now been called for a medical already! his surgeon has said that recover will prob take 4 months, and so far he has had sick notes from his consultant surgeon to cover the time he has been off of work. My question is can the medical assessment force his to do some kind of work? he is self employed handyman window fitter, and we hope he will be returning to this work after his 4 months recovery, but my husband is worried the medical will over ride the sick note given by his surgeon.

I am used to the claiming process as I have chronic renal failure and I am in the support group, so I am used to how to treat these tests, but he is in a very different situation to mine, as he has work to return to when he is better. Also what will be the use of him attending work related meetings if he is called for one, does anyone who has been self employed and attended one of these? thanks in advance

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7 years 6 months ago - 7 years 6 months ago #170824 by slugsta
Replied by slugsta on topic under surgeon sick note, called for medical
Hi Julie,

I'm sorry to hear about your husband's accident :(

The ESA assessment process has speeded up a lot. A while ago, people in your husband's situation would be back at work long before they would be due for a face2face!

A sicknote/fiTnote is essential to start an ESA claim. However, it is now up to the assessor/decision maker to decide whether he meets the specific ESA descriptors. As you know, these are very specific and have little to do with whether someone is fit for work!

The ESA guide explains the points system and what to expect at the face2face. It is worth your husband reminding himself of these before he attends the assessment.

ESA claims and appeals

No-one can force your husband to do any kind of work. However, if his ESA claim fails the reality is that he would have to sign on for JSA if he/you need money to live on!

It is an anomaly of the system that someone with a job awaiting their return still has to undertake work focused interviews/activities if allocated to the Work Related Activity Group. However, one hopes that any JobCentre adviser would take a sensible approach in these circumstances!

May I suggest that you favourite/bookmark this on your web browser now so that you can find it easily in future? This will allow you to return with further questions or comments about your husband's ESA without having to start a new topic each time. You probably remember that we strongly prefer everything relating to the same claim to be kept to one topic :)

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 7 years 6 months ago by slugsta.

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7 years 5 months ago #173069 by julie
Hi, well my husband had his face to face last wednesday, and all seemed to go well, assessor was very nice, and I am sure we answered all the questions without slipping up, the assessor did not look at my husbands injury as she said she had no wish to make the damage to his knee worse. Then today he got a phone call from DWP asking would he be around for a phone call tomorrow ( just one weeks after F2F ) to tell him the result and to add anything he may feel is relevant. what is everyone's gut feeling on this? cos mine is that they are going to find him fit to work( despite the fact he can only just walk and is only half way through his rehab!, and under a current sick note from a consultant)

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7 years 5 months ago #173083 by Gordon
Replied by Gordon on topic under surgeon sick note, called for medical

julie wrote: Hi, well my husband had his face to face last wednesday, and all seemed to go well, assessor was very nice, and I am sure we answered all the questions without slipping up, the assessor did not look at my husbands injury as she said she had no wish to make the damage to his knee worse. Then today he got a phone call from DWP asking would he be around for a phone call tomorrow ( just one weeks after F2F ) to tell him the result and to add anything he may feel is relevant. what is everyone's gut feeling on this? cos mine is that they are going to find him fit to work( despite the fact he can only just walk and is only half way through his rehab!, and under a current sick note from a consultant)


I'm afraid the most likely reason for the call is because they are intending to find him Fit for Work but there are some aspects of his limitations that they are not clear about. I would prepare a list of points of why he meets the criteria and keep this by the phone, we do hear of members in this situation who on explaining there issues in more depth have secured an award, some even for the Support Group.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: julie

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7 years 5 months ago #173177 by julie
so we got the call and it was( in a very long winded way) to tell him he has been found fit to work! my husband asked loads of questions, and submitted verbal evidence, but the DM just kept saying he could only go by what his medical professional has written. I asked ( as I also spoke to him, if they had contacted any of my husbands medical professionals( ie consultant and physio) he said no and they were not going to we would have to submit medical evidence from them ourselves in our reconsideration.

we are going to do this, and have contacted his consultant surgeon already for a letter.

we are also going to site the fact that the DWP "medical professional" admitted to us at the start she had no knowledge of bone/orthopaedic medicine and she did not make any kind of assessment on the injury itself

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7 years 5 months ago #173195 by Gordon
Replied by Gordon on topic under surgeon sick note, called for medical
Julie

Assessors are not required to have a detailed knowledge of a claimants conditions or injuries as they are assessing the limitations that the claimant has because of them not the conditions themselves.

I see your husband has a knee injury, were you hoping for him to qualify under the Moving Around Activity? If you were then you need to understand that this is not just a walking test, in addition it considers whether the claimant could self-propel a manual wheelchair over equivalent distances, the claimants does not need to be using a wheelchair or to even own one for this to be considered. Have a look at the ESA Claim guides for more information.

If you wish to challenge the Decision then the first stage to doing so is for your husband to request a Mandatory Reconsideration, this needs to be done in writing to the DWP, within one month of the Decision, to the office that dealt with your claim, have a look at our ESA MR & Appeal guide for details of the process, the ESA area also has template letters that you can use to make the request with.

www.benefitsandwork.co.uk/help-for-claimants/esa1

You should contact the DWP for a copy of the assessment report if you have not already done so, ask for the ESA85 to be sent, I would phone them but again follow up the request in writing. Once you have the assessment report you will have a better understanding of how the DWP Decision Maker has come to their conclusions and will then be able to argue against them.

His primary task is to show that he meets the criteria, there are many reasons he may have failed, he needs to address each of these but don't get bogged down in criticising the assessment report unless you can clearly show that it is incorrect, it is a lot easier to argue the facts of the situation;

"the assessor recorded that I walked 50m, I did but they have failed to document that I had to stop every 10m for a rest due to breathlessness"

than their opinions

"based on my observations of the claimant walking I believe that they can reliably walk more than 200m.

When you have a better idea of the issues with your claim, come back to the forum and we will do our best to help.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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