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TOPIC: Given home visit for esa but not for pip?

Given home visit for esa but not for pip? 1 week 4 days ago #175119

Hi all,

This is my first time posting, but have been reading through the forum and members only guides and has been most helpful, thank you!

I've got a question, I'm in the process of applying for both esa and pip. I've been asked to attend assessments for both. My GP wrote a letter stating that I needed a home visit as I'm struggling to leave the house due to my condition. I've received a letter today from esa stating that they will do a home visit, but when i contacted pip for an update they said that my request had been denied as I'd attended doctors and hospital appointments in the previous few months (I explained that this is the only time i leave, have to be accompanied everywhere and unable to walk to these appointments so must be driven there, and the rest of the tiime i'm pretty much bedridden)

Both esa and pip were given the exact same letter from my gp.

Is it worth me informing pip of esa granting me the home assessment, would this change their decision, or could it go against me and result in esa changing their decision about agreeing to the home visit?

Thanks in advance!
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Given home visit for esa but not for pip? 1 week 4 days ago #175140

Hi Sharon and Welcome to the forum, you might want to have a look at the following FAQ which explain where everything is

Welcome to Benefits and Work

I'm sorry that you are having this problem :( I wish I could say it is unusual - but unfortunately it is pretty common for claimants to be denied home assessments.

The assessments for PIP and ESA are carried out by completely different companies, I would not expect there to be any communication between them. They have clearly both had the same letter, one company is satisfied with that, the other feels that you can attend an assessment centre as you leave your home for medical appointments (we have heard this argument before!).

You can try contacting the PIP assessment provider and ask what they would need 1) in order to grant a home visit and 2) to complete the assessment on paper without needing to see you at all.

I also suggest you involve your MP, especially if your call does not bring about a satisfactory result.

Contacting your MP

May I suggest that you bookmark/favourite this on your web browser now so that you can find it easily in the future? This will allow you to return with further questions or comments about your situation without having to start a new topic each time. We ask members to keep everything relating to the same issue in one topic as it makes our 'job' much easier - and I hope you will find it useful too :)
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last Edit: 1 week 4 days ago by Mrs Hurtyback.
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Given home visit for esa but not for pip? 1 week 3 days ago #175312

Hi, I just wanted to update you and let you know I've managed to get the decision for denying me a home assessment overturned, cant quite believe it, but it definitely wasn't easy!
I'm sorry this is going to be a long post, but for anyone else thats in the same position i was and not sure how to proceed this is what i went through:

My mum and myself contacted atos customer service on 3 occasions yesterday, asking for details of the health professional who made the decision not to uphold my gps request for home visit, the reason it was denied, and for the details of what guidelines they used to reach that decision. They said that as I left the house on more than 4 occasions in the last 3 months for hospital/GP appointments that I was not housebound or bedridden and therefore would be able to attend assessment centre, despite my GP clearly stating that I was not able to do so.

They were unable to tell me the health professionals details or the guidelines used. They said the only way I might get this decision overturned is if i provided additional medical evidence for them to look at.

I then asked them to then clarify with me what medical evidence i needed in order for them to accept a home visit, they said they could not tell me this either and that its dwp that would know.

I then got transferred over to dwp, who stated that she'd never heard of a home visit being turned down if a gp had written a letter for this, and went to speak to her colleague. She came back and said that she'd get a case manager to call in the morning (said that they aim to get back to people within 3 hours during their opening hours).

So just after 8am got a call from a case worker, who quickly realised that she'd need to put us through to the case manager. He contacted atos and enquired as to why a home assessment was denied, he got told the same thing we did (not considered housebound as attended hospital appointments) He seemed understanding, but said that he could not overturn the decision or give details on what new medical evidence we'd need etc. He also offered to lodge a complaint for us, which we took him up on.

He also advised that if i'm unable to attend the appointment that instead of just not showing up that its best to let them know (earlier rather than later), atos would then refer it back to dwp, that would then look at the reason why i didnt attend and could over turn the decision based on this, although this isn't guaranteed.

So we decided to contact atos again, got told we were being put through to the manager, turned out she was actually customer service support and informed us that 'managers deal with the staff not the customer'. Therefore we asked about lodging a complaint with them, at first they denied having any means of doing this, but after pressing them eventually we got an email and address that we could write to (This email address is being protected from spambots. You need JavaScript enabled to view it. and their address is Client Relations Team, Atos Healthcare, PO Box 1006, Stockton-on-Tees, PS19 1UL)

We then brought up the request again to be told the health professionals name, profession and pin number, eg. NMC pin. After a lot of pushing, she gave the details that were in the public domain. I had 2 different HCP that looked at this. The first person looks at the form when its first received, and then passes it onto another HCP who makes the decision on whether to grant home visit or not. I was able to go onto the nmc (nursing and midwifery council) website and check their registration details, both the HCP's were mental health nurses and registrations were up to date,which is always good to know!

I then pushed them again to let me know what guidelines/criteria they used to base their refusal, as I had looked into this and in the faq on home assessments on the atos website it gives a broad overview of criteria for home visits and states that they use DWP guidelines for this. (www.atoshealthcare.com/pip/faq_view/Can_...fessional_in_my_home)

I've also looked up the dwp guidelines they used which is in the PIP assessment guide under section 2.7.20 (pages 47-48) (www.gov.uk/government/uploads/system/upl...assessment-guide.pdf)

This is what it states:

Home consultations
Consultations may potentially be carried out at a variety of locations but some will need to be carried out at the claimant’s home.
Providers may also decide to carry out a home consultation for business reasons or simply to give claimants choice. As a minimum they should consider whether a home consultation is necessary where a claimant indicates that they are unfit to travel to a consultation in a location other than their home or where travel would require high levels of support.

When considering a request for a home consultation, providers should consider:
• Does the claimant have a medical condition that precludes them from travelling?
• Has there been medical verification of the severity of the condition that precludes them from attending a consultation?
• Are there health and safety implications for a home consultation?
For example, the claimant or a person associated with them has had unacceptable claimant behaviour identified
• Any accessibility issues related to the planned location of consultations.

The request for a home consultation may come from a GP or other healthcare professional involved in the claimant’s care. When assessing such requests, providers should consider issues such as:
• Whether the request is based on medical fact rather than opinion e.g. “My patient has severe agoraphobia and cannot leave the house” rather than “I feel my patient would benefit from an assessment at home” or “My patient tells me they are unable to travel to an assessment centre”

48
• Does the request relate to the claimant’s medical condition rather than social circumstances at home?
In each case the evidence should be reviewed. At times it may be necessary to seek further clarification from the author of the report to clarify the medical facts.

Information that may help support a home consultation request may
be:
• Diagnosis suggesting significant disability that may make travel extremely difficult – e.g. incomplete quadriplegia
• Evidence that the claimant receives home visits or telephone consultations with their GP
• Evidence that the claimant has home visits from the psychiatrist/CMHT
• Claimants who are likely to find travel extremely stressful as a result of their physical or mental health condition.

Providers may also consider whether other options may be acceptable - for example if travelling on public transport is the issue,could a taxi be considered?

I was able to use this to state why these guidelines applied to me and that I fulfilled several components of this.

I also made a point of highlighting that I did not agree that because i attend hospital appointments that this means I'm neither bed ridden or housebound (they like to use this alot) I explained that these hospital appointments could not be completed at home (MRI, Xrays, Ultrasound etc) and that it would be detrimental to my health NOT to attend. I also said that I got brought into A and E via Ambulance, and that it was ridiculous to suggest that for those reasons I'm not home bound.

At this point I started getting upset and couldn't help but break down and spent a few minutes explained the effect attending these hospital appointments have on my health e.g. it takes 2-3 hours to get ready for an appointment as need help with washing, dressing etc. That i'm in pain whilst being driven to them. That these appointments tend to last 15-30 mins, and despite there being pain present, its a short enough period of time to make it doable, and you do what you have to do otherwise I wouldn't get treatment. I explained how this left me exhausted and I would spend the next few days trying to recover from this one appointment. I also mentioned how stressful and anxious it makes me. She then wrote down what I'd been telling her, and said she would speak to a healthcare professional about my case.

That was this morning, and I found out not long ago that they've now granted me a home visit and will get a letter in the post shortly for this!

I'm not sure which part turned their decision, or whether it was a mixture of it all, but I hope this helps others that get turned down for home assessments, and shows that it is possible to overturn their decision, but you need to be clear about why you need this!

Really sorry this is so long, but I've been unable to find any information on disputing this on the web, aside from contacting MP, so had to research the above myself, and if it helps just one person then its worth doing this post!

:) :) :)
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The following user(s) said Thank You: maggie68, Gordon, Mrs Hurtyback, sia

Given home visit for esa but not for pip? 1 day 18 hours ago #176220

Thank you so much sharon for taking the time to research and post, very helpful.
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Moderators: bro58, Gordon, Mrs Hurtyback, shelam
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