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ESA medical

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8 years 2 months ago #152540 by Livonia
Replied by Livonia on topic ESA decision following medical.
Hello, I am feeling deeply unwell and yes have spoken to a support line..

I had in the post a letter from dwp dated 29th Feb showing new payments (following 'a change in my circumstances' so from it me and my dtr have worked out I am in the work group not support group. At my medical I didn't tell them what I should have as was so anxious and sobbing so very emotional . I went blank really although strangely was talking more than I thought I would.

I haven't had a report from decision person or a copy of the assessment typed my doctor says we need that . She said she would support me . but time is short I cant get appointment until 15th March. (I did have a copy of the interview on tape - but we ran out of tape and yes we did talk some more that was probably relevant.:( but too late. so maybe a heads up for others ask for a fresh tape.

At least its not a complete no. I have had a lot of suicidal thoughts since I had that medical last week. I told them the last thoughts were probably December but my anxiety counsellor said she thought it was this year too I had got that wrong but I just cant concentrate on timescales or remember things properly. I think I am going through a bad patch (really hope so) but I am still not able to guarantee to keep appointments, attend on my own or sit in crowded waiting rooms....

I had also kindly from job centre an appointment to attend next week for work focussed interview . I cant face going just feel sick and ill. my form explained but maybe I didn't so much at the interview although my friend said I did. The appointment is tues next week - early in the morning ( I often sleep in as often don't sleep well at night or if taking sleeping tablets they aware.

Job centre letter describes about difficulty bringing someone crowded etc. and long waiting times. Just something at present I can't cope with. My first medical was cancelled for that very reason ..

Just don't know what to do we did look at members guides but don't see about getting written stuff from decision makers and maximus who I think did my computer report ( saw a doctor ).

Please help not your fault but I do feel desperate I have some support numbers just sat here feeling dwp just dont care if I jump of the cliff certainly feel pushed. I know I am lucky at least after claiming in August now have a decision but the tone of the job centre letter is awful. all about stopping money sanctions etc etc.

Thanks for reading. :(

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8 years 2 months ago - 8 years 2 months ago #152547 by Gordon
Replied by Gordon on topic ESA medical
Dizzy

I can't see from your previous posts, were you in the Support Group?

Let's deal with the immediate issues first. :)

I'm sorry if this adds to your distress :(

If you are now in the WRAG then your attendance at Work Focussed Interviews and many Work Related Activities become mandatory and you risk your ESA payments being sanctioned for failing to attend or participate.

If you really cannot attend the appointment that has been booked then you need to contact the JC+ advisor as a matter of urgency, they may be able to defer the appointment or carry it out over the phone.

The JC+ staff do not have access to any of the information associated with your assessment so they will be unaware of limitations that you have due to your conditions, that is usually what is discussed in the first meeting.

The ESA85 is not sent by default, so if you have not requested it then you need to contact the DWP office (not the JC+ one), that dealt with your claim and make a request, we recommend following it up in writing, there may also be an LT54. The Decision Maker does not provide a Statement of Reasons where an award is made so even though you have been moved down to the WRAG you will receive no further information, you can ask for SoR from the DM, but they rarely appear.

As to challenging the Decision

The first stage to challenging a Decision is for you 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 and template letters that you can use to make the request with.

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

Your primary task is to show that you meet the criteria, there are many reasons you may have failed, you need 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
Last edit: 8 years 2 months ago by Gordon.

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8 years 2 months ago #152548 by Livonia
Replied by Livonia on topic ESA medical
No I was not in any group as been in assessment stage since August.
I don't understand the abbreviations you have put sorry.

are we writing and asking for exactly what from DWP please
copy of report from face to face medical ?
copy of decision makers report?
copy of decision makers statement of reasons
will i know how many points I have scored do I ask for that too?

thank you

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8 years 2 months ago - 8 years 2 months ago #152549 by Gordon
Replied by Gordon on topic ESA medical
Dizzy

The ESA85 is the assessment report produced by Maximus

The LT54 is a report produced by the Decision Maker for DWP usage, but not all of the time, if there is one then it should explain why they made their Decision.

The Statement of Reasons (SoR) is a report produced by the Decision Maker (DM), but only when requested, even when a SoR is requested it is often not produced as the DWP do not have to do so if they reasonably believe that all of the information that it might contain has already been supplied to the claimant.

The WRAG (Work Related Activity Group) is one of the two groups that can be awarded for ESA, the other is the Support Group (SG).

You need to request the ESA85 and LT54 from the DWP, you can do this over the phone but we recommend following up the request in writing.

The ESA85 will show what points the assessor recommended and the LT54 should give you an idea of what the DM awarded, if different from the assessor.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 8 years 2 months ago by Gordon.
The following user(s) said Thank You: Livonia

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8 years 2 months ago #153437 by Livonia
Replied by Livonia on topic ESA medical
So I have had documents and no surprise doc report scored 12 points regarding 2 x 6 points for mental health but SD was restricted to award more points and made a special circumstances note itcwas detrimental for me to be found fit for work.

The decision maker hasn't completed their part in their report !

Early review recommend Ed in 6 months .

I can't see GP until 15th. Decision ltr 26 feb

Is it too risky to ask for reconsideration ?
I know I will struggle attending job centre its my dtr who will take me. Job centre refused appt over phone. So going to try attend with DTR end month

What happens if I stay in wrag.

My claim only just been assessed with medical but started in august last year.

DTR written this for me

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8 years 2 months ago - 8 years 2 months ago #153463 by Gordon
Replied by Gordon on topic ESA medical
Dizzy

The first question you have to ask yourself is whether you meet one of the Support Group Descriptors and can you show that this is the case. If you cannot then there is really no benefit in asking for an MR. If you do then you'll have to assess the risk to your current award.

It looks likely you qualified under Regulation 29, see the Claim guides for an explanation, as this deals with the risk to you or others if asked to work, it can be subject to interpretation by a Decision Maker.

This suggests that your only way into the SG may be via Regulation 35, again see the guides, this has very specific requirements which will need to be supported by medical evidence.

If you do want to challenge the Decision then I've supplied information on how to do this in a previous post.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 8 years 2 months ago by Gordon.

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