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Mandatory Reconsideration failed for work related
- Paul
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6 years 2 months ago #215212 by Paul
Mandatory Reconsideration failed for work related was created by Paul
My claim started in 2015 for serious lower back and leg pain. I was reassessed in June 2018.
In the medical questionnaire I ticked the boxes for mobilising, standing and sitting and reaching
Sitting and standing 30 mins and under
Walk up to 100 meters
Can't reach above head
I supplied medical evidence containing 2 private physiotherapist letters, a doctors letter and an MRI scan. The medical evidence was from last year. However one physiotherapist letter was from March this year which was the same time the questionnaire was completed.
I received the decision back by post. I was never contacted by phone. I was told it went to the wrong department. I don't fully understand what they mean with that. I was awarded zero points. In the report by the decision maker it didn't focus on the criteria only on points which were completely irrelevant to my case such as I was observed hold paper work (medical evidence) and two boxes of medication.
I requested the HCP report and realized it was a cesspit of lies. Wrong information on the leg raising test, reaching above head, mobilising, and standing and sitting. This female HCP was nasty right from the start of the assessment and I believe her decision was already predetermined.
Over the phone making a Mandatory Reconsideration (I should have done this in writing I now believe) I corrected the inaccurate statements.
However this morning I have received the Mandatory Reconsideration letter and they not changed their mind
I still don't have a full understanding of their reasoning for awarding me zero points. They are ignoring the criteria and the words of my private physiotherapist who detailed the criteria..
The resolution team has not refuted I can't mobilize for more than 100 meters. In the letter they now acknowledge I have tried using an aid and wheelchair but it didn't help. But they still haven't changed their mind on mobilising
Reaching was ignoring in the letter. They never addressed it.
Their argument for standing and sitting appears to be I have freedom to move around at the workstation and don't have to sit or stand completely still.
Now at the assessment I did stand for around 10 minutes, then sit for 10 minutes. But then felt the need to move away from the area. I walked from one end of the room to the other. Is this not classed as moving away from the workstation? They also claim an adjustable chair would help me.
What is classed as moving away from the workstation?
Reading through the Mandatory reconsideration letter is is utterly laughable, the terms and words they use, the ignoring of my medical evidence. It is nothing sort of disgusting.
I am going to appeal
Can someone help me with these questions please -
Do I need more evidence. If so, from who ?
What is classed as moving away from the workstation ?
Can you take legal cation again Maximus health care or the HCP. In my eyes a registered nurse should not be able to get away with deliberate false information.
Can you take your own camera to film in the assessment?
How old can medical evidence be?
This whole ordeal has been very stressful for me and would appreciate any help.
Thank you
In the medical questionnaire I ticked the boxes for mobilising, standing and sitting and reaching
Sitting and standing 30 mins and under
Walk up to 100 meters
Can't reach above head
I supplied medical evidence containing 2 private physiotherapist letters, a doctors letter and an MRI scan. The medical evidence was from last year. However one physiotherapist letter was from March this year which was the same time the questionnaire was completed.
I received the decision back by post. I was never contacted by phone. I was told it went to the wrong department. I don't fully understand what they mean with that. I was awarded zero points. In the report by the decision maker it didn't focus on the criteria only on points which were completely irrelevant to my case such as I was observed hold paper work (medical evidence) and two boxes of medication.
I requested the HCP report and realized it was a cesspit of lies. Wrong information on the leg raising test, reaching above head, mobilising, and standing and sitting. This female HCP was nasty right from the start of the assessment and I believe her decision was already predetermined.
Over the phone making a Mandatory Reconsideration (I should have done this in writing I now believe) I corrected the inaccurate statements.
However this morning I have received the Mandatory Reconsideration letter and they not changed their mind
I still don't have a full understanding of their reasoning for awarding me zero points. They are ignoring the criteria and the words of my private physiotherapist who detailed the criteria..
The resolution team has not refuted I can't mobilize for more than 100 meters. In the letter they now acknowledge I have tried using an aid and wheelchair but it didn't help. But they still haven't changed their mind on mobilising
Reaching was ignoring in the letter. They never addressed it.
Their argument for standing and sitting appears to be I have freedom to move around at the workstation and don't have to sit or stand completely still.
Now at the assessment I did stand for around 10 minutes, then sit for 10 minutes. But then felt the need to move away from the area. I walked from one end of the room to the other. Is this not classed as moving away from the workstation? They also claim an adjustable chair would help me.
What is classed as moving away from the workstation?
Reading through the Mandatory reconsideration letter is is utterly laughable, the terms and words they use, the ignoring of my medical evidence. It is nothing sort of disgusting.
I am going to appeal
Can someone help me with these questions please -
Do I need more evidence. If so, from who ?
What is classed as moving away from the workstation ?
Can you take legal cation again Maximus health care or the HCP. In my eyes a registered nurse should not be able to get away with deliberate false information.
Can you take your own camera to film in the assessment?
How old can medical evidence be?
This whole ordeal has been very stressful for me and would appreciate any help.
Thank you
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- Gordon
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6 years 2 months ago #215245 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Mandatory Reconsideration failed for work related
Paul
Fist of all for Standing and Sitting it is the accumulated time before you move away from the Workstation that is being tested.
Think of the workstation as a cashier station in a supermarket, so you can stand and sit as often as you like but if you actually walked away from the till then that is when the clock stops.
ESA is not a walking test, it is a Mobility test! In addition to your walking, it considers your ability to self-propel a manual wheelchair over the same distances, you do not need to be using a wheelchair or even to own one for it to be considered. SO even if you can show your walking is restricted unless you can also show that you cannot self-propel the wheelchair you will still not score points.
To answer your remaining questions.
Appeals are not always a question of supplying new evidence but you should certainly review the documents that you have supplied to see if they are supportive of your claim. One source of evidence is your medical records at your GP Practice.
I don't know of anybody who has taken legal action against the assessor, you can make a complaint to the Assessment Provider and to their professional body.
You cannot video record an assessment.
You should try and provide medical evidence that is less than two years old but if you can show it's relevance to your conditions as it is now then you can use older evidence.
The ESA Appeal guide has links to the SSCS1 form that you will need to complete and the Submissions guide has a complete example that you can use to help you fill it in, you do not need to provide detailed reasons at this stage for your request.
Once your appeal is accepted the DWP will prepare their submission to the hearing and send you a copy, whilst you should wait until you receive this to finish and submit your own, you should start to prepare your own case, an increased award will only be made by your showing that you score the extra points for one, so I would start by going back through your ESA50, the assessment report and the ESA Claim guide to see how you might show this is the case.
If you have further questions then please reply to this post and we will do our best to help.
Gordon
Fist of all for Standing and Sitting it is the accumulated time before you move away from the Workstation that is being tested.
Think of the workstation as a cashier station in a supermarket, so you can stand and sit as often as you like but if you actually walked away from the till then that is when the clock stops.
ESA is not a walking test, it is a Mobility test! In addition to your walking, it considers your ability to self-propel a manual wheelchair over the same distances, you do not need to be using a wheelchair or even to own one for it to be considered. SO even if you can show your walking is restricted unless you can also show that you cannot self-propel the wheelchair you will still not score points.
To answer your remaining questions.
Appeals are not always a question of supplying new evidence but you should certainly review the documents that you have supplied to see if they are supportive of your claim. One source of evidence is your medical records at your GP Practice.
I don't know of anybody who has taken legal action against the assessor, you can make a complaint to the Assessment Provider and to their professional body.
You cannot video record an assessment.
You should try and provide medical evidence that is less than two years old but if you can show it's relevance to your conditions as it is now then you can use older evidence.
The ESA Appeal guide has links to the SSCS1 form that you will need to complete and the Submissions guide has a complete example that you can use to help you fill it in, you do not need to provide detailed reasons at this stage for your request.
Once your appeal is accepted the DWP will prepare their submission to the hearing and send you a copy, whilst you should wait until you receive this to finish and submit your own, you should start to prepare your own case, an increased award will only be made by your showing that you score the extra points for one, so I would start by going back through your ESA50, the assessment report and the ESA Claim guide to see how you might show this is the case.
If you have further questions then please reply to this post 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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6 years 2 months ago #215279 by Paul
Replied by Paul on topic Mandatory Reconsideration failed for work related
Thank you for the helpful reply Gordon. I will have a read through available PDFs.
I have a few more questions
How do you show you that you cannot self-propel the wheelchair? Does my doctor or private physiotherapist have to include this in the letter. Me telling the DWP I have tried a wheelchair and it hurt my back, wasn't good enough
Does the physiotherapist or doctor also need to say in a letter - must move significantly away from workstation as well what they wrote about me struggling to stand and sit.
How long can an MRI be used for evidence. I understand physiotherapist and doctor letter can be updated but one can't get MRI every year?
Do you know why some HCP are nice and some are not? The HPC I saw before this time was very nice and looked at my medical evidence, where as this time it was very different.
Can you confirmed this below is correct
I now intend to go to my doctor and ask him for sick notes. Also ask him to back date the sick note to the time when my ESA was stopped. I then wait until the DWP to accept I am making an appeal and send me a letter confirming this. I then sent my sick notes to the DWP. I will be payed assessment rate at this time.
When I win the appeal the DWP will now also pay back the extra ESA. I made this claim for ESA work related in 2015, so this same claim should start again and I should still get the higher amount of £204 every two weeks. I'm asking this because I now know ESA work related payments have been reduced
Thank so much for any more help
I have a few more questions
How do you show you that you cannot self-propel the wheelchair? Does my doctor or private physiotherapist have to include this in the letter. Me telling the DWP I have tried a wheelchair and it hurt my back, wasn't good enough
Does the physiotherapist or doctor also need to say in a letter - must move significantly away from workstation as well what they wrote about me struggling to stand and sit.
How long can an MRI be used for evidence. I understand physiotherapist and doctor letter can be updated but one can't get MRI every year?
Do you know why some HCP are nice and some are not? The HPC I saw before this time was very nice and looked at my medical evidence, where as this time it was very different.
Can you confirmed this below is correct
I now intend to go to my doctor and ask him for sick notes. Also ask him to back date the sick note to the time when my ESA was stopped. I then wait until the DWP to accept I am making an appeal and send me a letter confirming this. I then sent my sick notes to the DWP. I will be payed assessment rate at this time.
When I win the appeal the DWP will now also pay back the extra ESA. I made this claim for ESA work related in 2015, so this same claim should start again and I should still get the higher amount of £204 every two weeks. I'm asking this because I now know ESA work related payments have been reduced
Thank so much for any more help
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- Gordon
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6 years 2 months ago #215289 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Mandatory Reconsideration failed for work related
Paul
You will need medical evidence to show that you cannot use a wheelchair over the ESA distances.
There are three arguments against the use of a wheelchair
- You suffer physical restrictions that would prevent you from using a wheelchair. For example; Arthritis in the hands, wrists or shoulder.
- You have conditions that would indirectly prevent your using a wheelchair. For example angina of asthma.
- Logistical problems would prevent the usage, however, this argument has been significantly devalued by a UTT Decision which suggests that the wheelchair could be stored at the workplace. This obviously ignores the issue of how the claimant gets to and from work, it can be argued against but issues such as ramps at home have been to a considerable extent negated.
The most important thing to explain with moving away from the workstation is why you need to do this, what is it that despite your being able to stand that means that you need to walk away. Once you have this then you can speak to those who support you for evidence to support this.
Yes, once your appeal is accepted and you have written proof of this then you can contact the DWP and ask to be placed on the ESA Assessment rate while you wait for a hearing.
A Fit Note from the day after your ESA stopped should enable payment, you will need to maintain one on file with the DWP until the hearing and any award is put into payment.
Gordon
You will need medical evidence to show that you cannot use a wheelchair over the ESA distances.
There are three arguments against the use of a wheelchair
- You suffer physical restrictions that would prevent you from using a wheelchair. For example; Arthritis in the hands, wrists or shoulder.
- You have conditions that would indirectly prevent your using a wheelchair. For example angina of asthma.
- Logistical problems would prevent the usage, however, this argument has been significantly devalued by a UTT Decision which suggests that the wheelchair could be stored at the workplace. This obviously ignores the issue of how the claimant gets to and from work, it can be argued against but issues such as ramps at home have been to a considerable extent negated.
The most important thing to explain with moving away from the workstation is why you need to do this, what is it that despite your being able to stand that means that you need to walk away. Once you have this then you can speak to those who support you for evidence to support this.
Yes, once your appeal is accepted and you have written proof of this then you can contact the DWP and ask to be placed on the ESA Assessment rate while you wait for a hearing.
A Fit Note from the day after your ESA stopped should enable payment, you will need to maintain one on file with the DWP until the hearing and any award is put into payment.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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6 years 2 months ago #215307 by Paul
Replied by Paul on topic Mandatory Reconsideration failed for work related
Gordon
It can be hard to get the doctor to go into such detail. However I get the impression if the HCP report is a damning one with inaccurate information it might not matter. I don't believe I was ever getting the benefit.
The DWP hasn't given me clear, robust reasons for zero points. They are cryptic, ignore evidence, ignore what I said, avoid the areas where I'm trying to gain points and massively biased towards maximus healthcare.
I will update this thread in several months when its close to my tribunal
Its a worrying time but at the same time I know my case is much stronger
Thank you
It can be hard to get the doctor to go into such detail. However I get the impression if the HCP report is a damning one with inaccurate information it might not matter. I don't believe I was ever getting the benefit.
The DWP hasn't given me clear, robust reasons for zero points. They are cryptic, ignore evidence, ignore what I said, avoid the areas where I'm trying to gain points and massively biased towards maximus healthcare.
I will update this thread in several months when its close to my tribunal
Its a worrying time but at the same time I know my case is much stronger
Thank you
Please Log in or Create an account to join the conversation.
- Gordon
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6 years 2 months ago #215317 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Mandatory Reconsideration failed for work related
Paul
A Tribunal panel will take a much more balanced approach to looking at the evidence and you will have an opportunity to explain your problems directly to them.
Gordon
A Tribunal panel will take a much more balanced approach to looking at the evidence and you will have an opportunity to explain your problems directly to them.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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