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TOPIC: esa appeal help wanted

esa appeal help wanted 4 months 4 days ago #182205

hello all ,and so grateful i found this website, its been a great help and in some ways a great comfort to know that im not alone in my struggle and circumstance ,but honestly i feel that after a year of this hanging over me ,im at the end of my rope ,
and due to the aggravation of my blood pressure and anxiety problems and general well being that this has and continues to cause ,that i feel i cant go on with my appeal ,as the thought of this hanging over me for a further 5 or 6 month and the whole appeals procedure ,is crushing

any help or advice or strategies will be most welcome ,apologies for the length of my post ,and thanks to all or any that can help

in a nutshell

i have burst discs 3 and 5 in my neck and the gel within has leaked and wrapped around my nerves ,detected by mri scan 10 years ago ,this causes pain in my neck shoulders and and at times numbness in my arms ,fingers and legs ,i also have a fluttering sensation and occasional involuntary jumping of my legs, pain when moving ,standing and sitting

then in 2008 i was hospitalised with blood pressure of 229 over 189 and diagnosed with malignant hypertension and unknown to me i had  it  for approx 6 years prior to my collapse,i had put the pains and numbness down to my neck injury  ,it was explained to me that this had in turn damaged my eyesight  ,liver ,kidneys lungs and caused my heart not to pump properly ,this causes me when under either a physical or emotional strain  to become short of breath ,and cough to almost the point of vomiting

since leaving hospital ive been medicated for this and had 4 esa assessments ,6 in total since my neck injury .all have found i met the esa requirements and put me in the support group

i filled out a esa form last february ,and stated as i had before that i could mobilise no more than 100m with out discomfort and would be short of breath ,coughing to almost the point of vomiting pains in chest arms and legs , and this would take around 20 minutes to return to a normal state i and i would be left exhausted and with a terrible head ache

no word until august ,i then had 2 assessment appointments canceled at short notice

i attended another one at 9 am on 2 october ,2016 and due to the distress and discomfort i was in after walking across the carpark and into the assessment centre 26 meters ,i was advised by the receptionist i was too ill to attend and to cancel and rebook ,

i was sent another appointment for 26 october at 1 o'clock ,at 11.30 the receptionist phoned me and asked if i felt well enough to attend or would i like to cancel ,presumably she remembered my condition and reaction from last time , i explained that this would be my normal reaction when ever i had to attend so would prefer to get it over with
on arriving i had the same reaction from the same distance traveled and the receptionist again advised me to go home ,by this point the assessment had been hanging over me for 8 month and was badly affecting every aspect of my life and i just wanted it over after around 20 minutes my coughing and breathlessness had eased ,

my assessment started approx 40 minutes after i arrived .during my assessment i found the hcp to be dismissive and disinterested in what i had to say about my conditions and how they affect me in day to day living  the hcp  did not want to know any details really, just seemed to want the answers to her  tick box questions. I tried my best to explain how my problems both mental and physical effect me on a day to day basis   but she didn't seem   interested,

when asked how far i could walk without pain and discomfort ,i told her  of my journey from the car to the reception ,i guessed 30 m ,and described my distress and discomfort i detailed earlier in this letter after such a short distance ,she said that was "quite normal " when i asked how that could be considered normal she ignored the question ,the previous client she had  before me ,when leaving told me of how disruptive my coughing and retching had been so she was certainly aware of my problems

the actual distance i walked has now been measured as 26 meters

she and the dm refer to the point that i told the hcp that " i could walk 100ms and would be okay after a short rest" ,and that" the hcp saw me walk 100m from the carpark" ,both totally untrue ,as the hcp was assessing another client at the time of my arrival she wouldn't have had any opportunity to observe me arrive ,and the fact parking space my wife used was less than 30m from the entrance to the center

i also notice she misunderstood or misrepresented many of my replies to her questions in her report ,other than the aforementioned mobilization distance and recovery time and the sitting and recovery time
 
eg she stated i use a mobile phone for calls and texts
but does not mention i use the speech command  facility to operate it 

says uses the computer to trace family tree
neglects to mention only  with my daughters assistance ,surfs internet falls in to the same category

goes upstairs for a bath twice a week
again only  with my sons assistance

would answer the door to a stranger
while given time i could mobilize to the door ,but would not even  think of doing so due to the anxiety and stress of dealing with a unplanned for and unknown person

came to assessment alone
the reason i came alone and if i have to got to appointments go alone is as i explained ,im not  comfortable discussing my mental problems and my" intrusive thoughts "dark thoughts of death in front of my wife and  family and want to spare them that hurt if or  when that happens that im no longer here

in fact there was no mention or consideration given to my "intrusive thoughts " as i said  i am jolted by sudden thoughts of my death by many horrible means ,strangling ,hanging ,drowning ,beaten to death,kicked to death  ,falling etc ,these are so vivid and disturbing that i feel like its real, i feel the cold of the water ,the impact  and i feel the pain and shock of it and that stays with me and im left feeling vulnerable and genuinely fearful of the future , these can and do occur at anytime of the day or night and come on with out warning ,and when they arrive i have no control  of them or way of stopping or distracting myself from them

never attempted self harm or suicide or thoughts of self harm or suicide

while ive never attempted these actions ,i tried to explain  they are never far from my thoughts , it feels like its inevitable that one day ill be taken from my family and somehow ive been  coming round to the thought that it would be for the best if i could have some measure of control over when and how that happens .hard enough to admit to yourself let alone articulate to a stranger .especially  one who treats this information  with rudeness and indifference

no points were awarded for sitting and standing in spite of me having to deliberately move 3 times in a approx 50 minute assessment due to pain and discomfort ,this  having been shown in a mri to have been caused by burst discs 3 and 5 ,the gel contained within the discs has leaked and impairs the nerves predominantly on my left hand side, ,when i tried to explain how i feel

i feel like im going to lock up and be unable to move again if i dont change position and feel the onset of anxiety and panic

and what i do at home when this occurs at home

i lie down and take the weight of my head off my neck

when i was trying to explain about the grinding sound  sound i "hear "in my neck when it moves,i was told as i burst disc 3 and 5 ,it was the unprotected vertebrae grinding together ,she said it wasnt that  ,so thinking  that if someone was qualified to tell me what something wasn't i would have expected them to be able to tell me what it was  .she ignored the question  . i tried to explain about a more recent pain in my right collar bone when sitting ,and was met by disinterest and indifference . in fact when i was trying to explain about my problems with depression and anxiety that i'm receiving treatment and medication for , that was  not mentioned in my assessment report ,she full blown yawned in my face ,she yawned 3 times in total during 50 minute assessment, im not sure if you can imagine how damaging that is and how that feels when you're trying to  talk to a stranger about some of your most private  personal thing and deepest fears , trying to articulate about suicide and death and intimate relationships with family and the best they can do is ignore it in the report ,in spite of seeing my prescribed medication ,and to just yawn in your  face

the decision was made initially that i didn't qualify for esa ,i was awarded 6 point for loss of conciseness
i submitted a mandatory reconsideration and was returned to esa awarded 9 points for mobilising plus my 6, but in the wra

i asked for this to be looked at again in light of my mobilising being less than 50 meters ,and was advised by the citizens advice that should appeal ,which i have done ,i received the documents from dwp 90 odd pages ,having attempted to read them ,the very sight of them makes me feel nervous and ill , it seems they are trying to overturn the mandatory reconsideration ,on mobilisation ,on the grounds i could use a wheelchair
my neck injury and  the pain in my neck and shoulders and collarbone  mentioned by the hcp in the report  ,would preclude the use of a wheelchair   


at the assessment my blood pressure was measured by the hcp at 200 over 129 ,
below is a exert from my letter to the dwp on the subject .apologies for crediting the CAB for this info ,but didnt want to blow your cover

there is also only a passing reference  to the fact that in spite of being diagnosed ,and  treated  and medicated  for over 8 years, and yet at the time of  my assessment that my blood pressure which  was taken approx 1 hour and 15 minutes after arriving , was  recorded by the assessor as being 200 over 129 which is as you will be aware  dangerously high and puts me at significant  risk from a stroke or heart attack ,plus i suffer and am affected by  the attendant symptoms associated with  Hypertension Stage 3 / Hypertensive crisis,at times  almost constant headaches ,dizziness ,blurred vision,flashing lights  loss of consciousness ,chest pains numbness in my left arm,  confusion and nose bleeds   

,this was my 4th assessment since being diagnosed with malignant hypertension  in 2008 i was admitted to coronary care with bp of 229 over 189 ,,the previous assessments have upheld my entitlement to esa  and placed me in the support group , at the last assessment ,approx 2 years ago my blood presure on medication was recorded at 189 over 120  the assessment before that in 2010 it was 180 over 120,which indicates that my condition is ,in spite of my treatment ,getting progressively worse
and potentially life threatening

the CAB pointed this section from your guide book and although it mentions wra in some cases .my  bp problems and readings put me in hypertensive crises  and malignant hypertension that and their attendant symptoms detailed earlier in this letter and my mobility and mental health problems would again  qualify me for the support group  as my last 3 assessments with lower bp readings did



"3.8.1 Life Threatening, Uncontrolled Disease.
1. The claimant is suffering from a life threatening disease in relation to which
(a) there is medical evidence that the disease is uncontrollable, or
uncontrolled, by a recognised therapeutic procedure, and
(b) in the case of a disease that is uncontrolled, there is a reasonable cause
for it not to be controlled by a recognised therapeutic procedure.
This non-functional descriptor (relating to life threatening disease) is very specific in
its wording and all the evidence must be carefully considered before applying this
non-functional descriptor. Any advice given to the Decision Maker that application of
this NFD is appropriate must be in keeping with an up to date consensus of medical
opinion. It should be noted that this NFD only applies to LCW and not LCWRA i.e.
it would still be considered reasonable for the person to engage in WRA.
For example when considering hypertension,
A claimant who attends the MECAC with no previous history of hypertension and
on no treatment where the blood pressure is measured and found to be high would
not fulfil criteria for this NFD as there is no evidence that their disease is
uncontrollable.
However where a claimant who attends a tertiary referral centre and whose
condition, despite intensive intervention, remains severe and uncontrolled and is lifethreatening,
would be considered as satisfying the criteria for this NFD to be applied."



in the first reconsideration it appears that my 200 over 129 bp reading was solely  attributed to my exertion at mobilising the 25 m from the car park  and would return to normal shortly ,whereas even after a hour and a quarter after this exertion  ,when my blood pressure was taken it was reading at 200 over 129  ,when  it is in fact  a serious, progressive  health condition with no known cure and a poor prognosis ,which is aggravated by physical and emotional exertion ,and stress


i also wondered if you think the assessment receptionists reaction would be pertinent or useful to me in regards this i found with you helpful wca hand book ,i cant pretend to understand its full meaning but thought it interesting

4.1.1 Clients Unfit to be seen
There are several circumstances where it may be that a claimant is unfit to be seen.
This may be identified before the assessment commences or during the course of the
assessment.
Identified before the assessment starts
If a claimant is identified as being unfit to be seen before the assessment begins
consideration must be given as to whether they can be given a second appointment.
If this is their first appointment, the claimant should be sent home unseen.
Administration staff will follow their normal Claimant Sent Home Unseen (CSHU)
procedures using reason “Claimant Unfit to be examined” and a second appointment
scheduled.
If this is their second appointment, the referral must be withdrawn. The referring
Customer Office should be contacted by administration staff to inform them that the
Claimant is unfit to be assessed and that the referral is being withdrawn. Before
returning the Case File to the Customer, a note should be attached explaining why it
has been returned.


again any help or advice or strategies will be most welcome ,apologies for the length of my post ,and thanks to all or any that can help

chris

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esa appeal help wanted 4 months 4 days ago #182234

C

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Some immediate observations from your post. I am taking it as written so forgive me if these are matters that you are already aware of.

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.

It may be obvious to you that your conditions preclude you from using a manual wheelchair but if you have not explained why you cannot in and with your ESA50 it's likely that those assessing you would not have come to the same conclusion, especially the Decision Maker who is not medically trained.

The Standing and Sitting activity tests your ability to remain at a workstation. You can move from a standing to sitting position and vice versa as many times as necessary but the clock will continue to tick until you are forced to move away from the (virtual) workstation. Your behaviour at the assessment does not suggest that this happened.

The Staying conscious when awake activity does not have a Support Group equivalent so based on the points you scored, your only obvious route to the SG is through Mobilising.

The guidance you quote applies only to the WRAG. In the phrase "It should be noted that this NFD only applies to LCW and not LCWRA ", LCW is applicable to the WRAG an LCWRA for the SG, however, you may be able to show that the Substantial Risk Regulation (35) applies, see the ESA Claim for details.

I wouldn't bother with the receptionists comments, they are not medically trained and would not have had access to your form or any other information related to your conditions, the guidance you refer to is for assessors.


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, 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 (ESA85), if you have not already done so, 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.

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

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Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last Edit: by Gordon.

esa appeal help wanted 4 months 3 days ago #182342

thanks for the repy Gordon ,and points taken

my main issues with the decision are

points awarded after MR for mobilisation of less than 100m ,when on 2 occasions i attended the assessment centre with in 24 days i mobilised less than 50m and was left and seen to be breathless ,coughing almost to the point of vomiting with pains in my neck and shoulders chest and arms and burning in my knees

while my esa50 filled in feb 2016 says i can mobilise no more than 100m ,i consider that in the intervening 8 months due to stress and worry and the attendant problems associated with ,my condition has deteriorated to my present level , i rarely go out ,only to doctors appointments etc and live almost exclusively down stairs so have little opportunity to test my endurance or gauge its decline
the fact that all paperwork refers to me supposedly telling the hcp that i can mobilise 100m before discomfort ,i did no such thing ,when i actually told her of my mobilising from the car park and resulting breathlessness ,neck and shoulders and chest pain that took over 20mins to ease ,that i estimated at 30m but was later measured in the interest of accuracy to be 26m ,on the wheel chair issue i feel my neck injury and the pain in my neck and shoulders and collarbone mentioned by the hcp in the report ,would preclude the use of a wheelchair


i thought the fact that the assessment receptionist although non medical saw the results of my mobilisation and advised me on both occasions that i was too unwell be be assessed and to return home ,and could verify my syptoms of my mobilisation if not the distance could be helpful

the fact there is also only a passing reference to the fact that in spite of being diagnosed ,and treated and medicated for over 8 years, and yet at the time of my assessment that my blood pressure which was taken approx 1 hour and 15 minutes after arriving , was recorded by the assessor as being 200 over 129 which is as you will be aware dangerously high and puts me at significant risk from a stroke or heart attack ,plus i suffer and am affected by the attendant symptoms associated with Hypertension Stage 3 / Hypertensive crisis,at times almost constant headaches ,dizziness ,blurred vision,flashing lights loss of consciousness ,chest pains numbness in my left arm, confusion and nose bleeds

,this was my 4th assessment since being diagnosed with malignant hypertension in 2008 i was admitted to coronary care with bp of 229 over 189 ,,the previous assessments have upheld my entitlement to esa and placed me in the support group , at the last assessment ,approx 2 years ago my blood presure on medication was recorded at 189 over 120 the assessment before that in 2010 it was 180 over 120,which indicates that my condition is in fact ,in spite of my treatment ,getting progressively worse
and could be considered potentially life threatening, my assessment in 2013 placed me in the support group with this said by the hcp

mr dodd suffers from musculoskeletal problems and hypertension
he is under the care of his gp and has been referred to the cardiologist for his hypertension ,he has had a recent admission due to his condition where his blood pressure was extremely high .he reports he has malignant hypertension ,due to this being untreated for 6 years this has damaged his eyes ,kidneys and lungs and he reports he will get breathless due to the condition ,due to the condition he would not be able to reliably and reapedly mobilise more than 50m due to his condition within a reasonable time scale
he suffers from musculoskeletal problems with his neck
the evidence available suggests review in the medium term
before next assessment it may be beneficial to get fme to reduce stress to the client



i also noted inaccuracies in the evidence ,such as ,it say i was telephoned on 18 nov to discuss the decision to not award esa and that i had nothing to say or additional information to add ,

i did not speak to anyone and have the decision letter that says they tried phoning but got no reply ,which changes the complexion of this supposed exchange significantly i feel

i also filled out my esa markin most conditions as it varies ,no mention of this was brought up or mentioned by the hcp during the assessment or report

i get muddled ,but thought i saw that was grounds for the report being unreliable

sorry to go on
cheers c

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esa appeal help wanted 4 months 3 days ago #182380

bonniedog

Showing that the report is inaccurate will not result in a higher award, unless you also show that you meet the requirements for one.

Forgive me but I really think you are wasting your time involving the receptionist, they are not medically trained , are unlikely to have any knowledge of the ESA assessment criteria and the information is effectively hearsay.

You can certainly use the statements from a previous ESA assessment to support this one, but you must show why it is still relevant to your conditions as they are now, this may be as simple as your conditions not being ones likely to improve even with treatment.

I've just noticed that you have already had an MR for your claim. So your next option is to appeal the Decision.

The ESA Appeal guide has links to the SSCS1 form that you will need to complete and instructions on how to complete it, 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 PIP2, the assessment report and the PIP 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

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

esa appeal help wanted 4 months 3 days ago #182398

cheers for the reply and the information ,sorry it wasn't clear in my first post ,but yeah im at the stage where ive received the dwp submission and am trying to work out how best to reply to it and the best strategy to approach this from ,
with regard to previous esa assessments ,would the fact that in spite of being medicated for 8 years my blood pressure is still extremely high and has risen on each assessment it has been recorded at from 180 over 120 to the most recent 200 over 129 , be a strong factor as it shows that previous esa assessment was still relevant and this impacts on my ability to mobilise due to pain ,breathlessness and fatigue as stated in my report from 2013 which placed me in the support group ,which i quoted in my last post

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esa appeal help wanted 4 months 3 days ago #182411

bonniedog wrote: cheers for the reply and the information ,sorry it wasn't clear in my first post ,but yeah im at the stage where ive received the dwp submission and am trying to work out how best to reply to it and the best strategy to approach this from ,
with regard to previous esa assessments ,would the fact that in spite of being medicated for 8 years my blood pressure is still extremely high and has risen on each assessment it has been recorded at from 180 over 120 to the most recent 200 over 129 , be a strong factor as it shows that previous esa assessment was still relevant and this impacts on my ability to mobilise due to pain ,breathlessness and fatigue as stated in my report from 2013 which placed me in the support group ,which i quoted in my last post


Yes you can use this information, but if you can explain the effects that walking would have on your blood pressure. My GP surgery has a blood pressure machine in reception, if yours has one or indeed if you have your own tester, make sure you are calm and rested and then test your blood pressure, walk 50m or as far as you can without significant discomfort or breathlessness and re-test.

Sorry if I keep mentioning this nut if you haven't included any reasons why you cannot self-propel a wheelchair then you must do this.

Gordon

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