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TOPIC: BIZARRE ATOS MEDICAL REPORT FORM

BIZARRE ATOS MEDICAL REPORT FORM 6 years 1 month ago #66213

Advice needed please as I'm totally baffled and unsure how best to proceed.

Have been on IB for 3 years (automatically met threshold due to receipt of high rate DLA care/mobility). Recently went through IB - ESA transfer. Claim form and loads of additional docs submitted but only a few days later, received phone call to confirm no medical assessment needed and have been placed in WRAG. Also was told that I wouldnt be contacted again for 2 years.

Letters now received from Job Centre confirming WRAG and that I will need to attend work focussed interviews/health assessment. Huge problem for me as both physical and mental health problems and thought I would be put into the support group. Not sure whether to appeal - thinking about it but a lot of hassle & not sure I'm up for that! Can anyone tell me how often these interviews take place? Can I take my carer? And will I be asked to go for these now of after the 2 years referred to?

No info on letter about how decision made to put me into WRAG so rang and asked for written reasons. Letter received (medical report form ESA85A) today and it makes no sense to me - completed by a registered nurse who says 'i advise a return to work unlikely for at least 2 years' and 'client found to have a significant level of disability ..... '. She also refers to a previous examination which is nonsense as i've never been examined by ATOS?! The letter then goes on to list all of the different activity descriptors and for everyone, the nurse has either said 'the available evidence DOES NOT suggest that the clients illness impairs them' or 'the available evidence suggests that the client IS LIKELY TO BE ABLE TO....' This has totally baffled me - if she feels that I'm not impaired or I'm likely to be able to do things, why has she then confirmed I've got a significant level of disability and wont be able to return to work for at least 2 years? Also, the report does not show how many points have been scored but I'm presuming it was more than 15 hence passing the limited capability for work assessment and being accepted for WRAG.

Unsure whether to submit appeal for support group or just accept WRAG decision but feel that I should still contact them about the ridiculous medical report form but can I still challenge this without appealing?

Thanks in advance of your replies.

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Re:BIZARRE ATOS MEDICAL REPORT FORM 6 years 1 month ago #66220

Wendy

WFI's are explained in more detail in the Understanding ESA guide in the Members Only area.

Whether you will be called to in in the short term is unlikely but not impossible. Attendance is mandatory, but they can ve deferred or even held over the phone, so this may offer you a way around having to to your local JCP office.

In addition to the ESA85, you can also ask for an ESA65, which explains the Decision Makers reasoning for the award.

Are there any reference to "Excpetional Circumstances" or to 29(2)(b) of the ESA Regulations, as it may be that this is why you have been placed in the WRAG.

To be placed in the Support Group, you will need to show you meet one or more of the SG criteria or the SG Exceptional Circumstances. If you believe this to be the case, then you can lodge an appeal on a GL24 form within one month of the date on the Decision letter.

Our ESA Appeals guide explains the process in more detail, and what you would need to do in terms of a submission and collecting evidence.

If you are considering making a complaint about the medical report, you should have a look at the ATOS Complant Procedures guide, also in the Members Only area.

If you have more questions, please come back to the forum.

Gordon

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

Re:BIZARRE ATOS MEDICAL REPORT FORM 6 years 1 month ago #66221

You can take a carer to your WFIs, which you can expect to start soon, not after the end of the two years. You can ask for interviews to be deferred but not waived.

It may be that the reference to a previous examination is an error from a previous decision made on the basis of medical reports.

There does seem to be an inconsistency with the report saying that you are not impaired but your getting ESA, but do bear in mind that it is not the assessor that determines whether you get ESA, but the DWP decision maker.

If you appeal, you could in theory lose all your points and be left with no ESA at all, so I would recommend that you see a Welfare Rights Adviser before appealing. It is possible to ask for the decision to be reviewed, but you run the same risk. If you appeal, the decision will automatically be reviewed.

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Re:BIZARRE ATOS MEDICAL REPORT FORM 6 years 1 month ago #66226

Hi Wendy

The only ESA85A that I have had sight of is the hand-written version in the Atos WCA handbook, which will be different to the computerised version.

Does your ESA85A list any of the Limited Capacity for Work descriptors or have a section giving advice regarding LCW?

As Gordon suggested the ESA65 will tell you what points the decision maker awarded you.

If you want to challenge the decision without appealing your only option is to ask for a reconsideration, but I would recommend appealing using the GL24 form as a reconsideration will automatically take place before the appeal. If the decision is not changed in your favour and you do not wish to appeal you can always withdraw your appeal at this point.

Regards

Derek

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