Re:Typical day?

Hi.
I have never been asked what my typical day was at ESA medicals. On my last one I was asked if I have a computer and if I liked to watch tv or go for walks.
I was astounded to find on the copy of the report that I sit on my backside all day watching tv and playing on my computer and nothing else and this is not what I do on any day.
Please be careful of what you say as they will use that to make a 'typical day' but hopefully you will get a better 'doctor' than I did.
Good luck

It might be of use to you to see this. It is a small extract from the training manual for ATOS assessors - in this case they are looking at people with ME/CFS. Remember this horrible condition is one which is a favourite target for ATOS because (a) it is expensive for them, as it is a chronic illness (i.e. one which just goes on and on) and (b) there is no accepted test.

Spot the "needle" in this passage:

6.Analysis of activities of daily living

An account of the activities of a typical day should be taken, in keeping with the general guidelines {See IB (Incapacity Benefit) and ESA (Employment and Support Allowance) Handbooks}. You should explore all of life's key activities in the process, such as feeding, cooking, keeping the house clean, shopping, gardening, social life and so on. Evidence of consistency should be sought in how each of these activities are managed. This in turn should be confirmed by informal observation.

It should be noted in interpreting this evidence that one of the common complaints of these patients is that although tasks can often be accomplished they cannot be sustained.

However, you should be alert to lifestyle patterns which may maintain disability; for example it is common for individuals with CFS to complain that they feel very unwell in the mornings, and yet this is clearly exacerbated by a routine where they stay in bed until lunch time.

So you have to be careful that you do not say that you can do things which might be misinterpreted.

Similarly note that any variation from what a nurse might think of as a "normal" routine may count against you - like staying in bed in the mornings. (I think they have cause and effect mixed up here.)

Note also that they will try to see whether you look to the HCP as if you followed that "day pattern".

Write what you think of as a "typical day" down on another piece of paper (i.e. NOT the form) and then "watch" yourself for a couple of days.

Then look at it and see what could be used against you e.g. "I spend a little time in the garden" could - like that - be written as does gardening most days for 2 hours.

You then re-write that to reflect just how long you spend (15 minutes), doing what and how it affects you.

I have wondered if I should not take a look at the "typical day" and then re-schedule all my activities to match ATOS's idea of what my day should be. No reading or writing on forums, for a start - that proves all sorts of things about planning, dexterity, language skills, sitting down time etc etc.

Don't know if I could, nevertheless I have begun to wonder if I (and a great many others) are going to have go back to looking like real "cripples" to get the benefits our masters will allow us.

You say that ME is "expensive for them". I'd like to clarify something - Atos who carry out the tests are not the ones out of whose budgets benefits are paid, therefore the expense of the illness does not affect them and we have no reason to suppose that it will influence them.

Survivor wrote:

You say that ME is "expensive for them". I'd like to clarify something - Atos who carry out the tests are not the ones out of whose budgets benefits are paid, therefore the expense of the illness does not affect them and we have no reason to suppose that it will influence them.

The guidelines for ATOS on ME were drawn up by the DWP (who do have a major stake in the cost).

We also know that Simon Wessely's work accounts for 6 out of 8 medical sources quoted in the training manual. Both he and Dr Mansel Aylward (CMO at the DWP when ESA was in the planning stage - now Professor Sir Mansel Aylward) have gone on record as saying that conditions such as "CFS" are a huge - and by inference unnecessary - burden on the state.

evidence: the training manual (from which my original quotation came)
Chronic Fatigue Syndrome - Guidelines for the Disability Analyst

Anyone submitting a claim based on ME/CFS disability would do well to know what training has been given in this area, and what expectations an ATOS HCP will have, both as to the nature of ME and what actions the claimant can take to make effective improvements. These factors are likely to influence judgements as to whether the WRAG or SG are appropriate and over what period a claimant may be "fit for work."

The phrasing of any claim based on ME/CFS has to be a careful balance. On the one hand it is crucial to account the direct physical effects of the illness - closely linked (as this site often points out) to the descriptors. On the other, anything that is seen as "excessive" may be used to justify dismissing the claimant's own account as "hysterical". Been there, had that done to me by a SEMA doctor (when SEMA - an ATOS-owned company - were doing the medicals).

The HCPs, and the decision makers, should also know that "For the purpose of DLA, however, the current law means that a claimant cannot be eligible for a higher rate of mobility unless his/her disability is considered "physical". For this purpose, CFS/ME is "physical". This was the point that I had to go to the Commissioner to establish, some years ago. Again this can be useful for a claimant to know.

The following comes from an ATOS document of 2010, just called "Chronic Fatigue Syndrome / Myalgic Encephalomyelitis"
which can be found at:
EBM: Atos Healthcare Chronic Fatigue Syndrome v. 2010

75% of those with CFS/ME are in the mild or moderate category. ...

Those with moderate CFS/ME do experience more marked limitations in activities of daily living. Mobility is likely to be restricted with difficulty walking more than 100 metres consistently but severe restriction of walking is unlikely. ...

The ability to maintain personal hygiene and nutrition is likely to be unimpaired.

It follows that if the HCP believes the claimant to have "Mild" or "moderate" ME/CFS then it may be difficult to establish some mobility or personal care problems. It may therefore be useful to try to get your medical advisor to commit themselves on the severity of the ME/CFS.

I speculate that the LiMA computer program, which governs many of the questions asked by the HCP and the conclusions drawn, may also have these assumptions built in to the program, as part of its claimed "Evidence-based medicine", which will be evident in the report which it helps the HCP to provide. If that is the case, then the above factors may have to be contested at tribunal.

I hope these notes will be useful to those claiming ESA or DLA (and certainly PIP in the future) as to what they may face when establishing daily living patterns.

Mod Edit :

As you should know as a long standing member, long posts such as this may be deleted due to the difficulty involved in examining them for inappropriate content in the pre-moderation area.

Please keep your posts to the normal format in future.

I have allowed this post because I feel that it may be of benefit to other members.

bro58

Would it be helpful to keep a diary for a few days, writing down exactly what you do each day? Also add the reasons why you are/are not doing something.

For instance (and I accept that this will probably not be the same for you as we have very different conditions)I don't get up until about an hour after breakfast, because this is when I take my morning dose of pain meds.

I know that this will be using up your precious reserves of energy, but it might be worth doing that now to help save agro at a later date!

They did this with me too. I mean I do struggle with everyday chores such as personal care etc. That isn’t incorrect but they have made me out to be a right lazy sod for my illness.

I worry deviating from this norm would land me as benefit fraud. So just how do people recover from conditions if they’re in the support group, for example?