Decision makers letter has not been received

Appeal’s query – following failed ATOS medical, Decision Maker’s letter has not been received by ESA Claimant
I act as a friend for a 45 yr old man Alex who has not been able to find and maintain a job for about 25 years due to his having Asperger’s syndrome and related anxiety and depression due to his failure to get a job - despite applying for many.
On Tuesday of this week, via the support of his local welfare right’s office, Alex received verbal confirmation that his ESA benefit payments had stopped due to his having failed a medical which he had at ATOS in June 2012.
Alex duly requested on Tuesday of this week by telephone that the DWP send him copies of his medical report (GL24) and a copy of the DWP Decision maker’s letter stating the reasons for the decision to put him off ESA.
The young pleasant and helpful woman at the DWP whom Alex spoke to agreed to post Alex his medical report and to search the file to see if she could find a copy of the decision make’s letter.
Alex duly received his medical report (GL24). He has not however received the DWP Decision Maker’s letter setting out his/her reasons for Alex being put off ESA allowance.
At a previous appeal Hearing which Alex won, (following helpful advice received from Benefits and Work ESA web resources) he successfully challenged specific unsubstantiated assertions which were made by the Decision maker in her letter.
Consequently, in preparing for this appeal I feel Alex is at a decided disadvantage by not knowing what has been stated in the Decision Maker’s letter.
Proposed action:
I think that I should support Alex in writing a formal letter to the DWP requesting that a copy of the Decision Maker’s letter be sent to him.
I would welcome advice about whether the above proposed action is seen as an appropriate course of action to take, regarding the missing Decision Maker’s letter. I would also welcome any comments about whether the DWP are in breach of any legal obligations by not sending Alex the DWP’s Decision Maker’s letter.

Many thanks,
Robert

Robert
Black wrote:

Appeal’s query – following failed ATOS medical, Decision Maker’s letter has not been received by ESA Claimant
I act as a friend for a 45 yr old man Alex who has not been able to find and maintain a job for about 25 years due to his having Asperger’s syndrome and related anxiety and depression due to his failure to get a job - despite applying for many.
On Tuesday of this week, via the support of his local welfare right’s office, Alex received verbal confirmation that his ESA benefit payments had stopped due to his having failed a medical which he had at ATOS in June 2012.
Alex duly requested on Tuesday of this week by telephone that the DWP send him copies of his medical report (GL24) and a copy of the DWP Decision maker’s letter stating the reasons for the decision to put him off ESA.
The young pleasant and helpful woman at the DWP whom Alex spoke to agreed to post Alex his medical report and to search the file to see if she could find a copy of the decision make’s letter.
Alex duly received his medical report (GL24). He has not however received the DWP Decision Maker’s letter setting out his/her reasons for Alex being put off ESA allowance.
At a previous appeal Hearing which Alex won, (following helpful advice received from Benefits and Work ESA web resources) he successfully challenged specific unsubstantiated assertions which were made by the Decision maker in her letter.
Consequently, in preparing for this appeal I feel Alex is at a decided disadvantage by not knowing what has been stated in the Decision Maker’s letter.
Proposed action:
I think that I should support Alex in writing a formal letter to the DWP requesting that a copy of the Decision Maker’s letter be sent to him.
I would welcome advice about whether the above proposed action is seen as an appropriate course of action to take, regarding the missing Decision Maker’s letter. I would also welcome any comments about whether the DWP are in breach of any legal obligations by not sending Alex the DWP’s Decision Maker’s letter.

Many thanks,
Robert

Hi RB,

Just in case your forum username is your real name, you may wish to change it, see :

My full name is showing, how can I stop it?

You keep refering to the GL24 as "The medical report", a GL24 is in fact an appeals form, as can be seen by downloading the GL24 from the download link on this page :

How to submit an appeal

A medical report generated at a face to face assessment (Medical) is called an ESA85, one generated if a face to face assessment does not take place is an ESA85A, see :

ESA medical – what forms to ask for?

&

ESA Forms


In the case of an ESA85, there should also be an ESA85S, a Personalised Summary Statement, where the ATOS HCP gives justification of their findings.

There should be a "scoresheet" with justification of why and how he was found "fit for work"

You may have to issue a SAR under The Data Protection Act 1998 to obtain these, if you're having problems getting them, see, :

www.dwp.gov.uk/privacy-policy/data-protection/

And the download link for a SAR Form : www.dwp.gov.uk/docs/request-for-personal-information.rtf

It may be prudent to request all documentation, written or electronic used in his ESA WCA, to cover all bases.

Remember that, even though you may be able to point to inaccuracies, etc, in the medical report, the important issue when appealing to be placed into The WRAG or SG is to show how he meets the qualifying descriptors, see :

Qualifying for the Support Group

Qualifying for the WRAG

It may help if you review :

ESA Guides

ESA FAQ’s

Appeals FAQ’s

Please return to this thread if you have any further general questions.

bro58

Hi RB,

Just to add,

If in talking of the " Decision Maker’s letter " , you are referring to the ESA Award (Or non-award)Notification Letter, then yes he should have received one, as it also includes his right to appeal.

It is unlawful as a decision concerning LCW and LCWRA, as part of the outcome decision, carries a right of appeal under s12 of the SSA 1998. Decisions which carry a right of appeal under s12 shall be notified to the claimant in writing in accordance with reg’ 28 of the Decisions and Appeals Regulations 1999.

A decision to award ESA in the WRAG (LCW) or ESA in the Support Group (LCWRA), or indeed a decision to find the claimant “fit for work” carries a right to appeal under s12 of the SSA 1998, see :

www.hmrc.gov.uk/nicmanual/volume_1/ssa_1998.pdf

Decisions which carry a right to appeal under s12 shall be notified to the claimant in writing in accordance with Reg 28 of the Decisions and Appeals Regulations 1999. See :

www.legislation.gov.uk/uksi/1999/991/regulation/28/made

Therefore, you should be notified in writing.

However, this ESA Award Notice would not have included any details of how or why he was found "fit for work"

bro58

Hi bro58,

Many thanks for your comprehnsive authoritative response to my query about not receiving the Decision Maker's notication letter that my friend with Asperger's syndrome had failed his Atos medical. I am much less muddled than I was as a result of your advice and feel more empowered and energised which is also giving Alex more confidence about his appeal, having just been told that he failed his Atos medical in June 2012.
We have decided not to formally request the Decision maker's notification letter. We feel we can use his/her legal failure to both formally notify Alex of his discharge from ESA by letter and perhaps more importantly his/her failure (contrary to DWP policy) to telephone Alex about the likely outcome of his medical assesment , and check if there were any additional information which Alex would like to offer such as "please speak to my GP who knows me very well" - as evidence to show that the decision to 'bump him off' ESA was simply taken on the sole basis of the computerised Atos test which Alex took with a physiotherapist- who appeared a competent physio carrying out the ATOS test to the Atos' standards (targets/estimates), did not come across as a good listener with any evident understanding of how disabling asperger's can be.
I look forward to reading the 3rd year report by the independent adviser (Prof Malcolm Harrison) of the WCA when it is is eventually published as well as looking at postings and resources on this wonderful site. Many thanks again, it is much appreciated. Robert

Robert
Black wrote:

Hi bro58,

Many thanks for your comprehnsive authoritative response to my query about not receiving the Decision Maker's notication letter that my friend with Asperger's syndrome had failed his Atos medical. I am much less muddled than I was as a result of your advice and feel more empowered and energised which is also giving Alex more confidence about his appeal, having just been told that he failed his Atos medical in June 2012.
We have decided not to formally request the Decision maker's notification letter. We feel we can use his/her legal failure to both formally notify Alex of his discharge from ESA by letter and perhaps more importantly his/her failure (contrary to DWP policy) to telephone Alex about the likely outcome of his medical assesment , and check if there were any additional information which Alex would like to offer such as "please speak to my GP who knows me very well" - as evidence to show that the decision to 'bump him off' ESA was simply taken on the sole basis of the computerised Atos test which Alex took with a physiotherapist- who appeared a competent physio carrying out the ATOS test to the Atos' standards (targets/estimates), did not come across as a good listener with any evident understanding of how disabling asperger's can be.
I look forward to reading the 3rd year report by the independent adviser (Prof Malcolm Harrison) of the WCA when it is is eventually published as well as looking at postings and resources on this wonderful site. Many thanks again, it is much appreciated. Robert

Hi RB,

I'm glad to hear that you have a better understanding of it now, as I realise how complicated the whole ESA WCA can seem.

You may also find The WCA Handbook helpful, as it contains guidance given to the ATOS HCP's who carry out the assessments.

It is the 7th link down this page : ESA Guides

ATOS do state that they have specially trained HCP's to deal with claimants with mental health issues, known as "Mental Health Champions", you may wish to enquire whether the assessing HCP was indeed classed as one of the above.

You may wish to peruse the ATOS Website, See :

www.atoshealthcare.com/claimants/our_healthcare_professionals

Hope this helps, please keep us posted.

bro58