Help re DLA / ESA caint take anymore!

I was sent forms to re-apply for DLA as it was due to end in Nov 2012. I returned the forms beginning of October. I recently received a letter saying I am no longer entitled to high rate mobility or middle rate care allowance and my benefit will stop in November. Late last year I attended an ATOS medical for my ESA. The Atos assessment was awful and I lost my points for my ESA benefit, I had to appeal, it took nine months before my tribunal hearing date, which was June of this year. In June of this year I won my appeal, the tribunal awarded me 18 points.

In the recent decision letter Re refusal of my DLA it states that they have used the information provided on the Atos Health care professional report who examined me for Employment and Support in September 2011. I was very distressed as to how that report can still be used when it is nearly 12 months old, but also I won my ESA Tribunal case IN June of this year, I have also just received another Limited capability form!.

Although the CAB advisor feels I should just go ahead with DLA Appeal, my sister feels that if I phone DLA first and ask to speak to a Manager that they will see they have overlooked the fact that I went to a ESA tribunal and won in June of this year, therefore the old Atos report should be invalid! My sister also feels I should make a complaint, my GP feels the same.

I wondered if I rang DLA to point out the fact I went to tribunal, would it affect my Appeal ????

Also where do I complain to re the situation I am in re DLA and ESA my GP feels I am being harrassed by them plus they have not taken into account my GP report, my GP feels ignored and said tehy are not happy they are being ignored.

I have been told I will lose my DLA and our disability premiums will be taken off my ESA, this is quite a bit of loss per week as my partner is unable to work due to severe heart condition and several health problems., but we will now lose our disability premiums until I can sort this mess out. I fear I am now near breakdown.

It looks like the ESA department have not updated DLA department re my tribunal case. I am totally depressed with it all. But fear of how best to handle it all especially with all the changes in the system.

When I won my appeal in June of this year I was also put into the WRAG, with 18 points, but the CAB Advisor said based on my GP report I really should be in the support group. I was to ill to appeal due to some further falls. Also I was told I was down for assessment again in December 2012 so CAB said they will help with that and hopefully I will be put in the support group.

The fact of this old Atos report now being used once again as caused a massive problem right through my DLA claims and I also fear the completion of the Limited capability form again if they are once again relaying on a old Atos report FROM 2011. It all seems a total mess but the effect on us as a couple is immence.

My GP as even started to mention that they may take a seperate complaint to ATOS and the DSS as they are not listening to their advise re my disability and difficulties.

Meg3 wrote:

I was sent forms to re-apply for DLA as it was due to end in Nov 2012. I returned the forms beginning of October. I recently received a letter saying I am no longer entitled to high rate mobility or middle rate care allowance and my benefit will stop in November. Late last year I attended an ATOS medical for my ESA. The Atos assessment was awful and I lost my points for my ESA benefit, I had to appeal, it took nine months before my tribunal hearing date, which was June of this year. In June of this year I won my appeal, the tribunal awarded me 18 points.

In the recent decision letter Re refusal of my DLA it states that they have used the information provided on the Atos Health care professional report who examined me for Employment and Support in September 2011. I was very distressed as to how that report can still be used when it is nearly 12 months old, but also I won my ESA Tribunal case IN June of this year, I have also just received another Limited capability form!.

Although the CAB advisor feels I should just go ahead with DLA Appeal, my sister feels that if I phone DLA first and ask to speak to a Manager that they will see they have overlooked the fact that I went to a ESA tribunal and won in June of this year, therefore the old Atos report should be invalid! My sister also feels I should make a complaint, my GP feels the same.

I wondered if I rang DLA to point out the fact I went to tribunal, would it affect my Appeal ????

Also where do I complain to re the situation I am in re DLA and ESA my GP feels I am being harrassed by them plus they have not taken into account my GP report, my GP feels ignored and said tehy are not happy they are being ignored.

I have been told I will lose my DLA and our disability premiums will be taken off my ESA, this is quite a bit of loss per week as my partner is unable to work due to severe heart condition and several health problems., but we will now lose our disability premiums until I can sort this mess out. I fear I am now near breakdown.

It looks like the ESA department have not updated DLA department re my tribunal case. I am totally depressed with it all. But fear of how best to handle it all especially with all the changes in the system.

When I won my appeal in June of this year I was also put into the WRAG, with 18 points, but the CAB Advisor said based on my GP report I really should be in the support group. I was to ill to appeal due to some further falls. Also I was told I was down for assessment again in December 2012 so CAB said they will help with that and hopefully I will be put in the support group.

The fact of this old Atos report now being used once again as caused a massive problem right through my DLA claims and I also fear the completion of the Limited capability form again if they are once again relaying on a old Atos report FROM 2011. It all seems a total mess but the effect on us as a couple is immence.

My GP as even started to mention that they may take a seperate complaint to ATOS and the DSS as they are not listening to their advise re my disability and difficulties.

Hi M3,

I am sorry to hear of your problems

I understand that your situation is quite complicated to explain, but can you please try and keep any future posts to a shorter format, as they appear as one solid block of text in the Pre-Mod area, which can make it very difficult to check for inappropriate content.

Unfortunately, this is not the first time that we have come across this scenario.

The DWP DM can use any medical report or evidence that they have at their disposal when coming to a decision on whether to award.

Therefore, a DLA Med Report could be used in making a decision on ESA, and vice-versa.

However, I do take on board the valid arguments that you have raised, ie, ESA Med Report 12 months old, different qualifying criteria for DLA and ESA, the fact that the original ESA decision (fit for work) was remade by the Tribunal.

It would certainly do no harm to contact The DLA DM, to raise your concerns.

Unfortunately with respect to your G.P.,and The DWP and ATOS seeming to ignore him/her, again we see this scenario all too often, have a look at this extract from The WCA Handbook Page 41 :


"2.7.2 The Role of the Atos Healthcare HCP
The Atos Healthcare HCP will provide advice to the Decision Maker using all their skills as a Disability Analyst. They will review all the evidence on file and provide advice on likely functional implications of any medical evidence provided.

The HCP must take into account that the primary role of the GP or hospital doctor is to diagnose and treat any medical conditions that the patient/claimant presents to them. Any information or medical report that the doctor provides to the Department for Work and Pensions in relation to disability benefits is a purely secondary activity to his therapeutic role.

A clinician does not routinely consider the functional restrictions or disabling effects of the medical conditions that they treat. They must take into consideration that the clinician may have no specific training in assessing disabilities in their medical education, and may have considerable difficulty in giving an accurate assessment or forming an opinion in relation to the functional restrictions experienced by their patient.

In addition clinicians usually have, at best, very limited knowledge of entitlement criteria to ESA through the WCA."

Which can be accessed from here :

ESA Guides

You could argue that as you have not had a DLA Medical Assessment, and as the DLA DM does not seem to have taken your G.P.'s input into account, that the DM, has not fully discharged his/her "Burden of Proof" which is on the DM, and not the claimant.

If you are not successful in trying to pursuade the DM verbally, your only other option would be to appeal, in which case an automatic reconsideration by a different DM would take place.

Have a look at :

DLA FAQ’s

Appeals FAQ’s

DLA Guides

With respect to your ESA reassessment, you may wish to consider using the PDF ESA50 this time, see :

Using The PDF Version Of The ESA50 Questionnaire

From :

ESA FAQ’s

Hope this helps.

bro58

Hi again M3,

Even though it appears that you did not have a DLA Medical, you may wish to request the following, as listed in this FAQ :

DLA Medical – What forms to ask for?

It may give you a better insight into the decision.

bro58

You may also wish to ask your G.P. whether he received a request for a factual report re : your DLA, from the DWP, as seen in the DLA/AA section on this page :

www.dwp.gov.uk/healthcare-professional/guidance/

Also here :

www.dwp.gov.uk/docs/medical-reports-completion.pdf

If the DWP did not send a factual report to your G.P., then again you may wish to argue that the DWP DM has not fully discharged their "Burden of Proof" in coming to the DLA renewal decision.

bro58

Hi Bro58
Just to let you know I rang DLA today to ask why the atos medical report for ESA had been used even though it was nearly 12 months old and I had won my ESA appeal in June of this year. The only advice the Manger could give me was it was the Adjudication Officer decision to use that report and it was only the Adjudication officer who can change the decision. I asked surely it falls under a complaint as the report should not have been used based on fact I won my Appeal in June of this year and the old decision based on that report had been set aside, then surely it was their error that old report had been used. She said although she was a Manager she could not change the decsion or comment furhter on that, she advised I send in my Appeal and then they can call back my file and it can be looked at again.
She gave me no propere advice on what complaint system was in place.
At the moment I am so worried about the loss of all my DLA Benefit and the fact it has an immediate effect on my ESA benefit, that also effects me and my partner as we also lose the couples disability premium.
I am so stressed as my ESA only backdated about september and sorted out after the tribunal hearing in June, in took them weeks to sort!
Thank you for all the links today which I am reading through, my DLA Appeal is going recorded delivery tomorrow. I also have to start re-completing another Limited capability Form !