Patricia Pearl - Small Claims Procedure - A Practical Guide


An excellent guide for the layperson in how to use the County Court - a must if you are intending to start a claim.

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  1. #1
    Basic Account Holder stalin's dead Novitiate

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    Default ESA decision timescale - help pls

    I had an ESA medical with ATOS yesterday morning which was the usual stuff but I have a couple of questions:

    1) Does the ESA medical assessor from ATOS have to be a qualified doctor to carry out the assessment?

    2) How long does it generally take from the date of the actual medical to get a decision from the DWP? I need this info because If Im turned down this will be deemed a 'change in circumstances' by the housing benefit people who will stop my housing benefit which in itself is a nightmare to rearrange. Moreover I will then have to appeal.

    Thanks and regards


  2. #2
    Basic Account Holder paulb1310 Novitiate paulb1310 Novitiate

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    Default Re: ESA decision timescale - help pls

    No the person has to be a "health professional". As for decisions, from people I have talked to it takes a couple of weeks - ring up and ask if you can be patient enough to hold on the phone.


  3. #3
    Basic Account Holder happyhamr Novitiate

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    Default Re: ESA decision timescale - help pls

    No proper "qualified", doctors/consultants at atos sorry hello

    stalins dead



    "that is the the whole problem"

    this is what should happen "in an ideal world"
    1- they receive your esa 50 form (acknowledge it,look,read and review it
    before you have medical, then you should be seen by some one who has some sort of idea/ clue what is actually wrong with you)

    "unfortunately this does not happen"(does not appear to happening,but should happen) "in my opinion"

    if you have heart problems.(you would not go to a dentist)

    with everybody coming over eventually from income support to ESA these atos farces will get quicker;(more people being seen each day, and more
    people getting "nil" points,not the "magical" 15 points) IMO

    "just dont sick or ill , now or in the future"


    in regard to your question 2 - 1 week to 2months.
    "who knows with the dwp"

    good luck happyhamr


  4. #4
    Basic Account Holder stalin's dead Novitiate

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    Default Re: ESA decision timescale - help pls

    thanks guys/gals


  5. #5
    Basic Account Holder sj01 Novitiate

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    Default Re: ESA decision timescale - help pls

    When the DWP do a 'reconsideration' after the ATOS medical is failed, is the reconsideration carried out by people with a medical qualification?
    If so then how are so many people winning their appeal.


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    Default Re: ESA decision timescale - help pls

    It can be a Doctor, or a nurse/midwife, or a HCP. The time from the assessment to the time of the decision can vary greatly. If you do need to appeal due to an unfavourable medical result, your benefit will be paid at the assessment rate until the final determination of your appeal - just inform the council that you have appealed against the decision and are awaiting reinstatement of your ESA pending appeal. Then, all they should do is suspend the claim to HB/CTB rather than terminate it. As soon as you recieve notifcation from the DWP that they have recieved your appeal, take it down to the council, get them to photocopy it, stamp the copy as a verified true copy and give you a receipt. Your HB/CTB should then be resumed.

    My advice is based on my opinion, my experience and my education. I do not profess to be an expert in any given field. If requested, I will provide a link where possible to relevant legislation or guidance, so that advice provided can be confirmed and I do encourage others to follow those links for their own peace of mind. Sometimes my advice is not what people necesserily want to hear, but I will advise on facts as I know them - although it may not be what a person wants to hear it helps to know where you stand. Advice on the internet should never be a substitute for advice from your own legal professional with full knowledge of your individual case.

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  7. #7
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    Default Re: ESA decision timescale - help pls

    Quote Originally Posted by sj01 View Post
    When the DWP do a 'reconsideration' after the ATOS medical is failed, is the reconsideration carried out by people with a medical qualification?
    If so then how are so many people winning their appeal.
    No, there is no requirement for the person to have a medical qualification. The reconsideration is carried out by the same people (but not always the same person) who made the original decision, in DWP by looking at all of the gathered evidence along with any new evidence which relates to the time of the original decision.

    At an oral appeal tribunal in relation to a dispute of the decision on ESA, there will be a medically qualified panel member.

    My advice is based on my opinion, my experience and my education. I do not profess to be an expert in any given field. If requested, I will provide a link where possible to relevant legislation or guidance, so that advice provided can be confirmed and I do encourage others to follow those links for their own peace of mind. Sometimes my advice is not what people necesserily want to hear, but I will advise on facts as I know them - although it may not be what a person wants to hear it helps to know where you stand. Advice on the internet should never be a substitute for advice from your own legal professional with full knowledge of your individual case.

    Please do not seek, offer or produce advice on a consumer issue via private message; it is against forum rules to advise via private message, therefore pm's requesting private advice will not receive a response.
    (exceptions for prior authorisation)


    If my advice has been helpful, please show your gratitude by taking a moment to click on the star icon on the bottom strip of my post






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  8. #8
    Basic Account Holder sj01 Novitiate

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    Default Re: ESA decision timescale - help pls

    That makes no sense because if people send medical evidence with their reconsideration then a person with medical knowledge should be deciding.


  9. #9
    Basic Account Holder happyhamr Novitiate

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    Default Re: ESA decision timescale - help pls

    hellow sj01

    my reconsideration (whatever) ,was done by a different decision maker (no medical experiance)
    The first time i found out about this is when i received the big "bundle" of evidence in MAY.,informing me of this "reconsideration".
    The "funny" thing is the date of this reconsideration is 30th MARCH

    Notified to customer on 30/03/10 on form/letter DR1

    so sj01 "your guess is as good as mine"

    cheers happyhamr


  10. #10
    Basic Account Holder happyhamr Novitiate

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    Default Re: ESA decision timescale - help pls

    yes , if gets to recon; and the Decision Maker has to make another decision(you would think by now that they would have the "common sense" to get the opinion of your doctor/ consultant who would be dealing with you

    they just want it to carry on, because if a proper doctor/ consultant had the chance to give thier opinios(you might get the extra monies ,you really should of been "entitled in the first place. IMO.

    1 more thing what is a DR1 form (anyone)

    cheers happyhamr

    sorry about; rolley es;(computer glitc)"pressed something i should not have


  11. #11
    Basic Account Holder happyhamr Novitiate

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    Default Re: ESA decision timescale - help pls

    sorry just one more thing;when it does eventually get to the tribunal, a lot of peoples are winning their appeals(no "gurantee" though)

    Reasons; 1 proper doctor evidence
    2 proper consultant evidence
    3"crap" atos (whatever)unqualified personnel
    4"crap" decision maker(s)(whatever)"Come ON
    5 - should never had gone this far in the first place."Why"
    6-dwp (mirrors& smokeletters"confusing
    7-people are Genuinely sick/ill in the first place(speak/ contact proper doctors at initial stage,so people do not have to go through all of this 8 - dwp d makers , would you send your mum /dad,son, daughter to a atos (whatever) "food for thought"
    cheers sj01 happyhamr


  12. #12
    Basic Account Holder COUNTMEIN Novitiate

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    Default Re: ESA decision timescale - help pls

    I Have a 'QUESTION' perhaps someone could clarify for me??

    Am I correct in thinking that the official line is...THAT ATOS DO NOT MAKE THE FINAL DECISION RE entitlement to ESA ( OR WHATEVER BENEFIT IS IN QUESTION) the DWP =DM make that final call??....

    If this is so, then why at my reconsideration by the DWP did a different decision maker from the one that made the original decision to deny me my ESA have to ' ask ATOS ' should this 'customer be re-assessed due to questionable first assesment/medical, and things not been taken into account at the assesment??....but ATOS SAID NO ( Blahdeblah etc etc ) ... so I wasn't re-assesed... and the descision was not revised..
    this DM goes on to say on her summing up/reasons for not revising the decision that ( and I quote) 'I disagree with both the original decision maker and the HCP choice of descriptors'....My representative who is helping me with my appeal as never known that to have been said before by DM at the DWP?
    I interperate that to mean that DM DONT make the final call ..ATOS DO?...

    Regards

    countmein x


  13. #13
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    Default Re: ESA decision timescale - help pls

    I can only give you an 'as far as I know' type answer. As far as I know it is the DM that scores the claim.
    That said, you make - and highlight - a very valid point that has been causing me increasing inquisitiveness. That is, just how far in bed together are the DWP and ATOS? I think they cuddle up far more than we're meant to see...
    Best wishes
    Rae


  14. #14
    Basic Account Holder happyhamr Novitiate

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    Default Re: ESA decision timescale - help pls

    I am exactly like you countmien in regard to decision makers
    had original DM decision; then reconsideration totally different DM

    Did you have to fill in a form yourself to request a "reconsideration". or does this just happen

    I personally did not request/ ask for a reconsideration (or any thing), just found out in MAY,even though i have letter dated MARCH 30 stating that
    Notified to customer 30/03/2010 on form/ letter DR1

    "This was news to me " because i did not receieve this until MAY

    Is this right ; do people have to request/ ask for a reconsideration,OR is this part of the "process" cheers happyhamr

    "like peas in a pod" kelcou (dwp&dm)

    countmein; who ever it suits" they will cover each others "arses"
    (dwp&dm) "NO accountability


  15. #15
    Basic Account Holder happyhamr Novitiate

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    Default Re: ESA decision timescale - help pls

    good night people

    stalins dead, hope you get a favourable outcome

    cheers happyhamr


  16. #16
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    Default Re: ESA decision timescale - help pls

    Quote Originally Posted by Kelcou View Post
    I can only give you an 'as far as I know' type answer. As far as I know it is the DM that scores the claim.
    That said, you make - and highlight - a very valid point that has been causing me increasing inquisitiveness. That is, just how far in bed together are the DWP and ATOS? I think they cuddle up far more than we're meant to see...
    Best wishes
    Rae
    Yes, the DM scores the claim, and should consider all the evidence, not just that presented by ATOS. We had a very useful post here a few weeks ago by a guy who'd spoken to his neighbour (a WCA DM) pointing out that the ESA50, therefore, is vitally important. If it's absent or poorly completed, that reduces the amount of information available to the DM, information that may go some way towards correcting errors, inaccuracies and inadequacies in the ATOS report.

    As to the relationship between ATOS and the DWP, well, I don't know about the higher ups, obviously, but at the processor/DM level, the contact is minimal. We send them referrals, they send us reports (I'm writing as if I still work there - it makes the phrasing easier ) and for the most part we don't communicate with them otherwise.

    It may amuse you (in a twisted sort of way) to know that we don't find it any easier to get through to them on the phone than the customers do :grin:.


  17. #17
    Basic Account Holder stalin's dead Novitiate

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    Default Re: ESA decision timescale - help pls

    I have severe epilepsy but how does anyone know this? I have a report from my GP and Cons. Neurologist that I have epilepsy but no one except me actually KNOWS how many seizures I have in any one week. EEG and other tests do not provide an unquestionable diagnosis for epilepsy so if my claim is turned down following the info that I have provided then surely they either dont believe the validity of the information I am providing ie they think Im lying, or they do believe it but are simply disqualifying everyone regardless of the disability

    If they do dismiss my claim then on what basis can they do this?

    My GP and Neuro reports say I have epilepsy
    My ESA50 that I completed tells them I am having around 4 seizures/week etc

    surely they have to make a decision based on the info provided rather than on a speculative judgement ie ATOS think i'm making it all up?


  18. #18
    Basic Account Holder COUNTMEIN Novitiate

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    Default Re: ESA decision timescale - help pls

    Quote Originally Posted by antone View Post
    Yes, the DM scores the claim, and should consider all the evidence, not just that presented by ATOS. We had a very useful post here a few weeks ago by a guy who'd spoken to his neighbour (a WCA DM) pointing out that the ESA50, therefore, is vitally important. If it's absent or poorly completed, that reduces the amount of information available to the DM, information that may go some way towards correcting errors, inaccuracies and inadequacies in the ATOS report.
    then what 'SHOULD' happen DOESN'T happen Antone? ( IMHO)....

    I do conceed that i did underestimate the importance of the ES50 FORM...Basically didn't know or realise how to complete it?? very confusing for me AND of course I know better now, but at the time I was very ill, and sick with worry about my deteriating eyesight and with numerous otherhealth issues and worries, as most people are when they're trying to claim ESA ) ...I just wanted it out of the way, sent back to them in tme before i had to go into hospital - I didn't realise that 'if you had a pulse, then you had to have a'so-called' medical!!
    BUT I did redeem myself ( or so I thought ) as I did send a thorough and explicit letter indicating ALL the issues I had with my health along with the appeal form I submitted...This( I think) is why the DM asked ATos to re-assess me....and as I've said, it seems that ATOS have the upper hand on the DM'S as he said NO...
    My rep tends to think??? - THE DM'S don't like to 'question ' or look like they're overruling the ATOS doctors?? ( in her humble opinion , of course:grin: )....so who does 'REALLY CALLS THE SHOTS?? NOT THE DM'S IT WOULD SEEM???

    The whole system is A disgrace, it's biased, corrupt and flawed beyond belief ( in my humble opinion of course)

    Can't wait to see what 'excuses aka LIES atos come out with tomorrow in the Guardian but they should be good one's cos that's one thing they are good at ' lies' ( imho)
    regards

    countmein x

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    Basic Account Holder paulb1310 Novitiate paulb1310 Novitiate

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    Default Re: ESA decision timescale - help pls

    So if I get this right - the DM gets the ESA50, the ATOS report and any other evidence. The ESA50 says "can't walk 50m", the ATOS report says no problem walking - which do they go for? The ATOS report? Why? Well because they are "paid" to provide an opinion. So whilst it is important to complete the ESA50 in detail in reality they won't believe a word you write on it unless ATOS agree?


  20. #20
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    Default Re: ESA decision timescale - help pls

    Quote Originally Posted by COUNTMEIN View Post
    My rep tends to think??? - THE DM'S don't like to 'question ' or look like they're overruling the ATOS doctors?? ( in her humble opinion , of course:grin: )....so who does 'REALLY CALLS THE SHOTS?? NOT THE DM'S IT WOULD SEEM???
    Several years ago when I was an I/B DM if the medical had been failed with a score of 10(ish)+ we would try our hardest to find extra points when doing a reconsideration or appeal, just to get the score upto 15, because if we didn't then the appeal board generally would. The more (relivant) information provided on the appeal the easier this was. Often, however the appeal letter would simply consist of "I wish to appeal against the decision to stop my benefit because it is wrong"! There was not much we could do with those

    It was much harder however to over rule the Atos doctor if the medical has been scored 0 & from what I read on here that's what appears to be happen nowadays.

    & for the record the general quality of IB50's completed by I/B claimants was terrible & made it much harder for us to help them when they did get disallowed. I doubt things will have changed much there.



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