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 zany_toon Novitiate

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    Default DLA and ESA Appeal and Tribunal Questions from a Newbie

    Hello,
    I hope I have this in the right place as am a new member. I really hope that some one can give me advice because I am completely lost now as to what to do.
    I am 26 and have suffered from severe depression for a number of years but since February 2010 it has been so bad that I haven't been able to work. I am self harming, suicidal and taking panic attacks and don't go out without some one being with me (in part due to the panic attacks but I also can't go anywhere new or take new routes to places I know because of Dyspraxia which interferes with my ability to follow directions, coordination etc.) I am attending both a psychiatrist and a psychologist and was assessed by a psychiatrist from my work who determined that I am unfit to work and will be unable to do so for some time. Medication hasn't helped a single bit. Now my work have awarded me their health insurance meaning I get a small percentage of my salary for as long as I am unable to work but they also stated that I had to apply for ESA and DLA, which I did. And I've had nothing but problems since.
    I received letters from DWP today advising that after attending their medical assessments I have been awarded 0 points and am not entitiled to any benefits. I have been in a complete mess all day and have just got to the stage that I want to give up fighting everything but eventually managed to calm down enough to phone them between the tears. They are sending out the things I need to appeal but I already have the appeal things for DLA. Despite sending an in depth psychological capability report from my work's psychiatrist (who spent almost 5 hours assessing me) to them they have ignored all information in it saying that I don't need the help or have any of the problems in it that I state. And my doctor and psychiatrist haven't included any information either other than that I have "low mood" (but they are telling me that I can't go back to work because I won't be able to cope.) I was honest at the medical assessment saying that I don't go out at all, I struggle to keep track of anything, don't do any of my hobbies anymore, had to have some one take me in and accompany me, self harm etc but they don't seem to have considered any of this either - despite the fact that the only way I could keep calm during the 10 minute assessment was to gouge a chunk of skin out my hand which the nurse noticed and didn't bother about. So a 10 minute assessment from an ordinary nurse not trained in learning difficulties or psychiatry has been able to say that she knows better than my GP, psychiatrist, psychologist and a work hired psychiatrist and that I can go back to work. If I was able to go back to work I would, I was on a good salary of 1200 per month and seconded onto a leadership role, all of which i have lost with being off ill - I'd give anything to go back and not be claiming the pitance from DWP!!
    So my questions are this, given my luck it will get to a tribunal stage which is just more stress. So can some one tell me, please:
    1. What does the tribunal entail?
    2. What happens if they decline the ESA appeal?
    3. Do they contact my doctor and work and tell them that I have to go back despite the fact that I had such a bad panic attack last time I was there I ended up being sick and could hardly breath? 4.Can I just not claim ESA and still be off while my work are paying me health insurance?

    I'm really really sorry for so many questions and the long post, but I haven't any one else to check this with as the woman who has been helping me from Money Matters has been away on holidayicon and doesn't get back for another week and I just can't stop worrying about this


  2. #2
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Welcome to the site.
    There are a number of members on the site who will be able to answer your questions.
    In fact some of your questions come up quite frequently.
    Try not to worry someone will answer here.
    In the meantime,there is some good info in the stickied threads at the top of this forum which you may like to read.

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  3. #3
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Hello and welcome to CAGicon. Life does sound tough for you at the moment, I'm sorry. I'll put a couple of answers to your questions below.

    1. What does the tribunal entail?

    It won't happen for many months. You'll be called in to see a panel. Have a read of my sticky about ESA appeals, I hope it helps you understand the system. To find the stickies, use the back arrow to come out of your thread and look in the yellow section near the top.

    2. What happens if they decline the ESA appeal?

    Well, obviously they won't pay you. I don't know much about re-applying, but I know people here have. Hopefully someone else will comment,

    3. Do they contact my doctor and work and tell them that I have to go back despite the fact that I had such a bad panic attack last time I was there I ended up being sick and could hardly breath?

    I don't think they will contact work.

    4.Can I just not claim ESA and still be off while my work are paying me health insurance?

    I would say you can. But the offset to your work insurance won't be made up by the insurer, so you'll be a bit worse off than you would be if you get ESA.

    I hope that helps a bit. If you think the medications isn't helping, have you discussed it with your psychiatrist? It could be that a different one would help.

    My best, HB


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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Just to fill in one of the questions - if you're not successful at appeal, you can reapply for ESA providing it has been at least six months since the decision refusing you ESA, after the medical.

    You would also be able to reapply for DLA as well.

    Regarding medical evidence, it is useful if you can get something related to the descriptors that apply to you for ESA, and something that says you can't go out alone for DLA, as well as anything that mentions any additional help with personal care that you may need for DLA - for instance you have dyspraxia, can you make a cooked meal from scratch?


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    Basic Account Holder zany_toon Novitiate

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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Thanks all for the replies and sorry for not being on again sooner! I didn't notice the sticky threads unti ltonight and have sat and read them. I wish I had found this site before going for the assessment.
    Honeybee - I have discussed my meds with my psychiatrist and although he has given me numerous different medications (so far 10 different medications and various strengths of them all) none of them seem to help so the consensus has been that the tablets just aren't the way forward. So I just need to hope that the psychologist and therapy will help.
    Leemack - no I can't cook a meal from scratch but my doctor has no notes of anything to do with my dyspraxia. It was diagnosed at school just before I left and the doctor at the time didn't want to know, so I have been left to deal with it myself as the school decided "well you are leaving soon and will be some one else's problem so there is no point in us getting involved." So I don't have any "proof " from specialists.
    I really appreciate the help from you, it's nice to know that some one can give me some advice because I didn't know where to turn.
    IN other news - I received the copy of the medical assessment today. The nurse who did it has lied out right about the lenthg of time for the assessment - I was in the assessment centre for 50 minutes, 40 minutes of a wait and 10 minutes of assessment. According to her though I was assessed for an hour!! She hasn't taken note of anything that was said, and half of the questions she has said I answered "doesn't apply to me" she didn't even ask. On top of that, I recognised her name. She didn't introduce herself at the assessment but I recognised her name as soon as I saw it on the paperwork yesterday. I met her once - she is friends of one of my mum's work colleagues. My mum accompanied me on the day of the assessment but couldn't place where she recognised the nurse from. So the nurse knew about me before going as the work colleague told my mum and I that she had discussed my illness with her. And the work colleague is forever telling us about how she (nurse) has said she will (and she said this when my mother met her before) "single handedly stop people claiming benefits - none of the lazy ***s deserve it." So I will make a point of mentioning this to the lady at money matters but I don't know whether I should get in touch with DWP to let them know before discussing this with money matters. Some one upstairs must hate me!!


  6. #6
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Well, as you know from my sticky, you should itemise everything you disagree with in the Atos assessment.

    I don't know about the possible conflict of interesticon thing, maybe Leemack or someone else will.

    My best, HB

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    Nottingham1989 [with leemack] June 2011
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  7. #7
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    I don't know about conflict of interesticon - certainly GP's at appeal who have previous knowledge of the appellant have to recuse themselves. I would think this should apply to anyone assessing you at medical. Personally, I would put in a complaint, stating the connection, and that the woman had prior knowledge of your illness and knows you, and should not have undertaken the medical, and the fact that she has bias against claimants and possibly against you. Ask for a new medical with someone who will assess you on the facts. You may also want to mention the fact that she lied about the length of the assessment - they have cameras in the waiting room, and could easily confirm what you're saying if they still have the recordings.

    But certainly someone who already has prior knowledge of you, should not be doing the assessment. How do you know what preconceptions the person already has about you that could colour their assessment.


  8. #8
    Basic Account Holder pinklisar Novitiate

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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Hi
    I don't know if this will help you or not but I went through a similar thing with my ESA. I am 28 and made a claim in June 09 for depression and anxiety after being told to leave my Universoty Course (where I was a student Mental Health Nurse - ironic I know) as I was too unwell to continue. I had my medical in October 09 and failed. I was awarded just 6 points for not being able to go to places I knew with out someone with me. The doctor doing the medical basically didn't listen to me. I got letters from my mum, my brother, my kuk sool won instructor and our lodger regarding my 'problems'. I also got a letter from my IAPT therapist and took them along to welfare rights who basically took over the appeal for me. They sent all the info to the esa and asked to revise the decision, they said no so it went to tribunal. I went to the tribunal in Sept 10 and won. I was awarded an additional 24 points. The tribunal was in front of a judge, a psychiatrist and a court worker who documented everything and it lasted less than an hour. They only focused on specific points of my medical that were relevent to my case and were really nice.
    I don't know of this post helps you but I wanted to let you know that you are not alone and I went through something similar and won.
    good luck
    Lisa x

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  9. #9
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Quote Originally Posted by zany_toon View Post
    IN other news - I received the copy of the medical assessment today. The nurse who did it has lied out right about the lenthg of time for the assessment - I was in the assessment centre for 50 minutes, 40 minutes of a wait and 10 minutes of assessment. According to her though I was assessed for an hour!! She hasn't taken note of anything that was said, and half of the questions she has said I answered "doesn't apply to me" she didn't even ask. On top of that, I recognised her name. She didn't introduce herself at the assessment but I recognised her name as soon as I saw it on the paperwork yesterday. I met her once - she is friends of one of my mum's work colleagues. My mum accompanied me on the day of the assessment but couldn't place where she recognised the nurse from. So the nurse knew about me before going as the work colleague told my mum and I that she had discussed my illness with her. And the work colleague is forever telling us about how she (nurse) has said she will (and she said this when my mother met her before) "single handedly stop people claiming benefits - none of the lazy ***s deserve it." So I will make a point of mentioning this to the lady at money matters but I don't know whether I should get in touch with DWP to let them know before discussing this with money matters. Some one upstairs must hate me!!
    It might be worth making a complaint. It's not her job to assess people and then write stuff that implies they're fit for work, based on her opinion of the welfare system.

    With regards to DLA - are you keeping a diary? Can you get statements from friends and family, explaining they've had to help you do thing?


  10. #10
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    Hi, I am new on here but wanted to share my experience of DLA and the appeal system. My 13 year old son has a kidney and bladder disorder. He has been getting DLA since he was a baby. During good times in his life he got lower rate of care component and difficult times highest rate. The rate determined by whether we had to do manual catheterization or not. I had to re-apply for DLA in July this year and although he was getting help with bodily function he was only given lowest rate of the care component. I asked them to reassess and provided medical evidence to support this request. It was kept at lowest rate so I appealed. The appeal board asked the DWP to reconsider and again it was kept at lowest rate. On 18 Feb I went to the appeal, and took with me all my son's medical records from Great Ormond Street, together with letters from consultants, doctors and our GP. Within 20 minutes he was unanomously awarded middle rate of cc which had to be backdated to July 2011. I sent a copy of the appeal decision notice to the DWP as I have read on previous threads here that it speeds them up updating their system. It is very true. Today I called them and was told that a letter is on its way to me and that the arrears have been paid into my bank account, issued today. The key message here is to be prepared and to take every piece of relevant information with you to an appeal. There is a Judge, a Doctor and a person who has knowledge of disability themselves, so its fair to say that jointly they will have a good understanding of what criteria need to be met for each of the rates. Once you leave the appeal after a win, copy the decision notice and send it to the DWP with a letter saying your bank details are the same as before, and that the person has not been in residential or hospital care and not been out of the country. It really speeds it up. Mine took 12 days from appeal date to payment date. Hope it helps.


  11. #11
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    should read backdated to July 2010


  12. #12
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    Default Re: DLA and ESA Appeal and Tribunal Questions from a Newbie

    The issue with the nurse is an ethical one and my understanding from my own studies at university is that she would have had to recuse herself when she realised she knew you and there is a conflict of interesticon. We all have to do it lawyers, Doctors, Psychologists the lot...I am sure its the same rule for her.

    You can complain about this and ask for recourse...they will need to give you another assessment without the new person knowing anything about the issue with the previous nurse. You need to provide evidence that the person knew you and you need to REQUEST that the new assessor does not have access to the notes the previous nurse has made. You also have the right under the Freedom of Information Act to see what information the DWP hold about you although this request must be put to them in writing.

    Hope all goes well for you and you get the result you are after.


    Quote Originally Posted by zany_toon View Post
    Thanks all for the replies and sorry for not being on again sooner! I didn't notice the sticky threads unti ltonight and have sat and read them. I wish I had found this site before going for the assessment.
    Honeybee - I have discussed my meds with my psychiatrist and although he has given me numerous different medications (so far 10 different medications and various strengths of them all) none of them seem to help so the consensus has been that the tablets just aren't the way forward. So I just need to hope that the psychologist and therapy will help.
    Leemack - no I can't cook a meal from scratch but my doctor has no notes of anything to do with my dyspraxia. It was diagnosed at school just before I left and the doctor at the time didn't want to know, so I have been left to deal with it myself as the school decided "well you are leaving soon and will be some one else's problem so there is no point in us getting involved." So I don't have any "proof " from specialists.
    I really appreciate the help from you, it's nice to know that some one can give me some advice because I didn't know where to turn.
    IN other news - I received the copy of the medical assessment today. The nurse who did it has lied out right about the lenthg of time for the assessment - I was in the assessment centre for 50 minutes, 40 minutes of a wait and 10 minutes of assessment. According to her though I was assessed for an hour!! She hasn't taken note of anything that was said, and half of the questions she has said I answered "doesn't apply to me" she didn't even ask. On top of that, I recognised her name. She didn't introduce herself at the assessment but I recognised her name as soon as I saw it on the paperwork yesterday. I met her once - she is friends of one of my mum's work colleagues. My mum accompanied me on the day of the assessment but couldn't place where she recognised the nurse from. So the nurse knew about me before going as the work colleague told my mum and I that she had discussed my illness with her. And the work colleague is forever telling us about how she (nurse) has said she will (and she said this when my mother met her before) "single handedly stop people claiming benefits - none of the lazy ***s deserve it." So I will make a point of mentioning this to the lady at money matters but I don't know whether I should get in touch with DWP to let them know before discussing this with money matters. Some one upstairs must hate me!!




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