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 eliotnpt Novitiate

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    Thumbs up ATOS Decision overturned and ESA awarded. Always appeal :)

    I have made two previous posts on this which can be read on pages 3 and 4 of the thread called - Atos - issues with assessment, started by honeybee13. The first explains that I was called for an ATOS "medical" as part of the process of migrating cases from Incapacity Benefit to ESA, and that I was awarded 0 points. Explaining also how this forum assisted with my putting together an appeal and what I should do. The second post explains what happened following that submission, that I received a letter stating the case would be reviewed in the office prior to going for Tribunal (being the opposite of what I was told on the phone), and that even with a medical certificate submitted, I still did not have my benefit reinstated (at the lower rate pending appeal).

    This morning, three weeks without any benefit, I heard from the DWP that they overturned the 0 points decision, have awarded me ESA and placed me in the Support Group. I will receive all benefit that I am owed paid into my bank over the next few days, and payment of ESA at the Support Group rate will be paid into my bank on my usual pay days.

    I was shocked to receive 0 points after receiving Incapacity Benefit for a number of years and always being awarded "more than 15 points" for both physical and mental health problems on many earlier medicals for IB. This forum really helped me, though, not only with the information in the stickys and in posts, but also in the links to other websites. It showed me I was not being singled out, I was but one person in many thousands who were suddenly being awarded 0 points and being told to claim JSA and get a job.

    I know there are a number of people who visit this forum wondering whether they should lodge an appeal. My answer to them is "Yes". You have nothing to lose (other than a lot of time) and everything to gain. Follow the stickys here, especially those dealing with how to present your appeal. Make sure you get a new medical certificate from your GP and submit it with your appeal form, writing on there clearly that you wish to be paid ESA at the lower rate pending your Tribunal. Follow that up with a fuller submission of papers outlining all the points that you disagree with on the medical report from ATOS (you will have to ask for this from the Job Centre who writes to you telling you that you failed the assessment). And I do mean outline every single point on the medical report that you disagree with, do not just pick one or two. In addition, make sure you read each section of the ATOS report whilst having a web page open showing the descriptors.

    My initial appeal was posted in under a week and comprised the official appeal form, a new medical certificate and a few typed pages outlining why I was appealing and giving a list of reasons. When I received the ATOS report, a very much larger document was prepared, following the advice on this forum, and going through every single point that I believed was incorrect, always referring to the descriptors and always ensuring I pointed out just how this or that would affect me in a work situation. I also had a lengthy letter provided by a close friend of mine who sees me on a daily basis and so could offer his observations. I then passed these documents to a Welfare Rights Officer at my local MIND. He was excellent, spent an hour talking with me, putting my mind at rest, calming me down, and said he would be happy to assist with my case. A few days later he telephoned and said he was happy with what had been typed as fuller information for my appeal and to post it to the the DWP. Knowing a Welfare Rights Officer, who was fully experienced in handling these appeals, was prepared to assist me and go to the Tribunal with me, was a great relief.

    If you are in the position of having failed your ESA medical, either your first or if it is part of the migration of claimants from Incapacity Benefit over to ESA, then you should appeal. It is hard work, it is very worrying and you will likely have to manage on reduced benefits (if you can ever get them paid). If you have mental health issues, contact your local MIND office or other mental health support organisation, they will have an experienced Welfare Rights Officer working for them or in a nearby office. You can also get advice and support from CAB and other places dealing with Welfare Rights. If you have a physical health issue, contact any major organisations or charities who support people in your position for advice. But, more than anything else, if you are genuinely ill, if you genuinely cannot work because of your health problems, do not give up and register unemployed, fight, fight and keep fighting. You only need one person to listen and support you, and the information you need to put an appeal submission together is on this forum.

    I had fully expected to wait nine months or a year and then appear before a Tribunal. As much as I feared that prospect, I was not going to lie down and let the ATOS "healthcare professional", a GMC registered doctor in my case (although not registered with the GMC as a practising GP) have the last word. Only you know your own illness and so the forms you have to complete, the ATOS assessment you have to go through, is insufficient to show full details of your individual case. It is therefore always up to you to point out the mistakes, the faults in the report, even any questionable or illegal parts (I had several points in my ATOS report that were clearly in breach of the code of practice).

    My case, I have been told today, is now concluded with no need for it to go to a Tribunal and be placed in the public domain, and it was concluded far quicker than I expected. I have been placed in the Support Group (although I have no idea what this means for me in the longer term) and my benefits will resume.

    I wish everyone who finds themselves in the position of failing the ATOS medical and having to appeal the very best of luck. Do not roll over and let them win if you are genuinely ill and unable to work. Appeal and fight your case no matter how much effort it costs you. You are not alone, you are one amongst many thousands in the same position, so do not give up hope.


  2. #2
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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    received a letter stating the case would be reviewed in the office prior to going for Tribunal
    This is normal.

    Congratulations.


  3. #3
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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    Hello again.

    That's great news, I'm delighted for you. How good that you had Welfare Rights to help as well. I hope your life gets back to normal now and that you're left in peace.

    Thank you for letting us know as well. I'm sure you will encourage other people going through the same thing.

    My best, HB

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    Thank you for taking the time to share your experience - it gives much hope to others. I'm glad to see that you got the right outcome, but I wish people didn't have to go through the ringer to get the outcome they deserved from the beginning.

    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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  5. #5
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    eliotnpt.thats good news realy,i have just been told after 5 years my claim for esa will stop
    i,am going to appeal against this in writing.and go and see my gp.did you have to send
    a doctors medical certificate with your appeal ? i was advised to claim jsa when i phoned up
    about this ? i said that claiming jsa makes it seem that iam well enough to work.but cant claim
    esa as iam not ill enough.so how can i claim jsa with heart problems ? and be availiable for work
    the whole issue surrounding this is very confusing,do they just want you to roll over and die ?
    and how would i be able to claim jsa if i have a partner that works full time.doesnt make
    any sence at all.but i,am disputing thier decision, so fingers crossed hey.but well done


  6. #6
    Basic Account Holder eliotnpt Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    Having a partner who works full time will certainly affect certain benefits you might apply for, that is something you would have to ask a more experienced member here for advice on.
    As for your ESA. You didn't say if you have been told that your benefit will stop or if you failed a medical examination, or for what reasons the benefit has been stopped. In my own case, I was failed by an ATOS "healthcare professional" and the letter I received suggested I should claim JSA. I chose to lodge an appeal and, yes, my GP gave me a medical certificate which was included with my appeal submission, together with a request that my benefit be paid at the lower rate pending the appeal being heard.
    There is a mass of good advice on this forum that you should spend time reading but, importantly, if you are going to appeal you should do so as quickly as possible because it is time limited, and ensure you enclose a medical certificate. You can always submit more information to add to your appeal after taking advice. If you have recently failed an ATOS medical, you will need to request they send you a copy of their report (telephone the ESA department who sent you your notification).


  7. #7
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    many thanks for your response,yes it was a failed medical assesment,on the day of the medical
    i was physically sick as i had,nt been feeling to well on the morning of the assesment.the doctor
    took my blood pressure and said it was high,but not high enough to show her concern ! she finished
    the rest of the assesment asking my partner any questions.as i was,nt up to answering them
    and yesterday i was sent a letter saying my claim for esa will cease,i have claimed incapacity
    or esa as it is now for 5 years on the same medical grounds and have always been allowed my claim
    which realy does,nt make any sence at all,i will contact them for a copy of my assesment and will
    go and see my gp for a medical certificate to send with my appeal letter.

    kind regards.


  8. #8
    Basic Account Holder eliotnpt Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    Then, sadly, you find yourself in the same position as many thousands of others at the moment. Telephone in the morning for an appeal form and request a copy of your ATOS medical report, and see your GP as quickly as possible. You will need to read the stickys on this section for the excellent advice they offer on preparing an appeal submission and ensure you reply to your medical report with reference to the descriptors. All the information is here on this forum to help you get started.


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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    The criteria for ESA and IB are different. There were some changes to ESA earlier this year.


  10. #10
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    will go and see my gp as soon as possible,i didnt know if to take the copy of my medical report with me
    however i suppose i can go back and see him when that arrives,and will phone them for a copy of this
    tomorrow,i didnt know if i had to request the report in writing ,but ill certainly ring them first thing.
    iam not use to benfits and the way the law stands,i have always worked apart from the last 5 years
    and when i did become ill it wasnt my decission to stop work it was my doctor that told me to cease working
    the unfortunate thing now is i have a new gp as the other ones retired and have never met him.i like
    every one else here am its not a case of wanting to be idle and expect to live off benefits for ever and
    would go back to work tomorrow if i could ,but i know i wont make it,and iam sure if i was to apply
    for a job and was asked about medical issues that would put them striaght off me,as they wouldnt
    employ me with heart problems,so iam stuffed all ways,if this fails,jsa as my partner works full time
    dont know about working tax credits we have a daughter,and do get child tax credits.or income support
    i realy dont know.but kind regards for the advise realy appreciate this.


  11. #11
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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    You do not have to claim JSA, they frequently tell people this but it is false information.

    You should receive ESA at the assessment rate up until your appeal tribunal.

    Good luck

    - dj

    PS Congrats to eliot npt

    Benefits rules are complex, and although I do try to inform and support people, I may get it wrong because the rules apply to individual claimants and their particular circumstances.
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  12. #12
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    hiya just an update regarding my appeal
    i sent in my appeal by letter and have recieved a response from them telling me,to obtain a medical certificate
    to back up my appeal,its also says that if appropriate they will revise their decision in my favour and my appeal
    will lapse and not be sent to the tribunals service..but if they can not revise in my favour they will send my appeal
    letter and papers giving their reasons to the tribunals giving their reasons and evidence, and will send me a copy
    of their decision.how ever they havent said that my esa will be restored while my appeal is in progress
    which is what i thought happened while your appeal was being heard.i have not claimed any other benefits
    such as jsa as ,it seems im not sick enough to claim esa but to sick to work.so iam stuck.on what to do next
    i will go and see my gp after christmas and obtian a medical report,i did ask for a copy of thier assesment
    in my appeal letter but this hasnt been sent.should i have been allowed to have my esa rstored until this
    has been dealt with .thanks in advance.


  13. #13
    Basic Account Holder eliotnpt Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    You needed to send a new medical certificate straight away with your appeal and write on the form that you wished your ESA to continue (at the lower amount) pending appeal. Adding also that you would be submitting further information to support your appeal as soon as you have it available. Without being covered by a current medical certificate, they will assume you are fit for work and so are either in work or else can claim JSA. Get your medical certificate as quickly as possible.


  14. #14
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    thanks for your respone.i will do that as soon as possible..in all the time 5 yrs that i have been claiming
    incapacity benefits,i have never been asked to submit a medical certificate, just attend the medical
    assesments when atos have sent for me and they have made their decisions from the assesment
    so that is why i didnt send one with my appeal letter.

    many thanks eliotnpt


  15. #15
    Basic Account Holder eliotnpt Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    ESA and Incapacity Benefit are assessed differently. Once you qualified for IB, your GP will have been notified and you would not have had to submit further medical certificates. Your regular medical examinations were sufficient for the Department to assess if you were incapable of work. However, ESA is a different benefit and the criteria for receiving it are also different. Rather than being a medical examination to see if you are too ill to work, it is more of an assessment to see what work you are capable of doing. Therefore, you have been found fit for work by ATOS, much like almost everyone who go for their medical now, and so have to register for JSA and find work. However, if you believe the ATOS decision is incorrect and you are too sick to work, that is why you needed to lodge an appeal. However, because you have been declared fit for some work (whether rightly or wrongly) you now have to show that you are too ill and this is why a new medical certificate is required. Incapacity Benefit is gone, ESA has taken over, and it is almost like a fresh claim for benefit. Whether you will qualify to have your payments backdated now I do not know, perhaps others using this forum with more knowledge can advise. But you must get that medical certificate to them without delay AND you must request they pay you ESA at the lower rate pending the result of your appeal.


  16. #16
    Basic Account Holder spots1 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    Hi waddington24

    You are doing right to appeal ...i had a phone callicon to tell me I had`nt the points and I was not happy the DM gave me till the 21st Nov 2011 to send more info in which I did from my gp who wrote a very damming letter to them stating that they should have been asked for there opininon before the med took place and one from my mental health team something that always happened on the ib meds ....however I got a letter on the 23rd dec stating that they had reconsidered and I was awarded esa ...I did not have to send any doc certs. in and it did not go to full appeal!!...however I am placed in the work related group and just awaiting advice as to what to do next on my own post ...good luck many of us on here are in the same Atos boat ...advice on here is brill and without it I would be lost for sure

    spots1


  17. #17
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    i have been to see my gp today and he has given me a medical certificate for 4 weeks.and
    has told me to return in 4 weeks time.for a re assesment of my mental health and medical condition
    i have sent this in by recorded delivery.and have requested that until such time iam able to claim
    esa at the lower rate until i return to see my gp and my appeal is considered.my gp has also
    given me anti depressants and have been also asked to complete form phq9.this is to assess
    my mental health and will help him decide on a further course of action to follow.should i have
    asked him to make my medical certificate until futher notice or is this standard until i return
    in 4 weeks.iam not to clued up on how this works as i have never been asked to send one in
    before although iam aware of the new changes made from incapacity to esa.

    kind regards


  18. #18
    Basic Account Holder eliotnpt Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    The length of medical certificate given by a GP is, I believe, determined by a number of factors, such as how long he/she expects you to be ill and unable to work, and how long he/she can realistically give you a medical certificate based upon your illness without seeing you again. In your case, it appears your GP has given you a 4 week certificate and wishes to see you before that time so he can reassess you further. He will then make a decision on whether to give you a further medical certificate. I would advise you see him on time because you will need to keep sending these medical certificates to the office handling your ESA claim since you cease to qualify for ESA once a medical certificate expires unless they have advised you (and your GP) that no further certificates need to be submitted. In this case, you will generally receive further assessments by ATOS or whatever other company the government engages.


  19. #19
    Basic Account Holder waddington24 Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    many thanks eliotnpt

    its just a case of waiting and see what happens from now.and if my appeal is turned down
    ill appeal against that decision to.i have always worked up until the last 5 years and it
    makes you realise just how difficult they make things for you to claim anything at all
    and yet there are those that simply abuse the system and get away with it.genuine
    sick people dont deserve the way they are being treated.but thanks for your input
    very much appreciated.fingers crossed


  20. #20
    Basic Account Holder markwelly Novitiate

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    Default Re: ATOS Decision overturned and ESA awarded. Always appeal :)

    read this with keen interesticon ,after winning three appeals went for atos medical in oct 2011 and was awarded 0 points as usual my problem is the dss wont pay me any money as iv not submitted sick note to cover the whole period from change to lower rate pending appeal,i suffer from agrophobia and dont visit the doctor unless absolutely neccessary when i did finally get there my old doctor had left the practice and the new one with the greatest reluctance said she woul not backdate the note as she had not seen me before and gave me a note to cover one month instead of two which the dss wont accept have phoned them over 6 times but they wont budge have had no money since 2nd nov 2011 when i asked the doctor why she would not backdate the note she said it was a legal document and she would be liable if there were any questions raised , i did the usual routine at the start asking the dss to reconsider normally you can count on filling the form in and recieving the knock back within ten days took them nearly three months this time and they also failed to send me the doctors report from the assessment,so there it is at the end of my rope here cant pay the bills christmas was the worst in history dont know what happens to housing benefit entitlement but can guess can only sympathise with those in same boat and applaud the people who have taken these people on and won, thanks for reading.



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