Rae's ESA...

[RaeUK]

I appreciate this is a very narrow field but maybe one of you clued up people might be able to advise...

I have Chronic Bronchitis, Stage 3, Severe (sounds like a shipping forecast!). For those who've read my posts, you'll know that I fall between the gaps for ESA. I can't meet the descriptors. I have applied for ESA twice in the past, failed twice and failed at Tribunal twice. I feel sorry for the Tribunal panels as they know what I'm going through but their hands are tied by the law. I'm now on my third application and haven't seen an ESA50 yet despite having had a rapid reclaim started in November 2011. It's not too much of a problem as I won't pass the criteria still. I suspect I'd need to be cuddling up to an oxygen bottle and be a week or two away from a double lung transplant for that to happen. Although, as far as a transplant is concerned, I've already decided I'll refuse one.

To put the state of my lungs into some perspective, they have the efficiency of an 80 year old. You don't need to be a mastermind to know what limitations that places on a person. I suspect that the DWP / ATOS get confused a bit as it is very unusual for a person of my age to have this disease at this level. (I'm 50, but keep that to yourself ok?). However, it isn't without precedent. Recently, a rare genetic defect has been identified which can make a person highly susceptible to lung disease whilst leaving the remaining organs as they should be. The Consultant who was telling me this (nothing to do with my disease) was quite excited. Apparently I'm the ideal candidate for organ donation. 'Look on the bright side, Rae' he said, 'you're lungs are knackered, you're going to die young but all your other organs will be in perfect condition'. Thanks. The downside, of course, is that I'm just not dying fast enough for ESA.

In recent years, I've grown highly susceptible to chest infections and to cold damp weather. The only thing I'm not susceptible to is attracting 15 points or more. I have come to understand something I couldn't before though. Why some people move to a different climate for health reasons. I get it now. Especially after the last few days of rain and cold. It will be the British weather, I suspect, that will finish me off.

So, where does that leave me? Apart from in the poo. I'd be interested in the following and finding out if it would apply to me and whether it was worth writing direct to the DWP DMs for consideration:

 

6.6 Exceptional circumstances

 

Even if the decision maker decides that you do not pass the limited capability for work test they can still treat you as having passed it if the health care professional has obtained evidence that one of the following exceptional circumstances apply: ...

 

2. You suffer from some specific disease or bodily or mental disablement and consequently there would be a substantial risk to the mental or physical health of any person if you were found not to have limited capability for work. This risk should be linked to work you could realistically do according to your education or skills.

 

(My italics)

 

A final point, the disease is progressive. It cannot get better and there is currently no cure. For some reason, many people don't seem to be aware of that.

Apols for the long post and I hope I've been sort of clear in my question...

 

Rae.

Edited June 8, 2012 by RaeUK

[Nystagmite]

For that descriptor, you must provide medical evidence. Is your GP / consultant willing to provide evidence which states "Rae's health would be at serious risk if he was to return to work because..."?

 

What a crap situation you're in. I really do hope it gets sorted for you.

[worried33]

My guess is that descriptor is probably very rarely used. I expect any doctor applying it would probably be questioned as to why as well given they have targets to meet.

 

I would think the most likely scenario is if someone did a suicide attempt with the threat of benefit removal.

[RaeUK]

I don't have a Consultant for this disease, Nystagmite, as there is nothing that can be done until the lungs degenerate even further. It's just a case of managing symptoms. In my area we don't even have access to pulmonary rehabilitation schemes which can help.

As for my GP, there would be no problem in getting a letter to the effect that 'Rae's health would be at serious risk if she was to return to work because...' My GP is incredibly frustrated that the DWP don't seem to understand my illness. When I was first diagnosed at this level, about 4 years ago, she was very insistent that I had to be extrmely careful about what I did. I've gone down hill a bit since then...

 

Worried33, I suspect my GP wouldn't have a problem with it...

 

And a further note, which might be of use to others in this situation, I understand that there is a mechanism available to the Tribunal Panel to flag up appropriate cases like this to those who formulate these criterias. I don't know anything more specific yet ...

[RaeUK]

Just wanted this to float around for another day or two to see if it attracts any further comment. Thanks ...

[Slatted]

I believe the clause may be used more than you think...that and the one that is similar but relates to WRAG....in appeals.

 

I am looking to using this to appeal a decision that has been made regarding my husband...nothing ventured nothing gained I say....

 

I think that in your case the exposure to more risk of chest infections and other stuff should be emphasised and even if you dont have a Consultant for appointments I am sure that your GP might be able to refer your situation to a Consultant who could lay out the increased risks to your health (if you get ill with infections then how can that be not related to your health...?). I am sure if the emphasis on NHS costs could be mentioned...like maybe more GP visits or hospital visits or tests or "free prescriptions" anything where money is involved (catch my drift) it is worth a try.

 

It is a horrible world where the genuinely ill are persecuted whilst I am sure a good "actor" may still pass WCA......after all they will have read the descriptors......

 

Good luck

 

They may charge for this though...but it could be worth it....

Edited June 10, 2012 by Slatted

[RaeUK]

Thank-you Slatted, good points there. I know I need to give this avenue careful and detailed consideration. But I don't feel there's much to lose as I'll simply keep on the ESA Assessment Phase merry-go-round otherwise.

There are unpleasant aspects to this disease that I don't like to mention in polite company. Most days it will take two to three hours minimum for my chest to clear from all the pleghm that's built up over night. (I call that my 'wake-up phase'). You can double that time in winter or the damp and cold. At worst it won't ease up for several days. Yuck! ...

[starman59]

Hi Rae, How is this affecting you mentally? Sorry not being personal. But say if it was making you depressed or feeling suicidal (hint hint ) then that could earn you more points with the corrupt atos system. I know how you feel by the way I do get ESA as I have osteoarthritis and rhumatoid arthritis. But the good news is th healthcare professional (a nurse) has said I would get better in six months. This was a year ago and i'm still waiting. So dont lose heart Rae and and keep at them. Good luck.

[reallymadwoman]

I don't see as you have anything to lose by going for 'exceptional circumstances', just make sure you've given it loads of thought before you go to your GP armed with a list of reasons why even part time work would adversely affect your health, just to make his job easier when he does his letter of support. Taking him a copy of the descriptor too.

[RaeUK]

Hi starman, I'm actually disturbingly well adjusted when it comes to my illness. I've made it my business to know as much about it as possible and what to expect as it progresses. I've never wanted to live to an old age and feel somewhat privileged to know that that won't be the case. I appreciate that may sound odd to some. If you like, I'm having my old age now! The only thing that gets me down a bit is having been stuck on the ESA assessment rate for almost 4 years now...

 

Hi rmw, I am very blessed with having an excellent GP and Practice. My GP has patiently filled out an (un)fit note for me every three months for almost 4 years now. She could do with a break! She knows exactly where I'm at with my disease and what I'm capable of or not capable of. I am happy to have such a supportive GP and such back-up and help from the Practice as a whole. If only the same could be said of the ESA system ...

[worried33]

I believe the clause may be used more than you think...that and the one that is similar but relates to WRAG....in appeals.

 

I am looking to using this to appeal a decision that has been made regarding my husband...nothing ventured nothing gained I say....

 

I think that in your case the exposure to more risk of chest infections and other stuff should be emphasised and even if you dont have a Consultant for appointments I am sure that your GP might be able to refer your situation to a Consultant who could lay out the increased risks to your health (if you get ill with infections then how can that be not related to your health...?). I am sure if the emphasis on NHS costs could be mentioned...like maybe more GP visits or hospital visits or tests or "free prescriptions" anything where money is involved (catch my drift) it is worth a try.

 

It is a horrible world where the genuinely ill are persecuted whilst I am sure a good "actor" may still pass WCA......after all they will have read the descriptors......

 

Good luck

 

They may charge for this though...but it could be worth it....

 

I think it probably does get used in appeals but I would be surprised if it was used much by ATOS.

[reallymadwoman]

ATOS are supposed to always consider if exceptional circumstances might apply before they find you fit for work or fit for work related activity.

 

I suppose it sounds good in their hand book.

[Slatted]

I think ATOS are supposed to consider all sorts of things...like what the person actually says and does at WCA...but it seems even that is a struggle for them:lol:.

[Guest amianne]

This poor lady died a few weeks ago due to the complications she has with her illnesses.

This was her posting on another site after hearing of her refusal to be placed in the Support Group.

 

 

Sat Jul 02, 2011 7:50 pm

 

Hello

 

had my tribunal appeal yesterday to be placed in Support Group.

 

I lost it

 

I'm am staying in the WRAG, but I just do not know what to do now. I have

multiple, chronic medical conditions which are very debilitating.

 

I appealed on the grounds of continence issues, but failed. They obviously

did not think it relevant enough for me to be put into the Support Group.

 

I did attend the Jobcentre when my initial claim was done for the Pathways to

Work part, and I was sent home by the lady I saw when we discussed my medical

problems as she said she could not help me as I was too ill to work and should

not have even been there. My health has even deteriorated since then as my

kidneys have got worse. The doctor at the tribunal yesterday told me that if I

was on dialysis I would automatically be in the Support Group. Not very helpful

really considering they deemed me as not being ill enough to go into the Support

Group.........I am being put on the list for a kidney and pancreas transplant, but that

does not make a bit of difference, and now the decision has been made by the

tribunal for me to stay in the WRAG I think I have to just keep going through

the motions, and carry on like this for as many times as it takes for me to be

assessed and the same decision to come out of it each time, and never being fit

enough to work.

It will be a very interesting situation when I do receive info regarding the

WRAG session when they are informed of this most recent decision.

 

I have vision problems, as mentioned above among other chronic conditions,

even with the new descriptors I still score points that mean I go into the WRAG

alone. I really feel I should never have been called in for a medical

assessment, but do not know what to do if this happens again. It seems an

extreme waste of time that I go for the assessements, but if it means ATOS are

ticking their boxes I guess that's why I am.

 

It is very frustrating and stressful, and does not do me any favours with my

health either. As I am just going to be going round and round in circles.

[starman59]

The trouble with atos is they get paid for everyone the can get out of a support group and into WRAG and as such they are in it for profit, not the welfare of genuine claimants. In my case I cannot walk 20 yards and use a stick. This in turn makes my right hand hurt like hell as my joints are swollen and very painfull.

Even the woman I saw at A4e asked what i was doing there as it's obvious to anyone with eyes I have problems walking and holding things (I can only type using one finger). What sort of work they expect me to do I have no idea. I have paid my taxes etc for 37 years and I feel like I am a criminal for claiming benefit.

My personal opinion is these so called professionals who asess us do not live in the real world and think genuine people are just trying to con money out the system.

[Slatted]

I think the problem is also that the appeals process is not always clear as it sounds as if some do not got to a Tribunal and also that the support needed from medical professionals may not always be forthcoming. (I am sure it is not uncommon to have experienced delays getting reports or appointments or anything from specialists?).

 

Surely, from what is being said on a lot of the threads, a lot of people are experiencing an increase in the intensity of symptoms due to the stress and anxiety of being in WRAG and that should be evidence of the exceptional circumstances alone as WRA are causing health problems.....just need medical evidence of that.....

[fightingback99]

Really sorry to read of the problem you've been having with this. 'one size allegedly fits all' assessment process. Madness that your GP's medical opinion for past 4 years is being overruled by an ATOS functional assessment.

 

I hadn't realised, and am sure many people still aren't aware the majority of outcomes come from a logic programme . It works in the background and is based based on 1000 Evidenced based medical facts and figures, which they claim allegedly covers the majority of illness/people. Assessors are encouraged to somehow fit you into the nearest relevant phrase whether you maybe fit or not as opposed to writing free text . Because LIMA's logic can't interpret it to 'assist' them with the decision outcome. No wonder so many people are left scratching their heads at the outcomes and some of the strange phrases written on their medical reports.

 

As your GP is supportive , he/she can hopefully write a report stating a return to even part time work would exacerbate your condition causing your lung capacity to deteriorate quicker than would be expected. and use the frequency of the amount of episodes you've had over the past year. It should stand to reason if every couple of weeks you're laid up with additional symptoms you can't fit in any regular.

 

But I'd also revisit the descriptors you didn't gain the points you should have, for when your next form and assessment arrive. Possibly because you have a stoical approach to your condition you've left enough room for the assassin I mean assessor to pick the wrong prescripted boxes for you. eg doing your shopping in a supermarket infers you can reasonably walk 200 to 400 metres. so if you do, but 3 out of 4 times it leaves you in very poor condition then for functional purposes better to say you can't.

 

There just too seems to be too much room for error in how these assessments are being done.

[RaeUK]

I don't recall this subject being raised here per se. On another forum, a member raised the point that where a doctor acting for ATOSH WCAs has clearly lied in his/her report to the DWP then that person should be reported to the GMC. Telling lies is, after all, contrary to the ethics a doctor should be working to. Quite serious misconduct. And, by extension, this goes for all the other HCPs who are members of a professional organisation.

Is this an area of complaint that we've unwittingly overlooked? I know that both of my WCAs, conducted by registered doctors, resulted in some incredible porky pies in the full ATOSH report. I never thought about making a complaint to the GMC for misconduct. They do, of course, have an obligation to tell the truth.

Is this something we should be giving more serious consideration to? ...

[abc123def]

On my first WCA, the one that I was awarded 0 points there was one direct lie. I went to Tribunal and said about it but I never thought to complain to the GMC. Tbh I don't think I had the mental energy to. I guess with unwell people that is going to be the problem?

[estellyn]

I don't recall this subject being raised here per se. On another forum, a member raised the point that where a doctor acting for ATOSH WCAs has clearly lied in his/her report to the DWP then that person should be reported to the GMC. Telling lies is, after all, contrary to the ethics a doctor should be working to. Quite serious misconduct. And, by extension, this goes for all the other HCPs who are members of a professional organisation.

Is this an area of complaint that we've unwittingly overlooked? I know that both of my WCAs, conducted by registered doctors, resulted in some incredible porky pies in the full ATOSH report. I never thought about making a complaint to the GMC for misconduct. They do, of course, have an obligation to tell the truth.

Is this something we should be giving more serious consideration to? ...

 

I think it would be difficult to prove for non recorded cases, and they are unlikely to lie when they are aware of recording. So the best time to catch them would be during covert recording -but yes if you could prove incontravertably that they lied during their duties as a doctor or nurse, then they could be reported to the relevant bodies.

[osdset]

I think it would be difficult to prove for non recorded cases, and they are unlikely to lie when they are aware of recording. So the best time to catch them would be during covert recording -but yes if you could prove incontravertably that they lied during their duties as a doctor or nurse, then they could be reported to the relevant bodies.

 

All the more reason for recorded WCA's, the screw has to be tightened on the HCP's to force them to conduct the assessments correctly.

[dpick]

I am waiting to see the result of the last assessment that I attended with a friend to me that person should have a limited capacity for work as they should have 15 points (from reading the descriptors) and were awarded 15 points at their last tribunal. For the assessment that had been prior to the tribunal they were awarded 0 points on the same information given to the tribunal and the same information for the last recorded assessment. Waiting results.

 

dpick

[debt4get]

this has been mooted on other anti atos websites (well the ones they havent managed to close down) and if you have evidence that lies were definitely told then reporting the HCP is a good idea...however, whilst not defending these people in any way...we all saw the panaroma programme on the sanctions that may occur if the HCP 'passes' too many 'clients' in effect they are in between 'a rock and a hardplace' it is the system that needs to change, it is ludicrous where ATOS blames the DWP the DWP blame ATOS, they including us blame the condems...but nobody is listening

[worried33]

I don't recall this subject being raised here per se. On another forum, a member raised the point that where a doctor acting for ATOSH WCAs has clearly lied in his/her report to the DWP then that person should be reported to the GMC. Telling lies is, after all, contrary to the ethics a doctor should be working to. Quite serious misconduct. And, by extension, this goes for all the other HCPs who are members of a professional organisation.

Is this an area of complaint that we've unwittingly overlooked? I know that both of my WCAs, conducted by registered doctors, resulted in some incredible porky pies in the full ATOSH report. I never thought about making a complaint to the GMC for misconduct. They do, of course, have an obligation to tell the truth.

Is this something we should be giving more serious consideration to? ...

 

The problem is do you get any written confirmation of the HCP's name?

[debt4get]

yeah you do...on the ATOS report at the bottom of the last page in glorious dayglo is the name and qualifications of the HCP....so you need to get hold of the report if want to complain