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stalin's dead

ESA decision timescale - help pls

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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

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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.

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

 

stalins dead:)

 

 

 

"that is the the whole problem":roll:

 

this is what should happen:) "in an ideal world":rolleyes:

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:roll:)

 

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:)

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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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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.

 

 

Please do not seek, offer or produce advice on a consumer issue via private message; it is against

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(exceptions for prior authorisation)

 

 

 

 

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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)

 

 

 

 

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

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hellow:) sj01

 

my reconsideration (whatever) ,was done by a different decision maker (no medical experiance:rolleyes:)

The first time i found out about this is when i received the big "bundle" of evidence in MAY.,informing me of this "reconsideration".:rolleyes:

The "funny" thing is the date of this reconsideration is 30th MARCH:confused:

 

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

 

so sj01 "your guess is as good as mine"

 

cheers happyhamr:)

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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:rolleyes:

 

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:confused:

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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:mad:

4"crap" decision maker(s)(whatever):eek:"Come ON:mad:

5 - should never had gone this far in the first place."Why"

6-dwp (mirrors& smoke:confused::confused:letters"confusing:rolleyes:

7-people are Genuinely sick/ill in the first place:rolleyes:(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:)

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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

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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

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I am exactly like you countmien in regard to decision makers:confused:

had original DM decision; then reconsideration totally different DM:eek:

 

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:confused:

 

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

 

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:rolleyes:" they will cover each others "arses":mad:

(dwp&dm) "NO accountability

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:) good night people:)

 

stalins dead, hope you get a favourable outcome:)

 

cheers happyhamr:)

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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:.


PLEASE HELP US TO KEEP THIS SITE RUNNING. EVERY POUND DONATED WILL HELP US TO KEEP HELPING OTHERS

 

 

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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?

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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:D)

 

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

Edited by COUNTMEIN
clarification

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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?

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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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... We send them referrals, they send us reports ...

 

I'm assuming, antone, that you mean the DWP get the ESA50, check it, then refer to ATOSH should an assessment be required? They then carry out the assessment and send you their report.

 

What I'm curious about is this: ATOSH sent me an ESA50. I then had to return it to them in their reply paid envelope. So they appear to have first sight of the form and - I can only presume - are first to check it. ATOSH then contact me to make an appointment for the WCA. Have the DWP abdicated this responsibility?

 

Just after a little clarification...

 

Best wishes

Rae

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I'm assuming, antone, that you mean the DWP get the ESA50, check it, then refer to ATOSH should an assessment be required? They then carry out the assessment and send you their report.

 

What I'm curious about is this: ATOSH sent me an ESA50. I then had to return it to them in their reply paid envelope. So they appear to have first sight of the form and - I can only presume - are first to check it. ATOSH then contact me to make an appointment for the WCA. Have the DWP abdicated this responsibility?

 

Just after a little clarification...

 

Best wishes

Rae

 

The procedure works like this (for ESA, IB may well be different):

 

 

  • Claim received for ESA
  • Claim accepted as valid and put into payment
  • DWP enters referral on a system called MSRS. This is normally sent to ATOS. I don't know the precise mechanism by which this is done - it's handled by a separate section at the DWP and my contact in that section is off at the moment, so I can't ask.
  • ATOS sends ESA50 to customer, and makes WCA appointment
  • ATOS receives ESA50 and conducts medical exam
  • ESA50 and medical exam result are sent by ATOS to DWP
  • DWP DM makes decision on claim
  • DWP closes referral on MSRS. If LCW has been accepted, enter new date for next WCA if appropriate. If not, flag claim for closure after time period for appeal has elapsed.

So I'm not sure if you'd call that "abdicating" responsibility. It's part of ATOS's contract that they send out ESA50 forms, and they do indeed get first sight of them. But the ESA50 is included, along with the WCA report, in an ESA55 folder that is sent to the DWP DM who makes the decision.

 

With ESA, there are very few cases where a WCA would not be required, but there are some. For example, if a customer sends a DS1500 form (for those who are terminally ill) then the DM opens an MSRS "TI" referral which wouldn't normally go to ATOS - no ESA50 would be required and the customer would be placed in the Support group.

 

There are other cases - if it's obvious to a DM from supplied medical evidence that no WCA is necessary ("this patient will spend the next year in hospital") then no referral to ATOS would be necessary.

 

The reason why ATOS gets first sight of the ESA50 is that it's supposed to guide the way they conduct the medical exam. ATOS, however, seems to act as if their contract requires them to fail as many people as possible, so they appear to me to have little interest in it. IIRC, FOI requests to see this contract have been declined on commercial confidentiality grounds.

 

In truth, I suspect they just stick the ESA50 on file and pay little attention to it until they need to send it to the DWP. That, of course, is a supposition based on no evidence beyond personal observations of the system.


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The contract is available, and a copy can be sent by post, but not in its entirity. Certain parts of it are exempt under sections 40 and 43 of the Freedom of Information Act 2000, and these areas will be removed prior to sending people a copy.


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)

 

 

 

 

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so now we know why atos dont take any notice of our ESA50 forms:eek::roll:

"makes you sick"( i wondered why i allways i had this feeling that my esa50 form had just not been read:rolleyes:)...Grrrr...

 

i had to send my esa50 form to WEMBLEY.

 

it does not which way you turn "its like your in a giant dwp&atos MAZE:mad:

 

so if the DM(s) make the decision."why do we need a medical" why dont we just send esa50 to them; crap just crap.

 

contract....... just the bits that will not "incriminate" them

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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 thiceice of ings will have changed much there.

 

Thanks Jabba for posting that , do you still work for them?...as I noticed in your opening sentence you said 'several years ago?.

I do/did get the distinct impression, that the second DM tried her darnedest to help/rectify things for me? - She even states that 'she disagreed' with original decision makers and HCP choice of descriptors???...but Bossman Doctor at ATOS, he said NO:x...

Thats whats confusing me, is it DM/DWP that have the say-so ( no, imho) or ATOS???

 

Regards

 

countmein x

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