Medical Assessment for Incapacity Benefit

[dan8]

Hi, I have just received notification that I have failed my Medical Assessment for Incapacity Benefit as I only got 9 points of the 15 points that I needed to retain my benefit entitlement. My main reason for claiming this benefit is due to suffering from General Anxiety Disorder and had evidence of this from my GP and Clinical Psychologist. But, it was not enough. I also suffer from back and knee problems for which I also provided medical confirmation from my hospital specialist. That too was not good enough. Can anyone help with advice on tackling this appeal? Thanks

[AnnoyedByDCAs]

I feel your pain, this happened to me back in 2008 and it took close to a year to get my benefits reinstated on appeal.

 

What helped me most was going to the CAB and getting referred to the CLA (Community Legal Advice) team where I got an advisor who took me through the appeals process and attended the tribunal with me.

 

Start the appeals process immediately - they told me to have them look at the decision again first before appealing but this resulted in close to 8 weeks delay before I could even apply for income support on hardship grounds. They also told me that I could claim JSA temporarily while waiting for the appeal and would be exempt from the actively seeking work rules pending the appeal but the Job Center seemed unaware of this and wanted all the usual paperwork promising to look for work in specific ways.

 

Are you sure you need 15 points? My failure letter neglected to take account of the lower points requirement for mental health but things may have changed a bit since then. I failed mine by a whole 2 points which were pretty easy to make up given that the assessor appeared to have used rather bizarre logic to deny points on some issues. Apparently the fact that I attended the medical meant that "I could easily find my way to unfamiliar places without assistance" despite the center being 10 minutes walk from my house and somewhere I'd had to visit on many previous occasions. Owning a mobile phone apparently meant that I could make and receive phone calls without becoming distressed which was fairly easily refuted.

 

They'll send you the report submitted by the person who examined you which I pretty much guarantee will annoy the crap out of you so make sure you get help from someone objective & try not to rant.

 

Good luck with your appeal.

[dan8]

Thank you so much for your very helpful reply. I had NO idea that the mental health threshold was much lower at only 10 points. So, I am only 1 point short of this requirement and hope to appeal it. I take on board your advice that I must lodge my appeal right away and I shall do this today. Although, I do not really have the resilience or stamina needed for a protracted fight. Nor the fortitude to queue up for the entire day to see a CAB advisor, so I may jump to the CLS route that eventually helped you. I don't suppose you have a land line number for them as that would be really helpful? I cannot afford the cost of non-geographical calls which their website advertises.

Thanks again for your immense help.

[AnnoyedByDCAs]

The appeals process isn't so much a protracted fight as writing a letter and a lot of waiting around to get the result - I went to an oral hearing but I don't know if it always goes that far. The appeal can be decided purely on written evidence.

 

My local CAB has a telephone advice line, yours may have one too. I'm not sure but I think I had to be referred to the CLA by the CAB rather than going direct. Plug your postcode into the search box you can find from the "get advice" link on the citizens advice website and also the one found from clicking the "Find a legal advisor" link on the community legal advice site. Both should give you local phone numbers you can use. Sorry I can't post hyperlinks yet, I need 20 posts for that but hopefully you can find the pages I mean.

 

Don't worry about the appeal too much - official statistics say 50% of those who appeal against a decision that they are capable of work and attend an oral hearing win their case. This goes up to 70% for people who are represented. Gaining a single point on appeal really shouldn't be difficult.

[roja]

It is a nice sharing...........

[KKnight]

The statistics show that people who get help with their appeal are much more likely to win their tribunal.

Good luck.

Kirst

[Roblynmouth]

Hi

I'm waiting for two appeals, one from Sep 2009 for a previous claim for ESA, then on becoming redundant i claimed for a second time and now have a second appeal in progress this time for failing to apply the regulations correctly June 2010

I wrote in November asking then when they intended to hold the first appeal i am still waiting

They dont like to rush things the DWP

[dan8]

Just an update on my situation. I made my appeal last month, November 2010 and I received my adjudication last week, on 20 December to tell me that my appeal had been successful upon re-consideration by a different adjudication officer at Incapacity Benefit. The decision letter stated that I did not have to face any further medical assessments until 11 November 2011, unless my circumstances or medical conditions changed. My benefit payments resumed from the date of the initial stoppage. I received an interim payment last week and the remainder today. Until now I had only received the reduced payments payable during the appeal process. I am so relieved, especially as I received this decision within just over a month of lodging my appeal. I submitted several letters from my hospital consultants confirming each of my different medical conditions, plus a medical conditions appeal form completed by my GP and a letter from a solicitor I contacted directly via the Community Legal Services telephone helpline. I did not have to pay the solicitor as I received this help for free under the government's free Legal Help Scheme available to Income Support recipients. I think that the amount of corroborating medical evidence that I submitted as part of my appeal and the solicitor's letter as a backup helped to clinch my appeal. If any of this information about submitting up-to-date medical evidence from the hospital consultants under whose care one is, as well as one's GP's confirmation of medical conditions suffered and how this impacts on daily tasks is useful for you, then please utilise it for your appeal too. I hope that you will succeed sooner rather than later. Goodluck, in any case.

[Roblynmouth]

Yo dude that's great and well done

I don't need any additional evidence as mine is about interpretation of the rules

[p45]

Hey Dan8...

Thank you for giving this Black Thursday some hope.

I've just recieved the dreaded "you've failed the medical assessment" letter on the grounds of nill points..

Firstly I have to say six weeks ago I had an intramedullary nail removed from my right leg.. doesn't sound that bad

when you hear the word "nail" but let me tell you, it's pretty far from the kind of nail one might imagine.

This is a tittanium rod that was inserted through the intire length of my shin bone through the knee cap as a resulf of

a work accident three years ago.

Removal didn't go as planned.. they said it should be a Thirty minute procedure..It took two and a half hours..

 

I've also got Carpel tunnel in both hands which was established by a sprecialist and i'm currently waiting for surgery.

I've got an operation schedualed for march for a trigger finger (thats nothing to do with shooting people) but my ring finger

on my dominant hand gets locked in the closed position..

Looking at the questions that I answered I can see how loaded they were now..

"Walking more than 200 metres" unless I turned up in a wheelchair i'd have to say yes

"Can you sit and stand for longer than 30 minutes" If that's not retarded I don't know what is.

"You can bend kneel or squat enough to pick up a light object off the floor" I guess if I saw a score on the floor I'd make the effort..

And the list goes on.."Usually strangers understand what you are saying" or "you can hear someone talking loudly on a busy street"

and my favourite has to be "Do you have control of your bowels and your bladder" WTF

So what I'm hearing is can I walk further than 200 metres without pooing my pants, and could I understand strangers telling me that

I've had a trowser accident.

How come I scored no points.. Having Carpel tunnel in both hands suck.. Imagine having numb hands, and when you hold stuff

you get that feeling when you've hit your funny bone, which keeps you awake till 4am. I also forgot to mention here that my trade is a carpenter.

Power tools, sharp chisels, numb hands REALLY. crap now I'm depressed again..

Where do I go from here??

[dan8]

Hi P45,

 

I am so sorry to hear of your plight. But for the Grace of God go I!

 

Let me send you the link to 'Appealing Against Incapacity Benefit' that helped me tremendously. It is a briefing note written by the Welfare Rights Unit at Leicestershire County Council and it was most insightful for me. In addition, I printed out the appendix at the end which is the GP's input on your behalf explaining your medical conditions and how they impact on your daily life in terms of what you are able and unable to do. If you could get your GP to fill it in on your behalf and send it signed and dated to your local Jobcentreplus office then it may make all the difference in your appeal against that dreaded decision. Also, you may be better advised to opt for depression and general anxiety syndrome in addition to your acute physiological medical conditions and utilise both the physical and psychological impairments as the basis of your appeal. Here is the link: I'm afraid I've received a message to say that I cannot post links in this message. Well just go to leics.gov.uk/appealing_incapacity_benefit.doc. Hope this helps. Good luck.

[shamrockglen2000]

hi i got a form to fill in from esa filled it in and sent it back got a reply saying i got enough points and my benifet will continue and will be reveiwed on december 2011 i thought everone had to go to a medical to change over to esa

[dan8]

Yes and no. It depends on what grounds the initial qualification was for the IB entitlement and if the corroborating medical evidence supplied for it was reasonably current for no new medical assessment to be required. It also depends on how busy your local JCP office was at the time it received your switch-over claim form as there are decision targets that have been introduced to avoid claimants having many months of waiting for an adjudication while receiving the appeal rate benefit throughout that time. It is a cost saving exercise really! But well done for now.

[shamrockglen2000]

i have been on ib for 5 years i was asaulted i have been dignosed with depression and anxiety post traumatic stress disorder and mild cognitive impairment also nerve damage in neck and arm iam on pregabalin 600mg for nerve damage lodine 600mg painkiller quinen for cramps and mirtazapan for depresion i have been to medical twice in that time and got the points i needed this is the third time i have filled form in and it said i got enought points and it said it would reveiw me again in december 2011 iam woried about having to go through all this again in december

[paparaw]

I've just failed my medical scoring a wonderful '0'. Not bad for someone who is completely house-bound with Post Traumatic Stress Disorder after being left for dead unconscious in a river and had to be taken to my assessment by two helpers/advisors. I've talked my position over with my Housing Advice Worker, Mental Health Worker and Benefits Advisor and they all confirmed the same thing- ATOS (the supposed health experts who run the assessments) work on a commission basis and are openly told NOT pass people through their medicals . The advice I can give to people in our predicament is to use every charity available to help with appeals, get you're local MP involved (just prey to God that's he's not a Tory) and make sure you're doctor and/or health worker is involved, Before you hear about your appeal you MUST contact the Benefits Agency and apply for Income Support. Hope you have good luck.

[shamrockglen2000]

just waiting on the dreaded letter coming through letter box to fill in, then have to go to atos medical ,everyone i know thats went for it has been found fit for work

[**Margaret**]

:Update:

 

The Benefits Agency merged with the Employment Service over 10 years ago. Both services, operating under the name Jobcentre Plus, are now part of the Department for Work and Pensions.

 

Appeals against fit for work decisions need to be submitted in writing. Letter to include the word 'appeal' or a GL24 form sent to the benefit delivery centre, at the address on the ESA65 disallowance notice. The form is available on request from a benefit delivery centre or can be downloaded from the internet.

 

For some claimants, assessment rate employment n support allowance has replaced income support pending the outcome of an appeal.

 

Margaret.

Edited October 20, 2012 by **Margaret**

[globularity]

Sounds like I am screwed, I am currently on incapacity benefit because I have Bi-polar, I have been stable for 2 years now as my condition is controlled by drugs. I also do permitted work for 10hrs a week at a supermarket. I can cope fine with part time work but am worried full time work will be too much pressure for me and will cause me to have a manic episode (dont generally have lows). Any advise, I have an Atos appointment on the 6th november

[paparaw]

The only way I can see people passing these unfitted for work TESTS (they're not assessments) is to go drunk/high (or preferable both), wearing rags, smelling of as many bodily waste products as possible and record the whole meeting. On a serious point I would strongly advice everybody going to an ATOS assessment to

1. Take someone with you.

2. Record the interview.

[Nystagmite]

On that note, don't actually make an effort as such and go as you'd normally dress, etc.

[dolphina]

I have just had my medical assessment this morning. I have got RSD in both my right hand/wrist and right foot/ankle, the assessor was a nurse who hadn't even heard of the condition and I was out within 15mins, was asked some bizarre questions and a very brief examination. She informed me a decision would be made by herself within 15mins of me leaving and a report would be uploaded immediately to work and pensions and I will hear within 2-3weeks. I have a gut feeling she will say I will be transferred to JSA, I haven't worked since 2003 and was medically dismissed from my job as I was incapacited for the foreseeable future, at that time I only had it in my hand so am a lot worse now....watch this space I suppose. I'm just annoyed at the fact that she is making a life changing decision for me based on just 15mins spent with me and yet none of my medical notes from GP and consultant have been took into account

[Nystagmite]

You won't be transferred to JSA. You can appeal the ESA decision and receive ESA in the meantime.

[dolphina]

You won't be transferred to JSA. You can appeal the ESA decision and receive ESA in the meantime.

 

Was that reply meant for me?

[Nystagmite]

Was that reply meant for me?

 

Yes

[dolphina]

How come? If I don't meet the 15point threshold I thought they can put me on JSA