Tribunal hearing coming up next week

[Pritti]

also the only 'representative' i have is my mom, i don't have the first clue as to weather i 'need' anybody else or who to ask etc, any advice on this? i am from the birmingham area

 

I am in London, and also have a tribunal hearing coming up next week. I suffer from epilepsy - my fits are exacerbated by stress anxiety and depression, all of which was why I was put off work - initally because stress caused a fit, sent me off my bike and into hospital. My student daughter is going with me. I'm is such a state, I am thinking of not going at all and letting her go and just read a statement on my behalf. Is that acceptable.

[honeybee13]

Hello Pritti and welcome to CAG. As your position isn't the same as norby, I think you should have a thread just for you. I'll ask admin to fix it for you.

 

My OH spoke to a tribunal chairman before I had my appeal. I wasn't planning to attend, like you, but this man said it's the worst thing you can do. I plucked up my courage and went along and I won. I have a sticky on the titles page of this forum that might help you formulate what you want to say. If you use the back arrow to come out of your thread, the stickies are in the yellow section at the top.

 

Do you have any help like the CAB, Welfare Rights or a charity that specialises in epilepsy?

 

My best, HB

[maroondevo52]

Hello and Welcome, Pritti.

 

I've started a new thread for you, please continue to post here, regarding this issue.

 

Thanks.

 

Scott.

[Pritti]

Thank you for the help. Before I read all of this, I had prepared a long statement in which I pointed out all the problems with the DWP doctor's findings. It's 3 pages long and I wonder - do you think my local CAB may be willing to read through it and comment or advise? My daughter is lovely and supportive, but she is only young and I can't expect her to actually represent me or comment on the papers - so I was hoping a CAB might. After all, I'm supposed to be the mum!!

[honeybee13]

Hello again. Have you seen a copy of your Atos assessment? That's what I used for my appeal, as per the 'sticky' template and it's worked for some other caggers too. You're trying to prove that you should have had at least 15 points, instead of the measly score they gave you.

 

If you haven't already, I think you need to go through the 'score sheet' with a fine tooth comb and pull apart every answer that you think is wrong. You need to play the DWP by their own rules and spell out what score you think you should have been given. Forgive me if this is what you've already done, I just wouldn't go to the CAB until you think you've spelled out your case so a reasonable panel would see that your assessment wasn't right. I can't comment on whether CAB will comment, they vary, but there's no harm in asking.

 

Also, don't forget about Welfare Rights [may be with the CAB, may be somewhere else] and any charity that deals with your condition.

 

My best, HB

[Pritti]

Dear Honeybee

You have been so very helpful - and you don't know me from a bar of soap. How very kind.

 

I'd prepared a general statement for my daughter to read at the hearing in case I couldn't face it, but with your advice, I have now gone through the whole medical report. Late in the day, I know, but forms and formal things scare me terribly. My insides turn to jelly and I literally want to wet myself.

 

However, my daughter came over yesterday and we cobbled something together in response to each question.

 

I know it's a frightful cheek, when you have been so good to me, to ask more, but do you think you could go over it for me? Or do you know someone who can?

 

I've sent it as a reply to the email forwarded to me by the webmaster in case you feel able to do so. If you can't, I will understand.

 

Warmest regards and much gratitude.

pritti

[honeybee13]

Hello Pritti. I'm very happy to help; if I can help one person who is going through what I went through, it's worth it. But as my signature says, several people have won, and that's only the ones I've been told about.

 

I haven't received anything from you by PM, but would you be prepared to put your suggested reply on the thread here? You can't PM me because you only have 3 posts to your name here atm. If you post up the thread without your personal details, other people should be able to help you as well.

 

HB x

[Pritti]

Thank you Honeybee. You've named yourself so well. A sweet honey and a busy bee. Here is the statement I've prepared. It's rather long, because I had so much to take up and explain. Many thanks and eternal gratitude.

Pritti.

Statement to the tribunal

 

I am appealing against the decision made on 24th June 2010 to decline the award of Incapacity Benefit on the grounds that I have not attained 15 points from the combined Physical and Mental Health descriptors following my Personal Capability Assessment for Work on 20th May 2010. I believe that I do attain the required threshold of 15 points. I hope that the Tribunal will support my appeal and that the Tribunal will authorise the re-instatement of my award.

I hope that the tribunal will bear with me in the manner in which my case is presented. It is important that I state my case in this manner ie in writing, since it is in the nature of my condition that I cannot tell from day to day what I shall be able to manage on the day of the hearing. I may be well enough to travel and sit through a hearing. I may not.

Further, I have had some difficulty in obtaining assistance with this appeal. Most mental health charities do not have the resources. To obtain help from a Citizens Advice Bureau, I would have to go to my nearest, which is more than 5km from my home and wait to be seen because they don’t have the staff for appointments. I have therefore relied on the assistance of unskilled family members to assist me over a period of time, in stating my case in this manner.

------------------------

 

I would like to refer the Tribunal to Evidence Item 3 in the Incapacity Benefit Appeal Submission. This is Form IB85 – the medical report of the doctor appointed by the Department for Work and Pensions and is at pages 23-45 of the Appeal Submission.

 

This medical report does not reflect accurately those matters discussed and assessed at the medical examination that I attended on 20th May 2010. Referring to the content of the Medical Report Form, on:

* Page 23, the medical report states that I take Amitriptyline for pain relief and that I take no medication for depression.

The correct position is that I have been prescribed Amitriptyline for depression and Zopiclone for insomnia because lack of sleep was making me edgy and tearful, with uncontrollable mood swings.

What I do take for pain, is a range of medication, which includes Diclonfenac, Naproxen and Co-codamol.

*Page 23, the medical report states that I have had no hospital treatment of investigations in the last 12 months and further on that I “used to attend the neurology out-patient department at Queen Square hospital. The treatment finished 2 years ago.”

 

The correct position is that my epilepsy, the efficacy of my medication, the condition of the lesion on my brain which affects the epilepsy – are all monitored by the National Hospital for Neurology and Neurosurgery at Queen’s Square. My doctor refers me back for a check up every 2 years. I have an MRI scan and an EEG to check whether the growth on my brain is stable or has grown. I have various blood tests and assessments and depending on what these reveal I continue attending the hospital or revisit in a year or two for my check up and scan. There is therefore no “treatment” which has “finished” as stated by the DWP doctor, but an ongoing situation. I explained to the DWP doctor that Prof Duncan at the hospital suggested surgery but that I had declined the operation because I was too fearful of its possible failure and couldn’t cope emotionally with the thought of an operation.

*Page 24 The report states that I only have minor seizures every few months from which I recover after 2-3 minutes.

 

What I told the doctor is that I have petite mal episodes, the duration of which may be as short as 2-3 minutes or substantially longer. I have no way of knowing, since I have to rely on observers to tell me how long I have been “out”. If nobody is present, as there often is not, I don’t know how long the episode lasts. Petite mal episodes can hardly be equated with “minor seizures”. Whilst not as dramatic as a grand mal seizure, each petite mal episode leaves me as debilitated and exhausted as a full-blown fit.

I wish to note that my petite mal episodes have increased in frequency since the refusal of my claim for incapacity benefit by the DWP and the stress all this has led to.

When I am affected by the epilepsy, it causes disorientation, including loss of hearing and dizziness and whilst I am conscious and therefore appear recovered after a few minutes, the disorientation and tiredness persist for some hours.

*page 23, the medical report states that I am not currently receiving mental health treatment. This is only true partly. I told the DWP doctor that I’d been receiving psychotherapy and counselling for some years whilst I was working. After I stopped working, I had long term counselling from the counsellor at my previous GP. I told the DWP doctor and put in my questionnaire, that my current GP has repeatedly referred me for cycles of treatment with the counsellor at his clinic. I was not making much progress with her. My doctor then referred me to the Psychological Therapies Service with which I was awaiting appointments at the time I saw the DWP doctor. They have a long waiting list.

I should add that since I saw the DWP doctor I have attended the PTS. They have assessed me and referred me for treatment. I am awaiting further appointments. In the interim, I have deteriorated so much that I have been obliged to see my GP because I can’t afford private treatment while waiting for the NHS treatment. At the last, on 9th March 2011, he expressed great concern about my mental health, since he had never seen me quite so bad. I was barely able to function. He suggested continued and monitored medication until I could access therapy and wants regular appointments so that he can observe my condition. My husband has to return from work in the middle of the day to check up on me.

*page 23, the medical report says that the main reason for my leaving work was physical health.

There is a contradiction between the doctor’s report, which says that I stopped work because of physical health and the Secretary of State’s response to my appeal (page 2 of the incapacity benefit appeal submission) which correctly states that I stopped work because of depression. I have epilepsy and my fits are often triggered by stress. I had several part-time jobs as well as a young child at the time when I was first diagnosed as suffering from stress, anxiety and depression. I also felt that I was racially bullied at work but was not able to cope emotionally with the stress of taking this up. These mental health factors caused me to have a fit when I was commuting home from work by bicycle. I was hospitalized as a result. However my GP at the time diagnosed the mental health factors as triggering the physical factors – stress led to my having a fit on my bike. Thus it was mental health that caused me to stop work.

*pp 23-4 the medical report states that I occasionally wake unrefreshed because I am thinking about things, that I am able to fully care for myself, regularly perform household duties, engage with friends, take exercise and have only mild mood swings, sometimes cry and feel distressed.

The reality is, as I told the DWP doctor, that I have good spells when I can in fact perform at the level he has stated as my norm. I do, however, sometimes go for months without being able to do any of the things he mentions. When my anxiety keeps me awake for so many nights running that I am moody, tearful and near suicidal, I have to resort to taking courses of sleeping tablets, which in turn result in fatigue and general lassitude during the day and an inability to perform ordinary every day tasks such as those he mentions. Yes, I do try to leave the house and sometimes go for a walk or to the library, since my GP recommended these as possible self-help when I am able to do so. I therefore try to do this, even though it makes me very tired and in need of rest for some hours after doing so. I might have a week in which I am able to go out and then months when I don’t go out, see friends or go to the library or do any of the things he mentions. These are the times when I either don’t get out of bed or do so and then sit in the yard crying or hide in the shed or my room because I can’t cope with doing anything, seeing people or speaking to them, when I think of saving up my sleeping tablets and taking them all in one go but am prevented from doing so because my husband monitors my medication.

*pp26-7 and pg 29, the medical report states that I am able to perform certain physical exercises and concludes that “musculoskeletal problem causes no significant restriction of sitting, rising and bending or kneeling” and later that my “musculoskeletal problem causes recurrent pain and this leads to mild restriction of standing, walking and climbing stairs.” It also notes that I had a fall two months before the examination.

Whilst my physical problems are not the main reason for my application for incapacity benefit, the reality is that I have had physiotherapy on and off for musculoskeletal problems for many years. The lack of continuity is not because of improvement in any problems I have, but because the nature of physiotherapy treatment on the NHS means that one can only have 6 treatments at a time, before having to be sent back to one’s GP who has to make a fresh referral which can take months. I told the DWP doctor that I was awaiting physiotherapy because of problems coming downstairs. I also told him that I am prone to falls and injuring myself. In fact, I had two falls since I saw him. One of them was so bad that it completely incapacitated my left hand. Even though I am right-handed, this meant that I was unable to dress myself properly, see to my personal care or perform any household tasks. I also injured my hip in the fall. I have had ongoing physiotherapy at Finchley Memorial Hospital – two appointments per week, one for each of the problems. The failure of my hand to respond to treatment and oral painkillers prompted the hospital to give me three successive corticosteroid injections at their pain clinic in an attempt to relieve the swelling and pain. I am still receiving treatment for both problems. As I have stated, my physical problems are not my main problems, but they do exist, they do limit my ability to function appropriately. As I get older (I am now 53) they are unlikely to improve.

*Page 2 of the Incapacity Benefit Appeal Submission points out that I did not submit a doctor’s statement (med 4) from my doctor

This is true, but, as can be seen on my IB50 at page 19, the letter accompanying my IB 50 did not require me to send a med 4. I was at no stage asked to provide this and assumed that this meant that the DWP would itself contact my doctor for his statement.

When I received the appeal documents, I asked the Psychological Therapy Service, to supply me with documents to state what my condition was and how it would affect my ability to hold down a job. They called me to say that they would support my claim but required some forms to complete. Neither they nor I knew where to obtain the forms, so I then wrote to the tribunals service requesting the forms. I was called by the clerk of tribunals to say that you don’t send out such forms. I explained that I was a loss as to how to proceed then to get the documentary evidence I need. I then returned to my GP. He, too, said that he was under the impression that once I have filled out my IB50, the DWP would contact him and ask for a statement on my condition and my ability to work. At my last visit, on 9th March 2011, he expressed great concern about my mental health, since he had never seen me quite so bad. He told me that I was to tell the tribunal that he would provide a statement when it required him to do so. I have no reason to doubt that what he says is true about the way in which medical evidence is supplied by him. He is an experienced GP. Despite this confusion, I hope that he will return to his clinic in time to issue me with the statement required, since he has made it very clear that he does not regard me as being fit for work.

*Pp 36-7

The questions relate to a range of everyday tasks, which according to the medical report, I am fully capable of doing.

The reality is that I can do these only on good days. My responses were prompted by the doctor eliciting them from me, making me feel as though only a truly stupid person wouldn’t be able to do any of these things. I felt obliged to say yes very often just to please him.

Here are some examples - Cta - The telephone

He asked if I could answer the telephone reliably and take a message. I said yes, because I was taught to answer a phone as a child and thought he meant whether I could in theory answer a phone, not whether in fact I do answer it. In actual fact, I never answer the phone during the day time and my husband encourages people to only call when my husband is home at night. The mobile phone my daughter gave me stays switched off in a drawer. I rarely make calls to friends. My husband makes our household related calls.

CTb – Sitting for hours doing nothing

The doctor went on prompting me and prompting me – do you do this, do you do that, do you really just do nothing, surely you do? On and on until I said well yes, I read a bit. Yes, I cook a bit.

CTc and CTd – Concentration, reading, bills

The doctor asked whether I could follow a story and read an article in the paper. Of course I told him that I could. I have done such things since I was a child. I am depressed and anxious. I am not stupid, as the doctor noted. I didn’t understand that he meant whether I still have an interest in doing so now, else I would have told him that the reality is that whilst I used to read for hours in my well days, now my concentration span allows a shameful and uninterested few minutes at a time. I have no interest in anything for long. I don’t regard this as normal concentration levels. What I really can’t do is deal with my own finances and correspondence. Nothing scares me like a letter or a phone call. I don’t know what’s in it. It might be bad. I might have to do something. Someone might be going to do something to me. I leave such things to my husband or my daughter and if I know a bill or letter has come, I won’t sleep until my husband shows me he’s seen to it.

CTe - Sociability

I don’t know what makes the doctor think that I am usually sociable. I could go days without saying much to anyone except greeting or muttering. It’s been months since I’ve seen friends. I don’t socialize with neighbours – I have never been in their houses or they in mine.

CTf – Risks in the home

Yes, I can prepare a meal when I feel up to it. However, the many burns and cuts on my hands and stains on the floors testify as to how often I have accidents in the kitchen. My husband found the gas on the other day when he came downstairs, after I’d been up all night making tea and forgetting to turn things off.

CTg – Agitation or confusion leading to accidents

I am often anxious and confused but because I am equally often to tired or uncaring to do anything but lie on the couch or hide in the shed, I don’t have as many accidents as I would have if I did things.

A lot of the CT (completion of tasks) questions seem to revolve around my ability to use a telephone and a telephone book. Of course these are things I could do, objectively, if I were well. I could read, if I had the interest in it. I could see friends, watch TV, read the TV guide – if I wanted to. The problem with being depressed is that I don’t want to. I can’t be bothered to. Nothing interests me enough to make the effort. The doctor didn’t ask me that. Can you do these things is not the same as asking whether you do in fact do them or are prevented from doing them because you can’t make yourself do them. Objectively as an educated adult, I have lived a life which enables me to do all of these things. Subjectively, as someone with depression, I can’t actually make myself do any of them.

Daily Living

DLa I often need encouragement to get up and start the day. What my husband does is get me up when he goes to work and makes me dress as he does. Sometimes he even takes me out before work, if I can manage it, even if it’s just to walk to the corner to try to get me going for the day.

DLb It is true that I don’t drink having been raised a teetotaller.

DLc I have mood swings which are so bad that I shout at my husband and daughter, then don’t speak to them for days or weeks. Yes, I have never attempted suicide, but I have considered saving my sleeping tablets in order to take them in one go. My husband takes charge of my medication, so I can’t do this.

DLd It is true that I am clean and tidy. My husband cares for me and ensures that I am. My husband keeps the house tidy but I often get obsessive about it and get extremely upset and even abusive about people not taking their shoes off in the house, leaving things around, or doing anything which I don’t like in the house. I have been so abusive about this to my husband and daughter that my daughter prefers to live away from home. I would cause a huge row with her about the slightest thing eg a cup left in the sink or a bed unmade. I expect her and my husband to keep the house pristine and when they don’t I throw huge tantrums. Just before my daughter left home I threw fruit at her because she hadn’t arranged the fruit bowl properly. Then I get weepy and upset and hide, refusing to talk to them.

DLd To say that I “adjust daytime activities to fit in with sleeping pattern” is a misleading. I don’t sleep at night. I sweat. I pace. I bite my nails, pick at my feet, scratch my scalp until it bleeds. I overheat in bed and then go sit up in the dark all night, often talking to myself to get myself to go back to bed. Then I face the day exhausted and lie on the couch all day or sit in the yard talking to myself. This is what the doctor means by adjustment.

Coping with Pressure

CPa It is not correct to say that I stopped work due to my physical ill health (see above).

CPb I attended the examination alone because my husband works and my daughter had final exams. He put me on the bus. She fetched me when I’d gotten strung out by the examination.

CPc The answer to the question of whether I avoid carrying out routine tasks because I think they will be too stressful or tiring was yes. I would prefer to keep busy but I can’t keep my attention on anything. I do not always make the main meal for my husband. When I can’t, he comes home and makes it or my daughter comes and cooks and puts things in the freezer. When the doctor asked about queuing at the bus stop or post office, I said yes because if I were well, I could do that. However, I have not been able to go to the post office or shops for a while. I don’t know what the doctor means by saying that I am able to manage most tasks. The doctor asked whether I can do these things, which I took to mean can I do them objectively, have I proved able to do so in the past, not whether my condition now prevents me from doing so. There was no room in the examination to tell the whole truth rather than provide one word answers. The truth is that I am often scared and panicky for no reason. Letters frighten me, phone calls frighten me because I think people want something from me that I can’t do, that I’ve done something wrong, that I’m in trouble. Yes I would prefer to be busy, but I am unable to keep busy or concentrate on anything for too long. Change frightens me. I don’t deal with household administration. My husband and daughter do those things. I couldn’t even get to contacting CAB on my own because I was scared to do so. As the doctor noted, I am afraid of strangers and of crowds and being too long with people outside my family.

Interaction with other people

OPa I explained to the doctor that I am able to care for myself because I have a supportive husband and daughter

OPb The doctor saw me on a day when my medication had made me tired enough to appear placid, until I snapped and got very upset, which he didn’t record. To say that I have a placid nature is wrong. I have frequent outbursts and have in the past thrown things, such as my daughter’s lunch when she didn’t eat it, or the pots and pans when she didn’t clean them.

OPe

I am alone from the time my husband leaves for work until he gets home except when he comes home during the middle of the day to check up on me when I have an unusually bad patch. I rarely see friends because he would have to make arrangements and take me and he doesn’t often have time. When he does make time, I very often feel too tired or disinclined to go out or have people over, so I make him cancel the arrangements.

OPf

There are times when I can and do go out alone. There are also weeks, even months when I can’t and don’t

In conclusion, I believe that the scoring of my Personal Capability Assessment should be revised, primarily with regard to my mental abilities. As the doctor noted, for most of the examination I was “placid”. I answered in a way which would satisfy him. In addition, this was not a proper examination which allowed for fulsome explanation, beyond yes and no. Mostly, as I’ve said, I answered yes when asked whether I could do something, because I took him to mean whether or not I could objectively, not in my current state, perform certain tasks.

I hope the Tribunal will support and find in favour of my appeal, determining that I am incapable of work.

 

________________________ _________________

 

I declare that the content of this Summary forms the basis for my appeal and that the information is correct and complete as far as I know and believe.

 

 

_________________________ _________________

[honeybee13]

Hello Pritti. I can't look at this right now, but will do so over the weekend. In the meantime, some other clever caggers may have comments for you.

 

HB x

[Pritti]

Thank you so much Honeybee. You have been an invaluable support to me - after all the months of seeking advice, your has been the best and given with such kindness. And I don't even know you.

Warmest regards

Pritti:-D

[honeybee13]

Thank you so much Honeybee. You have been an invaluable support to me - after all the months of seeking advice, your has been the best and given with such kindness. And I don't even know you.

Warmest regards

Pritti:-D

 

You're making me blush now, I'm not that special. I do care though, will comment more when I can.

 

HB x

[Nystagmite]

How does (I don't have the energy to read your long post - sorry) having the problems you have relate to the descriptors of the PCA?

 

It's advisable to go - that way, they can see what you're like and therefore, get a better idea of your disabilities.

[leemack]

Hi Pritti, can I ask a few questions, then I'll get back with some suggestions later on.

 

Do you have any other evidence you're offering, for instance from your doctor etc?

 

Did you score any points at the medical, if so which ones?

 

I've made some notes, but I'm pretty sleepy, so I'll post again tomorrow if that's OK.

 

Lee

[honeybee13]

Hello there. Leemack has made some good points, hope you can tell us.

 

I've read your submission and it's certainly long and comprehensive! I'd be interested to know what Leemack thinks, but I think it would make it easier for the panel to understand if you can make your answers in bullet-point form.

 

At the end of my appeal, we set out the DWP descriptors and said how many points I should have been allotted for each one.

 

For instance, section 11 on page 21 of the descriptors, staying conscious [i guess that covers epilepsy], you can choose which description you think you fit and show how many points would be awarded for that.

 

Then section 13 cover awareness of hazards, which you could look at for leaving the gas on, etc. Again, put the descriptor that fits you and say how many points.

 

And so on, go through all the desriptors and draw up a little table of all the ones you think you should have points for, showing which desriptor and the points, then add them up. I imagine you'll have in excess of 15.

 

Speak to you later, HB x

[Nystagmite]

Just to add to what HB said:

It would help to give an example of what has happened. IE, you said that you have petite mal seizures. During these seizures, do you hurt yourself or others? Do you need to be restrained to stop you hurting yourself / others? What happens after? Do you just sleep it off? Are you confused?

[leemack]

Hi Pritti

 

What I've done is to copy your statement and I'll do comments/suggestions in blue. These are only suggestions, and you can go any way you want with your statement. Everyone approaches these statements differently, and its important you're happy with whatever you submit as you need to stand by it.

 

I asked some questions in an earlier post as it is very important to know how many points you scored and whether you have other evidence and incorporate this into the statement.

 

It is very important that you attend the tribunal. This is so the tribunal can see you, ask you questions and gather evidence from you. If you do not attend then the evidence of the medical WILL be what the accept, unless you have very good alternative medical evidence.

 

 

 

 

Statement to the tribunal

 

 

 

I am appealing against the decision made on 24th June 2010 to decline the award of Incapacity Benefit on the grounds that I have not attained 15 points from the combined Physical and Mental Health descriptors following my Personal Capability Assessment for Work on 20th May 2010. I believe that I do attain the required threshold of 15 points. I hope that the Tribunal will support my appeal and that the Tribunal will authorise the re-instatement of my award.

I hope that the tribunal will bear with me in the manner in which my case is presented. It is important that I state my case in this manner ie in writing, since it is in the nature of my condition that I cannot tell from day to day what I shall be able to manage on the day of the hearing. I may be well enough to travel and sit through a hearing. I may not.

**Further, I have had some difficulty in obtaining assistance with this appeal. Most mental health charities do not have the resources. To obtain help from a Citizens Advice Bureau, I would have to go to my nearest, which is more than 5km from my home and wait to be seen because they don’t have the staff for appointments. I have therefore relied on the assistance of unskilled family members to assist me over a period of time, in stating my case in this manner.** Good opening statment, though the part ** to ** is not necessary - though if you have been unable to obtain evidence, for instance if your GP would charge for a report, or other problems you have had, this would be the place to state that.

 

 

------------------------

 

 

 

 

 

I would like to refer the Tribunal to Evidence Item 3 in the Incapacity Benefit Appeal Submission. This is Form IB85 – the medical report of the doctor appointed by the Department for Work and Pensions and is at pages 23-45 of the Appeal Submission.

 

This medical report does not reflect accurately those matters discussed and assessed at the medical examination that I attended on 20th May 2010. Referring to the content of the Medical Report Form, on:

 

* Page 23, the medical report states that I take Amitriptyline for pain relief and that I take no medication for depression.

The correct position is that I have been prescribed Amitriptyline for depression and Zopiclone for insomnia because lack of sleep was making me edgy and tearful, with uncontrollable mood swings.

What I do take for pain, is a range of medication, which includes Diclonfenac, Naproxen and Co-codamol.

 

*Page 23, the medical report states that I have had no hospital treatment of investigations in the last 12 months and further on that I “used to attend the neurology out-patient department at Queen Square hospital. The treatment finished 2 years ago.”

 

The correct position is that my epilepsy, the efficacy of my medication, the condition of the lesion on my brain which affects the epilepsy – are all monitored by the National Hospital for Neurology and Neurosurgery at Queen’s Square. My doctor refers me back for a check up every 2 years. I have an MRI scan and an EEG to check whether the growth on my brain is stable or has grown. I have various blood tests and assessments and depending on what these reveal I continue attending the hospital or revisit in a year or two for my check up and scan. There is therefore no “treatment” which has “finished” as stated by the DWP doctor, but an ongoing situation. I explained to the DWP doctor that Prof Duncan at the hospital suggested surgery but that I had declined the operation because I was too fearful of its possible failure and couldn’t cope emotionally with the thought of an operation.

 

*Page 24 The report states that I only have minor seizures every few months from which I recover after 2-3 minutes.

 

What I told the doctor is that I have petite mal episodes, the duration of which may be as short as 2-3 minutes or substantially longer. I have no way of knowing, since I have to rely on observers to tell me how long I have been “out”. If nobody is present, as there often is not, I don’t know how long the episode lasts. Petite mal episodes can hardly be equated with “minor seizures”. Whilst not as dramatic as a grand mal seizure, each petite mal episode leaves me as debilitated and exhausted as a full-blown fit.

**I wish to note that my petite mal episodes have increased in frequency since the refusal of my claim for incapacity benefit by the DWP and the stress all this has led to.

When I am affected by the epilepsy, it causes disorientation, including loss of hearing and dizziness and whilst I am conscious and therefore appear recovered after a few minutes, the disorientation and tiredness persist for some hours.** Do not include this starred section. One of the issues I've seen at tribunals is clients getting caught up in trying to differentiate between condition at the time of the medical and a worsening condition, confusing the issue and the appeal fails. You need to state only how you were at the time of the medical. An appropriate thing to put here would be to establish frequency of seizures at the time of the medical - frequency is very important as this is what one of the points scores is based on. So how many seizures did you have in the six months prior to the medical?

 

*page 23, the medical report states that I am not currently receiving mental health treatment. This is only true partly. I told the DWP doctor that I’d been receiving psychotherapy and counselling for some years whilst I was working. After I stopped working, I had long term counselling from the counsellor at my previous GP. I told the DWP doctor and put in my questionnaire, that my current GP has repeatedly referred me for cycles of treatment with the counsellor at his clinic. I was not making much progress with her. My doctor then referred me to the Psychological Therapies Service with which I was awaiting appointments at the time I saw the DWP doctor. They have a long waiting list.

I should add that since I saw the DWP doctor I have attended the PTS. They have assessed me and referred me for treatment. I am awaiting further appointments. ** In the interim, I have deteriorated so much that I have been obliged to see my GP because I can’t afford private treatment while waiting for the NHS treatment. At the last, on 9th March 2011, he expressed great concern about my mental health, since he had never seen me quite so bad. I was barely able to function. He suggested continued and monitored medication until I could access therapy and wants regular appointments so that he can observe my condition. My husband has to return from work in the middle of the day to check up on me.** Again its best not to include the section on deterioration. You want the tribunal firmly focused on how you were at the time of the medical, and not thinking you were better then and worse now.

 

*page 23, the medical report says that the main reason for my leaving work was physical health.

There is a contradiction between the doctor’s report, which says that I stopped work because of physical health and the Secretary of State’s response to my appeal (page 2 of the incapacity benefit appeal submission) which correctly states that I stopped work because of depression. I have epilepsy and my fits are often triggered by stress.** I had several part-time jobs as well as a young child at the time when I was first diagnosed as suffering from stress, anxiety and depression. I also felt that I was racially bullied at work but was not able to cope emotionally with the stress of taking this up. ** These mental health factors caused me to have a fit when I was commuting home from work by bicycle. I was hospitalized as a result. However my GP at the time diagnosed the mental health factors as triggering the physical factors – stress led to my having a fit on my bike. Thus it was mental health that caused me to stop work. I would not include the starred section just because you don't want to lead the tribunal down the path of thinking this is an isolated situation, but you do want them to see that work causes you excess stress that aggravates your condition.

 

*pp 23-4 the medical report states that I occasionally wake unrefreshed because I am thinking about things, that I am able to fully care for myself, regularly perform household duties, engage with friends, take exercise and have only mild mood swings, sometimes cry and feel distressed.

The reality is, as I told the DWP doctor, that I have good spells when I can in fact perform at the level he has stated as my norm. I do, however, sometimes go for months without being able to do any of the things he mentions. When my anxiety keeps me awake for so many nights running that I am moody, tearful and near suicidal, I have to resort to taking courses of sleeping tablets, which in turn result in fatigue and general lassitude during the day and an inability to perform ordinary every day tasks such as those he mentions. Yes, I do try to leave the house and sometimes go for a walk or to the library, since my GP recommended these as possible self-help when I am able to do so. I therefore try to do this, even though it makes me very tired and in need of rest for some hours after doing so. I might have a week in which I am able to go out and then months when I don’t go out, see friends or go to the library or do any of the things he mentions. These are the times when I either don’t get out of bed or do so and then sit in the yard crying or hide in the shed or my room because I can’t cope with doing anything, seeing people or speaking to them, when I think of saving up my sleeping tablets and taking them all in one go but am prevented from doing so because my husband monitors my medication. Here you should tell the tribunal, on average how many good days and bad days you have a week. So for instance if you are good for a week and then bad for months an average might be 6 bad days to every 1 good day.

 

***pp26-7 and pg 29, the medical report states that I am able to perform certain physical exercises and concludes that “musculoskeletal problem causes no significant restriction of sitting, rising and bending or kneeling” and later that my “musculoskeletal problem causes recurrent pain and this leads to mild restriction of standing, walking and climbing stairs.” It also notes that I had a fall two months before the examination.** I would simply point out that these are two contradictory statements regarding musculoskeletal problems and in fact your condition at the time was.....whatever it was. Also point out that the fall was not in isolation but part of a pattern of falls. The highlightled section below is unnecessary and again draws attention to deteriorations in health since the medical which can't be taken into account.

Whilst my physical problems are not the main reason for my application for incapacity benefit, the reality is that I have had physiotherapy on and off for musculoskeletal problems for many years. The lack of continuity is not because of improvement in any problems I have, but because the nature of physiotherapy treatment on the NHS means that one can only have 6 treatments at a time, before having to be sent back to one’s GP who has to make a fresh referral which can take months. I told the DWP doctor that I was awaiting physiotherapy because of problems coming downstairs. I also told him that I am prone to falls and injuring myself. In fact, I had two falls since I saw him. One of them was so bad that it completely incapacitated my left hand. Even though I am right-handed, this meant that I was unable to dress myself properly, see to my personal care or perform any household tasks. I also injured my hip in the fall. I have had ongoing physiotherapy at Finchley Memorial Hospital – two appointments per week, one for each of the problems. The failure of my hand to respond to treatment and oral painkillers prompted the hospital to give me three successive corticosteroid injections at their pain clinic in an attempt to relieve the swelling and pain. I am still receiving treatment for both problems. As I have stated, my physical problems are not my main problems, but they do exist, they do limit my ability to function appropriately. As I get older (I am now 53) they are unlikely to improve.

 

*Page 2 of the Incapacity Benefit Appeal Submission points out that I did not submit a doctor’s statement (med 4) from my doctor

This is true, but, as can be seen on my IB50 at page 19, the letter accompanying my IB 50 did not require me to send a med 4. I was at no stage asked to provide this and assumed that this meant that the DWP would itself contact my doctor for his statement.

When I received the appeal documents, I asked the Psychological Therapy Service, to supply me with documents to state what my condition was and how it would affect my ability to hold down a job. They called me to say that they would support my claim but required some forms to complete. Neither they nor I knew where to obtain the forms, so I then wrote to the tribunals service requesting the forms. I was called by the clerk of tribunals to say that you don’t send out such forms. I explained that I was a loss as to how to proceed then to get the documentary evidence I need. I then returned to my GP. He, too, said that he was under the impression that once I have filled out my IB50, the DWP would contact him and ask for a statement on my condition and my ability to work. At my last visit, on 9th March 2011, he expressed great concern about my mental health, since he had never seen me quite so bad. He told me that I was to tell the tribunal that he would provide a statement when it required him to do so. I have no reason to doubt that what he says is true about the way in which medical evidence is supplied by him. He is an experienced GP. Despite this confusion, I hope that he will return to his clinic in time to issue me with the statement required, since he has made it very clear that he does not regard me as being fit for work. This part is unecessary and the part regarding GP statement ie he would not give you one but will give the tribunal one, should be covered at the beginning where I commented.

 

At this point I would say something like: The medical examination was unfit for purpose for assessing my mental health issues. the questions were structured to provide a yes or no answer, leaving no opportunity to explain the mental health issues or expand on variability according to good and bad days, as such I answered what I could do on a good day, but was not given the opportunity to explain what I couldn't do on a bad day. I have on average x good days and x bad days a week (insert number as appropriate).

 

Below is where you need as Honeybee pointed out to have a more structured approach. The way to do this is to pick all descriptors that you think you should have scored points on and write that descriptor in bold, then underneath give examples of how you fulfill the descriptor. There's very good information below that can be used. As an example:

 

Answering the telephone and reliably taking a message.

I believed this question was about knowing how to answer a phone and take a message. Although I do this on a good day, on a bad dayI never answer the phone during the day time and my husband encourages people to only call when my husband is home at night. The mobile phone my daughter gave me stays switched off in a drawer. I rarely make calls to friends. My husband makes our household related calls. (2 points)

 

This needs to be done for every descriptor you think you score points on including the descriptor regarding loss of conciousness - which covers your seizures. Any physical decsriptors should be placed before the mental health descriptors.

So its best to rearrange the section in green into that format and you don't need to include page numbers.

 

*Pp 36-7

The questions relate to a range of everyday tasks, which according to the medical report, I am fully capable of doing.

The reality is that I can do these only on good days. My responses were prompted by the doctor eliciting them from me, making me feel as though only a truly stupid person wouldn’t be able to do any of these things. I felt obliged to say yes very often just to please him.

Here are some examples - Cta - The telephone

He asked if I could answer the telephone reliably and take a message. I said yes, because I was taught to answer a phone as a child and thought he meant whether I could in theory answer a phone, not whether in fact I do answer it. In actual fact, I never answer the phone during the day time and my husband encourages people to only call when my husband is home at night. The mobile phone my daughter gave me stays switched off in a drawer. I rarely make calls to friends. My husband makes our household related calls.

CTb – Sitting for hours doing nothing

The doctor went on prompting me and prompting me – do you do this, do you do that, do you really just do nothing, surely you do? On and on until I said well yes, I read a bit. Yes, I cook a bit.

CTc and CTd – Concentration, reading, bills

The doctor asked whether I could follow a story and read an article in the paper. Of course I told him that I could. I have done such things since I was a child. I am depressed and anxious. I am not stupid, as the doctor noted. I didn’t understand that he meant whether I still have an interest in doing so now, else I would have told him that the reality is that whilst I used to read for hours in my well days, now my concentration span allows a shameful and uninterested few minutes at a time. I have no interest in anything for long. I don’t regard this as normal concentration levels. What I really can’t do is deal with my own finances and correspondence. Nothing scares me like a letter or a phone call. I don’t know what’s in it. It might be bad. I might have to do something. Someone might be going to do something to me. I leave such things to my husband or my daughter and if I know a bill or letter has come, I won’t sleep until my husband shows me he’s seen to it.

CTe - Sociability

I don’t know what makes the doctor think that I am usually sociable. I could go days without saying much to anyone except greeting or muttering. It’s been months since I’ve seen friends. I don’t socialize with neighbours – I have never been in their houses or they in mine.

CTf – Risks in the home

Yes, I can prepare a meal when I feel up to it. However, the many burns and cuts on my hands and stains on the floors testify as to how often I have accidents in the kitchen. My husband found the gas on the other day when he came downstairs, after I’d been up all night making tea and forgetting to turn things off.

CTg – Agitation or confusion leading to accidents

I am often anxious and confused but because I am equally often to tired or uncaring to do anything but lie on the couch or hide in the shed, I don’t have as many accidents as I would have if I did things.

A lot of the CT (completion of tasks) questions seem to revolve around my ability to use a telephone and a telephone book. Of course these are things I could do, objectively, if I were well. I could read, if I had the interest in it. I could see friends, watch TV, read the TV guide – if I wanted to. The problem with being depressed is that I don’t want to. I can’t be bothered to. Nothing interests me enough to make the effort. The doctor didn’t ask me that. Can you do these things is not the same as asking whether you do in fact do them or are prevented from doing them because you can’t make yourself do them. Objectively as an educated adult, I have lived a life which enables me to do all of these things. Subjectively, as someone with depression, I can’t actually make myself do any of them.

Daily Living

DLa I often need encouragement to get up and start the day. What my husband does is get me up when he goes to work and makes me dress as he does. Sometimes he even takes me out before work, if I can manage it, even if it’s just to walk to the corner to try to get me going for the day.

DLb It is true that I don’t drink having been raised a teetotaller.

DLc I have mood swings which are so bad that I shout at my husband and daughter, then don’t speak to them for days or weeks. Yes, I have never attempted suicide, but I have considered saving my sleeping tablets in order to take them in one go. My husband takes charge of my medication, so I can’t do this.

DLd It is true that I am clean and tidy. My husband cares for me and ensures that I am. My husband keeps the house tidy but I often get obsessive about it and get extremely upset and even abusive about people not taking their shoes off in the house, leaving things around, or doing anything which I don’t like in the house. I have been so abusive about this to my husband and daughter that my daughter prefers to live away from home. I would cause a huge row with her about the slightest thing eg a cup left in the sink or a bed unmade. I expect her and my husband to keep the house pristine and when they don’t I throw huge tantrums. Just before my daughter left home I threw fruit at her because she hadn’t arranged the fruit bowl properly. Then I get weepy and upset and hide, refusing to talk to them.

DLd To say that I “adjust daytime activities to fit in with sleeping pattern” is a misleading. I don’t sleep at night. I sweat. I pace. I bite my nails, pick at my feet, scratch my scalp until it bleeds. I overheat in bed and then go sit up in the dark all night, often talking to myself to get myself to go back to bed. Then I face the day exhausted and lie on the couch all day or sit in the yard talking to myself. This is what the doctor means by adjustment.

Coping with Pressure

CPa It is not correct to say that I stopped work due to my physical ill health (see above).

CPb I attended the examination alone because my husband works and my daughter had final exams. He put me on the bus. She fetched me when I’d gotten strung out by the examination.

CPc The answer to the question of whether I avoid carrying out routine tasks because I think they will be too stressful or tiring was yes. I would prefer to keep busy but I can’t keep my attention on anything. I do not always make the main meal for my husband. When I can’t, he comes home and makes it or my daughter comes and cooks and puts things in the freezer. When the doctor asked about queuing at the bus stop or post office, I said yes because if I were well, I could do that. However, I have not been able to go to the post office or shops for a while. I don’t know what the doctor means by saying that I am able to manage most tasks. The doctor asked whether I can do these things, which I took to mean can I do them objectively, have I proved able to do so in the past, not whether my condition now prevents me from doing so. There was no room in the examination to tell the whole truth rather than provide one word answers. The truth is that I am often scared and panicky for no reason. Letters frighten me, phone calls frighten me because I think people want something from me that I can’t do, that I’ve done something wrong, that I’m in trouble. Yes I would prefer to be busy, but I am unable to keep busy or concentrate on anything for too long. Change frightens me. I don’t deal with household administration. My husband and daughter do those things. I couldn’t even get to contacting CAB on my own because I was scared to do so. As the doctor noted, I am afraid of strangers and of crowds and being too long with people outside my family.

Interaction with other people

OPa I explained to the doctor that I am able to care for myself because I have a supportive husband and daughter

OPb The doctor saw me on a day when my medication had made me tired enough to appear placid, until I snapped and got very upset, which he didn’t record. To say that I have a placid nature is wrong. I have frequent outbursts and have in the past thrown things, such as my daughter’s lunch when she didn’t eat it, or the pots and pans when she didn’t clean them.

OPe

I am alone from the time my husband leaves for work until he gets home except when he comes home during the middle of the day to check up on me when I have an unusually bad patch. I rarely see friends because he would have to make arrangements and take me and he doesn’t often have time. When he does make time, I very often feel too tired or disinclined to go out or have people over, so I make him cancel the arrangements.

OPf

There are times when I can and do go out alone. There are also weeks, even months when I can’t and don’t

**In conclusion, I believe that the scoring of my Personal Capability Assessment should be revised, primarily with regard to my mental abilities. As the doctor noted, for most of the examination I was “placid”. I answered in a way which would satisfy him. In addition, this was not a proper examination which allowed for fulsome explanation, beyond yes and no. Mostly, as I’ve said, I answered yes when asked whether I could do something, because I took him to mean whether or not I could objectively, not in my current state, perform certain tasks.

I hope the Tribunal will support and find in favour of my appeal, determining that I am incapable of work.** I would delete this and end with something simple, as the explanations have already been given, so for example:

 

I respectfully request that the tribunal find that I score in excess of 15 points on the personal capability assessment and that I am as such incapable of work.

Edited March 12, 2011 by leemack

[Nystagmite]

It may help to keep a diary for a week or two. I personally can't, when asked, say how many better and bad days I have a week.

[leemack]

It may help to keep a diary for a week or two. I personally can't, when asked, say how many better and bad days I have a week.

 

At this point it won't help unless they tell the tribunal their health is the same now as at the time of the medical. The tribunal can only look at the picture of how it was then and not now. I realise how difficult it is.

[Pritti]

Dear Honeybee, Leemack and Nystagmite

First, thanks a million for all the very clear and incisive suggestions. The DWP doctor's assessment led to my scoring exactly 1 point on the mental health test. It is as though he'd examined a completely different person. Which he might have - if he got me on one of my manically good days, I would have been the friendliest nicest person, just eager to please and say what the nice doctor wanted. Or on my too out of it to bother days - which is how it started off - then he upset me and I left in tears, totally hysterical - none of which he noted because he said only that I was "placid" during the examination.

Anyhow - I take my hat off to you, for having taken more trouble than the doctor, to actually read my statement and in so doing LISTEN to me, which he just didn't do and I couldn't make him because I had nobody there to speak for me.

I have now amended the statement to put it into the format you all suggested and I have taken up almost all of HB's suggestions and edits. God, you're good. I assume each descriptor is worth one point and with that in mind, I make it 15 points that I emerge with on the mental health test.

One final question - The hearing is on Friday. Do I post this statement to the tribunal now, or do I take it with me. I could post it first class tomorrow but I don't have the doctor's letter yet. It's so hard to get appointments, let alone letters. I hope to have the letter by Friday if my doctor is back by then and has the letter ready?

My thanks to all of you

Warmest regards, especially to you, HB.

Pritti

Edited March 13, 2011 by Pritti
forgot something.

[honeybee13]

Hello there. Well done you. My only suggestion is to follow the link to the descriptors, because you may well deserve more than one point per problem. You may well find that some of your problems deserve 3-6 points, maybe more. Please take the time to find out a bit more about the scoring system, you can find the link in my sticky. Let me know if you can't.

 

Also, for any health problems you had at the time of your Atos assessment, check out the points for them as well and add them to what you're submitting.

 

I hope Leemack or someone else will comment on when to send the document.

 

HB x

[leemack]

Dear Honeybee, Leemack and Nystagmite

First, thanks a million for all the very clear and incisive suggestions. The DWP doctor's assessment led to my scoring exactly 1 point on the mental health test. It is as though he'd examined a completely different person. Which he might have - if he got me on one of my manically good days, I would have been the friendliest nicest person, just eager to please and say what the nice doctor wanted. Or on my too out of it to bother days - which is how it started off - then he upset me and I left in tears, totally hysterical - none of which he noted because he said only that I was "placid" during the examination.

Anyhow - I take my hat off to you, for having taken more trouble than the doctor, to actually read my statement and in so doing LISTEN to me, which he just didn't do and I couldn't make him because I had nobody there to speak for me.

I have now amended the statement to put it into the format you all suggested and I have taken up almost all of HB's suggestions and edits. God, you're good. I assume each descriptor is worth one point and with that in mind, I make it 15 points that I emerge with on the mental health test.

One final question - The hearing is on Friday. Do I post this statement to the tribunal now, or do I take it with me. I could post it first class tomorrow but I don't have the doctor's letter yet. It's so hard to get appointments, let alone letters. I hope to have the letter by Friday if my doctor is back by then and has the letter ready?

My thanks to all of you

Warmest regards, especially to you, HB.

Pritti

 

It is important to put down about your seizures - having two seizures in 6 months scores 12 points!! This should add to mental health descriptors to give more than enough points.

 

Also the mental health descriptors score one or two points each, its best to check. Here is a link to the descriptors and scores near the bottom of the page.

 

http://www.disabilityalliance.org/f25.htm

 

You might as well take the statement and doctors letter with you, but give it to the clerk when you arrive so the tribunal can look at it before the hearing starts.

 

Lee

[stalin's dead]

It is important to put down about your seizures - having two seizures in 6 months scores 12 points!! This should add to mental health descriptors to give more than enough points.

 

Also the mental health descriptors score one or two points each, its best to check. Here is a link to the descriptors and scores near the bottom of the page.

 

http://www.disabilityalliance.org/f25.htm

 

You might as well take the statement and doctors letter with you, but give it to the clerk when you arrive so the tribunal can look at it before the hearing starts.

 

Lee

 

-

LM,

 

I have grand mal seizures around 3x/per month and you state that 2 seizures every 6 months attracts 12 points. Are you sure this is correct?

 

thanks mate

 

SD

[honeybee13]

Hi SD. I copied and pasted the DWP descriptors [link in the template letter on my sticky]. This is what is says. Not all the columns came out, but I hope the points are clear. I don't know if Leemack meant that 6 points can count twice, hopefully she'll be back later to tell us.

 

My best, HB

 

 

Descriptors Points

 

a) At least once a week, has an involuntary episode of lost or altered 15

consciousness, resulting in significantly disrupted awareness or

concentration

 

b) At least once a month, has an involuntary episode of lost or altered 9

consciousness, resulting in significantly disrupted awareness or

concentration

 

c) At least twice in six months immediately preceding the assessment, 6

has had an involuntary episode of lost or altered consciousness,

resulting in significantly disrupted awareness or concentration

 

d) None of the above apply 0

[leemack]

Honeybee, Pritti has said its an incap appeal, I think, not esa, in which case the points are slightly different than for esa. If you click on the link in my post above it shows the incap descriptors and points. If I've got this wrong Pritti, please let me know.

 

Pritti, for 3 seizures a month, the score would be 15 points for incap, I believe. But was this the frequency of seizures at the time of the medical? If so you need to make sure your statement makes it clear how many seizures you were having, describe what happens when you have a seizure, how long does 'altered consciousness' last, and for instance do you also lose bladder control - that scores points too. And make sure your doctor's letter is specific about seizures.

 

Continence - Other Than Bedwetting

 

• No voluntary control over bowels - score 15
  
• No voluntary control over bladder - score 15
  
• Loses control of bowels at least once a week - score 15
  
• Loses control of bowels at least once a month - score 15
  
• Loses control of bowels occasionally - score 9
  
• Loses control of bladder at least once a month - score 3
  

Remaining conscious

 

Remaining conscious without having epileptic or similar seizures during waking moments

• Has an involuntary episode of lost or altered consciousness at least once a day - score 15
  
• Has an involuntary episode of lost or altered consciousness at least once a week - score 15
  
• Has an involuntary episode of lost or altered consciousness at least once a month - score 15
  
• Has had an involuntary episode of lost or altered consciousness at least twice in the last 6 months - score 12
  
• Has had an involuntary episode of lost or altered consciousness once in the last 6 months - score 8
  

Note: Following CSIB/803/2005 and CSIB/8188/2005, a decision made by a tribunal of commissioners, the wording of Activity 14 is that as amended on 6th January 1997 (see SI 1996/3207). This replaces the old wording - Remaining conscious other than for normal periods of sleep.

Edited March 15, 2011 by leemack

[honeybee13]

Oops, you're right Leemack, thank you for mentioning that. What a complicated system we have.....

 

My best, HB