Atos messing around.

[frustrateduk]

hi, i hope someone here can help.

 

i have two long term chronic conditions and it is my turn to be merged from incap to the new esa.

 

my partner did my esa50 and we sent it off, then realised we had forgotten to provide date when we could not make a medical.so we phoned them with the dates.

 

two weeks ago i had a call from my GP saying they had heard from atos and wanted to see me for a twenty minute appoinment re my claim. which is on the 19th sept

 

today we had a call from atos to arrange for my medical. arrange my foot, we were rail roaded into an appintment on the 12th sept.a date we had told them we could not make

 

i belong to a fibromyalgia support forum and a member has spoken of thier battle with atos and how in fact they keep breaching their contract with dwp in how they do things.

(not sure if i am allowed to post the site?)

this is sort of the gist of what i need help with...

 

 

''When you first complete the ESA form, you should provide a cover letter requesting the name of the "qualified" healthcare professional who will review the information that you have provided. You need to know who is responsible for deciding whether a face to face meeting is necessary. You can inform the DWP that you may wish to independently check with the GMC that the individual is qualified.

You should insist that the "qualified" healthcare professional provides you in writing the medical reasons why they feel a face to face meeting is essential. You can inform the DWP that you may wish to independently check with the GMC that the medical reasons are consistent with medical best practice.

Where appropriate, you should stress to the DWP that in order for a valid assessment to be made the "qualified" healthcare professional should contact your GP and or Consultants for details. Remember you are a patient or claimant or War Pensioner. You are not a customer or client. You are not medically qualified to diagnose or assess yourself.

If you think you are entitled to the allowance you should insist that the DWP should pay the allowance immediately and not wait for the DWP to find out the name of the "qualified" healthcare professional.

It is likely you will be harassed by the Atos Healthcare appointments clerks. You should politely but firmly inform them that you are waiting for the DWP to provide you with the information you have requested. You can email Atos Healthcare Customer Relations ([email protected]). Keep copies of all correspondence. Never use the phone as you need to create a paper trail that could be used in the High Court.''

 

i feel as if i am being treated all back to front by atos.

 

i did not realise i was able to request the information suggested above so have no idea if i will be seen by anyone with knowledge of m.e and fibromyalgia:|

my conditions come under cat.3 of five categories which lists who gets called to a medical, who doesnt. cat.3 is 'tentativly invite to medical examinations centre'

 

and now i find i am to seen for a medical before my gp even sends them the information they requested of him

 

what should i do~i am wondering if i should e-mail them saying that i request an appointment after they have the gp's information which they requested.

[frustrateduk]

sorry i coulnt find this bit when i posted...

 

''It is so important that you are told who the medical advisor is, what their qualifications are and why they feel a face to face assessment is necessary. If the medical advisor does not have specialist knowledge of the pathology and treatment of your medical condition and declines to consult with your GP and or Consultants, then Atos Healthcare are in breach of Contract. In such a case the medical advisor should be reported to the GMC (http://www.gmc-uk.org/). In such circumstances it could be argued that any advice given by Atos Healthcare to the DWP is a written defamation (libel). It could further be argued that Atos Healthcare have acting illegally in that contrary to Law they have not carried out a valid and legal medical assessment which they are required to do in conformance with statute, regulations and the detailed Contract signed with the DWP.''

 

by insisting on seeing me and not waiting for my gp's report are they in breach of thier contract?

[speedfreek]

The short answer is maybe?

 

Whilst there might be some mileage in that approach, there is no guarantee that the end result (with everything from your Dr included) would not still result in being called to a face to face assessment.

 

So.. whilst it might be handy in discrediting the report, interesting to know and be grounds for a valid complaint afterwards. It's going to take a lot of effort and cause you a lot of stress for something which is just basically a delaying tactic.

 

It might be helpful if you explained why you are trying to go down this root?

 

If it's a home visit you are after you need to talk to your Dr and ask for a letter of support.

 

Oh and dealing with the ATOS booking line. You have to be very forceful with them and insist that they re-book any appointment you can not attend. Keep escalating the request and keep making it until they do. They can not make decisions on anything else and will actively fob you off if you try. In order to get an answer or decision on something you have get the number for medical services off them. They're not much better but at least they can make decisions about things.

 

One of the highlights of my experience with them, was when on my insistence they cancelled an appointment only to then re-booked it, for exactly the same date and time as the one cancelled. Try as she might (and she tried hard) there was only really going to be one conclusion to my phone call regarding it.

[leemack]

I think difficulties with your approach are:

 

You're not having a medical, its a work capability assessment.

 

Atos don't have to provide doctors to do this, any health professional can do.

 

There are only certain conditions that require an assessor with knowledge in that field. This because they're assessing whether you have limited capability for work, its a basic assessment and NOT a medical. Fibromyalgia and ME are not conditions that require a assessor with specialist knowledge.

 

The best way to pass the assessment is to concentrate on the descriptors, be well prepared before you go and answer the questions in the right way. See the sticky on ESA medicals for further info.

 

I think people giving you advice such as they have, distracts you from the real issues. I really don't see what would be achieved by asking those questions at this point, except to get you worried and stressed about not getting the answers you want. And what case are they planning on bringing to the high court?

[frustrateduk]

thanks speedfreak and leemack.

 

my big concern is that they are insisting i go see them before they get the report that they requested from my GP. i dont fancy having to go down this whole route again because they just are insisting i go on such an such a date...

the woman on the phone told me it was for a medical:|

[speedfreek]

This seams to be the form your Dr would have been sent

 

http://www.dwp.gov.uk/docs/esa113-interactive.pdf

 

Being honest I don't know. You need somebody to advise you on the exact regulations for this before you act.

 

As everything I read about that form is summed up in this FOI request

 

http://www.whatdotheyknow.com/request/58925/response/149674/attach/2/FoI%20280%2010.02.11.doc

 

"The ESA/IB113 is usual issued when a customer may potentially be

PCA exempt as per regulation 10. In these cases the form is issued

to their HCP/consultant/GP to determine if regulation 10 applies."

 

And the Drs notes for it concur and say basically http://www.patient.co.uk/doctor/Certification-in-Primary-Care.htm

 

GPs may also be asked to complete a form ESA113 for patients with a severe disability, who might be entitled to benefit without the need for a face-to-face assessment.

 

You need to find out 1, what form your Dr has 2, when it was sent 3, when it has to be returned by. Next unless somebody here knows contact DIAL/MIND/CAB for specific advice on the subject.

 

If you don't/can't find out the answers to the above then you'll have to turn up for the assessment unless you get them to rebook it for a later date

[leemack]

There are conditions that with just info from the doctor a decision maker may allow you to bypass the assessment (they call it 'medical' but its not a medical), but it is very dependant on what the condition is, how well the eSA50 is completed and what info is available from the dr. Fibromyalgia is not one of these conditions - not sure what your other one is.

 

Many people are horrified to discover the poor information provided by their doctors, if any - many don't send the form back.

 

Railing against being told you need an assessment is not really going to help, unless you meet one of the circumstances allowing you to be treated as having limited capability for work related activity - this is the only automatic pass - decision makers are not required to automatically pass anyone else, though are using discretion with those with certain long term illnesses trasferring from incap to ESA.

[speedfreek]

This is a little different Lee as this is now about have ATOS followed official & proper procedure in calling for a face to face.

 

So a change to the original question some what and something we can not give general advice on.

 

Especially when we have no idea on what form or the time frame involved in its issue etc.

 

The only thing we can advise on is that they have to turn up to the assessment appointment or face sanction.

 

Other than that the OP has to get the correct info as I've indicated from their Dr then approach an organisation who can tell them exactly where they stand.

 

Once they have that we could take a look and I'd be very happy to know the final result. But with time scales etc & professional advice only a phone call away personally I'd run with that.

 

p.s Lee I'm pming you

[leemack]

Speedfreek, not entirely sure what you're saying there.

 

What I was saying is the OP shouldn't have been advised she wouldn't get a 'medical'. In most cases there are no guarantees.

 

Yes, some transferring from Incap are being decided on ESA50 alone, but most of these have severe long term disabilities with little or no hope of recovery. But even then they had no expectation of a guaranteed pass.

 

Those with more variable conditions, with a chance of having recovery - or those with badly completed ESA50's or little or no medical evidence will be called in.

 

In my experience conditions like fibromylagia, chronic fatigue, ME, depression, anxiety disorders, general back pain are very often called in for a 'medical' due to the variability and perceived subjectivity of the conditions. It may not be right, but its the way it is at the moment.

 

there are some cases where a 'medical' has been arranged and then the drs evidence arrives, which gives all the information required and the appt has been cancelled and the person placed in the support group.

 

I agree though that the first port of call should be the GP, to see what, if anything has been written.

 

I stilll don't think that asking for the names of decision makers or assessors achieves anything. Not providing the information would not cause a Tribunal to find in an appellant's favour as its a simple procedural matter - the most a person could do is complain if they could show that procedure hadn't been properly followed - they might get an apology.

 

If they could show in their complaint that a face to face assessment was unecessary given the volume and quality of info provided, then they might get an apology, or if they could show severe harm and distress, maybe a small concilliatory payment.

 

But its true, no matter how the OP feels they need to attend the assessment or have their benefit stopped.

[speedfreek]

Lee I agree totally with all that unequivocally it goes without saying.

 

What the OP is now asking is not about names of HCP's and DMs but about a very specific part of the process ATOS have to follow when deciding if a face to face assessment is needed.

 

So was it correct for them to be called for a face to face before whatever form their Dr received was returned.

 

With what the OP has posted so far there is no way to determine that one way or the other.

 

All it would do in theory if proved correct is nullify the current decision to call them in for a face to face and mean once it's received make a new decision on it.

 

I think it would be interesting to know one way or the other. I also think that unless we get enough information to look at it any further debate on the subject is just pure speculation, an irrelevance and pointless.

[leemack]

OK, I understand now, and of course you're right about that - the speculation is pretty pointless, and there's little the OP can do about it anyway.

[frustrateduk]

speedfreak thank you for the information re the form.

my OH is calling our surgery today for that information.

 

(i have m.e, fibromyalgia, constant high cholesterol, contant anaemia because of the m.e and fibro, and diabeties from which i have started having hypos because of all the medication i have to take because of it~and all the assosiated problems/side effects from the conditions~plus ongoing post-op gynachological problems which are being investigated. my weekly pill-box houses over 100 tablets a week that i have no option of taking)

 

anyhoo...

 

the day bfore yesterday he contacted atos on the number he was given by the appointments woman...the chap on the other end of the phone sounded like the squeeky youth usually seen in The Simpsons flipping burgers,which was the only amusing thing about the conversation.

 

oh asked for a change in the date because the date we were given was when we had informed them we would be away and that we wanted to see someone once they had the information that they had requested from our gp.

 

he was told that they could not book appointments more than three weeks in advance (funny that given they are an it group!) and he tried to give us appointments again when we were away. when questioned about the date it turns out they have the dates we had proveded wrong on their system:!:.

 

he also denied that they had sent my gp a form, then later said i didnt need to go to see my gp re the form:???:-to which my oh said that my gp had phoned and requested i have a twenty minute appointment to go through the said form and again that we only wanted to make my appointment after i had seen my gp to ensure that they had all the information their end, otherwise what a waste of time for everyone.

 

we were then told that we were 'deliberately making oursleves unavailable for thier appointment'-that is when my oh became very angry with them and requested to speak with a supervisor, well squeeky kept going around the wreakin about them being in a meeting etc and said he would get them to call us back.

 

well 45 minutes later the phone (which my oh had beside him) rang for two rings and as soon as he picked up it went dead.

he phoned straight back and it was answered by squeeky. oh said that we had recieved a call and squeekys response was 'oh so you missed the call' to which oh replied that it had rung twice and disconnected and that he had called back immediately, squeeky flustered a bit and said nothing.

 

however this time he was much less confrontational and said they would cancel the appointment and contact me once i had seen my gp.

 

...my sugery has just called and the form my gp has is esa113.

[leemack]

Basically, even if you did fall into the group that might not require a medical, they would need that form back from your GP before they made that decision.

 

If it is well completed and gives info relevant to the descriptors (both WRAG and support group), then you may get a letter in the post saying you don't have to attend the assessment.

 

But its unpredictable, and as I said before, conditions like fibromyalgia are more likely to be called in for assessment.

 

Before you go to the GP appt, read up on the descriptors and get straight in your head what information you need your GP to get across.

 

This ESA50 guide may be useful, although its for completing the ESA50, the information that you need to get across is the same - though in less detail on the GP form, because its not terribly comprehensive. This is just the physical health descriptors:

 

http://www.consumeractiongroup.co.uk/forum/showthread.php?316210-ESA50-Guide

Edited August 26, 2011 by leemack

[speedfreek]

Well that sounds promising although I have to add a very large word of caution here.

 

If this was me I'd wait a couple of days then start making phone calls to the DWP and then ATOS in that order, to get exactly what has happened and what will happen next confirmed.

 

As this worries me

we were then told that we were 'deliberately making oursleves unavailable for thier appointment'

 

Unless you have recorded that call you need to follow it up that they have agreed to postpone making the appointment until that form is returned. You also need to confirm that your benefit will/has not been stopped for refusing to attend i.e. the quoted statement above.

 

I gave advice in post 6, you've ignored it and gone ahead anyway. The reason why we refused to advise on this subject is that the wrong advice could lead you to having your benefit stopped.

 

Blunt I know but it's for your benefit that you get everything officially confirmed so that you know what you have to do next.

[frustrateduk]

speedfreak there is no pm from you in my inbox.

 

we have both phone calls recorded

 

my OH called my local DWP office the next morning and explained everything that had gone on and that we were concerned about atos contacting them to say we were deliberately making ourselves unavailable. he was on the phone for ages with her and she has put it down on my records what has happened and that they had cancelled the appointment pending the report from my gp.

[speedfreek]

All I can say is result and very well done especially with making recordings of the calls

 

My post above is due to my general (and founded) paranoia about covering all bases. A lot of people do get caught out by that which leaves them in a bit of a pickle. You look to have all bases covered so there's nothing more I can add.

 

This is an interesting question and I'd still like to find out for certain what the answer is! Anybody fancy doing a FOI request?

 

As with the IB to ESA transfer process moving forward I'd suspect more people might find themselves in this situation.

 

A definitive answer may 1, save some disabled folks the stress of a face to face and 2, stop ATOS getting their 30 pieces of silver for assessments that are against the rules.

[frustrateduk]

thanks speedfreak

i have also e-mailed (and saved it) them just going over what was agreed and that i would like a letter confirming their cancellation.

 

i have been determined to stick to my guns with them because i have heard so many awful things people have gone through and to me it just sounds as if they are trying to bypass the esa113 they sent to my gp and get me through their system quickly and, for them, easily, and into a work group.

 

i have no problem with attending any of their meetings, i have nothing to hide with regard my illnesses but refuse to be rail roaded by them, accused of things and have them say one thing then contradict it in the same conversation....

 

sorry i will calm down now:madgrin:

[frustrateduk]

speekfreak i thought this might interest you.

i had an email today from atos customer relations...

''Thank you for your enquiry.

There are no notes on our system regarding the conversation you had with Simon; I have therefore, emailed his Team Leader and asked her to speak to him about the conversation to ascertain what information you were given. I will reply to your email as soon as I received Simon's recollection of the call.''

i am so glad we had the two calls recorded:!:

[speedfreek]

Well it's hardly unexpected really is it?

 

As I'll repeat - until you have firm advice that you are correct - you are putting your self through undue stress and risking your benefits.

 

Although you now have a case and evidence for a complaint against ATOS on a new matter - i.e. being lied to. You are still no further forward on getting anything else sorted.

[frustrateduk]

here is an update...

 

we did not back down in insisting an appointment after they had received the esa113 from my gp.

they finally agreed and gave me an appointment the week following my appointment with me gp.

 

the day before my appointment with atos they telephoned to say i did not need to attend the medical as i was going straight to the esa support group.

 

so although it was stressful and upsetting i am glad we stood up to them and insisted on an appointment after they had the proper information

[honeybee13]

That's good news for you, I'm pleased. Well done on making a stand.

 

My best, HB

[count orlok]

Well done, and congrats, it must be a relief know where you are. We've been trying to sort out all our benefits, what with Pension credits, DLA, carers allowance, carers premium, ESA, there is so much to sort out and I can't believe that you need to inform each dept that the other dept is giving you this and they should be giving you that. Thing is if you didn't know you'd easily miss out, the lump sums are useful though when they eventually get it sorted, and it is such a relief not having to worry your money stopping.