Missed ATOS medical.

[leeseylee]

Hi all hoping someone can help me advise my brother, I have had some excellent advice in the past

 

Basically my brother applied for ESA about 6 weeks ago, he doesnt have a permanent address at the moment and is basically sofa surfing, he is suffering from severe depression too, his mail gets sent to his ex, she managed to loose the appointment letter from ATOS (the less said about that the better me thinks!) as soon as he knew it was lost he sent a letter to DWP asking to reconfirm the appointment (no money = no way to call their rip off number!) 2 weeks later got a letter to say that his benefit would be stopped as he missed the appointment.

 

He went down to the job centre to use their phone (didnt consider this option before, but a friend pointed this out) to explain and ask what he should do now, they said they had never received the letter requesting confirmation of his appointment or his most recent sick note (both were sent) and he was told basically tough luck, you need to call back in two weeks to see if we will reconsider the decision (its been about 4 weeks now since he had a payment from them).

 

Now I have done a bit of reading up this morning before coming here, and it seems like he isnt going to have much luck here, but wondering what is the best way forward? Appeal and wait (could be months before he gets another appointment) new claim (is this possible?) crisis loan?

 

Any help would be greatly appreciated.

[honeybee13]

Hello there.

 

I'm trying to get you some help with this.

 

My best, HB

[leeseylee]

Thank you. Just reread my OP and I realised have made a mistake its been about 10 weeks since he first claimed not 6.

[ErikaPNP]

He can do all three.

 

The problem is that during an appeal, he won't be entitled to receive any money pending the decision - this is only for people who have attended an assessment and not been granted sufficient points. If he plans to appeal, he needs to do this straight away as he only has one month from the date of the decision to do so. Calling back in two weeks to see if they will reconsider? - that's very bad advice given by the contact centre, unless of course he had already requested a reconsideration and they are giving that as a timescale to call back for an update.

 

A new claim will not secure payment until after a successful assessment, if the last decision was made in the last 6 months - unless there is a significant deterioration of the condition or he is claiming on a new condition.

 

He can apply for a Crisis loan however they will not be able to pay him for an indefinate period and there will come a point where they will refuse to pay any more.

 

He can phone ESA again and request a call back from the ESA department itself. When you call that number you are getting through to a contact centre anywhere in the country, not the actual department that processes benefit. The contact centre have basic access to computerised records for general enquiries only, they have no access to his paper file and are unable to trace physical paperwork. If ESA are able to locate his letter they can then decide whether they will perform a reconsideration based on that or not.

 

However the issue that I forsee is that they may decline to revise the decision in his favour by stating that they do not schedule appointments (ATOS does this and this is stated in letters he should have been sent previously). Their argument will be that he knew an appointment letter had been sent to him and that he did not do enough to ensure that he attended. Not saying it's right but I have seen that argument used before.

 

There is another option. That is submitting an appeal and claiming JSA on a restricted jobsearch in the interim period. I do not like to advise people to do this but it may be his only alternative. It is a last resort though.

 

I'm sorry that I cannot be more helpful.

[speedfreek]

A new claim will not secure payment until after a successful assessment,

 

Sorry to quibble here but I thought that it was no payment until a WCA has been undertaken and a decision made?

 

New decision/claim over rules the fail to attend and hence ESA is payable again win or lose?

 

6 month rule will not apply it's just no new claim can be paid until a determination has been made one way or the other.

 

Have a look at Worrieds' thread as there's rule about 8 week fast tracking of claims rather than 13 weeks for assessment.

 

Not great but 8 is better than 13 just!

 

Also post envelopes dates, bank holidays etc. ATOS send out appointment letters 7 days or less in advance. So....

 

to have the ATOS app letter and the DWP letter for failure to attend arrive on the same day given how fast the DWP work is a bit suspect.

 

Keep everything inc envelopes and check them especially dates as my speedy sense is tingling meaning something doesn't fit here but I'm not sure what?

[ErikaPNP]

Sorry to quibble here but I thought that it was no payment until a WCA has been undertaken and a decision made?

 

That's exactly what it means. A successful (decision favourable) assessment (WCA). Don't apologise, by the way - the bonus of an open forum is for debate and qualification of advice.

 

New decision/claim over rules the fail to attend and hence ESA is payable again win or lose?

 

No. The decision of a 'fail to attend without good cause' is always treated as not having limited capability for work. Any decision of not having limited capability for work means that any repeat claim for ESA within the next 6 months will not be paid until an assessment has been carried out and a decision made, unless the person is claiming for a new condition or a significant deterioration of the existing one.

 

Worried's thread does not talk about fast tracking claims rather than waiting the 13 weeks. That thread relates to payment of the increased rate (WRAG or Support group) elements after the 13 week assessment phase when no assessment has been performed within the 13 week period.

[speedfreek]

Well call me silly and slap me about with a frozen penguin as ever Erika you are correct!

 

Nada until passed or JSA claimed

 

The rest of the post about fast tracking and postal date may be helpful

[leeseylee]

Quote - to have the ATOS app letter and the DWP letter for failure to attend arrive on the same day given how fast the DWP work is a bit suspect.

 

I don't know where you got the idea he got the appointment letter and a DWP letter on the same day, I said it was about 2 weeks later.

 

To everyone else, thanks so much for your help, some of its a little bit over my head but at least I can pass on the best course of action to my brother and keep fingers crossed.

 

BTW whats he supposed to appeal? because he has contacted ESA today and they have given him the number for ATOS, so if he calls them and they refuse to give him another appointment can he appeal that decision? (sorry to sound dim!)

 

Also can I just clarify, if he is able to make a new claim he wont receive any money until he has had another assessment?

Edited April 30, 2012 by leeseylee

[ErikaPNP]

 

BTW whats he supposed to appeal? because he has contacted ESA today and they have given him the number for ATOS, so if he calls them and they refuse to give him another appointment can he appeal that decision? (sorry to sound dim!)

 

 

He is appealing the decision to stop his ESA.

 

Assuming that his ESA claim has been terminated, which appears to be the case.

 

Note: It will have been terminated if the letter he got from DWP states something along the lines of

 

"We cannot pay you ESA from X date. This is because....."

 

And it will go on to say something to the effect of that they have decided that he does not have limited capability for work because he did not attend the assessment on x date at x place.

 

If the letter simply asks him to make another appointment then his claim has not stopped. But I have never known them to stop someone's benefit and ask them to make another appointment if they have not attended the arranged one.

 

If his ESA claim has been stopped, ATOS will not be able to arrange another appointment, because the claim no longer exists. He cannot appeal a decision not to give him another appointment because that is not a decision on his claim. It is only decisions on his claim made by DWP which can be appealed.

 

Unless you can scan and post the letter here (personal details removed) or write it out (word for word, personal details removed) it is a bit difficult to gauge whether or not his claim has been stopped. We can only draw inferences based on what you have posted, what the law is and what they (DWP) normally do.

 

Also can I just clarify, if he is able to make a new claim he wont receive any money until he has had another assessment?

 

That's right, if the claim is made within 6 months of this one ending - unless his condition has significantly deteriorated or he is claiming with a different condition than he was before, in which case he would be paid.

 

If he resorts to claiming JSA, pending the appeal outcome, JSA would go into payment.

[leeseylee]

I have just read worried's thread, he had a much better cause for missing his appointment and still had to jump through hoops to get the decision overturned!

 

Have just asked my brother to have a look at his paperwork (he is staying with me for a couple of nights) he hasn't actually had a letter to say his payments have been stopped, but they have. He has one that says please explain why you missed your medical and a form to fill in.

 

I am just wondering if its worth going though all this, he is stressed and anxious as it is, which is really not helping his depression, and wondering if I should just tell him to make a new claim and wait for a new appointment????

 

P.s. special thanks to Erika for taking the time to write such lengthy replies, it really is appreciated.

[worried33]

The advice given to me was appeal but at the same time also do a new claim. One is to back the other up, if you win the appeal or get a reconsideration then the new claim will be cancelled, if you dont then the new claim will be what is relied on for more money.

 

In my own appeal I had 3 bits of hard evidence that the DWP made mistakes on my postcode, I also had a case number from a past upper tribunal decision written out to remind the tribunal of a past ruling which stated the DWP need to prove the address is correct and the letter was sent out to allow 7 days of notice. My 7 days notice happened to be only 3 days after the new years holiday period which probably helped my case as even the DWP accept postal problems at that time of the year.

 

I think your brother will have a harder time convincing good cause but I would still appeal because ultimately the truth is he didnt get the letter and as such was not possible for him to attend the appointment. But at the same time do the new claim as well which is whats needed now to get a new medical booked.

 

I was told 8 weeks is the fast track time but as it turned out my medical was actually booked in about 3 weeks. The DWP submitted almost immediatly they said and any delay at that point was down to ATOS. The medical I am still having to attend so I am not out of the woods yet I can still fail that medical and then will have to appeal that but obviously the consequences for failing a medical are nowhere near as grave as missing a medical so I am mighty releived. Also even tho I was entitled to no money I submitted sick notes as well. Good luck.

[ErikaPNP]

I have just read worried's thread, he had a much better cause for missing his appointment and still had to jump through hoops to get the decision overturned!

 

Have just asked my brother to have a look at his paperwork (he is staying with me for a couple of nights) he hasn't actually had a letter to say his payments have been stopped, but they have. He has one that says please explain why you missed your medical and a form to fill in.

 

I am just wondering if its worth going though all this, he is stressed and anxious as it is, which is really not helping his depression, and wondering if I should just tell him to make a new claim and wait for a new appointment????

 

P.s. special thanks to Erika for taking the time to write such lengthy replies, it really is appreciated.

 

This changes everything. Do not appeal, there's nothing yo appeal against yet. Complete the form explaining why and send it off. If they then come back and stop his ESA, that's when you appeal.