Urgent -complex possible atos impending appointment- please help

[patientmanabc]

Hi, I’m new to your forum, and I’m need of desperate help. My friend Is coming up to my two year deadline regards Atos/ Maximus (I understand it’s not Atos anymore?) so I am completely out of the loop.

 

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He suffers from many of the below from aged 25 years old

 

*Severe drug use amphetamines cocaine, alcohol for 20+

(Drug use stopped 18 months ago) medication for alcohol and drugs given

 

*Severe Depression been on-going for 20+ years, antidepressants, medication- (but increased due to father dying suddenly 3 months ago and his elderly mother mom having a stroke recently. – His drinking has gone through the roof 60+ units a weeks at least.

 

*seen Councillors for drugs and drink for almost two years, up until a few years ago

.*Severe Social anxiety/ and before that extreme agoraphobia- major most severe problem that he was written off work for- 20+ years

 

*Bdp – (made worse by face damage) body dysmorhpic disorder – on-going

 

Also BDP worsened by mugging in 2007 -Resulting in an operation- (MAJOR OP.)

 

(8 years ago) Maxiofacial reconstruction- facial reconstructive surgery- This was two 4 hour operations that were botched within weeks of another and then another massive operation - Zygomatic osteotomy 3 months later - 15 hour op, 8 surgeons. (Traumatic MENTAL recovery took 18 months)

 

Has on-going hernia problem, operation was pencilled in and missed twice over three years due to on-going mental health issues

 

Left Knee operation probably required (ligament rupture and miniscule tear in cartilage of left know) and possible lesser in right knee- missed appointment through on-going mental health issues- anti- inflammatory, pain killers given

 

Weakened Achilles tendons, possibly causing altered gait, causing knee issues- cannot run and limps.

 

Gastro- stomach problem (collapsed a few years ago- symptoms never followed up as discharged himself from hospital due to anxiety- consultant arranged op for hernia- never went BACK FOR SCAN

 

These things are all facts but the psychological issues were accepted and written down by THE gp (AND ATOS) but were never followed up by a psychiatrist

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He was written off to such an extent that (Atos twice over a 4 year period attempted to get him into an interview and he DIDN’T EVEN NEED TO ATTEND THE INTERVIEW AFTER THE DR WROTE TO ATOS *BOTH TIMES)

 

The last appointment request was two years ago (august) and the letter provided by that same GP at the time meant Atos left him alone. But time could be running out!

 

The dilemma really is this:

 

1 his original doctor left to go back to the USA. He was progressive and understood the situation!

 

2 He has since failed to find/ trust any replacement DR at that clinic, he virtually never attended the clinic unless it was, hernia, or knee related or injury related; maybe 5 times in the last two years, Worse he gave up thinking about a future Atos appointment until recently, and because of the way he hasn’t attended interviews, EVER, we don’t know what his current (ATOS) situation is! I.e. SUPPORT GROUP ETC

 

 

3 we are guessing that Atos will send him an appointment soon? (But feel we have left it extremely late, if the timing is correct)

As mentioned previously, the last call up was two years ago, which he didn't need to attend, due to the intensity of his Dr's letter (august two years ago)

 

It would seem that Atos are no longer company that runs this situation. And we are unaware of new guidelines in terms of new appointments.

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My uninformed approach is to:

 

1 Get him to see a new GP consistently over next three weeks (providing that is the time Atos /Maximus) send him an appointment and build up a rapport with that GP?

 

2 then ask for a letter of update?

 

3 I have spoken to the clinic and the manager and they are willing to get a printout of all medical records and all previous correspondence with his old good GP to send to Atos /Maximus but this will be two years old. Would that still help?

 

4 if we do manage to see a new GP (patient friendly!) And build up a good rapport and then get a more or less updated full report?

 

4a would it be best to DEFINITELY get the (possible impending) appointment in august delayed somehow, and if so how would we go about this?

 

5 I suppose most important question is the two year gap a problem?

 

5a would ringing Atos to find out his current situation be positive or would that just remind them and hasten the process

 

6 does the two year medical rule still applies in terms of being served an interview notice?

 

My MAIN questions are-

 

1 what is the criteria required to pass the ‘Atos’ medical or indeed in my client’s case not need to attend. Are they the same as before? Is there still a two year reapplication rule for a medical? What’s forms need to be read or groups can one be placed in nowadays?

 

2 will it be now difficult to ‘prove’ my clients illness, due to the fact he didn’t really see any new DR’s in the last two years, in a capacity to dealing with the psychological issues or at least attending consistently - i.e. he has been ‘off the radar?’

 

3 the length of time between a GP letter for Atos, almost two years ago) and now? - a patient can’t just turn up to a NEW GP and demand a letter to write him off work for two years.

 

4 any important info needed for the current system/ company Maximus? Is there any more information that I need to know to pass on to the current GP he is about to see?

 

5 any links to information and help/ professional forum or otherwise as I’m running out of time to help this person! Has it been left too late?

 

6 is it essential to bring proof ALL proof of, physical injuries that have affected him, i.e. hernia, knee, face x-rays, letters appointments, etc. and that some of these injuries that would have also affected his mental well-being. For instance the massive op on his face? Maybe getting a personal letter from his surgeon even if the op was years ago?

 

You have to remember my client is ill and he’s going to have to approach a new GP, and ask for a letter?

I have been advised by the manager of the clinic (who is not a GP) to see the DR first and explain all issues so they can get to know the patient. INSTEAD of just asking for a Dr’s letter, as this may seem manipulative to the GP?

I am loath to offer any advice that could possibly hinder my client’s success at an appointment or (preferably an abstention from a medial interview in the first place!)

 

Finally I am not personally an advocate-

 

Are there any private advocates or free ones that you can get that thoroughly know the maximus/benefit medical interview system? So they can go with my client? And can you point me to a guideline for passing said interviews. As stated before through my client has had letters that have meant he has never needed to attend the previous two interviews! Would this still be the case? PLEASE HELP AS IT’S URGENT ON BEHALF OF A GOOD PERSON IN A BAD SITUATION.

[honeybee13]

Hello and welcome to CAG. I expect the guys will be along later with thoughts for you.

 

When you say this person is your client, what is your role please?

 

We don't recommend fee-charging people on CAG, I'm afraid, it's against our rules. It is possible to find a welfare rights advisor through your local council or CAB, but you're up against a tight deadline.

[honeybee13]

Hello again, replying to your PM.

 

The guys will tell you if this is too complicated, hopefully they will see your thread now it's in the main benefits forum.

 

HB

[Lapsed Workaholic]

You say, basically, that your dilemma is that you guess that ATOS will send your friend a letter asking him to attend an appointment. That would suggest that no such appointment has been arranged yet and your dilemma is premature.

 

Everything you are doing, or propose to do, may not be necessary and until you are informed by ATOS, or whoever, of what is required, what your friend needs to do and what evidence, if any, he is required to provide, you won't know what is required and what needs to be done.

 

It would be equally pointless to offer advice without knowing what exactly advice is required on. When your friend receives the anticipated letter you will know what to do and/or what advice you may need. In the meantime, unless you know different, there appears to be nothing to worry about.

[estellyn]

I don't see a problem. He's seen doctors - you mention medications, his antidepressants being increased. As long as they're aware of his issues - if you're concerned that they might not be, a letter to the surgery detailing his current state of health both physical and mental could be written with a request to scan to his medical file due to his old doctor leaving and new doctor taking over.

 

Is he having problems now that merit a visit to the doctor or a referral for mental health help/support? If so he should see a doctor.

 

There are delays to many appointments due to atos going and maximus starting, so there is no telling when the esa50 form (the thing that comes to be completed before the appt) will arrive.

[daverules]

Has as been mentioned by Lapsed Workaholic I also think your worrying about something that has not happened yet.

 

I think it would be a good idea to get your friend to start appointments with his new doctor now so the Dr can get to

know his case and then if the Atos appointment comes through the Dr will be able to write on his behalf having seen

him and make an assessment in his favor.

 

However if you leave it until he receives an Atos appointment the panic will set in to get him seen by his Dr and there he will

be required at short notice to understand your friends history and write on his behalf, better to prepare now so in the event

of the Atos appointment coming through the Dr will have had time to access your friend and build a Dr/patient relationship.

 

I hope your friend gets the help he needs.

 

Regards to all

[patientmanabc]

i cant pm as not enough posts, frustrating, but if you could all read the following, i would appreciate it thanks

 

thanks for your responses. Lapsed Workaholic, may i say I don't think you quite understand.... see a

 

 

dave rules- thanks dave i think your right to try and sort things out now! could you read A (below and offer an opinion? thanks)

 

** estellyn he hasn't really seen a dr in two years, he isnt currently taking meds. as i said he went off the radar. hes in the same condition as he was when his original dr left. I never said his medications were being increased? could you read below and offer an opinion?

 

 

A- its not a guess, atos said themselves it would be two years before they contact my friend again. that takes place august, so we dont want to wait until a letter comes through, as waiting times to see drs, consultants are longer than the two weeks they give you for appointments.

 

you see that last time this happened he WASN'T prepared and its only through the grace of god and my help that he didnt have to attend an appointment. if he had of done!!! he would have failed as he didn't have an advocate and would have failed the medical or refused to attend. this is why we NEED advice. to prepare, it will take weeks to gather evidence, you cant just phone up hospitals and ask for records, there is lots of red tape to go through, AND MULTIPLE People to speak to. i dont understand why people are saying dont worry, if a form comes through with an appointment in two weeks, and we cant get the information required for six weeks that causes a problem.

 

 

1 do you think is it essential to bring proof ALL proof of, physical injuries that have affected him, i.e. hernia, knee, face, x-rays, letters appointments, etc. to any possible appointment? This is important as these documents will take a long time to get? thanks

 

 

2 do you know if there are there any private advocates or free ones that you can get that thoroughly know the maximus/benefit medical interview system?

 

3 just to confirm- as long as he sees a dr now and uopdates his details?, it shouldnt be difficult to prove hes in the same condition and get a letter, is this true?

 

any help would be great!

[honeybee13]

Hello again.

 

I would say the first step is to go and see a doctor and discuss the problems. Unless he has a GP who is up to speed with his current condition, you aren't going to have any back up.

 

Does he have anyone like a CPN or a charity that deals with his condition?

 

ETA: We don't like advice being given by PM for various reasons. As long as no names are mentioned, there is not reason why advice can't be given on the thread. And as I said before, we can't recommend advocates, lawyers and so on under site rules.

 

HB

Edited July 13, 2015 by honeybee13

[mikeymack2002]

When you or your client attend the interview, give them the following information please it will assist you.

 

 

 

1. Dr's name address
   
2. Consultants name and address
   
3. CPN same as above
   
4. Rehab unit if client attends
   
5. Any reports that you or they may have
   
6. A medical release authorisation letter signed by client
   
7. 3rd party authorisation letter naming you as a 3rd party.
   
8. Include any telephone numbers for the above....
   

Providing the listed information the DWP will contact everyone that deals with your clients conditions, they will then make their decision once all the information from the relevant people concerned is received by them. The DWP will always look to get 1st hand evidence from the above. Then all you can do is wait for the letter stating what they will award if they do...

[daverules]

Hi there,

Regarding A:

 

My initial appointment with Atos should have been in 2009 but wasn't carried out until 2010 and I was informed I would be seen again in 2014 but as yet nothing has taken place and no information received as to when it would take place.

 

Has been mentioned on several forums that there will be a long delay in re-examining people on current Esa until they deal with the backlog of current new claims.

 

To be honest I wouldn't take it as gospel that they will contact your friend at the end of two years, they give you a time frame but in the present climate it is totally unrealistic.

 

Regarding documentation take all and any that refers injuries and illnesses, they will photocopy it and read it when they write up the report.

 

But just to reiterate please try and get your friend to begin the process of talking to the Doctor so as to be prepared.

 

It really is a lottery as to whether he will be seen at the end of his two years or it will be delayed.

 

Regards

[estellyn]

i cant pm as not enough posts, frustrating, but if you could all read the following, i would appreciate it thanks

 

thanks for your responses. Lapsed Workaholic, may i say I don't think you quite understand.... see a

 

 

dave rules- thanks dave i think your right to try and sort things out now! could you read A (below and offer an opinion? thanks)

 

** estellyn he hasn't really seen a dr in two years, he isnt currently taking meds. as i said he went off the radar. hes in the same condition as he was when his original dr left. I never said his medications were being increased? could you read below and offer an opinion?

 

 

A- its not a guess, atos said themselves it would be two years before they contact my friend again. that takes place august, so we dont want to wait until a letter comes through, as waiting times to see drs, consultants are longer than the two weeks they give you for appointments.

 

you see that last time this happened he WASN'T prepared and its only through the grace of god and my help that he didnt have to attend an appointment. if he had of done!!! he would have failed as he didn't have an advocate and would have failed the medical or refused to attend. this is why we NEED advice. to prepare, it will take weeks to gather evidence, you cant just phone up hospitals and ask for records, there is lots of red tape to go through, AND MULTIPLE People to speak to. i dont understand why people are saying dont worry, if a form comes through with an appointment in two weeks, and we cant get the information required for six weeks that causes a problem.

 

 

1 do you think is it essential to bring proof ALL proof of, physical injuries that have affected him, i.e. hernia, knee, face, x-rays, letters appointments, etc. to any possible appointment? This is important as these documents will take a long time to get? thanks

 

 

2 do you know if there are there any private advocates or free ones that you can get that thoroughly know the maximus/benefit medical interview system?

 

3 just to confirm- as long as he sees a dr now and uopdates his details?, it shouldnt be difficult to prove hes in the same condition and get a letter, is this true?

 

any help would be great!

 

This is what you said that led me to think he had seen a doctor:

 

*Severe Depression been on-going for 20+ years, antidepressants, medication- (but increased due to father dying suddenly 3 months ago and his elderly mother mom having a stroke recently. – His drinking has gone through the roof 60+ units a weeks at least.

 

I'm not sure I quite understand this though as if you know he needs doctor evidence for the assessment, then make sure he sees a doctor.

 

This is the timeline when an assessment is due.

 

The person is sent a form to complete called an esa50, it is a long form and he can get help from cab or a welfare rights organisation in his area. there is usually 4 weeks to complete the form and send it back.

 

Once the form is received by maximus, an assessor will look it over to decide if an in person assessment is needed or not.

 

then either an appointment is scheduled or it is put in a pile to be scheduled later when it reaches the front of the queue.

 

He is never going to just get through an appointment for two weeks time, the above process takes several months minimum and often longer. and an appointment can be delayed if needed.

 

No he doesn't need to take proof of everything with him - x rays are probably a bit much, but any relevant to the descriptors for ESA that apply to him, is very useful.

 

cab or welfare rights can give assistance with the esa50 form, but these organisations usefully do not have funding to go to an assessment. Approaching a mental health charity for an advocate might be an idea, but again, resources are pretty stretched everywhere - can you go with him?

 

If he hasn't seen a doctor in 2 years then yes, he needs to go. It also sounds like he needs assistance with his mental health and alcohol intake, so seeing a doctor would be good for that too. As long as the gp knows the situation, then when the gp writes to them for more info, they'll be able to give an up to date account. They may be willing to give your friend a letter, but he might have to pay for it.

[patientmanabc]

to estellyn you wrote earlier:-

'As long as they're aware of his issues - if you're concerned that they might not be, a letter to the surgery detailing his current state of health both physical and mental could be written with a request to scan to his medical file due to his old doctor leaving and new doctor taking over.'

 

can you break this down? what is a 'request to scan to his medical file? ' do you mean write a 'report' and give it to the surgery, so that all this current info in on his medical file? Thanks

 

 

and to daverules:- would it be wiae to contact atos/maximus and ask about the timeline with them or is that not such a good idea.

 

thanks for all your help and to the others, lapsed etc

[daverules]

Hi,

to be honest I wouldn't contact them, you may just prompt them to look at the case and arrange an assessment.

 

Whilst your not hearing from them you can get everything in place ready for when it comes around but if you do

alert them to the fact he is due an assessment at two years mark they may push his case forward forcing the situation

to get letters, medical records, etc to become a matter of urgency causing him stress, something he obviously could

do without.

 

Regards

[patientmanabc]

thanks daverules. i owe you. and all the other great answers - thanks

[estellyn]

to estellyn you wrote earlier:-

'As long as they're aware of his issues - if you're concerned that they might not be, a letter to the surgery detailing his current state of health both physical and mental could be written with a request to scan to his medical file due to his old doctor leaving and new doctor taking over.'

 

can you break this down? what is a 'request to scan to his medical file? ' do you mean write a 'report' and give it to the surgery, so that all this current info in on his medical file? Thanks

 

 

and to daverules:- would it be wiae to contact atos/maximus and ask about the timeline with them or is that not such a good idea.

 

thanks for all your help and to the others, lapsed etc

 

OK, firstly, it sounds as if your friend needs to see a doctor, but it also seems to me that maybe you're looking for a way he doesn't have to see a doctor - is he refusing or reluctant to go?

 

For a letter to the surgery, it is simply telling the new doctor what the current issues are - mental health, physical, alcoholism, and if he can't attend the surgery due to his mental health then this needs to be mentioned too. It could even be written by you with a signature of authorisation from your friend for you to write on his behalf. And yes, medical records are now stored digitally so any letters can be scanned to your friend's medical file.

 

But being frank with you, your friend needs to see a doctor for both mental health and alcoholism. I hope you can help him to do that.