A Having problems getting ESA85 Statement from recent WCA

[jason2723637]

no i think but could be wrong you can appeal but wont get paid pending appeal? (but im not sure this is the case you may still get paid if your ESA claim was originally made prior to 30 march 2015) ie have to go on JSA or is the new "six month" rule (which would prevent this) in effect maybe ring em and find out ? though in your case as your already got a worsening condition prob not worth it

[tommy456]

Yes but theoretically they would have to re claim for the same conditions and it be refused first before they could request a MR and then go onto appeal,again , not sure if it would involve a new WCA as well, without being paid wouldn't they ?

 

Which would be a long way around it, when if you think that the decision of the tribunal was wrong,and you are able to find an error in law , then as said prior you would seek leave to appeal to the UT , who would likely pass it back to a tribunal judge, who would exclude the doctor and judge from the previous hearing from future tribunal hearings for your case, and it would be re listed

 

The new rules from may 15 as far as I'm aware will also apply to claims, WCA 's MR's before that date , that's how vile IDS is

 

My WCA was in August 14, my first failed tribunal hearing was in Nov/Dec 14 which thanks to the DWP JC+ i could not attend due to being sanctioned , this was heard in my absence originally ,and refused,

 

i did manage to get that decision set aside as i had good reason for not attending , then in march iirc, tribunal awarded 9 points but appeal refused, this decision was also set aside due to an error in law , case re listed, then the next time In July 15 was adjourned for copies of the audio recording from WCA , and again in Sept 15 due to the playback equipment not having a seek or pause options, playback was stopped ,because i needed the toilet judge wanted to hear it all,

 

Then 1 further date was postponement due to CAB case worker not able to attend ,

had the panel at the march tribunal acted within the law ,

and done their job properly i would of scored the 15 points

or would of been able to reclaim for the same conditions ,

as more than 6 mths had elapsed since my WCA

[jason2723637]

yeh prob best to go for new claim for significant worsening condition one thing though its weird that you scored points (was it 6 less then 15?) in the appeal prior to the very last appeal where they scored you zero how do they do that then?

 

one thing "The new rules from may 15 as far as I'm aware will also apply to claims, WCA 's MR's before that date , that's how vile IDS is" I know IDs is vile but according to the new six month rues what does this mean -

 

" Note that the amended rules apply only where the claimant is now appealing against a WCA failure following a claim made on or after 30 March. So a claimant who claimed ESA before 30 March and appeals against a WCA failure on that claim can get ESA pending appeals under the old rules – ie, it does not matter if it was a second or subsequent WCA failure."

 

please note -" ... it does not matter if it was a second or subsequent WCA failure." What does this mean in context? I thought you can only have one WCA prior to a MR then appeal.

 

 

http://www.cpag.org.uk/content/esa-and-abolition-six-month-rule

[tommy456]

Yeah they gave a total of 9 points for all the conditions ,

But possibly the reason why only 9 points was because they decided to deliberately not give me the results there and then.

 

and then went on to do something very sneaky IMO ,

they observed me walk back to the rail stn some 80mtrs stopping once to wait for traffic ,

 

before making their decision ,

But because that meant that i wasn't given the opportunity to be questioned or explain and it was after the hearing ect,

that was deemed as an error in law,

I cannot help but think how many times have they done that unchallenged ?

 

They do that (give a different decision) because they from a official standpoint don't know what the decision was,nor does it count , and both judge and unlicensed dr were excluded from taking part in further proceedings,

 

IMO these tribunal Panels aren't as independent as some like to think

[worried33]

Hi tommy.

 

Sorry for your bad news.

 

The mistake you may have made is you simply concentrated on your diagnosis. Really you have to explain why you qualify for points. Mobility points are harder to get now because the DWP are encouraging decision makers to not reward points if they deem you able to mobilise with the use of aids.

 

In my case I have medical professionals advising me aids are unsuitable for a variety of reasons, the two main reasons been given where I live, it is not scooter,wheelchair suitable and in addition I was told a wheelchair would hinder my health further (I have been told I need to walk as much as possible to try and improve my condition). I made sure my WCA was recorded and verbally informed the ATOS HCP of my reason for exemption to make sure it was recorded.

 

This aid's situation is a huge grey area legally, because they seemingly are allowed to pretend people have aid's which they don't have which is clearly not fair, but those are the rules set out in the DWP guidelines.

 

There is also the option of qualifying for ESA by proving that denial of the benefit would further deteriorate your condition and in particular be dangerous to you and/or others.

 

Sadly you have to be quite versed in the legal side of this to state your case strongly, this I feel applies to both WCA's and appeal's. Turning up for WCA's assuming the HCP will be non biased and see things your way will often end with bad results.

 

Also remember tribunal members have a responsibility to be fair to both you and the taxpayer, they cannot award everyone points because they feel sorry for them, they have to make a decision based on the evidence in front of them on the day. So even if you feel they already have evidence from the WCA, its wise to repeat that on the day to make sure they aware, and of course they wil likely observe you when walking to make a judgement call based on that as well.

[tommy456]

Well they had more medical evidence at the tribunal than at the WCA ,

in part because i had/have zero faith whatsoever in the farce known as the WCA

 

there as far as i am concerned is on one outcome that being fit for work & zero points,

because that is what this government want at the end of the day

 

As far aids such as walking aids, i could not use a crutch or walking cane, due to a weakness in my right wrist due possibly to osteoarthritis which will be down to a previous serious injury to it , and i don't consider myself in need of a wheelchair again the wrist could be a problem with using a wheelchair, but for that to a reasonable option funding would be needed

 

Their rules are pure bs why have they been allowed to get away with this?

 

It's like the letter from my GP without knowing what exactly is needed information wise about my conditions to be of maximum benefit seems to be key, because a GP just explaining what your medical conditions are , and a brief description of how they affect you , isn't really enough,

 

they need to explain how far you can walk and the nature of the problems,

as well as their opinion regarding use the use of aids if they see them as appropriate or not ,

 

Part of the problem is that your GP will prescribe things like aids if they feel they would be of a benefit to you,

because , a GP has a duty to act in their patients best interests ,

where as the DWP ECT aren't interested in what is best for people at a WCA you are not regarded as a patient and they are not acting in the capacity of doctor or nurse ,

 

we are claimants they are interrogator who happens to have some degree of medical knowledge ,

or are ex GP's and nurses so the Hippocratic oath is out of the window,

 

It's like some of these ex Doctors at tribunals ,

who will try and argue about the qualification of the MCAS specialist who after examining me and my x-ray formed the opinion that i will need full knee replacement surgery in the future ,

 

and should i decide to go ahead with this ,

I will be referred directly to the orthopaedic surgeon ,

 

the ex doctor was trying to make light of it by saying that he was a physiotherapist ,

She i think was maybe a little behind the times with how the NHS works today, or a bit senile maybe

[Nystagmite]

Did you provide evidence in regards to the walking aids and why you can't use them?

[tommy456]

Nope , but i did give an explanation as you why , ie tried in past to use crutches but unable to , but my wrist wasn't listed on my WCA therefore couldn't be used for the tribunal just same with my foot OA (crutches were from A &E dept) when i dislocated my knee and fractured the patella

 

Regards to walking aids these i would imagine would be prescribed by my GP? because i don't have the funds to buy them ,

 

These assumptions /expectations are unreasonable , Like my knee condition , it is intermittent it will lock /feel like it is starting to dislocate it's totally random it can lock after only 3-4 paces other times after a longer distance ,or not at all,

 

so should fall in the reliably and repeatedly part of the up to 50mts ,

also the expectation that people should be using pain relief ,

 

why if i am not constantly in severe pain?

my pain threshold may be a lot higher than theirs,

i may not want my senses numbed or become dependant on pain relief ,

most of which has a limited benefit,

 

just because someone doesn't have prescribed pain relief doesn't mean they don't have problems ,

being prescribed pain relief doesn't mean that the patient uses it

[Nystagmite]

Those assumptions aren't, imo, unreasonable. Those of us with sensory impairments are expected to use other aids too.

 

Not all of us who take pain relief every day are in pain every day. I am given pain relief to prevent chronic pain.

[tommy456]

Well after scoring Zero points at my last appeal hearing , having now at last got the statement of reasons ect, reading through it i find that my suspicions are confirmed on how the out of touch and quite possible senile ex DR at the appeal arrived at their decision ,

 

They have totally failed to recognise the severity of my knee joint, in that they do not realise that the extended scope physiotherapist at the hospital is now the one that decides if someone's condition requires surgical intervention or not, they do this without the need to consult a surgeon ,

 

If i had elected to follow his advice then i would of been referred for the operation and seen a surgeon who would of explained all the risks and the procedure ect ect,

 

The idiot seems to think because i was not offered physio therapy that there's nothing wrong with me,

 

The damage has passed the stages that i would see any benefits from physio therapy and the steroid injections, now which part of that they didn't understand i don't for the life on me understand, surely this failure to grasp my conditions and how they affect me, is an error in law?

 

My new claim for esa has reached the stage of my 1st appointment for the WCA farce, but as i require a ground floor location, and want the interrogation audio recorded that will have to be re arranged, considering that my new claim only started in Dec 15 this is fast , IDS needs throttling

[Nystagmite]

surely this failure to grasp my conditions and how they affect me, is an error in law?

 

But do you meet the criteria of ESA and score 15 points? Because that's all that matters.

[tommy456]

Yes i believe that i do, and so does my GP,

But the state thinks it knows better, when it really knows nothing , They even said that if i thought my knee was serious enough that i would of elected Surgical intervention How dare those they, I didn't realise that by not having a total knee replacement you don't meet the criteria for ESA these days,

 

Even the tories and IDS haven't as yet changed the rules to make this the case,

this in part was how they came to their decision this has to be a error of law, certainly an error of fact ,

 

I always knew that the system all of it was corrupt and this proves it, they were not interested in my case and wanted to get my case over with so that they could go home, imo

 

Well my GP has the ESA WCA descriptors that are applicable to my conditions , and also the statement of reasons so he can see what i'm up against, and what info is required ,

 

My GP wasn't impressed or surprised by this as it isn't the first time a patient has lost their appeal ,and knows that they have an agenda so aren't as unbiased as some like to think they are,

 

hopefully my GP will get a more detailed report from the MCAS Dr who examined my knee and requested the upto date X-rays ,

maybe he will also explain how the NHS works in the year 2016 and also how it has been working for the past decade, for the benefit of who are paid as tribunal judges and so called HCP's Who are out of touch like the last tribunal panel that i had ,

 

My GP will also go into greater details regarding what was written by him in his letter to the tribunal ,

because they have also misinterpreted some of that as well , common sense was clearly out of the window that day

[honeybee13]

Hi Tommy.

 

I can see what Nystagmite is asking. Have you gone through the DWP descriptors to see which ones match your condition? You need to tell them why you can't work and how your knee and maybe other problems affect you. Without tailored answers, your appeal may not work.

 

Have you looked at the forum stikky for appeals and tribunals?

 

HB

[tommy456]

Yes re the descriptors mobilising cannot reliably or repeatedly mobilise (Walk) more than 50mts on level ground,

I also cannot descend stairs without a lot of pain and risk falling ( but they don't have a pigeon hole for that)

 

I also have a new condition of osteo arthritis in my right forefoot ( big toe joint ) this gives me pain which increases the longer i spend stood up or the more i mobilise (that wasn't part of the wca that i appealed) as it is more recent , the ibs continence descriptor, loose control at least once a month,

 

They didn't grasp why my GP has said that pads were not something that he would prescribe, as they are designed for use by people who are typically housebound who can't move much, not for someone who can, also using continence pads wouldn't be a long term solution,and would cause a lot of issues in a workplace environment , and i would still need to wash/shower and possibly change clothes ,

 

Use of walking aids, none because of the nature of my condition being random , and also my opposite wrist is too weak , it has never been the same after enduring commuted fracture,

 

The last panel where ignorant , It's like my GP put in his letter that i take a drug to control a condition, that shouldn't be taken at face value that it completely stops or controls the problem, But they even took that at face value, when the reality is the Drug does very little most of the time

 

Well this Maximus company are fast at getting everyone through the WCA ,

i had to arrange another appointment as the interrogation centre was on the 1st floor, lifts don't work in the event of a fire, and i don't do stairs ,

 

they gave me a new date on the phone,

but couldn't be sure if the recording equipment would be available at this other interrogation centre on the date give,

 

if i ain't heard by 2 days before i should ring them and check,

they still don't have enough recording equipment probably the same gear as ATOS used

 

I told them that getting to and from a place of work could/would be an issue due to the condition of my knee,

that will randomly lock/catch or actually be starting to dislocate , the thing is worn out ,

 

hence why the extended scope physiotherapist at the hospital formed the opinion that surgery was the only treatment that was appropriate,

as the others physiotherapy and injections into the joint wouldn't give any benefit ,

 

the NHS have used this MCAS for referrals for surgery for the past 10yrs according to my GP

GP's can't refer patients directly to orthopaedic surgeons any more,

something the senile old bat at the hearing didn't know

[jason2723637]

im no expert in the physical descriptors only have personal experience of ESA with regards to cognitive functions

(guess with cognitive it may be more complex and less clear cut than the physical descriptors).....

 

but just quick note you probably know this but like I said in other threads

any letter from your GP should be tailored to your descriptors ie not that you just have a health condition

but why your health condition prevents you from working...

 

... as you can see what IDS is upto...

.so give yourself the best chance ..

..makes you think how come appeals rate success is only 40 % its like there just flipping a coin!

- they have debate after debate in the house of commons that the WCA is not fit for purpose and should be scrapped! were still waiting.... good luck

 

NB - I guess your GP will state that you - " cannot reliably or repeatedly mobilise more than 50mts on level ground" or such in his own words?

 

oh yeh and ATOS's profit margin on the outsourced contract from DWP is supposedly 14% something to think about next time someone feels unjustly kicked off ESA

 

above post meant in the past tense now maximus has taken over wonder what there profit margin is/will be

[tommy456]

Well the CAB adviser who is dealing with my claim's Has looked over the statement of reasons from the last appeal and isn't happy with the way that they have come to their conclusion,

 

they seem to of lost the plot to some degree,

because some of it doesn't make any sense,

and he also feels that there is a possibility that there has been an error or errors of fact,

but has to let his supervisor go through it,

and if like the last time they may find other less obvious errors too

 

I hope it does go to the UT for another set aside ,

because i would be kidding myself if i thought the looming WCA for my new ESA claim will award any points

 

it's a foregone conclusion that it will be zero points and i'm considered to have the fitness of an athlete by some computer software and a so called HCP who is breaking the Hippocratic oath if a nurse or doctor, unless they have all had a frontal lobotomy by their masters @ ATOS / MAXIMUS

[Nystagmite]

Do you receive DLA mobility / PIP mobility for walking?

[tommy456]

Funny that you mention PIP because the CAB adviser suggested that i should apply some time ago as he thought there was a possibility that i met the minimum criteria for mobility side of things ,

 

i applied for PIP and ATOS

did what they do best give as many Zero points as they can ,

 

They don't say an lot in there decision papers

so that is going for a MR to see how exactly they arrived at their conclusion ,

which seems to be that because i was able to walk from the nearest railway stn to the consultation centre(that's a joke?) a distance of i think 300mtrs they claim it to be, i get no points,regardless of me having to stop several times and it taking longer than it would take to go from A to B,

 

On arriving they said they didn't have me on their system,

and asked if i had received a letter advising a rescheduled appointment which i obviously had not,

or did they think that i like wasting my money on train fares ?

 

then i was kept waiting for over 1hr before actually being seen,

the consultation was a joke in particular the method used by the so called nurse to examine my knee,

IMO the whole thing is corrupt

[tommy456]

After some deliberation i reluctantly decided that my previous claim for ESA was unlikely to ever succeed,

 

i started a new claim ,

Had the WCA farce and their report scored me a 0 no surprise what so ever

But the DWP decided to contact me before making their decision ,

 

after asking me a few questions and me explain things i was told that i would be awarded 6points, and my esa claim would be closed,

 

Yet again they were of the opinion that my knee problem did not meet the criteria of the mobilising descriptor,

Because they or their rules assume that i could use a wheelchair to propel myself for 200mtrs or more without becoming short of breath ,and something about a heart condition ,

 

And this is deemed to be reasonable ?

[jason2723637]

one query did you make a new claim as new condition or worsening curious as the March 2015 rules are new and wondering how people are coping....

[Nystagmite]

Did you ever send in evidence stating why you can't use a wheelchair or other mobility aids?

[jason2723637]

also no not reasonable at all how can they expect to disregard a heart condition or fatigue simultaneous to it not be mitigating with respect to their mobilising descriptor

 

Edited to add (as above) - did they disregard any evidence? if you had any to send?

[tommy456]

one query did you make a new claim as new condition or worsening curious as the March 2015 rules are new and wondering how people are coping....

Both new and a worsening of existing condition

 

Did you ever send in evidence stating why you can't use a wheelchair or other mobility aids?

 

Well the have had evidence some time ago regarding my back, but nothing from my GP so far about why i couldn't use a walking stick/crutch or wheelchair TBH the wheelchair hasn't really been considered as being a appropriate or reasonable option/solution

 

But i shall be looking into getting some evidence as i most probably have arthritis(or osteo arthritis) in my hands (finger joints) and in one wrist due to a commuted fracture several years ago, though these haven't been x-rayed so far because the wrist tends not to bother me until i put any kind of strain on it, Talking to my CAB adviser about this he says if my GP will provide something further that includes the wrist problem and details about my back i may well need another x-ray report on that , (partial slipped disc)lower back as the original is several years old ,

 

They rang i think because they weren't sure about something , But my knee problem and forefoot problem which are on opposite limbs even with medial evidence from the Extended scope physiotherapist at the hospital (Who GP's have to refer patients to for similar issues) as they can no longer refer patients directly to orthopaedic surgeons ,) Who says that in their opinion i required a full knee replacement because my knee is shot, this counts for nothing , IMO yes they ignored the evidence Proving that basic common-sense is lost with these people

 

Did you ever send in evidence stating why you can't use a wheelchair or other mobility aids?

 

Well the have had evidence some time ago regarding my back, but nothing from my GP so far about why i couldn't use a walking stick/crutch or wheelchair TBH the wheelchair hasn't really been considered as being a appropriate or reasonable option/solution

 

But i shall be looking into getting some evidence as i most probably have arthritis(or osteo arthritis) in my hands (finger joints) and in one wrist due to a commuted fracture several years ago, though these haven't been x-rayed so far because the wrist tends not to bother me until i put any kind of strain on it,

 

Talking to my CAB adviser about this he says if my GP will provide something further that includes the wrist problem and details about my back i may well need another x-ray report on that , (partial slipped disc)lower back as the original is several years old ,)

 

Then their arguments are basically floored , because you can't be expected to use a manual wheelchair with if doing so would cause you pain, and even better if you have a bad wrist , as you would be going round in circles,

(i'm used to that already)

 

I keep forgetting about this 10min time limit to edit my posts, even though the option to edit is still visible

 

also no not reasonable at all how can they expect to disregard a heart condition or fatigue simultaneous to it not be mitigating with respect to their mobilising descriptor

 

Edited to add (as above) - did they disregard any evidence? if you had any to send?

As said they did mention something about heart conditions , so probably this was a exception as well if it would leave you short of breath propelling yourself around

[jason2723637]

is it clear cut on making a claim for a worsening condition does it say "....worsening condition " on your fit/sick note? according to DWP they expect your worsening condition to be worse enough as to potentially score 15 points since your last WCA when you reclaim however I expect this is not taken literally although is that why you F2F WCA was sooner than expected you think ?

[tommy456]

GP just put an emphasis on the MCAS recommendation that RE total knee replacement instead of just the condition, and also some new conditions too

 

As for the audio recorded fascicle F2F being within 13wk time scale , Maybe i was targeted by them, or maybe it was just because they didn't have a backlog ,I did discuss this concern with my CAB case worker, but all could say is that they are supposed to be done within 13wks and was dismissive about them targeting me

 

One thing that i can't really get my head around is when asked about my one of my other issues IBS the frequency of accidents , over several different periods, over the past 12mth months i answered at least 20 times maybe more and at least once each month ,

 

that should give me 15points should it not? i was told they would award only 6points ??? seems like they make up the rules and regulations as they go along imo

Common-sense is something they never apply , imo all government agencies lack in basic common sense

 

2 things are certain in all this

 

1, I ain't going away

2,My medical conditions aren't likely to go away ,or improve significantly any time soon,

 

If i decide to claim JSA i am going to use their rules guidance against them as much as i possibly can , that will mean doing nothing that isn't mandatory, no giving them my E-mail login ,not using the job search web site to apply /seek work, not accepting the default 90mins travel time from home, in the Job seekers agreement , demanding that the work search be restricted and not using their electronic signature devices

 

Continued from above post (due to time restriction of 10 mins ) If they won't co operate I'll just use the 13wk extended period of sickness instead,because in a world that has and uses basic common sense, I and many like me would not have to claim JSA when we are actually unfit to work in order to survive untill a MR has been processed and in some cases someone's application to appeal has been received and processed/accepted &copy sent to DWP By the tribunals service