ESA Medicals & Support group

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  • phepiaphepia Posts: 1,475
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    Congrats on getting moved!
    Out of comple nosiness how did you find the tribunal and what descriptors did you argue for?

    Did dwp turn up? And on what grounds did they refuse to start with?
  • Bernard_Doyle1Bernard_Doyle1 Posts: 67
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    I was due to have a PIP medical assesment with ATOS in a couple of weeks. However I've now received a letter from them saying due to further information being received from the hospital I no longer have to attend an examination. They go on further to say they will imform DWP and I should hear from them in due course.

    So does this mean my claim has been successful or does it mean it has failed and they don't want to waste time seeing me.

    It's all very confusing and stressful.

    Anyone else had this type of letter and what did the DWP say?

    many thanks
  • Miss C. DeVilleMiss C. DeVille Posts: 6,042
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    I was due to have a PIP medical assesment with ATOS in a couple of weeks. However I've now received a letter from them saying due to further information being received from the hospital I no longer have to attend an examination. They go on further to say they will imform DWP and I should hear from them in due course.

    So does this mean my claim has been successful or does it mean it has failed and they don't want to waste time seeing me.

    It's all very confusing and stressful.

    Anyone else had this type of letter and what did the DWP say?

    many thanks

    It sounds to me like you've been successful, otherwise they would still want to see you. If you had failed I would have thought they would have told you in the letter explaining why.
    Sounds like you've had a good result. :)
  • JasonJason Posts: 76,557
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    Won my appeal today. Yay :). That's played 2, won 2. I don't doubt they'll have me back sooner rather than later.
  • LakieLadyLakieLady Posts: 19,722
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    Well done Jason!
  • JasonJason Posts: 76,557
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    LakieLady wrote: »
    Well done Jason!

    Thankyou :)

    Getting the full written report sometime next week so i'll get a better idea of when i'll invariably be summoned again.
  • Miss C. DeVilleMiss C. DeVille Posts: 6,042
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    Happy for you Jason. Glad it was good news.
  • LuckyyemLuckyyem Posts: 598
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    Hi all! I am just going through the process of applying for PIP, I have been placed in the ESA support group. My question is, with the PIP paperwork I've heard you complete it as if it is you on a bad day, is this correct? If so I'm concerned because on my worst days I am bed bound, I even need help to get up to use the toilet but on a day to day basis with medication I can function.
    Thanks in advance
  • JasonJason Posts: 76,557
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    Happy for you Jason. Glad it was good news.

    Thankyou M'Lady :) *doffs virtual cap*
  • TelevisionUserTelevisionUser Posts: 41,416
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    Luckyyem wrote: »
    Hi all! I am just going through the process of applying for PIP, I have been placed in the ESA support group. My question is, with the PIP paperwork I've heard you complete it as if it is you on a bad day, is this correct? If so I'm concerned because on my worst days I am bed bound, I even need help to get up to use the toilet but on a day to day basis with medication I can function.
    Thanks in advance

    You'll read various advice about this aspect from stating what is an average day to stating what is a standard bad day is to saying that the absolute worst day should be used as the example. Careful judgement has to be applied here because it is potentially risky to go down the route of misrepresentation. For what it's worth, my advice would to perhaps rule out the last of those three options I mentioned and look at your case again and make sure that it is defensible (you should be able to get help from the Citizens Advice Bureau or similar when it comes to getting help with filling out forms). I hope that helps.
  • LuckyyemLuckyyem Posts: 598
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    You'll read various advice about this aspect from stating what is an average day to stating what is a standard bad day is to saying that the absolute worst day should be used as the example. Careful judgement has to be applied here because it is potentially risky to go down the route of misrepresentation. For what it's worth, my advice would to perhaps rule out the last of those three options I mentioned and look at your case again and make sure that it is defensible (you should be able to get help from the Citizens Advice Bureau or similar when it comes to getting help with filling out forms). I hope that helps.

    Thank you for the reply. I'm going to get a benefits person from our local council to go through it with me. It's so confusing!
  • TelevisionUserTelevisionUser Posts: 41,416
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    Luckyyem wrote: »
    Thank you for the reply. I'm going to get a benefits person from our local council to go through it with me. It's so confusing!

    I don't know if this is going to help but some charities produce PIP guides and a couple of links are provided below, one in respect of physical health and one in respect of mental health:

    http://www.actionforme.org.uk/Resources/Action%20for%20ME/Documents/pip-filling-in-the-form-copier.pdf

    http://www.rethink.org/resources/p/personal-independence-payment-pip
  • LuckyyemLuckyyem Posts: 598
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    I don't know if this is going to help but some charities produce PIP guides and a couple of links are provided below, one in respect of physical health and one in respect of mental health:

    http://www.actionforme.org.uk/Resources/Action%20for%20ME/Documents/pip-filling-in-the-form-copier.pdf

    http://www.rethink.org/resources/p/personal-independence-payment-pip

    Thank you, will have a look through.
  • LakieLadyLakieLady Posts: 19,722
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    Luckyyem wrote: »
    Hi all! I am just going through the process of applying for PIP, I have been placed in the ESA support group. My question is, with the PIP paperwork I've heard you complete it as if it is you on a bad day, is this correct? If so I'm concerned because on my worst days I am bed bound, I even need help to get up to use the toilet but on a day to day basis with medication I can function.
    Thanks in advance

    No, you've been misinformed. The "worst day" principle applied to DLA, PIP's predecessor.

    PIP is much less subjective than DLA. There is a list of criteria, called "descriptors", and different levels of ability/disability attract a certain number of points. For points to be awarded, that descriptor must apply for the majority of the time. You'd be well advised to have a look at them before you go and see the benefit adviser, so that you have an idea of which are likely to apply.

    Bear in mind that if you can't do something safely, reliably, repeatedly and in a reasonable amount of time, it counts as not being able to do it.

    Supporting evidence is important, gather all the documents you can: doctor's letters, test results, a "significant medical history" extract from the records held by your GP.

    On the plus side, in my experience people in the support group are generally entitled to a PIP award: if you're too ill for work-related activity, you are likely to have care or mobility needs. Bear in mind that they will also look at your ESA medical questionnaire when they decide on your PIP application.

    Definitely see a benefits adviser, they'll have done so many of these they'll know what works and what doesn't.

    Good luck!
  • LuckyyemLuckyyem Posts: 598
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    LakieLady wrote: »
    No, you've been misinformed. The "worst day" principle applied to DLA, PIP's predecessor.

    PIP is much less subjective than DLA. There is a list of criteria, called "descriptors", and different levels of ability/disability attract a certain number of points. For points to be awarded, that descriptor must apply for the majority of the time. You'd be well advised to have a look at them before you go and see the benefit adviser, so that you have an idea of which are likely to apply.

    Bear in mind that if you can't do something safely, reliably, repeatedly and in a reasonable amount of time, it counts as not being able to do it.

    Supporting evidence is important, gather all the documents you can: doctor's letters, test results, a "significant medical history" extract from the records held by your GP.

    On the plus side, in my experience people in the support group are generally entitled to a PIP award: if you're too ill for work-related activity, you are likely to have care or mobility needs. Bear in mind that they will also look at your ESA medical questionnaire when they decide on your PIP application.

    Definitely see a benefits adviser, they'll have done so many of these they'll know what works and what doesn't.

    Good luck!

    Thank you for the reply, I have an appointment early next week for someone to go through it with me.
  • SuperAPJSuperAPJ Posts: 10,402
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    Thanks for all the useful posts in this thread. After previously scoring zero points at my ATOS assessment, I won my appeal today and have been placed in the Support Group.

    I certainly couldn't succeeded without the help of the local CAB in preparing my appeal.

    Having previously read a few horror stories elsewhere, I was relieved how pleasant the Judge and doctor were and how laidback the whole experience was...although I still was thinking "I haven't said enough. The appeal will be turned down." whilst waiting for the panel to reach their decision.
  • Bernard_Doyle1Bernard_Doyle1 Posts: 67
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    I'm really upset and angry. Got a letter from the DWP today informing me that they are cutting my PIP payment to £21.80 per week. I was getting just over £75 per week. I've not had a medical assessment.

    I did receive a letter saying I needed an assessment but then a few weeks later I received another letter informing me that they had all the necessary information required and I would no longer have to attend the assessment and that the DWP would be in touch in due course.

    Well that letter came today. I'm so confused and upset. Why are they doing this and what can I do. I can't manage on that amount.

    feel like giving up on everything.
  • TelevisionUserTelevisionUser Posts: 41,416
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    I'm really upset and angry. Got a letter from the DWP today informing me that they are cutting my PIP payment to £21.80 per week. I was getting just over £75 per week. I've not had a medical assessment.

    I did receive a letter saying I needed an assessment but then a few weeks later I received another letter informing me that they had all the necessary information required and I would no longer have to attend the assessment and that the DWP would be in touch in due course.

    Well that letter came today. I'm so confused and upset. Why are they doing this and what can I do. I can't manage on that amount.

    feel like giving up on everything.

    Presumably on your decision notification letter, the option of an appeal is mentioned? I provided links to some PIP related documents issued by a couple of charities six posts above and they might be worth reading but if you wish to appeal this decision then I definitely recommend getting the help of an advisor from any one of the nearest Citizens Advice Bureau (plug in your postcode here https://www.citizensadvice.org.uk/about-us/how-we-provide-advice/advice/), local council benefits advice section or community law centre. Good luck! :)
  • LakieLadyLakieLady Posts: 19,722
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    SuperAPJ wrote: »
    Thanks for all the useful posts in this thread. After previously scoring zero points at my ATOS assessment, I won my appeal today and have been placed in the Support Group.

    I certainly couldn't succeeded without the help of the local CAB in preparing my appeal.

    Having previously read a few horror stories elsewhere, I was relieved how pleasant the Judge and doctor were and how laidback the whole experience was...although I still was thinking "I haven't said enough. The appeal will be turned down." whilst waiting for the panel to reach their decision.

    Well done. Always nice to hear of a good outcome.

    It never ceases to amaze me how many people get a nil points outcome and are subsequently placed in the support group.
  • LakieLadyLakieLady Posts: 19,722
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    I'm really upset and angry. Got a letter from the DWP today informing me that they are cutting my PIP payment to £21.80 per week. I was getting just over £75 per week. I've not had a medical assessment.

    I did receive a letter saying I needed an assessment but then a few weeks later I received another letter informing me that they had all the necessary information required and I would no longer have to attend the assessment and that the DWP would be in touch in due course.

    Well that letter came today. I'm so confused and upset. Why are they doing this and what can I do. I can't manage on that amount.

    feel like giving up on everything.

    Appeal it. Make an appt with a CAB or other local advice agency.

    Go through the letter and the descriptors (they are easy to find online) and see where you think you should have been awarded points but were awarded zero.

    From the amounts you quote, I'm guessing you've lost your daily living component completely. If you've only missed out by a couple of points, your chances of success are excellent.

    Bear in mind that they cross-reference your PIP form with the ESA questionnaires, so if they've used info from your ESA50 it may have been out of date, or different because the questions are different and they've drawn inferences that are incorrect.

    You have to submit a mandatory reconsideration within a month of the date of their letter: if you can't get an appointment before then, just write them a letter, making it clear you are asking for a mandatory reconsideration, and telling them what you think you should have been awarded points for and why.


    Are you not getting any other benefits apart from PIP, eg ESA? Unless you live with a partner who is working, you should be entitled to something.
  • nomad2kingnomad2king Posts: 8,415
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    LakieLady wrote: »
    Well done. Always nice to hear of a good outcome.

    It never ceases to amaze me how many people get a nil points outcome and are subsequently placed in the support group.
    Regulation 29.
    Exceptional circumstances
    29.—(1) A claimant who does not have limited capability for work as determined in accordance
    with the limited capability for work assessment is to be treated as having limited capability for
    work if paragraph (2) applies to the claimant.
    (2) This paragraph applies if—
    (a) the claimant is suffering from a life threatening disease in relation to which—
    (i) there is medical evidence that the disease is uncontrollable, or uncontrolled, by a
    recognised therapeutic procedure; and
    (ii) in the case of a disease that is uncontrolled, there is a reasonable cause for it not to be
    controlled by a recognised therapeutic procedure; or
    (b) the claimant suffers from some specific disease or bodily or mental disablement and, by
    reasons of such disease or disablement, there would be a substantial risk to the mental or
    physical health of any person if the claimant were found not to have limited capability for
    work.
  • [Deleted User][Deleted User] Posts: 40
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    Hi everyone :)

    My brother in law is currently on indefinite DLA, middle rate care and higher rate mobility. He’s not being assessed for PIP yet but I’d just like to get everything in order for when the time comes, because I can be a bit of a panicker :D

    He has neurofibromatosis and down syndrome, as well as scoliosis. He has a neurofibroma on his hip and that combined with the scoliosis makes walking very painful for him, and impossible depending on the situation (eg he can’t use stairs at all). He also has a neurofibroma on his vocal chords which means he can’t speak. Due to his learning difficulties he can’t read or write (and he couldn’t really hold a pen if he could, he has a very limited range of movement in his fingers), so he needs constant care.

    At the moment we only have a short letter from his doctor from a previous assessment (not sure what it was for, was a few years ago) saying that his condition will never improve and that he’s incapable of working. We’re going to get a full medical report from his GP and I’m hoping that with that the switch over to PIP should be fairly straightforward, I can’t really see much they could argue over but it’s better to be prepared, so is there anything else that could possibly help?
  • LakieLadyLakieLady Posts: 19,722
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    If he's under the care of a specialist for his NFM or scoliosis, copies of any letters from them to the GP could be helpful, as will any sort of professional assessment, care plan, occupational therapy assessment and so on. Statements from those involved in his care can be helpful too.

    I'd still get advice from a benefit specialist, either from CAB or from one of the specialist charities (Mencap or similar) to complete the form.

    Hopefully, he won't have to go to an assessment. I'm curious as to how they'd assess someone who can't speak and can't write.

    The DWP give plenty of warning of the change before they even send out the forms, so no need to panic yet.
  • pinkprintpinkprint Posts: 536
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    i have another issue with the ESA wrag group :(

    yesterday i had an appointment with my adviser at 4pm. i had chronic anxiety in the morning, and a migraine which i can get in the heat sometimes.
    i called up the work programme provider at midday to ask to rearrange the appointment as i was not well. i spoke to my adviser and he said : ''hang on let me check if it was a mandatory appointment or not (silence for a few seconds), yes its mandatory, you will get a letter from the job centre, make sure you write on the back of it what was wrong with you and get a doctors note''

    i found this strange as i called in sick once before and never got told this. and i only asked to rearrange the appointment, and i actually called in, its not like i did not turn up, why will i be getting a letter from DWP ?! im confused now, and im also confused by this 'mandatory' thing hes talking about, i always assumed i had to go to the appointments anyway. i only have the appointment written down with a signature on a flimsy piece of paper he gave me.

    will i be sanctioned?

    this WRAG group is making me worse. i am doing everything they ask, i even am going to there 6 week anxiety workshop starting next week.
    this pressure is just getting too much for me now. its all i think about morning and night.
  • LakieLadyLakieLady Posts: 19,722
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    I'd write to them anyway, enclosing a medical certificate if you can get one, explaining that had good cause for not attending, ie a migraine, which was triggered by the heat and by your anxiety.

    Also make sure that you tell them that you rang to try and rebook, but that the adviser wouldn't make you another appointment, so they know you didn't just fail to attend. In theory, they could suspend your ESA until you attend the appointment, but as you have "good cause" they really shouldn't.

    ESA really ought to be relaxed about people missing appointments because of illness. After all, it's a benefit for people who are in poor health, so it's pretty damn likely to happen.
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