ESA Support Group Criteria

Hello, I wrote before about being in the support group and that I'd requested the piece of paper with the detail. Someone asked if I would post again with the information which is about stress causing further problems.

The form I have is ESA85A called ESA Medical Report Form. It says "I advise that the client meets support group criteria as they are suffering 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 they were found not to have limited capability for work-related activity.

I advise that work could be considered within 18 months.
Evidence considered: The Med 3, 113 and consultant letter, and report from 2010, 2007, 2008, 2014. The medical evidence indicates there would be substantial mental or physical risk if the client were found capable of work or work-related activity because the client is diagnosed with a mental health problem. Referred to Recovery Team and allocated a care co-ordinator.
Recently commenced anti psychotic for high anxiety levels. Vulnerable to deterioration with additional stressors. The available evidence suggests review in the medium term.


So I hope that provides information about the 'vulnerable to stress' part.

The things which are interesting to me is that this medical was firstly for PIP. Also I thought I saw that each ESA application starts from there, not according to this report which seems to have looked at evidence from several years back (when I claimed incapacity benefit)

A lot seems to depend of me being supported by the mental health team (I enclosed care plans) and I also have quite a severe physical health problems which can require hospitalisation / operation if it flares up. But there isn't any mention of that just the mental health. They were talking about me being supported by the GP again at some point (as we have a GP specialising in psychiatry) but I am unsure, if this makes it seems as if I've just, recovered. they have said this would be on the proviso that if I needed, I'd be able to go straight back into the recovery service or crisis team.

Orangeblossom wrote: Hello, I wrote before about being in the support group and that I'd requested the piece of paper with the detail. Someone asked if I would post again with the information which is about stress causing further problems.

The form I have is ESA85A called ESA Medical Report Form. It says "I advise that the client meets support group criteria as they are suffering 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 they were found not to have limited capability for work-related activity.

I advise that work could be considered within 18 months.
Evidence considered: The Med 3, 113 and consultant letter, and report from 2010, 2007, 2008, 2014. The medical evidence indicates there would be substantial mental or physical risk if the client were found capable of work or work-related activity because the client is diagnosed with a mental health problem. Referred to Recovery Team and allocated a care co-ordinator.
Recently commenced anti psychotic for high anxiety levels. Vulnerable to deterioration with additional stressors. The available evidence suggests review in the medium term.


So I hope that provides information about the 'vulnerable to stress' part.

The things which are interesting to me is that this medical was firstly for PIP. Also I thought I saw that each ESA application starts from there, not according to this report which seems to have looked at evidence from several years back (when I claimed incapacity benefit)

A lot seems to depend of me being supported by the mental health team (I enclosed care plans) and I also have quite a severe physical health problems which can require hospitalisation / operation if it flares up. But there isn't any mention of that just the mental health. They were talking about me being supported by the GP again at some point (as we have a GP specialising in psychiatry) but I am unsure, if this makes it seems as if I've just, recovered. they have said this would be on the proviso that if I needed, I'd be able to go straight back into the recovery service or crisis team.

Hi Ob,

Thanks for returning with your response.

I think that you are referring to your topic : Here.

"The form I have is ESA85A called ESA Medical Report Form"

Yes, this is an ESA Medical Report that is compiled by an ATOS HCP, if they feel that they can make recommendations on a WRAG or Support Group (SG) award on paper evidence alone, without the need for a "Medical".

See : ESA medical – what forms to ask for?

"It says "I advise that the client meets support group criteria as they are suffering 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 they were found not to have limited capability for work-related activity."

This means that you have been placed into The SG under The Exceptional Circumstances Rules under : ESA Reg 35 for entry to The SG (LCWRA)

Rather than under one or more of : The SG (LCWRA)Schedule 3 Functional Descriptors

"I advise that work could be considered within 18 months."

This is the recommended period before you should be reassessed. (The Prognosis)

With an 18 months prognosis, one would normally expect to start the reassessment process a couple of months before the end of the 18 months period. (i.e. Some 16 months after the SG award)

"Evidence considered: The Med 3, 113 and consultant letter, and report from 2010, 2007, 2008, 2014."

Med 3 = A sick note/fit note issued by one's G.P.

113 = An : ESA 113 Questionnaire which would have been sent to your G.P. to fill in and return.

"and report from 2010, 2007, 2008, 2014" = It looks like they have referred to previous Medical Reports here.

However, we always advise members not to rely on ATOS having access to any historical evidence, as there is no guarantee that they will have.

Even if they have, you will be assessed on how you are at the time of the assessment that you are currently undergoing.

It is not clear whether or not you have recently undergone a successful PIP assessment, but we are aware that The DWP are using PIP Medical Reports to help make decisions on ESA, and vice-versa.

bro58

:woohoo:Hi OB

Many thanks for coming back to the forum re: stressors etc., and specific wording they used on 85A. I think it was myself that asked if you might be able to enlighten us.

Am very grateful, but most of all am so pleased for you that you got the correct result which you deserved!

P

That's Ok, and thank you for further info Bro. So the GP was asked to fill in a form, I didn't realise that. I know they did one for me years ago (suppose that was the original Med 3 for incapacity benefit).

yes, I have the PIP enanced rate care (no mobiliy) for 3 ears. Based on the same assessment. She was a very nice lady, from Atos who did a home visit.

I thought Atos were meant to be bad, now am feeling a bit scared about this new maximus lot. Even though looks likewon't have another for a while.

Orangeblossom wrote: That's Ok, and thank you for further info Bro. So the GP was asked to fill in a form, I didn't realise that. I know they did one for me years ago (suppose that was the original Med 3 for incapacity benefit).

yes, I have the PIP enanced rate care (no mobiliy) for 3 ears. Based on the same assessment. She was a very nice lady, from Atos who did a home visit.

I thought Atos were meant to be bad, now am feeling a bit scared about this new maximus lot. Even though looks likewon't have another for a while.

Hi Ob,

"Maximus believe things will improve from the very start of the contract in March"

As seen in : Today's News Article.

It is likely that ATOS HCP's will be taken over to Maximus en masse.

It is pot luck with respect to how "good" the assessing HCP will be.

The best that we can do is be prepared as much as we can for each eventuality.

You only tend to see "bad" experiences on the Net and in Newspapers, the vast majority of ESA claimants have positive experiences.

bro58

That's true. She actually seemed to want to help me, for example first asking if i could do an activity, then going on to ask what trouble I'd have with it or changes I'd need to make to do it. At the end she said she could see it was a very genuine claim, I had plently of evidence and she would try and ake sure i had a long term award, as the anxiety may improve but the other condition, unfortunately is incurable and will not.

yes hopefully they will keep these trained nurses and not re-train them in a scary American manner