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ESA claim - Mandat Recon unsuccesful

  • TeumessianFox
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9 years 1 month ago - 9 years 1 month ago #132219 by TeumessianFox
ESA claim - Mandat Recon unsuccesful was created by TeumessianFox
Hello,

I had my WCA in February. As is not unusual it was a slightly rushed assessment (they were running an hour behind due to staff shortage) and I was rushed on a couple of occasions. I was also asked a number of closed questions, and leading questions, and was not given time to process questions and structure my thoughts - a problem due to my dyspraxia. In short, not suitable at all and a farce. There were also errors of fact made in the report. Most notably thiat "(I) m not on medication for (my) mental health". This is not true. I take the same medication for my epilepsy as I do the bipolar. It manages both conditions. This was explained clearly in the WCA (which was then used by the DM in judging that the decision would not result in a significant deterioration in my health). I believe these errors of fact therefore cast doubt on how effectively I was observed and listened to in the assessment.

I was awarded 6 points - this was for monthly seizures. I was giving no points for the mental descriptors despite having bipolar disorder and dyspraxia/possible Autism Spectrum Disorder (the Autism Spectrum Disorder was diagnosed two weeks after my WCA).

I should mention that I did not name the autism on my ESA50 (as it was not diagnosed), though I did make it known I was waiting assessment for autism in the WCA. Unfortuantely I wasn't given the opportunity to discuss how the (then possible) autism affects me in the WCA. I as not even able to go into detail about the dyspraxia (which was diagnosed). The assessor only asking closed questions such as "did you attend a normal school" and "did you complete your degree" - none of which give any information regarding how I actually COPED in education.

The Mandatory Recon was denied. Unfortunately I was not able to get my autism report to them in time so could provide no additional evidence beyond a vague GP letter stating my condition had deteriorated since the decision to find me not to have LCW.

I firmly believe I meet at least three descriptors (6 points each for change in routine, getting about, and seizures/impaired consciousness. Possibly social engagement and inapp behaviour too). I also believe I qualify under speecial rules, as my condition has worsened as a result of being found to not have LCW (suicidal thoughts increased, anxiety regarding engaging with JSA appointments - already I've been too unwell to attend three appointments) and I misuse painkillers and have relapsed since the decision. I am therefore looking to appeal.

However, what sort of position am I in regarding the autism as it's a new diagnosis since the WCA. The decision maker suggested in my Mandat recon notice that I make a new claim if I wanted the autism to be considered as it is a "new condition". It is not a new condition. I've had it since birth and was therefore affected by it during the WCA. But I'm concerned that as I still mentioned the possibility of a diagnosis, but didn't talk about the difficulties I face, this will work against me. I therefore hope the tribunal will take the difficulties associated with autism into account.

Also, I don't receive regualar support from mental health services despite my diagnosis of bipolar. I've found mental health services to be very poor and they have only misdiagnosed me in the past. Most recently I had an assessment with a CPN and psychiatrist, but they were confused as to why I was referred to them and not talking therapies as theyfound me high functioning. It remains that I am incapacitated by periods of depression and having increasingly storng suicidal thoughts, not to mention the Nurofen abuse. But my GP, and local mental services, provide little to no support. I do see a counsellor through a drug addiction charity to support me with the Nurofen and personal difficulties. In short, this has left me with limited medical evidence for my mental health.

If anyone can provide any feedback it would be greatly appreciated Thank you.
Last edit: 9 years 1 month ago by . Reason: tick.

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9 years 1 month ago #132234 by Gordon
Replied by Gordon on topic ESA claim - Mandat Recon unsuccesful
TeumessianFox

Welcome to the forum, you might want to have a look at the following FAQ which explain where everything is

Welcome to Benefits and Work

The National Autistic Society describe Autism as a lifelong development disability, so there is no reason to believe that your daily living activities would not have been affected by this condition at the time that you were assessed, providing that you receive a diagnosis I can see no reason why the Tribunal would not take account of it at appeal.

However a diagnosis, whilst important, will not in itself get you the points you require for an award!

Have you requested a copy of the assessment report, if not contact the DWP office that dealt with your claim and ask for a copy of the ESA85 to be sent to you, if you phone we recommend that you follow it up in writing.

With regard an appeal, have a look at our ESA MR & Appeal guide which has links to the forms that you need in order to make an appeal, once the appeal is accepted by the Tribunal Service they will notify the DWP and you should be entitled to payment of the Assessment rate.

www.benefitsandwork.co.uk/help-for-claimants/esa1

You might also want to have a look at the following fact sheets.

Disability Rights UK Factsheet - Appeals and reconsiderations

Preparing for a Tribunal

Good practice for those appealing

MOJ Video of ESA Appeals Process and Tribunal

Your aim in the appeal is to show that you meet the criteria for an award, so I would also have a look at our ESA Claim guides to make sure that you fully understand the criteria against which you are being assessed and how the DWP view these.

If you have more questions then please reply to this topic and we will do our best to help.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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  • TeumessianFox
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9 years 1 month ago #132246 by TeumessianFox
Replied by TeumessianFox on topic ESA claim - Mandat Recon unsuccesful
Thanks for the reply.

I did request a copy of my ESA85 prior to making the mandatory recon. This is how I realised there are errors of fact in the report (incorrectly stating that I am not on medication for my mental health, incorrectly stating that I go to shops alone - I don't during periods of depression and anxiety which have typically been 50 - 70% of days over the last six months, and incorrectly stating my last hypomanic episode was five years ago). I also clearly explained that I haven't managed taking one of my medications well, but this was not mentioned in the ESA85. Instead the assessor stated that I "manage (my) medication effectively". Completely wrong. Unfortunately I did not record my WCA, so it's my word against the assessor.

Now this information has been used by the decision makers. The second decision maker still insisting that I use public transport alone, and self-care effectively including managing my own medication. This isn't true on at least half of days.

One thing that particularly frustrates me is the DWP's insistence that as I trained with Samaritans showing little disability, and do one shift there a fortnight, this is a strong reason why I don't have limited capability for work. I fail to see how doing a small amount of voluntary work, on days I'm well, demonstrates I don't meet the descriptors I feel I do meet.

It's just been suggested by someone on another forum that I haven't helped myself by mentioning in the WCA that I was awaiting an autism assessment, but then not mentioning my difficulties in my WCA even if I didn't have the official diagnosis at the time. After all, I still had the diagnosis of dyspraxia and both conditions overlap. It's just I struggled in the WCA due to communication difficulties and tiredness, and it was a little rushed and questioning inappropriate.

I attended the WCA and did not ask for adjustments, such as the use of a word processor to structure my answers, which I now realise was a mistake.

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9 years 1 month ago #132255 by Gordon
Replied by Gordon on topic ESA claim - Mandat Recon unsuccesful
TeumessianFox

If you are saying that you did not include all of the issues that you have with your daily activities on the ESA50 the it would obviously not be possible for the DWP to take them into account when coming to a Decision, you can now present these problems as part of an appeal, but I would expect you to have to explain why they were not originally included, I suspect that an argument that you were waiting for a diagnosis will not be accepted, as a Tribunal panel likely take the view that you either have the problems or not, a diagnosis merely identifies the cause.

However, if you are saying that you included the problems but did not attribute them to your having Autism, then this would be a different matter. This is where a diagnosis is important as it adds credibility to the problems you have and often the severity of them.

Unless you can show that the assessment was managed inappropriately, the panel may expect a complaint to have been lodged with the Assessment Provider, you are probably wasting your time raising issues in regard to how it was carried out, whilst the panel may have some sympathy, you will only receive an award by showing that you meet the criteria for one.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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  • TeumessianFox
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9 years 1 month ago #132259 by TeumessianFox
Replied by TeumessianFox on topic ESA claim - Mandat Recon unsuccesful
Thanks again Gordon.

I included some, if not all, on my ESA50. Though how well I completed the ESA50 is another matter. It's just the Decision Maker (and assessor) argue that I don't have difficulties with a change in routine because I do a regular Samaritans shift (not true, and fail to see how this shows I don't cope well with a change in routine as a Sams shift is something expected and does not change). Similarly I can't have difficulties dealing with other people because I'm a Samaritan (which is people facing). They don't accept that I still find this very draining, and with additional social expectations and stress I'm even unable to do a Sams shift.

As for not attributing problems to the autism as fully as I could have. My argument is that while I'm high functioning and have good insight, this is largely more relevant to my mental health as I can remember a time when I didn't have the bipolar, so can compare. I've always had the autism/dyspraxia, so to me the difficulties I face are not difficulties, but just me being me. Some I'm not aware of, others I just accepted as "part of me", so hopefully the diagnosis does give credibility.

I didn't lodge a complaint as I suspected I would be wasting my time. I'm fairly confident of demonstrating in a tribunal why I meet certain descriptors. I just hope they don't use the innaccurate/false aspects of my medical report against me. I'll try and get as much evidence as possible to counter this , but I'm not sure if this will be enough. We'll see.

Thanks again.

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