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8 years 7 months ago #141333 by abcd69
ESA Appeal was created by abcd69
I was on Incapacity Benefit since 1995, and DLA low care & high mobility since 1997. I had my ESA assessment in July, they awarded me 0 points, have done the MR and they didn't change the decision. Appeal papers now sent to the court/tribunal.

My issue is a physical disability, limited walking/standing etc due to an ankle injury which needed surgery in 1993. Last month I was told I have osteoarthritis in the ankle and knee, and possibly hip, the knee gives way approx 3 times per day. Been referred to physio for knee and hip, and referred to orthopedic surgeon for ankle.

I also suffered a broken collarbone in 2008, because my leg give way. This needed surgery, and been in pain since. Recently had more x-rays and been referred to another orthopedic surgeon as x-rays reveal scarring on shoulder. I now need to get an ultrasound next week on shoulder as surgeon suspects rotator cuff injury.

The ESA report says I am able to use a wheelchair and therefore score 0 points on Mobilizing. I also scored 0 points on standing/sitting as they say I live a "sedentary lifestyle". I spend most of my time at home, lying on the settee as its more comfortable for me than sitting normally. If I am sitting in a normal dining room chair I can only manage 15-20 mins as this makes my hip painful and uncomfortable. I then need to stand up and move away, usually to lay back on the settee again.

The ESA report also says that I declined examination, this is an outrageous lie. As it was the assessor that told me as I was clearly in that much pain and discomfort I did not need to do the examination, and that I would probably have trouble getting onto the bed.

What I'd like to know is, is my arthritis and shoulder injury enough to claim that I cannot use a wheelchair? If so any previous cases known that I can quote at appeal to help?
Also about standing/sitting, surely laying on a settee is different to sitting at a workstation? If so any previous cases known that I can quote at appeal to help?

I have a report from 1997 from my ankle surgeon stating my walking is limited to 25 metres. Is this evidence valid after so long or will it be refused?

Anything I can do about the lies in the ESA report?

I have sent my GP a letter asking for a copy of my medical records to help in my appeal.

I'm currently claiming JSA and DLA, I get a disability premium added to JSA so atm I get the same as I did before when claiming IB and DLA. If I was to get a sick note, and go onto ESA Assessment rate would I still get a disability premium?

Thanks

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8 years 7 months ago #141348 by Gordon
Replied by Gordon on topic ESA Appeal
abcd69

Welcome to the forum.

To try and answer your questions.

As you have identified the ESA test is of your mobility in addition to looking at your ability to walk with any aids that can be reasonably used, the test also considers your ability to self-propel a manual wheelchair over equivalent distances.

Your ability to walk or propel a wheelchair can be limited by significant discomfort or breathlessness, it is important to understand that this does not mean without pain.

Significant discomfort is not defined further in the legislation, the only thing I can say is that it is considered to be less than significant pain.

There are typically three reasons why a claimant would be unable to use a wheelchair; there are reasons why they cannot use one;

- there may be practical issues such as storage although this has been somewhat depreciated by recent UTT Decisions, or the claimant has received medical advice not to use one.

- the claimant suffers from angina, asthma or a similar condition which would reasonably be expected to be aggravated by their operating a wheelchair.

- or lastly, that they have a physical condition such as an injury or condition such as Arthritis effecting their hands or arms through to the Upper chest which would result in significant discomfort.

From your post the latter may apply, your issues are that the injury is old, you say you are in pain, but are you receiving pain treatment? Is the pain sufficient to be described as significant discomfort?

The Standing and Sitting test was amended at the beginning of 2013 to read Standing, Sitting or a combination of both, so if you move from one to another and even do this repeatedly the clock does not stop, so even though you can only sit in a chair for 15 minutes if you can then stand for 45 minutes, or could stand for 5 minutes and then sit for 15 minutes again, and so on then you will not score points.

You mention lying on a settee, certainly this would not be considered as Sitting although I do remember one ATOS assessor trying to argue that it still fell within the Descriptor, but that was some time ago, but do you do so because it is easier or more comfortable for you to do so, rather than having to do so because you cannot sit? Your earlier statement suggests the former at least in part.

The final aspect of the Standing and Sitting test is the claimant remaining at a workstation for the majority of the time, the key point here is that it is not all of the time, it is acceptable for the claimant to move around at the workstation. If you would need to walk away due to significant discomfort or exhaustion, then you need to explain in detail what this means and show that it would reasonably mean your leaving the vicinity of the workstation.

I would be careful of quoting UTT Decisions unless you fully understand the detail and implications of the Decision you are referencing, it is unusual for UTT Decisions to make black and white statements about what is or is not included in a Descriptor. You also need to check that the legislation has not been changed since the Decision was made potentially making the Decision redundant, that more recent Decisions do not make it obsolete or that their are not Decision that contradict the one that you are looking at.

The following page has summaries of the more important Decision related to ESA

www.disabilityalliance.org/how-we-can-he...nd-support-allowance

You can also search the TS database.

www.osscsc.gov.uk/Aspx/default.aspx

Gordon

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

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8 years 7 months ago #141355 by abcd69
Replied by abcd69 on topic ESA Appeal
Thanks for the reply.

I walk with a stick, usually stay at home most of the time, walk 6-7 metres at home before sitting down, and doing that the knee gives way approx 3 times per day. I take prescribed co-codamol tablets, and I buy Nurofen plus, take 8 of each per day. This doesnt remove the pain, just makes it more acceptable to me. Walking causes more pain and stiffness, which to me is significant discomfort, and does cause breathlessness. At the assessment centre I walked approx 40 metres taking 10 mins, stopping every 10 metres for a rest. When I got to reception I had to sit down, otherwise I would of collapsed.

Sitting and standing, sitting 15-20 mins causes pain, aches and stiffness in hip, foot to swell. I can only stand approx 2 mins as then my back starts to hurt. I wouldn't be able to go back to sitting, as the discomfort would remain, I'd need to lay down on settee for an hour to relieve the stiffness.

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8 years 7 months ago #141363 by Gordon
Replied by Gordon on topic ESA Appeal
abcd69

Your primary goal at the MR and if necessary at an appeal is to show that you meet the criteria, so you should explain the things you mention in your post to the DWP, you may have done this already on the ESA50 but you need to go through your form and evidence, the assessment report and our ESA Claim guides and make sure it is clear why you meet the Descriptors.

Gordon

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

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8 years 7 months ago #141366 by tedthered64
Replied by tedthered64 on topic ESA Appeal
My word! This is alarmingly similar to my ESA assessment. Can't help but think assessors are following some sort of agenda!

My assessor also stated that I declined an examination, which was a barefaced lie!

Best of luck with your appeal.

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8 years 7 months ago #141375 by abcd69
Replied by abcd69 on topic ESA Appeal
Already done MR, and thats been refused, 0 points again. They come back to the same thing, can use a wheelchair. Already sent appeal papers to the tribunal, I have appointment with welfare rights next week to go through the case with me. Hopefully they can shed some light on a few things. So at appeal, I guess I firstly need to argue that I cant reasonable use a wheelchair due to arthritis in ankle, knee and hip, which would worsen if I was to use a wheelchair as I need to remain as "active" as possible, and using a wheelchair would cause excess pain in my shoulder. Hopefully I'll have enough medical evidence to support the above when I get the medical records from GP. Hopefully I win that, then its a case of arguing how far I can walk, and sitting/standing.

I've heard about reg's 29 and 35, I think these would apply as I would be a substantial risk to hurting myself and others if I was to fall over. Also being a health and safety risk as I'm not allowed upstairs in the job centre, they wont allow me to use the lift, as its not in use in a fire, and I'd not be able to get downstairs. So I would assume this must also apply to the workplace?

I was thinking about asking for a wheelchair assessment, if they were to say I'm not suitable for a manual wheelchair then that should help in an appeal.

I'm sure they will mention I declined the examination at the appeal hearing, hopefully I can keep my cool as I hate liers. I'll be asking that any further assessments are recorded in future.

I'm also looking through your guides on PIP, as no doubt I'll have the DLA to PIP soon, got a letter in Jan/Feb saying it could be later this year or 2016. But as I have a failed ESA assessment I'd expect it to come sooner rather than later.

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