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ESA medical turned down help on what to do next

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8 years 1 month ago #153119 by cazz55
Hello im new to the forum and website and looking for help im cazza and im a 60 .
In Jan 2014 I had a heart attack after tests and being in hospical for a week I was diagnosed with heart failure and a leaking left ventricle .I was in part time employment cleaning at the local pub/b&b. I was payed Statutory Sick Pay from my employer for 28 weeks then I claimed ESA.
My GP signs me off for 6 months at a time with a sicknote . My GP and heart specialist at the hospical have both said they do not want me to work again.
In feb 2016 I had my esa medical assessment were I was asked all the normal questions then the last 10 mins I was asked about another medical matter, in 2015 I had a frozen shoulder I had to have 1 injection ,its around 75% better now my esa claim started before I had this problem and has not been put on any of my sicknotes only on my file at the doctors.
Yesterday 07/03/2016 I had a phone call from someone from ESA telling me that I have failed the medical assessment because of not having the right number of points , she also said my frozen shoulder is getting better and I can walk even tho my GP has told me to try and walk each day to help with my heart and lungs . She then directed my call to the local job centre to make a appointment to start a claim for JSA .
Today 08/03/2016 Ive just got back from making a claim for JSA the jobcentre the advisor wasn’t very helpfully , but totally agreed that im not fit for work (ticking timebomb) She put on file I will be looking for part time work 16 hours
As from next monday I have to travel 18 miles each way on the bus to sign on every day for 4 weeks , every day I am drained out of breath and not well due to the tablets I need to take to say alive. I take water pills to remove water from my heart and need to use the tolet upto 5 times a hour.
Ive booked in with my GP but my appointment is not until 18/03/16
Where do I go from here ? as I want to appeal
Thanks for your time

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8 years 1 month ago - 8 years 1 month ago #153131 by Gordon
Cazz

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

ESA has very specific criteria that a claimant needs to meet in order to receive an award, it's easy to miss this just from the EAS50 claim form.

The first stage to challenging a Decision is for you to request a Mandatory Reconsideration, this needs to be done in writing to the DWP, within one month of the Decision, to the office that dealt with your claim, have a look at our ESA MR & Appeal guide for details of the process and template letters that you can use to make the request with.

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

You should contact the DWP for a copy of the assessment report if you have not already done so and ask for the ESA85, I would phone them but again follow up the request in writing. Once you have the assessment report you will have a better understanding of how the DWP Decision Maker has come to their conclusions and will then be able to argue against them.

Your primary task is to show that you meet the criteria, there are many reasons you may have failed, you need to address each of these but don't get bogged down in criticising the assessment report unless you can clearly show that it is incorrect, it is a lot easier to argue the facts of the situation;

"the assessor recorded that I walked 50m, I did but they have failed to document that I had to stop every 10m for a rest due to breathlessness"

than their opinions

"based on my observations of the claimant walking I believe that they can reliably walk more than 200m.

I would go through our ESA Claim guides (same link as above) with your ESA50 and the assessment report to see where you have failed to meet the criteria and to explain why you do.

When you have a better idea of the issues with your claim, come back to the forum and we will do our best to help.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 8 years 1 month ago by Gordon.

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8 years 1 month ago #153144 by cazz55
thanks gordon , ive just phoned and asked for my assessment report to be sent to me was told 5 to 7 days .

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8 years 1 month ago #153557 by cazz55
After 4 nights with only a hand full of hours sleep and 1 meal ive a update .

Yesterday 10/03/2016 , i received my ESA85 , today 11/03/2016 i received my ESA65
I am shocked to say i have scored ZERO points .

physical capability 0 points
mental cognitive and intellectual 0 points

The letter says that there is NO evidence to indicate that i fall under any of the exceptional conditions for receipt of ESA .

As you all know it refers to life threatening conditions , surely heart failure is classed as a life threatening ?

As its friday i phoned the number up what was on the ESA 65 to make sure the address is correct to send my M.R back to after i have tryed to write it .
After a small conversation i was told the M.R dept would ring me back today within the next 3 hours , i explained that ive only just opened the letter 10 mins before making the call , so ive unplugged my phone as i cant cope talking with them right now was this the right thing to do .

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8 years 1 month ago - 8 years 1 month ago #153574 by Gordon
Cazz

One question, one comment. :)

Did you expect to score points for any of the "normal" descriptors?

I'm afraid it is not enough to have a life threatening condition, there must be significant risk of you suffering harm from the condition and that risk must be the result of your being asked to work (Regulation 29 for the WRAG), or from your doing Work Related Activity (Regulation 35 for the Support Group).

If you can't show these points with supporting evidence, then you are unlikely to meet the requirement for either of the Exceptional Circumstances Regulations.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 8 years 1 month ago by . Reason: "any"

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8 years 1 month ago #153621 by cazz55
Thanks for your reply gordon, another night with a hour or two sleep.

I will be trying to start my MR today but have no idea were to start
Do i use the ESA85 and point out all the discrepancys.

Is there a template or guild on here how to do this ive tryed looking but cant find anything.

thanks.

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