ESA reassessment - home visit request plus timing

Thanks Gordon.

Hi again,

Received my Medical Report form re ESA this morning.

I've typed it out here as the context for my advice requests:

'Prognosis: I advise that work could be considered within 12 months
'Justification of Advice
'Evidence considered: the Questionnaire, Med 3, GP letter and specialist letter, and report from 2011, 2012, 2014. The Questionnaire and medical evidence suggests the client cannot mobilise unaided by another person, more than 50 metres without stopping because of significant discomfort or exahaustion due to Chronic Fatigue Syndrome, Postural Orthostatic Tachycardia Syndrome. This suggests the client has limited capability for work and work-related activity.
The letter from the clients Occupational Therapist indicates that the client can only walk a few metres before triggering fatigue and lightheadendess. Her sitting tolerance is only a few minutes. The GP confirms that she starts to get symptoms very quickly on standing, and that she gets fatigued very easily. The most common symptoms are fatigue, weakness, lightheadendess, palpitations, nausea and dizziness which are present for the majority of time.
On balance it is likely that she would struggle to mobilise short distances repeatedly and reliably. Fatigue would restrict the safe and reliable use of aids to improve mobility.
Although the ESA50 indicates that the clients mobility fluctuates, she reports that it has been consistently very poor, usually only managing a few metres, for the last few months. Due to the variability it may be appropriate to reassess in the medium term.
The available evidence suggests in the medium term'


Is there anything I can do to challenge the decision of when to reassess, or would it be just as stressful / risky as an ordinary Appeal process ( and most likely ultimately still result in the same reassessment date on top of this)? The PIP assessor came to a very different conclusion about my prognosis than this ESA assessor with very similar written evidence (although the PIP assessor did also meet me, in contrast to the person writing this report, and had met other patients with PoTS during her previous nursing career so understood a lot about it automatically).

I have been seeing a GP at my current practice every month over the last 6 or 7 years for an average of 30 mins, so they know me and my health conditions really well. My GP is confident that I will not be well enough to work by the next reassessment date (or for some time afterwards). They are also aware that I am desperate to return to work - paid or unpaid - and that I find it extremely distressing that I am currently unable to do so. I have also had lots of input from a specialist OT since 2012 and she also wrote a strong report, including this paragraph:
‘H’s main focus has always been to find a way to return to purposeful employment as she valued her previous role as… However, over the period of time that I have known her, she has never been unable to sustain a level of activity equivalent to work. She would still like to aim towards retraining in future years and tries to read literature that will help her towards this goal. However, she has not been able to maintain periods of occupation on a sustainable, reliable or repeatable basis, even on a voluntary or leisure activity basis. We continue to focus on increasing her stability and then gradually increasing activity levels but there has not been a significant change that would enable her to work or undertake any work related activity. Furthermore, if she tried to do so this would undermine her energy management programme that she is currently undertaking under the NHS.’

Referring again to the ESA assessor’s report, I don’t know what the reports from 2011, 2012, 2014 the assessor mentioned are (would they be earlier ESA assessment reports?), but these refer to a time before I was diagnosed with the autonomic nervous system dysfunction condition Postural Orthostatic Tachycardia Syndrome, following a significant deterioration in my ability to stand or sit upright. My walking ability has consistently been extremely poor for about the last 18 months but before this was still usually poor and consistently unreliable for years before this. My ability to sit upright for any length of time has been consistently poor for about 18 months and as well as feeling lightheaded, I also struggle to think if I try to sit for longer (I am semi lying down whilst writing this and still keep losing concentration. It has taken me hours to write!).

The assessor's report seems fairly accurate in a number of ways but doesn't mention the recurrent severe brain fog and concentration difficulties I experience associated with both CFS and PoTS, which occur multiple times on a daily basis, even if I am lying down and which would get in the way of me being able to work, and consistently has done for years. Also, it completely fails to mention my other diagnosis of Complex PTSD, including associated anxiety, which also affects me on a daily basis and, for which I've been having weekly psychotherapy for the last 5 or 6 years. Ridiculously, the more benefits assessments I have and the more frequently they come around the slimmer the chances of me being able to return to work because the stress the process has on me affects me badly physically as well as psychologically. I am sure this is true for a vast number of benefits claimants. (Rant over)

If there is little likelihood of extending time before reassessment this time round, is there any advice you can give me for next time to give me a bit more respite (and chance for health improvement) in between reassessments?

Apologies for the long length of this message. I struggle to summarise. Please feel free to edit before posting, if necessary.

Ok, thanks for the advice.

HI,

I'm adding to this thread because I posted a number of times last year and this is a continuation of the subject.

My reassessment forms have come through today from the Health Assessment Advisory Service and, as expected by myself and all my health care providers, my health conditions and symptoms remain the same. I've been in the Support Group for years and, in theory, still have about 8 years of higher rate PIP (both components) to go. Not sure why there was such a discrepancy between the two reassessment time scales because they were both allocated on the basis of the same conditions and symptoms.

I have a couple of questions. One, is it possible to complete the ESA 50 form online? I did this last year, but can't find the option so far. If it's possible, could you send me a link?

Also, since things haven't changed, is it ok for me, my OT and GP to copy and re-use what we wrote last year for that ESA application? And maybe add a statement to say that we have done this because there has been no change? Unfortunately the GP that was new to me last year just before my last reassessment and supported me then with letters has now left so it my current GP would be copying the words of someone else.

I was having monthly appointments with my GP for many years but this was changed to 6- weekly appointments last year (due to GPs leaving the practice). So I still have regular continuous contact with the GP practice. My symptoms are unusual and complicated but there is a long record of notes and letters by other GPs and other health care professionals. I have a prebooked appointment with my GP on Thursday, which seems good timing!

I will be requesting a home visit assessment again for the ESA assessment which last time, took two letters (from GP and OT), my own request and supplementary additional faxed letter from GP requesting this to work last time - in fact HAAS went from telling me I had to go in to an appointment to deciding to just do a written assessment so I didn't see them at all. Are home visits still very difficult to obtain and do you have any additional advice for phrasing the home visit request to try to get it accepted first time around that I might not have already thought of? (I realise this is a bit of a vague question!)

Thanks and best wishes.