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Need help re: ESA appeal

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5 years 1 month ago #228604 by Lee
Need help re: ESA appeal was created by Lee
Hi all

I think I'm in big trouble regarding my appeal to receive ESA.

I have suffered from anxiety, claustrophobia, agoraphobia and panic attacks for many years and am unable to work because of this.

I had to fill in a Limited Capability for Work questionnaire before Christmas and received zero points.

I filed a mandatory reconsideration request and am awaiting its result (obviously this will be the same as the original).

I previously had the support of my long-standing GP, but he has now retired. I asked my new GP to write me a supporting letter and she has just gotten around to doing so - unfortunately it is barely a paragraph long, and simply states what medication I am on.

I will be trying to book an appointment with her to ask her to expand on the letter and go into more detail, but I doubt she will as I have only had two appointments with her so she doesn't know the full extent of my condition. I am unable to contact my retired GP.

I am now in a state of high anxiety because I know this supporting letter won't be good enough and my eventual appeal will be turned down.

This will leave me with no income whatsoever - my condition means I would be unable to attend Jobcentre and apply for Jobseekers Allowance etc. I just couldn't do it.

What can I do?

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5 years 1 month ago #228626 by Gordon
Replied by Gordon on topic Need help re: ESA appeal
Lee

What award did you have previously and how was it made? Was it Descriptor based or for some other reason such as Substantial Risk?

What evidence did you submit last time? How old was it? Could you argue that it is still relevant?

Have you seen any other doctors in the last year or two?

Gordon

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

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5 years 1 month ago #228645 by Lee
Replied by Lee on topic Need help re: ESA appeal
Gordon, thank you for replying.

I believe it was descriptor based, but I'm not sure.

Last time I made an appeal I had the help of my GP, who wrote a detailed analysis of my condition, and my MP, who wrote a letter of support based on my GP's recommendation.

I am pretty much in the same situation now, but these support letters were written three years ago, so I'm not sure they would help my current appeal.

As I say, my old GP retired last year and I have only had two or three appointments with my new one so she hasn't really got to know my full condition yet.

I am on the waiting list for CBT therapy, but she hasn't included this in her letter - though she has mentioned a problem I had with my knee from a few weeks ago, which is obviously irrelevant when it comes to my appeal, which is based on my mental illness.

I am going to have to try and talk to my new GP and see if she can amend her letter, but I doubt she will.

Really, I'm just needing advice on whether or not my appeal will stand any chance of succeeding with such flimsy support from medical professionals.

I have been three months without any income now, and if this appeal fails, that will continue for the foreseeable future.

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5 years 1 month ago - 5 years 1 month ago #228654 by Gordon
Replied by Gordon on topic Need help re: ESA appeal
Lee

Appeals are not always about the evidence although it certainly makes it easier.

Many claimants are parked by the DWP and do not have up to date medical information, so the GP may still be relevant if you can show that your conditions are ones that are not likely to change or even prone to deterioration.

You can balance off not having a lot of evidence by explaining your limitations in more detail.

Have you considered whether you have properly explained your problems in your claim form, is it possible that you have misunderstood the Descriptors, described your problems in terms that do not match the Descriptors or failed to make appropriate use of the reliability criteria or the need for your limitations on the majority of days to be considered?

I would go back to basics and go through your form, the report and the PIP Claim guide to see whether you can better explain your problems better.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 5 years 1 month ago by Gordon.
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5 years 1 month ago #228668 by Lee
Replied by Lee on topic Need help re: ESA appeal
Thanks again Gordon.

You say "You can balance off not having a lot of evidence by explaining your limitations in more detail."

Doesn't that just come down to whether DWP believe what I am saying? I might send in the letter my old GP sent the last time I went through all this. It was years ago, but it's something I suppose.

Yes I have gone into great detail on all the descriptors - the biggest one for me is Coping with Change - i got zero points but think I should have been awarded points for it - I had a panic attack because of a change to my routine around Christmas and am still suffering because of it.

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5 years 1 month ago #228681 by Gordon
Replied by Gordon on topic Need help re: ESA appeal
Lee

For the MR it will be the DWP but Decision Makers pace unreasonable reliance on the assessment report, a Tribunal will take a much more balanced approach.

Also, assessors and DMs tend to see things in black and white terms when often the claimant's problems are grey, explaining your problems in more depth can cut through that grey and make your problems more visible.

But you also need to consider what the ESA Descriptors say, so for Coping with change

14 (a) Cannot cope with any change to the extent that day to day life cannot be managed. 15 points
14 (b) Cannot cope with minor planned change (such as a pre-arranged change to the routine time scheduled for a lunch break); to the extent that overall day to day life is made significantly more difficult. 9 points
14 (c) Cannot cope with minor unplanned change (such as the timing of an appointment on the day it is due to occur), to the extent that overall, day to day life is made significantly more difficult. 6 points
14 (d) None of the above apply. 0 points

So think about the changes that you have to deal with on a daily basis. How do you avoid or at least minimise change? When faced with change how do you cope? What level of change are you unable to cope with? How does this manifest itself? How long are you affected?

You don't have to tell me but these are the sorts of things you need to think about and answer.

Our ESA Claim guides have more information.

Gordon

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