ESA WRAG appeal info & advice needed asap

Hi,

I need help and advice ASAP. I have just been told after my ATOS WCA medical that I have qualified for ESA WRAG status. Should I appeal this status as one of the descriptors for 15 points was denied as I did not provide medical proof.

Just for some background info I have been on IB for 13 years and now transferred to ESA. I suffer from Fibromyalgia, Arthritis in knees, Asthma, back problems, arm and hand pain and numbness, Achilles Tendonitis, Tinnutus, Hypothyroidism and fecal incontinence on a weekly basis. I am a female in my late 50's.

I had done some basic research prior to filling in my ESA questionnaire and requested a recording of the ATOS interview which was granted and I received a copy CD. After the ATOS medical I requested the below:

Please supply the information about me I am entitled to under the Data Protection Act 1998 . Please supply me with copies of the following information:

1. Copy of my ESA85 assessors report ( RECEIVED)
2. Copy of my ESA85 Decision Makers Score sheet
3. Copies of all the medical evidence the HCP or Atos used for my WCA
4. Who made the decision that a face to face assessment was necessary and the medical reasons for the face to face assessment ( RECEIVED)
5. All CCTV video footage taken of me entering, exiting and whilst in the building on xxxxxx or any other CCTV recordings ATOS may have made during the time of my visit (even if they are for training purposes).

I was dismayed to read my ESA assessors report as it is inaccurate and the fact the ATOS nurse told [MOD EDIT] about my medical. Even though the medical was recorded the nurse said I sat on a chair without arms and rose three times during the ATOS medical and I had no problems rising from my chair. In fact the nurse provided me with a chair with arms prior to the ATOS recorder being switched on. ( I did use my own digital recorder switched to record from the moment I entered the ATOS building and I would advise anyone going to an ATOS medical to do so!) Furthermore more contradictory mistakes were made in the ESA85 report . The point I most strongly disagreed upon is that there was no evidence of incontinence from my GP. I moved a few years ago but I did see my previous GP about incontinence and was given a physical exam and this should have been recorded on my medical notes. I have not seen my current GP about this problem but am making an appointment to see her next week. I was unaware I had to provide medical evidence prior to taking my ATOS medical and the ATOS nurse noted that " the evidence does not suggest significant functional disability". I am also putting in a FOI next week for access to my GP medical notes. Dealing with incontinence is very embarrassing and I feel humiliated and distressed by the whole episode . As far as I am aware the DWP cannot impose treatment or inspect my bottom! I am willing to see my GP though. And it is on this basis that I want to appeal the decision taken by ATOS. Another criticism I make is that the ATOS nurse may have a qualification for a general physical . I do not think they are suitably qualified to make judgements based on mental and cognitive functions and I really think something should be done to address this issue! My ATOS nurse noted I suffered from depression which I do not and I do not believe she was not qualified to make this observation! I think the ATOS nurse did not understand Fibromyalgia and the "psycho-motor retardation" she noted was due to the pain and fatigue caused by fibromyalgia and certainly not depression!
Further more I was totally confused as my prognosis showed as " I advise that work is unlikely in the longer term .....The evidence suggests improvement is unlikely in the longer term.
I was informed by the DWP this week that I have ESA WRAG status that is partly contribution-based which is very confusing! I have not received my ATOS score sheet so do not know at this point what my score is although I have requested that info.
I think I should appeal based on the basis of the prognosis and the weekly incontinence issue. Any advice would be welcome. Do you think I should appeal? and if I appeal will I get the same ESA WRAG rate while the appeal is pending?
Best wishes from MOLLY

mollsi wrote: Hi,

I need help and advice ASAP. I have just been told after my ATOS WCA medical that I have qualified for ESA WRAG status. Should I appeal this status as one of the descriptors for 15 points was denied as I did not provide medical proof.

Just for some background info I have been on IB for 13 years and now transferred to ESA. I suffer from Fibromyalgia, Arthritis in knees, Asthma, back problems, arm and hand pain and numbness, Achilles Tendonitis, Tinnutus, Hypothyroidism and fecal incontinence on a weekly basis. I am a female in my late 50's.

I had done some basic research prior to filling in my ESA questionnaire and requested a recording of the ATOS interview which was granted and I received a copy CD. After the ATOS medical I requested the below:

Please supply the information about me I am entitled to under the Data Protection Act 1998 . Please supply me with copies of the following information:

1. Copy of my ESA85 assessors report ( RECEIVED)
2. Copy of my ESA85 Decision Makers Score sheet
3. Copies of all the medical evidence the HCP or Atos used for my WCA
4. Who made the decision that a face to face assessment was necessary and the medical reasons for the face to face assessment ( RECEIVED)
5. All CCTV video footage taken of me entering, exiting and whilst in the building on xxxxxx or any other CCTV recordings ATOS may have made during the time of my visit (even if they are for training purposes).

I was dismayed to read my ESA assessors report as it is inaccurate and the fact the ATOS nurse told [MOD EDIT] about my medical. Even though the medical was recorded the nurse said I sat on a chair without arms and rose three times during the ATOS medical and I had no problems rising from my chair. In fact the nurse provided me with a chair with arms prior to the ATOS recorder being switched on. ( I did use my own digital recorder switched to record from the moment I entered the ATOS building and I would advise anyone going to an ATOS medical to do so!) Furthermore more contradictory mistakes were made in the ESA85 report . The point I most strongly disagreed upon is that there was no evidence of incontinence from my GP. I moved a few years ago but I did see my previous GP about incontinence and was given a physical exam and this should have been recorded on my medical notes. I have not seen my current GP about this problem but am making an appointment to see her next week. I was unaware I had to provide medical evidence prior to taking my ATOS medical and the ATOS nurse noted that " the evidence does not suggest significant functional disability". I am also putting in a FOI next week for access to my GP medical notes. Dealing with incontinence is very embarrassing and I feel humiliated and distressed by the whole episode . As far as I am aware the DWP cannot impose treatment or inspect my bottom! I am willing to see my GP though. And it is on this basis that I want to appeal the decision taken by ATOS. Another criticism I make is that the ATOS nurse may have a qualification for a general physical . I do not think they are suitably qualified to make judgements based on mental and cognitive functions and I really think something should be done to address this issue! My ATOS nurse noted I suffered from depression which I do not and I do not believe she was not qualified to make this observation! I think the ATOS nurse did not understand Fibromyalgia and the "psycho-motor retardation" she noted was due to the pain and fatigue caused by fibromyalgia and certainly not depression!
Further more I was totally confused as my prognosis showed as " I advise that work is unlikely in the longer term .....The evidence suggests improvement is unlikely in the longer term.
I was informed by the DWP this week that I have ESA WRAG status that is partly contribution-based which is very confusing! I have not received my ATOS score sheet so do not know at this point what my score is although I have requested that info.
I think I should appeal based on the basis of the prognosis and the weekly incontinence issue. Any advice would be welcome. Do you think I should appeal? and if I appeal will I get the same ESA WRAG rate while the appeal is pending?
Best wishes from MOLLY

Hi m,

Welcome to Benefits and Work

Please do not post duplicate posts. All posts have to be pre-approved by the Moderators before they show on the forum.

Therefore, there will always be a delay between you posting, and it appearing on the forum.

The length of any such delay will depend on how many Moderators are on-line, and how busy we are.

Can you also try and keep your posts to a shorter format, as long posts may result in the Mods missing the actual queries within the post.

Now for your queries.

We cannot advise whether or not you should appeal The WRAG award, that is a decision that only you can make.

However, if you feel that you should have been placed into the SG, you have 1 month from the date of The WRAG Decision Notice letter to do so.

This can be done using a GL24 Form, which can be downloaded and printed off (from around page 20) from the link on this page :

How to submit an appeal

See also : Sending Documents to the DWP or ATOS

Pertinent to appealing The WRAG award, see also :

How long do I have to appeal?

Do I have to attend WFIs while I appeal?

Is there any risk to challenging a decision?

What will I be paid while I appeal?

From our : Appeals FAQ’s

There is also an ESA Appeals Guide on this page :

ESA Claims Guides

You may also wish to review The WCA Handbook, and the relevant ESA Claims Guides whilst on that page.

You must first decide whether not not you do qualify for the SG.

This can only be achieved by fulfilling at least one of SG Functional Descriptors :

SG (LCWRA)Schedule 3 Descriptors

And/or by qualifying under ESA Regulation 35 :

ESA Reg 35 for entry to The SG (LCWRA)

PLUS Post 28/01/13 Amendment of :

(3) In regulation 35(1) (certain claimants to be treated as having limited capability for work-related activity)(6), for sub-paragraph (b) substitute—

“(b)the claimant is-

(i)receiving treatment for cancer by way of chemotherapy or radiotherapy;

(ii)likely to receive such treatment within six months after the date of the determination of capability for work-related activity; or

(iii)recovering from such treatment,

and the Secretary of State is satisfied that the claimant should be treated as having limited capability for work-related activity; or”.

From :

www.legislation.gov.uk/uksi/2012/3096/regulation/4/made

See also : Qualifying for the Support Group

From our : ESA FAQ’s

Many people who are placed into The WRAG receive a prognosis of "In the longer term". Remember being placed into The WRAG does not mean that you are fit for work, it means that you have Limited Capability for Work. (LCW) Whereas being placed into The SG means that you also have Limited Capability for Work Related Activity. (LCWRA).

You do not have to make an FOI to obtain your G.P. records, you can do this at your G.P. practice by filling in a request form covered under DPA 1998.

See : Requesting Your Medical Recordsl

If you feel that you need professional face to face advice please see potential sources, here :

Where to get advice?

I think that I have covered all your queries. If not, please reply to this topic.

You may wish to Bookmark/Favourite this page for ease of future reference.

bro58

I have a friend who suffers from frequent urinary incontinence but, despite a GP letter, the DM said that there was 'no evidence' of this. I am at a loss to know what kind of evidence one could provide. Maybe parcel up dirty underwear and send it to them??

Well I certainly feel like it! If its not hard enough experiencing it it makes it worse when someone who knows nothing about it cans so easily dismiss it... but what can one expect from ATOS!

Yesterday on Radio 4 there was a Doctor talking about why he could no longer work for ATOS and had tendered his resignation due to the pressure ATOS had placed on him to deny ESA support group status when dealing with a terminally man. He was very angry and upset. It makes you wonder though why anyone would want to work for a company like ATOS????

Mrs Hurtyback wrote: I have a friend who suffers from frequent urinary incontinence but, despite a GP letter, the DM said that there was 'no evidence' of this. I am at a loss to know what kind of evidence one could provide. Maybe parcel up dirty underwear and send it to them??

I believe that the latest ESA descriptors do allow for scoring a few points if you would be at risk of incontinence if you did not stay close to a loo. How are you supposed to prove that? It sounds as though getting caught short in the doctor's surgery may be the only answer!

Looking at the new PIP forms for GPs it looks as though the DWP have decided that the next line of attack is going to be demanding ever greater standards of "proof" for medical problems. I do not see how we are supposed to provide "proof" of pain.

The evidence from Dr Rowe on the BBC radio and TV was that Atos are to regard the ability to get from your living room to the kitchen as "proof" that you have a range of about 200m. Then if you say that you can't get from the kitchen to the living room, they will say that you haven't proved it!

The only answer I can find is to make sure that, every time you visit a doctor's surgery that you call their attention to every problem you have - and not just in front of the doctor. You go for a blood test - leave your jacket on so that the nurse witnesses you needing help to get it off. You need to get on an examination couch? Don't struggle on because the doctor is in a hurry - ask for help or get the couch lowered for you. If you feel too knackered to make any sense - go in anyway so that everyone can see what it's like on a bad day, even if you have to go back a week later and say it all again. Get the doctor to repeat everything, because you need to have someone else write it down.

And even then, make sure that you tell the doctor to ask the nurse about your problems getting your shoes on and off. It's making a nuisance of your self, but the DWP aren't leaving you with many choices if you want the benefit - let's hope your surgery staff understand that.