Can this be right?

First off - a big thank you to Benefits and Work for all the help and info!

I need help here as I am so frustrated!
Quick explanation. Transferred from IB to ESA - No medical - Placed in the WRAG group.

I was medically retired from a well paid job in the Civil Service, I did not want to leave but had no choice.
My main illness is degenerative discs (lower spine) which cause me severe pain when walking Also, sitting upright is extremely painful. In the ESA50 I explained all this and the fact that I suffer severe vertigo. And also I am being investigated by a heart consultant because of heart irregularities which causes shortness of breath.
I stated that I could NOT walk 50 metres without severe discomfort, pain and breathlessness - which I assumed would be enough to place me in the Support Group.

I saw my GP today and discovered that ATOS/DWP never asked for any information. Unfortunately, my GP although very sympathetic explained that their practise would not write letters to back up evidence as ATOS disregarded these... suggested I contact my MP !!

I received from DWP the ESA85A, which states ...

---

The available evidence suggests the client has a significent level of disability due to disc degeneration, such that they would have limited capability to work.

Long term condition, ESA 50 content indicates he has tried several analgesics and use of wheelchair in the past but unable to use it due to pain and Urticaria affecting the hands. Likely to meet criteria for LCW based on mobility and standing and sitting. No report of any improvement.

The available evidence does not suggest that the client has severely restricted musculo-skeletal or cardio-respiratory function, such that they would be unable to mobilise more than 50 metres.

ADVICE: I advise that the person meets the criteria for having limited capability for work.

---

( DOESN'T THE SECOND PARAGRAPH ABOVE CONTRADICT THE THIRD PARAGRAPH?)


What I cannot understand is WHAT they are basing their evidence on? I attended several medicals when on IB and it was always accepted that I could not walk 50 metres. Now ATOS/DWP are saying I can - without any evidence to back their dismissal of what evidence I gave them .... I wrote them a long explanation of my condition and how it affects my everyday life.

Obviously I am about to appeal to placed in the SG - but it seems to boil down to my word against theirs!

Any help or advice would be appreciated.

Colin wrote: First off - a big thank you to Benefits and Work for all the help and info!

I need help here as I am so frustrated!
Quick explanation. Transferred from IB to ESA - No medical - Placed in the WRAG group.

I was medically retired from a well paid job in the Civil Service, I did not want to leave but had no choice.
My main illness is degenerative discs (lower spine) which cause me severe pain when walking Also, sitting upright is extremely painful. In the ESA50 I explained all this and the fact that I suffer severe vertigo. And also I am being investigated by a heart consultant because of heart irregularities which causes shortness of breath.
I stated that I could NOT walk 50 metres without severe discomfort, pain and breathlessness - which I assumed would be enough to place me in the Support Group.

I saw my GP today and discovered that ATOS/DWP never asked for any information. Unfortunately, my GP although very sympathetic explained that their practise would not write letters to back up evidence as ATOS disregarded these... suggested I contact my MP !!

I received from DWP the ESA85A, which states ...

---

The available evidence suggests the client has a significent level of disability due to disc degeneration, such that they would have limited capability to work.

Long term condition, ESA 50 content indicates he has tried several analgesics and use of wheelchair in the past but unable to use it due to pain and Urticaria affecting the hands. Likely to meet criteria for LCW based on mobility and standing and sitting. No report of any improvement.

The available evidence does not suggest that the client has severely restricted musculo-skeletal or cardio-respiratory function, such that they would be unable to mobilise more than 50 metres.

ADVICE: I advise that the person meets the criteria for having limited capability for work.

---

( DOESN'T THE SECOND PARAGRAPH ABOVE CONTRADICT THE THIRD PARAGRAPH?)


What I cannot understand is WHAT they are basing their evidence on? I attended several medicals when on IB and it was always accepted that I could not walk 50 metres. Now ATOS/DWP are saying I can - without any evidence to back their dismissal of what evidence I gave them .... I wrote them a long explanation of my condition and how it affects my everyday life.

Obviously I am about to appeal to placed in the SG - but it seems to boil down to my word against theirs!

Any help or advice would be appreciated.

Hi C,

Phew, that is a long post, please try and keep them to a shorter format in future.

" ( DOESN'T THE SECOND PARAGRAPH ABOVE CONTRADICT THE THIRD PARAGRAPH?)"

Unfortunately, no it doesn't.

Para 2 :

" Long term condition, ESA 50 content indicates he has tried several analgesics and use of wheelchair in the past but unable to use it due to pain and Urticaria affecting the hands. Likely to meet criteria for LCW based on mobility and standing and sitting. No report of any improvement."

This is stating that you have scored at least the minimum 15 points required to be placed into The WRAG, and are therefore classed as having Limited Capability for Work. (LCW)

WRAG (LCW)Schedule 2 Descriptors

So they are stating that you have at least 15 points across activity 1, and activity 2, of the above descriptors.

Therefore, you could have scored 9 points for "Mobilising" and 9 points for "Standing and Sitting". or it could be 9 points for one of the activities and 6 points for the other.

To have gained entry to The SG, you would have had to have scored the 15 points maximum on either activity 1 :

1(a) Cannot, unaided by another person, either:

(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

Which is the same as activity 1 of the SG Descriptors.

Or, activity 2 :

2(a) Cannot move between one seated position and another seated position which are located next to one another without receiving physical assistance from another person.

SG (LCWRA)Schedule 3 Descriptors

Para 3 :

"The available evidence does not suggest that the client has severely restricted musculo-skeletal or cardio-respiratory function, such that they would be unable to mobilise more than 50 metres."

Is stating again that you do not score the maximum 15 points in activities 1 and 2, which in turn means that you do not fulfill activities 1 and 2 of The SG (LCWRA) Descriptors. Hence, no SG award, as you have not been assessed as having Limited Capability for Work Related Activity. (LCWRA)

Just to clarify, it is not simply a "Walking Test" it also takes into account whether or not you could self propel a manual wheelchair unaided, even if you don't normally use one :

"1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid is normally or could reasonably be worn or used."

This is explained in our guide entitled " Employment and Support Allowance claims on physical health grounds: a guide to the work capability assessment." under the heading :

"New ESA50 form" on this page :

ESA Claims Guides

If you need any advice on appealing, please repost to this topic, and I will try to help.

bro58

bro58

Thanks Bro58- I did actually try to keep the post short !

To boil it down to one question really ...

(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

I stated that I could NOT mobilise more than 50 metres - and evidence that I could not use a wheelchair which they seem to have accepted.

My complaint really is how can they make this decision without consulting my GP or calling me in for a medical. All they have to go on is MY evidence which they obviously dispute!

Thanks for your time .... Colin

Colin wrote: Thanks Bro58- I did actually try to keep the post short !

To boil it down to one question really ...

(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

I stated that I could NOT mobilise more than 50 metres - and evidence that I could not use a wheelchair which they seem to have accepted.

My complaint really is how can they make this decision without consulting my GP or calling me in for a medical. All they have to go on is MY evidence which they obviously dispute!

Thanks for your time .... Colin

Hi C,

No problem

It is just that the Mods have to read every post before approving them.

Sometimes with long posts, the actually query can go missing, which I must say was not the case with yours.

My comments were for all viewing members benefit.

You could make such an argument.

Are you sure that your G.P. has not filled in an ESA113 questionnaire at the DWP/ATOS's request.

Although the issuing of an ESA113 is the exception rather than the rule.

ESA 113 Questionnaire

Your G.P. receptionist should be able to confirm whether an ESA113 was issued or not.

You could also issue a SAR to the DWP requesting all documentation used as evidence in coming to the WRAG decision.

SAR :

SAR Form Download

From this page :

DWP Data Protection Policy

Sending Documents to the DWP or ATOS

However, do not miss your one month deadline to appeal, if you have not received the above, as they have 40 calendar days to comply.

You should concentrate on reiterating how and why you qualify for The SG. Once you appeal, the WRAG award will be reviewed by a different more senior DM.

If you cannot obtain a letter of support from your G.P., you could request copies of your G.P. records, and use any relevant extracts as evidence in your appeal. :

Requesting your medical records

bro58

Hi C,

Just to add,

You have received the ESA85A, but there will also definitely be an LT54.

Maybe an ESA113, dependent on whether one was issued.

To cover all bases, cite the ESA113, and The LT54, and add on a request for "All" documentation used in evidence.

See :

ESA Forms

ESA medical – what forms to ask for?

A lot of people get hung up on disputing information within an ESA85A medical report. However, although this can help, the reviewing DM and indeed an ESA Tribunal Panel, (if it gets that far) will be looking solely on whether you have proven (on the balance of probabilities) that you fulfill at least one of the SG Descriptors.

bro58