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TOPIC: payments suspended and how to appeal

payments suspended and how to appeal 8 years 10 months ago #37018

  • pendle
Hello
I received my notification to say that I had failed the medical and received 0 points.

On the advice of the Working Links advisor (I saw them voluntarily), I wrote a letter to say that I was intending to appeal and that I wanted my ESA reinstated whilst the appeal was going through.

I've not received any money and a JCP advisor said that I wouldn't get anything until the appeal had been lodged.

Is this correct? I have received my medical report and I am going through it carefully, but it's 33 pages. There are a lot of inaccuracies.

Is there an example of an appeal that we can look at for guidance? For example, one of the errors on my report relates to my sleep problems, the report says:

“The condition started 3 months ago.
Has had this problem since she has been taking Sertraline tablets. Has medication to help her, but does not use a sleep machine. Has to take Temazepam to get to sleep – this helps but wakes up feeling tired. Is tired during the day and has lack of energy.”


This statement is confusing because it's actually relating to two separate sleep issues - insomnia which was discussed at the medical and sleep apnea which wasn't, but is on my ESA50 form. I've put the above statement in my appeal notes and say in reply:

The statements are confusing and misleading. There are two sleep ‘problems’:
Insomnia
•Insomnia has been a problem on and off for several years brought on by stress and anxiety.
•It became chronic and unbearable after a change in medication for depression to Sertraline, of which insomnia is a side effect. Temezapam was prescribed (up to 40mg per night).
•I advised the HCP that although Temezapam helps me to get to sleep it is not a quality sleep and I’m still tired and exhausted the following day.
•The HCP stated that I do not use a sleep machine – a sleep machine is not necessary for treatment of insomnia.

Sleep Apnea
Sleep apnea was diagnosed in 2009. A CPAP machine was prescribed and used up to approximately three weeks after bariatric surgery on the advice of a sleep specialist nurse. A further oximetry test was scheduled for September 2010 but has been postponed until December 2010 due to the labyrinthitis. This further test will confirm if the the sleep apnea is no longer present, should this not be the case, then the CPAP machine will be re-prescribed for long-term use.


Is this the sort of thing I should be putting? The sleep problems are not why I have been claiming ESA, but something that I have trouble with. The statement is misleading and I want it known. But sleeping is not something you're scored on. I only be writing comments about what I'm scored on?

There are a couple of other items which were omitted from the report but discussed (I made notes) and some which are completely wrong.


Pendle

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Re: payments suspended and how to appeal 8 years 10 months ago #37024

  • de1
hi pendle,

have u sent off the gl24 yet? i failed my medical in september and they stopped my esa, but was receving esa again within 2 weeks of sending the gl24 in. i also got a backdated payment for the days i hadnt been paid.

the cab rang dwp for me a few days after sending the gl24, not sure if that helped.

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Re:payments suspended and how to appeal 8 years 10 months ago #37027

pendle

In order to lodge an appeal you need to complete a GL24 form and send it to the DWP, a copy of the form is at the end of the following document

www.dwp.gov.uk/docs/gl24dwp.pdf

Appeals normally need to be lodged within four weeks of the original decision. There is an "ESA Appeals" document in the Members section.

Once you appeal has been lodged you are entitled to receive ESA at the Assessment rate until your Tribunal is held. I believe, but cannot confirm that this should be paid from the date of the decision.

You should seek help from an appropriate advisor with regard to submitting evidence and setting out your case to the Tribunal.

Gordon

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

Re:payments suspended and how to appeal 8 years 10 months ago #37037

  • pendle
Hi there

I've not sent off the GL24 yet, because i've got a 33 page medical report to comment on which is full of errors - hence my comment re the sleep problem which is one of them.

regards
Pendle

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Re:payments suspended and how to appeal 8 years 10 months ago #37044

Hi Pendle

I don't know what Sleep Apnea is (nor does my spell checker), and didn't even know there is such thing as a sleep machine, but that's not relevant.

It is correct that you will not be paid ESA assessment rate pending appeal until the appeal is lodged. However, it is not necessary to send a detailed appeal statement with the GL/24 form. You can post the form with a brief explanation of why you disagree, and further information/evidence later. Please read our ESA appeal guide, which gives detailed advice regarding this step.

You are right to point out any flaws, inconsistencies, inaccuracies or contradictions in the medical report, but it is not the main focus of the appeal. As you say, you don't score points for sleep problems in the WCA, but if your sleep problems affect your ability to perform the WCA activities, that would be much more relevant.

Hope this has been helpful.

Derek

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Re:payments suspended and how to appeal 8 years 10 months ago #37046

  • pendle
Thanks Derek.

For your info, sleep apnea is where you stop breathing during your sleep - most sufferers will actually be dreadful snorers and it can lead to heart problems. The sleep machine is a CPAP machine and you wear a mask over the face and it moves air at a set rate through your system so you don't stop breathing.

Anyways, thanks for your advice. I shall send off the GL54 form and say that I wish to appeal and will send off the appeal documentation later on.

Pendle

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