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ESA assessment does DM go with what HCP says

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6 years 2 months ago #205927 by Twinkletoes
Hello
This is my first entry to forum. My son has just has his first ESA (income related) assessment. I requested HCP medical report one week after assessment and received it the following day. The HCP medical report has indicated 18 month review and from her descriptors I have calculated 27 points awarded. Some of her entries state descriptor does not apply, but has given no explanation as to why he does not meet that descriptor? Should HCP have given an explanation?
My question is it likely that the dwp decision maker will not go with the HCP report and award him less points (less than 15, so would not qualify for esa). My sons GP provided evidence to support his claim. Such as stating that he need prompting to dress, wash etc. The HCP stated before assessment that he had good medical evidence.

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6 years 2 months ago #205977 by Gordon
Twinkletoes

It's unlikely that the Decision Maker will move significantly away from the points recommended by the assessor,

If 27 points have been recommended then it implies that one of the scores might be for 15 points, if so does this correspond with one of the Support Group Descriptors?

Gordon

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6 years 2 months ago #206044 by Twinkletoes
Replied by Twinkletoes on topic ESA assessment does DM go with what HCP says
Hello Gordon, Thank you kindly for your reply. Upon reading the HCP medical report again, none of the descriptors are equivalent to the 15 point score and HCP has indicated that in her opinion none of the exceptional circumstances apply. So it looks like support group will not be the outcome of his ESA assessment. My son has difficulty with social interaction with people he knows and people that he does not know. ESA activity 16 - the HCP choose descriptor: Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual (9 points)
However, HCP report goes on to say: "He reports that he can at times go out with his friends but that he has not been out with them in several weeks. He will always drink before he goes out as he feels very anxious and this helps with the anxiety."
What my son was trying to explain that he takes alcohol before meeting up with friends as he is anxious meeting them. He has just started University in September so everyone is unfamiliar to him and he has difficulty interacting and making friends. The GP report stated: "Difficulty mixing with other people, using alcohol to relax before going out with friends/peers. Can find social interaction overwhelming at times, which exacerbate his anxiety and mood. Tends to avoid social situations."
My question is: In view of GP report would he not meet the descriptor: Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual (15 points support group)?
Or am I missing something - should the GP report be more specific?
Your opinion would be much appreciated.

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6 years 2 months ago #206066 by Gordon

Twinkletoes wrote: My question is: In view of GP report would he not meet the descriptor: Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual (15 points support group)?
Or am I missing something - should the GP report be more specific?
Your opinion would be much appreciated.


I'm afraid, based on the GP letter he does not meet the criteria for this Descriptor.

You must take the Descriptors as they are written, so whilst it may be possible to argue that "always precluded" does not mean never, it is not far off, so I think that you will struggle to show that "can at times go out with his friends" meets this criteria, also "very anxious" may not meet the requirement for "significant distress".

Gordon

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6 years 2 months ago #206615 by Twinkletoes
Replied by Twinkletoes on topic ESA assessment does DM go with what HCP says
Thank you for you reply. My son has just received ESA decision letter. Please bear in mind that this is his first initial claim for ESA which he claimed in September and was in receipt of the assessment benefit amount. The medical assessment carried out by HCP took place the following January 2018. Decision letter sates "a decision on your capability for work. You have moved from the Support Group to the Work Related Activity Group". I don't understand this. This is the first decision letter he has received and he does not have any other letters that state he was in the Support Group. I have asked ESA to send out all reports that the decision maker used in order to arrive at their decision. Is it possible that the decision maker had decided to place him in the Support Group but then this was changed after the HCP report was received?
He has also been asked to attend an interview with a work coach. Which I understand is the process with the WRAG. Is it possible that he could have this interview deferred until March sometime (when i would be able to attend with him). He has problems interacting with people that he does not know and when under pressure/stressed he does not retain information and ends up agreeing to something just to get out of the situation. I am concerned that he would not be able to explain his situation properly and end up with with WRAG obligations that would not be suitable for his health situation and he would not be able to fulfill those obligations.
Your comments would be much appreciated.

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6 years 2 months ago #206635 by Gordon
Twinkletoes

The most likely answer is that it has been sent in error.

The DM would not make a Decision before receiving the assessment report, It is possible that they initially decided on the SG but on review realised that your son did not meet the criteria, but I think this is unlikely.

Either way it is moot if he is now in the WRAG.

Contact the JC+ advisor dealing with his claim, their contact information should be on the appointment letter, they can defer the appointment but it will be up to them to do this.

Are you going to challenge the award?

Gordon

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