'Evidence' Problem

Hi

I was moved from Incapcity Benefit to ESA last September and placed in the WRAG.

Because I had been left alone on Incapacity Benefit for years I stupidly assumed that it was a change in name only, and therefore got an awful shock when I went for my WFI at the job centre and found out exactly what being in the WRAG would entail. The advisor I saw came into the interview room with an appeal form in her hand and said that in her opinion I should be in the Support Group which I had assumed was a no-brainer. I wasn't called for a medical and in my head that meant that they had realised that my agoraphobia would render the WRAG activities impossible. Wrong!

Anyway, to cut a long story short, I appealed and lost and it's now waiting to go to tribunal. When I received my appeal pack though, I was gobsmacked for want of a better word.

The original decision to place me in the WRAG group was based partly to a P45 on my file. The decision maker makes reference to it and says that it suggests that I have had paid employment in the current tax year. It's actually the P45 that I was sent, along with everybody else presumably, when Incapacity Benefit stopped and I was moved to ESA. I immediately wrote and told them this and received a letter of apology and a copy of the amended response which had all reference to the P45 removed. But that's not the point, is it? The original decision was made with that P45 on the table, as 'evidence' that I had worked last year, when I haven't worked since 1995. It's not as simple as just erasing all references to it, is it?

Secondly, the report says that the decision was made on the basis of my ESA50 and a Med 3 form. I haven't spoken to anybody in my doctor's surgery about my condition for at least 10 years, since they told me that there was nothing else they could do for me except prescribe medication, which they have continued to do. How therefore can anybody have signed a sick or fit note when nobody has talked about it to me? There wasn't a copy of the note in the appeal pack so I have no idea who signed it or what it said, but seeing as I haven't had a regular doctor for about 8 years and don't actually know the names of the GPs at that surgery these days what can I do?

They also called me by the wrong name throughout the report. Obviously I questioned this but stupidly (as I now realise) I asked them to confirm that it was a typographical error and not confusion between me and another person. They must have breathed a huge sigh of relief when they confirmed it was a typo, I handed them that on a plate.

Finally, having now seen the supprt group descriptors, it's fairly clear to me that I fit at least 2 of them. This isn't just wishful thinking on my part, I've shown the paperwork to friends and family without any prompting and they are all of the same opinion. Without exception they are all incredulous at the whole situation.

I know now that I have been incredibly 'Pollyanna' in my approach to all of this, but I honestly thought that if I told it as it is all would be well. I am extremely lucky in so much as if this decision goes against me at tribunal it won't be the end of the world because my husband can just about support us both with a bit of belt tightening. But that's not the point; I am just furious that I have told them everything, as I was encouraged to do, and yet somebody is implying that I am lying, or worse, not worthy.

Anyway. I want to draw the tribunal's attention to the P45 debacle and the fact that it probably had some bearing on the original decision, to the fact that a doctor whom I have almost certainly never met has produced a document with no basis for doing so, and that two of those descriptors apply to me. The question is, how do I do it? Do I send a 'covering letter' back with the tribunal enquiry form, or wait until I have a date and then send it?

Any and all advice would be gratefully received, and thank you for reading.

Hi CT, and welcome to the forum


Welcome to Benefits and Work

I am sorry that you have had such a rude awakening! I am assuming, from what you have said, that the initial reconsideration upheld the original decision and you are now awaiting appeal? Our appeals resources are here
an there is an FAQ that deas with adding pages to your submission

ESA apeals

It appears that your username might be your real name. If that isthe case,you might want to change it in order to maintain some anonymity on a public forum

My full name is showing, how can I stop it?

If you have any further questions, please come back and ask them on this thread. You might like to make this a favourite so that you can find it easily in future.

CT wrote: Hi

I was moved from Incapcity Benefit to ESA last September and placed in the WRAG.

Because I had been left alone on Incapacity Benefit for years I stupidly assumed that it was a change in name only, and therefore got an awful shock when I went for my WFI at the job centre and found out exactly what being in the WRAG would entail. The advisor I saw came into the interview room with an appeal form in her hand and said that in her opinion I should be in the Support Group which I had assumed was a no-brainer. I wasn't called for a medical and in my head that meant that they had realised that my agoraphobia would render the WRAG activities impossible. Wrong!

Anyway, to cut a long story short, I appealed and lost and it's now waiting to go to tribunal. When I received my appeal pack though, I was gobsmacked for want of a better word.

The original decision to place me in the WRAG group was based partly to a P45 on my file. The decision maker makes reference to it and says that it suggests that I have had paid employment in the current tax year. It's actually the P45 that I was sent, along with everybody else presumably, when Incapacity Benefit stopped and I was moved to ESA. I immediately wrote and told them this and received a letter of apology and a copy of the amended response which had all reference to the P45 removed. But that's not the point, is it? The original decision was made with that P45 on the table, as 'evidence' that I had worked last year, when I haven't worked since 1995. It's not as simple as just erasing all references to it, is it?

Secondly, the report says that the decision was made on the basis of my ESA50 and a Med 3 form. I haven't spoken to anybody in my doctor's surgery about my condition for at least 10 years, since they told me that there was nothing else they could do for me except prescribe medication, which they have continued to do. How therefore can anybody have signed a sick or fit note when nobody has talked about it to me? There wasn't a copy of the note in the appeal pack so I have no idea who signed it or what it said, but seeing as I haven't had a regular doctor for about 8 years and don't actually know the names of the GPs at that surgery these days what can I do?

They also called me by the wrong name throughout the report. Obviously I questioned this but stupidly (as I now realise) I asked them to confirm that it was a typographical error and not confusion between me and another person. They must have breathed a huge sigh of relief when they confirmed it was a typo, I handed them that on a plate.

Finally, having now seen the supprt group descriptors, it's fairly clear to me that I fit at least 2 of them. This isn't just wishful thinking on my part, I've shown the paperwork to friends and family without any prompting and they are all of the same opinion. Without exception they are all incredulous at the whole situation.

I know now that I have been incredibly 'Pollyanna' in my approach to all of this, but I honestly thought that if I told it as it is all would be well. I am extremely lucky in so much as if this decision goes against me at tribunal it won't be the end of the world because my husband can just about support us both with a bit of belt tightening. But that's not the point; I am just furious that I have told them everything, as I was encouraged to do, and yet somebody is implying that I am lying, or worse, not worthy.

Anyway. I want to draw the tribunal's attention to the P45 debacle and the fact that it probably had some bearing on the original decision, to the fact that a doctor whom I have almost certainly never met has produced a document with no basis for doing so, and that two of those descriptors apply to me. The question is, how do I do it? Do I send a 'covering letter' back with the tribunal enquiry form, or wait until I have a date and then send it?

Any and all advice would be gratefully received, and thank you for reading.

Hi,

Welcome to Benefits and Work

Just in case your forum username is your real name, you may wish to change it, as the forum can be read by the general public.

See : My full name is showing, how can I stop it?

The comment on what I assume is your ESA85A Medical Report regarding your P45, is absolutely ludricrous.

In my opinion, there is enough errant information included within the ESA85A to totally discredit it.

You would have to make a complaint to ATOS as a seperate matter regarding the quality of the ESA85A, their contact details can be found top right of this page :

www.atoshealthcare.com/claimants

You may also wish to enlist the support of your M.P. , see :

Contacting your MP

Even though discrediting the ATOS ESA85A Med Report may help your cause, it would probably only result in another assessment, probably in the form of a face to face.

You could also raise this issue with The DWP, and/or The Tribunal, however, the important issue regarding your appeal is to reiterate how and why you qualify for The SG, see :

Qualifying for the Support Group

There is also an ESA Appeals Guide on this page, along with our ESA Claims Guides, which may be worth reviewing :

ESA Claims Guides

See also : Appeals FAQ’s

ESA FAQ’s

&

Complaining to ATOS Healthcare

Please repost on this topic, if you have any further queries.

bro58

Just to add,

We see the MED3 ( which is a "fit note" issued by one's G.P.) referred to quite often in ESA85A's. As in your case a MED3 has not been issued by the G.P.

We think this is because a lot of the phrasing on an ESA85A is generated by the LiMA software which ATOS use. It would therefore seem that the ATOS HCP's are not ammending the "Stock" phrases generated by LiMA.

bro58

bro58 wrote: Just to add,

We see the MED3 ( which is a "fit note" issued by one's G.P.) referred to quite often in ESA85A's. As in your case a MED3 has not been issued by the G.P.

We think this is because a lot of the phrasing on an ESA85A is generated by the LiMA software which ATOS use. It would therefore seem that the ATOS HCP's are not ammending the "Stock" phrases generated by LiMA.

bro58

So what would the Med 3 form actually be? The exact wording on the medical report form is "The available evidence from the ESA50 and the Med 3 has been used to give advice in this case" - I phoned my doctor's surgery today and they confirmed that nothing had been requested from or given by them....

CassieT wrote:

bro58 wrote: Just to add,

We see the MED3 ( which is a "fit note" issued by one's G.P.) referred to quite often in ESA85A's. As in your case a MED3 has not been issued by the G.P.

We think this is because a lot of the phrasing on an ESA85A is generated by the LiMA software which ATOS use. It would therefore seem that the ATOS HCP's are not ammending the "Stock" phrases generated by LiMA.

bro58

So what would the Med 3 form actually be? The exact wording on the medical report form is "The available evidence from the ESA50 and the Med 3 has been used to give advice in this case" - I phoned my doctor's surgery today and they confirmed that nothing had been requested from or given by them....

Hi CT,

The likelyhood is that there is no MED 3, it is just that the ATOS HCP has not ammended the electronically generated statement, to just say ESA50.

bro58