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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

ESA - wrong diagnosis/assumption of condition

AW71
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Slater & Gordon

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Total Posts: 12

Joined: 3 August 2015

I’m currently assisting a client with PIP appeal, this client has recently been placed into the Support Group for ESA so I wondered whether obtaining a copy of the medical report might help with the appeal for PIP.
Upon receiving the ESA85A it turns out that my client has been diagnosed, by the healthcare professional, as suffering with Alzheimer’s disease which in fact he is not. He does have a neurological condition which does give him cognitive impairment but they have said his impairment is due to Alzheimer’s - should we rectify this with the Dept (ESA) or just leave them to believe this is what our client has.
The wording they have used on the ESA85A is: the Med3 suggests the client has cognitive impairment (which he has) or mental disorder due to Alzheimer’s and cannot learn how to complete a simple task.
I have questioned this with the client and his wife assures me that she only recalls the Med3 notes stating memory problems as his condition as it took some months to diagnose him, which in fact, diagnosis is still on-going in his case.
I fear our client may struggle to obtain ESA again if we inform them their information is wrong, as he hasn’t had a full diagnosis of what he is actually suffering with so therefore we don’t have the supporting evidence despite the end result (him being unable to learn a simple task) is correct.
I’d be grateful for anyone’s views on this.
Many thanks

Dan_Manville
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Mental health & welfare rights service - Wolverhampton City Council

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Joined: 15 October 2012

I’d leave well alone.

Their assessment of his functional ability is correct. That’s the key issue; it’s the cognitive impairment rather than the diagnosis that is relevant.

There is also the possibility that they obtained an ESA113 that disclosed a diagnosis not yet known to the family.

past caring
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Welfare Rights Adviser - Southwark Law Centre, Peckham

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Joined: 25 February 2014

Two points;

1. If the HCP went off and made their own diagnosis and this is not what client said, then that’s on ATOS.

2. Much more importantly, entitlement is not based on diagnosis (though one needs to hhave some physical or mental health condition - and clearly he has) but on the effects of the condition. If the ESA85 is a reasonably accurate assessment of those effects and of the client’s abiility to perform the various activities, then the fact the ‘wrong’ condition is stated by the HCP is neither here nor there….