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

New tests on limited capability for work???

Scarcab
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Scarborough Citizens Advice Bureau

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Hi All,
Cl has severe problems with his back and instead of boring you with the details I will just skip to the end. ESA 85 report – relevant features of clinical examination – ‘Cannot bend forward to reach his knees’. Underneath in a summary of functional ability – ‘Although he is restricted with bending, he can reach things on the ground by squatting’.  0 points. I understand that for knees (Descriptor 3A) we get 15 points. Numerous contacts to the DWP.  First few – no response. Most recent contact via Tribunal – lucky to hear back but decision still not changed. Could not believe. Before we got copies of the report – we wrote to the gp and specialist. Both backed cl up. – decision not revised as the EMP’s opinion is preferable!!! Now it is going to the Tribunal and I find it really hard to understand. I thought this can’t be right and that gave it one more go. Phoned BDC and I found out that apparently ‘the decision can’t be revised from 0 to 15 points and that cl can do for example office job as he can squat to pick a paper from the floor. Therefore he does not have lcfw‘. Am I missing on something in here? I will be very grateful for any comments and help in understanding the above.

A.

Ariadne
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Social policy coordinator, CAB, Basingstoke

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Not ESA I know, but with the equivalent IB descriptor I have seen an ATOS doctor actually report under the observations that the claimant could not bend to touch his knees, and STILL not give him 15 points - more than once, as well.

Scarcab
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Scarborough Citizens Advice Bureau

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Thank you Ariadne and Tony. Good to know that I’m not going mad. All the best

A.

OldhamCABWN
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Welfare Benefits Caseworker - Oldham CAB

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Having read this thread and I know its not ESA but it very much reminds me of a IB (PCA) appeal case i have ongoing at the moment.
In summary, my client suffers from Grand Mal Epilepsy, has seizures 2-3 times a week, poorly controlled, loses consciousness during the seizures. My client is under two neurologists/epilepsy specialists and has regular appointments/tests.
My client attended a medical assessment in relation to IB (PCA) and scored 0 points.
IB85 reads as follows with the descriptor relating to consciousness,
Relevant features of clinical examination - client gets fits at least once a week.
Summary of functional ability - The customer’s fits are poorly controlled, and result in frequent episodes of lost consciousness during waking hours that prevent them from safely continuing with any activity.
The ADA then awarded the descriptor Fg No Problems with Consciousness (0 points)
I cannot understand why the descriptor Fb Has an involuntary episode of lost or altered consciousness at least once a week (15 Points) was not applied.
What is even more bizarre about this decision is that after the medical examination my client had a seizure in the waiting room and was helped by the very same ADA. This of course was not noted in the IB85.
I too am now having to go to a tribunal with this case as the decision maker has refused to revise the decision, ridiculous!

nevip
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Welfare rights adviser - Sefton Council, Liverpool

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Kafkaesque!

Vonny
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Welfare rights adviser - Social Inclusion Unit, Swansea

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You should be ok - a recent pca appeal in the ib85 it stated cannot bend to reach knees but went on to award no points and so no points awarded by decision maker.
At hearing tribunal asked client 1 question - ie is this the case that you cannot bend to reach knees - client said yes - appeal won in 60 seconds - client completly bemused.

Peter Turville
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Welfare rights worker - Oxford Community Work Agency

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Only this morning at tribunal -

WCA appeal, client with significant back injury & pain following accident, high dose opiate based pain killers etc etc. 0 points. clnt sent add. med. ev. to JC+ (MRI scan report). Atos Healthcare further opinion is that this evidence did not change opinion of 0 points. DM therefore refused to revise. Extensive additional med. ev. obtained in prep for hearing and sent to TS well in advance of todays hearing but not issued to parties by admin. centre so not seen by panel. Tribunal allow the appeal on the original med.ev. alone before hearing time and client not required to attend.

In our expeience there is nothing unusual in this account of WCA/PCA appeals! Since introduction of WCA we have been successful in 93% of cases.

We are now regularly complaining about quality of Atos healthcare proffessionals reports especially in cases of 0 points. A standard reply to complaint is normally recieved. The address for complaints is

Atos Healthcare,
Wing G, Block 1,
Government Buildings,
Otley Road,
Leeds, LS16 5PU.

Co-incidentally recieved a response to a complaint today which includes this instructive information:

” ....because the [esa85] reports are completed electronically, the HCP makes use of drop-down boxes within the computer program (they are also required use free-test [whatever that means??] ). This means that a lot of the text within the reports is interegal to the program, and is not typed by the HCP.”

Which rather supports the conclusions of CIB/511/2005, CIB/476/2005 etc.

With all the Govt. announcments about welfare cuts one wonders why they are silent about the vast sums of money being wasted because of the poor quality of Atos opinions and the large number of unnessesary tribunal hearings etc etc. 

Would it be reasonable to assume that the one thing that won’t come out of the current review of the WCA and proposed changes to the test is the way it is implemented in practice?

nevip
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Welfare rights adviser - Sefton Council, Liverpool

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” ....because the [esa85] reports are completed electronically, the HCP makes use of drop-down boxes within the computer program (they are also required use free-test [whatever that means??] ). This means that a lot of the text within the reports is interegal to the program, and is not typed by the HCP.”

The drop down boxes have a list of alternatives and the HCP simply selects the option nearest to the claimant’s answer, which might be still miles away from the truth.  There is a provision for the HCP to manually override and type in text but this takes time and its use is not encouraged.  Staggering way of going about things isn’t it?

nevip
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Welfare rights adviser - Sefton Council, Liverpool

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In a similar vein, saw a client this morning, lost HR Mob/HR Care on renewal.  EMP report commissioned.  Client telephoned DBU and was told decision made using GPFR and consultant’s report.  EMP report not yet received from medical services.  GP swears did not complete GPFR and I saw copy of e-mail saying so.  DWP decision notice says only information used was claim form.  Client, quite rightly, livid.  It just keeps on getting better doesn’t it?

Nicky
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Supervisor Welfare Benefits, Barrow-in-Furness, Citizens Advice Bureau

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Appeal papers rec’d today which show clients IB medical lasted 13 minutes!!!!! Pffft!

P.E.T.E
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Head of Welfare Rights at Barnsley MBC.

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“Pffft!”

The perfect submission!  Says it all.

oldhamcabwn
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Welfare benefits caseworker - Oldham CAB

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wayne needham - 03 September 2010 02:25 PM

Having read this thread and I know its not ESA but it very much reminds me of a IB (PCA) appeal case i have ongoing at the moment.
In summary, my client suffers from Grand Mal Epilepsy, has seizures 2-3 times a week, poorly controlled, loses consciousness during the seizures. My client is under two neurologists/epilepsy specialists and has regular appointments/tests.
My client attended a medical assessment in relation to IB (PCA) and scored 0 points.
IB85 reads as follows with the descriptor relating to consciousness,
Relevant features of clinical examination - client gets fits at least once a week.
Summary of functional ability - The customer’s fits are poorly controlled, and result in frequent episodes of lost consciousness during waking hours that prevent them from safely continuing with any activity.
The ADA then awarded the descriptor Fg No Problems with Consciousness (0 points)
I cannot understand why the descriptor Fb Has an involuntary episode of lost or altered consciousness at least once a week (15 Points) was not applied.
What is even more bizarre about this decision is that after the medical examination my client had a seizure in the waiting room and was helped by the very same ADA. This of course was not noted in the IB85.
I too am now having to go to a tribunal with this case as the decision maker has refused to revise the decision, ridiculous!

Just to update, we attended the tribunal and appeal was allowed (surprise surprise), the descriptor we asked for immediately awarded. The Judge was furious that this case had been put before them and apologised for making me take time out of my busy schedule to attend and apologised to my client as well.

Wayne