Appeal, appeal, appeal..

I’m beginning to feel like an ESA appeal machine. It’s all I seem to do these days. I’m picking up on average 4-5 new WCA failures every week and have appeal bundles coming out of my ears. I’m sure I’m dealing with more WCA failures than I was a year ago (and it was bad enough then). I’ve currently got 10 subs on the go simultaneously and am beginning to reach the point where I’m transposing names, medical conditions, etc.

Is anyone else noticing a significant increase in WCA failures?

Statistically, my ESA appeal workload is 4 times higher than it was a year ago

I currently have WCA appeals coming out of my ears as well. They have increased significantly in the past year and now represent the majority of my caseload (approx 10-15 subs in last 2-3 weeks).

At least PIP may present a slight change when the first decisions start to come in. Although I expect with the ATOS points scoring system they will be very simliar to WCA appeals.

Glad it’s not just me. I fear that once PIP kicks off, I shall be transposing PIP/ESA subs as well as mixing up my clients.

(Nice to hear from you Lucy- we still miss you BTW!)

We are also overwhelmed with WCA appeals (where have all the DLA’s gone?) and have had to put a stop to new referrals for the time being.

What is noticable (compared to pre April 11 WCA criteria) is the number of clients who are awarded 0 points (compared to say 9 or 12 pre April 11). About 50% of our WCA caseload are migration cases (mostly with 0 points).

Of course 9:10 continue to succeed at appeal (but not on revision - which we do use, as a matter of policy to obtain hard evidence of how **** revision decisions are in practice, if we have obtained evidence well in advance of a hearing date). God help us when mandatory revision applies in Oct.

There appears to be a new phrase DMs use to justify WCA revision decisions: “[claimant] has enclosed Doctor’s letter. This confirms [claimant’s] medical conditions, it does not give a description of his/her functional limitations within the terms of the Schedule.”

Amongst last weeks tribunal decisions;
(1) 4th time we have represented client at WCA appealed - DM 0 points - tribunal 42 points.
(2) 0 points - 15 points under Sch 2 activity 1 (plus others) and therefore support group.
Both had compelling medical evidence but the above phrase in the revision decision.

Yep….familiar story here too…..

HCP - “there was no medical evidence to support his claimed level of loss of consciousness at time of assessment” - 0 points

Client sends in Med 3 with GL24 - GP says - “fits every week, no warnings, lasts more than one hour. Unable to leave house on own as no warning of fits”

Reconsideration - “Mr X has not provided any additional evidence to enable me to change the decision…...”

Oh yes-that particular cut & paste job drives me mad.

I have a similar one in my batch of bundles in progress. Client attracted nil points. Client’s psychiatrist provided detailed letter outlining client’s (considerable) symptoms and difficulties in relation to coping with change, getting about, social interraction, etc and concluded by stating that in her opinion, client will only ever be capable of supported voluntary work at some future point and that any attempt to force him into a work-focused environment at this stage is likely to undo all the progress made so far. Detailed support letters were also provided from a specialist nurse who sees client weekly and the client’s floating support worker, both on similar lines. DM states ‘Mr X has not provided any additional evidence…’ etc, etc.

One of the issue’s my clients keep commenting on is the statement that they tried to ring the client to explain the decision etc etc….a hell of a lot of clients are telling me this just isn’t true and that there have been no attempts to contact them by phone from JCP.

Yes, clients have said that to me too. Either that, or the (very brief) conversation is then used as a basis for stating client has no difficulty with social interraction, as happened with the client I mentioned in my last post. He (unusually for him) answered his mobile, realised it was someone he didn’t know, panicked, said ‘no’ when asked if there was any further information he could provide and hung up as soon as he could.

Talking of social interraction, I am enjoying a snippet from one of my ongoing bundles. Client has chronic insomnia amongst other mental health-related symptoms. He told the (foreign) HCP that he had ‘fun and games’ at night (in trying to get to sleep). Nil points on social interraction on basis ‘client plays night games and is often up for most of the night’...

I feel like a Support Group appeal machine. I get constant referrals from the JobCentre staff and now our local ‘partner organisation’ - appalled at the claimants they are having to do ‘Work Focused Activity’ with, who are clearly not capable and should be in the Support Group. Most of these appeals are overturned at GL24 stage and many as late appeals because they never understood what group they were in in the first place ( some go back to 2012). The first they know about the implications and the first advice they get about appealing and coming to us for help is when they go for their WFI’s or see their work activity advisors/monitors. In fact going to DIAL for help is starting to even appear on their work programme agreements !
I feel like a stuck record. Many of these are mobilising or mental health cases (or both) and many of my subs are near identical up to a point. I only deal with one office and often one particular appeals officer. They must be sick of seeing my name on subs. We have handled to differing degrees 86 appeals since 1st april. At this rate we will be well over double figures on last year - and like others swamped with ESA and very few DLA appeals. Heavens knows what will happen when the PIP appeals start rolling in. I’ve always thought of becoming a professional face painter, may be this would be the time ......

between 01/04/13 and 30/09/13 I have attended the same number of appeals as i did in the previous 12 months. About 90% are ESA appeals.
I have had a very high success rate with most of them being placed in the support group (Reg35 is a great help)
I received my first December 2013 appeal date today