My benefit claims

I've been working on my own benefit claims over the last month or so; ESA and DLA. I have to say that I am sincerely disappointed with the DWP. Until now I had pretty much given them the benefit of the doubt; I thought that the employees were not to blame for how the system works, but as much victims of it as the claimants. Just part of the machine.

I can now categorically tell you that, sometimes, they do not even look at our application forms before making a decision. I realised after posting my DLA form that I had not signed it. I therefore fully expected it to be turned down, with a letter asking me to resubmit it, having sign it. However, what I actually received was a fail based on the medical assessment I had for ESA 18 months ago.

I will point out at this juncture, that the medical 18 months ago was over-turned immediately. It was wrong, the assessor had made unreasonable assumptions based on no evidence, which I clearly illustrated to the DWP as soon as I received her report. I received ESA from a reconsideration, and placed a complaint against the assessor to Atos. (Atos of course defended her).

While it is outrageous that they are using outdated evidence, that is not my point. Had they actually looked at my form they would have realised straight away that they could turn it down based on the lack of signature. They didn't look at it! That is disgusting. Do they have the slightest idea of how much effort, how much energy, how much blood sweat and tears, go into those forms? I severely neglected Christmas preparations because they expected the form back just before Christmas; my waking hours were utilised on the form (plural actually, as I had my ESA50 too). They obviously do not care. I wonder how many people are declined at this stage, not realising that their form has not even been looked at, and not aware that they can appeal. I wasn't aware that you could appeal the first time I was declined after all. No one actually teaches you how the system works.

I can't help thinking that it would save them money if they didn't faff around like this, playing silly buggers. If they actually processed peoples claims properly when they were first sent in, based upon their form and accompanying evidence, surely there would be less need for appeals.

Unfortunately, my experience with ESA is no better. In fact I think I would go as far as to say it's worse. It's a lot more complicated though, so if you cannot follow what I try to explain now, don't worry too much about it.

Whilst getting divorced in 2010 I applied for ESA over the phone. The DWP friendly telephonist I spoke with checked that I had enough National Insurance Credits to claim Contributions Based ESA. My ex had tried to scare me, telling me that I hadn't paid enough of them, which is why we checked, and why it is so memorable that I did have enough of them. (My ex was trying to scare me regarding money in a lot of ways). So, I applied for CB-ESA, got through the application process, and started receiving ESA basic rate.

At the beginning of November I moved into my own flat (call this location A), so changed my address over the phone with the DWP. A couple of weeks later in November I received my divorce settlement. I phoned the DWP to find out if this had any baring on my claim, as I had heard that it could do. I was told that I would no longer receive ESA payments, but that my National Insurance would still be credited. It's a shame that I did not know the system so thoroughly then, as what he told me was wrong and I would have recognised it.

In December I went to stay elsewhere (call this location B) while problems with my flat were sorted out, so I phoned the DWP and gave them the new address again. At that time I was not informed of any problems with my claim.

I moved again in March due to problems with location B, and location A never got sorted out (so call this location C). I contacted the DWP again to give them the address for location C. I was told that they could not change the address on a closed claim. I asked when the claim had been closed, and was told it had been closed in the November, when I had told them about the divorce settlement. I was astounded, as I had not been told in November that he was closing my claim, nor had I received any paperwork to that affect.

When I had returned to location A to check I'd got everything, I found two letters from the DWP; one summoning me for a medical assessment, and another telling me that because I had not attended the medical assessment my benefit would be revoked. They were dated February, and expected me to be at the medical a few days before I found the letters.

So they had screwed up:

• they should not have discontinued a Contributions Based ESA claim based upon a divorce settlement. Contributions Based ESA is not means tested.
• if my claim was closed in November 2011, and you cannot change the address on a closed claim, then I should not have been able to change my address in December.
• when my claim was closed, I should have received paperwork to inform me.
• if my claim was closed in the November, I should not have been summoned for a medical assessment in February.

So, recently, my GP gave me a fit note to cover me for two months. He wanted me to have some income. I wasn't sure what you do with fit notes, so I phoned the DWP to ask. I spoke to one of their helpful telephonists (as opposed to the unhelpful ones), who tried her best to initiate an ESA claim for me, but just could not do it. My record was screwed. Every time she tried to start a claim the computer gave her an error. She probably should not have told me that really. Anyway, she put a request in for me to be sent an ESA1 in the post so that I could fill it in manually and return it myself.

I received the claim pack for Housing Benefit.

I received the claim pack for Carers Allowance.

I received the claim pack for some Disability thing I've never heard of.

Eventually an ESA1 arrived.

On the ESA1 you have to decide whether you wish to claim for Contributions Based ESA, or Income Related ESA. Being aware that my record was a complete mess I thought I'd better check what state my National Insurance was in, so, again I phoned the DWP. I was given a different number to contact the NI Office. I spoke to a lovely man who told me that I have three years of Class 1 credits, should have no problem placing a claim, and that he was disgusted that I was having to do the DWPs legwork for them. 

So, confident that they'd screwed my record up enough for me to claim Contributions Based ESA, I ticked that box. Surprise surprise; I received notification back that I do not have enough NI to claim Contributions Based. I already know I can't claim Income Related because my other half's earnings are above the threshold, despite the fact that his outgoings don't allow him to support me.

I'm stuck in a rut. I have made my MP aware of the situation. She is trying to get my National Insurance sorted out, but I suspect that when it is sorted out it will still not be the right kind of credits to claim ESA. She has also given me a supporting letter for my DLA reconsideration, as she was already aware of my health before any of this happened. 

Over the last few weeks, working on these claims, I have found out a couple of things that people with M.E. may find interesting:

M.E. claimants, along with claimants who suffer from mental health conditions, are given time limit concessions. That means that they are expected to get their forms back a little late. The DWP telephonists aren't actually aware of this, so if you're phoning the DWP to inform them of lateness, you'll need to explain it to them. It's also a good idea to remind decision makers in a note with your claim. I wouldn't advise returning your form late if you can avoid it, and certainly not weeks late.

M.E. is assessed as CFS by Atos. The Atos guidelines for assessing CFS do not tell the assessor what kind of condition it is, but give them the choice as to whether they assess it as a physical condition, a psychological condition, or a mixture of both. Personally, I don't like this. M.E. is recognised by the WHO and NICE as being a neurological condition, with neurological indicators. The DWP is supposed to use doctor's to assess neurological conditions, but M.E. is exempt from this. I was assessed by a nurse. I know others who have been assessed by physiotherapists, health workers, etc. The reason for this is, apparently, that people with M.E. do not show neurological indicators. Well; I know I do. I also know that they are described in some detail on my form. As such I SHOULD be assessed by a doctor, but can guarantee I will not be. 

Honestly, it probably doesn't make any difference. I just feel indignant that M.E. is degraded in this way.

Olana's 10 step guide to the ESA50

I am aware that the ESA50 has changed since I wrote this piece. I do endeavour to re-write it, with the new ESA50 in mind. However, the principles outlined below still apply to the new form. Good luck!

The brown envelope arrives. You've been waiting for it. Either you knew it would happen because you've heard rumours about people being transferred from Incapacity Benefit to Employment & Support Allowance, or you recently sent a sick note to the DWP and made the first steps to applying for ESA over the phone. Either way, that brown envelope isn't particularly welcome. Inside is the ESA50 form; the form that gives people nightmares.

You're not going to have nightmares though, because I'm going to help you fill that form in. We approach this as a project, and if possible, we actually make it fun.

First: look at the letter that came with the form. There is a date on it by which you must return the form. You usually get between four and six weeks. You will aim to have your form ready to post a week before that date.

Second: take a deep breath, and think about your frame of mind. No one you know will read your form. The people who do read it are of no importance to you. You MUST let your guard down to fill it in. Everyone who is ill has that mask that they put on every day, the smiley face, the 'I'm ok' facade ... now you take it off. The difficult part is being totally honest with yourself.

Third: make sure you have some treats available. Filling in the form can be very depressing, so you will take frequent breaks and do something you like, speak to someone you love, eat some comfort food, etc. Do not expect to get the whole form done in one day.

Ok, now let me explain a few things about how all of this works.

- Atos and the DWP are not looking at what you can't do, they are looking at what you can do. As such you need to think in terms of your worst days; so that 'what you can do' is realistic every day. [I am assuming the the majority of my readers have M.E. or Fibro, which are fluctuating conditions. If you do not have a fluctuating condition then don't worry about statements like this one].
- They use 'descriptors' to score you. You are given points for each part of the form. You need 15 points in total to claim ESA. 15 points in only one section will put you in the Support Group.
- You need supporting evidence. By default your word is not to be believed. Ideally you will get letters from your GP and any specialists that you are seeing or have seen. This is one reason it's important to have a GP who is sympathetic to your illness. [If you're not yet going through the ESA process, but expect it to be upcoming, I highly recommend seeking a good GP now]. 

- The person who looks at your form and your supporting evidence has about 20 - 30 minutes to look through everything. As such you want it to be as comprehensive as possible.

We will come back to all of that bit by bit as we go through the form though.

Step 1)
Do not make a mark on the form they have sent you. Instead download a claim form here:
http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/@money/documents/digitalasset/dg_195544.pdf
If you have access to a Word version of the form, even better.

Step 2)
Fill in the easy stuff:
- Name address, etc
- Skip 'About your illness' for now
- Dates you can't make in the next 3 months. If you're uncertain what medical appointments you have coming up, you should be able to find out over the phone from your GP surgery.
- Your medications. Make notes to yourself if you need to come back to anything later.
- Your GPs info.
- Info about your specialists. They only provide space for one specialist. If you're using a Word version of the form then copy and paste the table as many times as you need it. If you're using the PDF, then create a Word document, mark it 'Extra Info', put your NI number, DOB and name on it, and put the information about your other specialists there. Any information that you can't fit on the PDF add to this Word document with the question number beside it as you go through the form.
- the paragraph about your hospital visits
- etc

Step 3)
"About Your Illness & Disabilities"
What a small box, huh!?! We are not going to be using their boundaries. You will want some time to work on this section, and you will probably keep coming back to it as you fill in the rest of the form.

You may think I'm telling you to put too much information here.  You don't have to follow my advice. The way I look at it; it's the first thing the Decision Maker reads on the form, this is where you paint the picture of what your life is like.

So:
- Make a list of your illnesses, yes, all of them. It may look something like this:
* M.E.
* Fibro
* Hypermobility
* Hypothyroidism
* Cystitis
* Eczema

- Underneath each illness create bullet points of each symptom you suffer from that illness. It will start to look like this:
M.E.
* extreme weakness
* orthostatic intolerance
* extremely poor memory
* vulnerability to infection

- Write a little more description next to each symptom that you feel requires it. Not a huge amount. Something along the lines of:
* extremely poor memory: short term memory, long term memory, memory recall, all affected badly.
* vulnerability to infection: hyperactive immune system, eg. My body reacts to a cold as if I have full blown influenza.

- After the symptoms for the illness, make a new list of the ways you have adapted for that illness. Still keeping it brief. Some examples:
Underneath M.E.
* I use a shooting stick (walking stick with seat) for general use outside of the house. It aids my balance, helps me coordinate, and I use the seat part when I cannot cope in situations where a person would normally remain standing.
* I take or hire wheelchairs when I have to be out for longer periods of time, because I can only comfortably stand for about three minutes.
Underneath Cystitis.
* I also carry Cymalon sachets so I can start treatment immediately.
I personally put this list in italics on the form to distinguish it from the symptoms, but I do not believe you can do that within a PDF.

- Write a series of paragraphs about your life. Still remembering the reader has a time limit. Describe how your life was before you became ill, and then write about what your life is like now. I described my work, my social life and hobbies I was forced to give up in order to illustrate that lying in bed all day and watching the television really are not up my street (remember, we're scroungers, that's what they assume we like doing). I also made pains to explain how much I was earning when I became ill, how much I would be earning now, and showed them the maths that being on ESA is a fricking massive pay cut; not a choice any sane person would make! If you've lost friends and family because of being ill make sure they know it. If you've decided you can't have children, due to illness, again, put it in. Any sacrifices you've made due to illness; include them.

- Finally, four more paragraphs and one line. One paragraph describing your worst days, one describing your 'average' days, and one describing your better days. (Don't use the word 'best'). Then a paragraph explaining how many of each you have per week (or per month if you don't have a 'normal' week). Finally add a sentence after everything else stating that you will be filling in the rest of the form in reference to your worst days. That line there covers your bum for when a nasty DWP operative catches you popping into Tesco at some point down the line.


Ok, you've done that section? You're doing really really well! That's the hardest part of the whole form to get done. If you're struggling with it, don't worry, you'll get further inspiration both as we go through the rest of the form and as you potter around doing your usual day to day things.


Step 4)
Right, now let's have a look at the Descriptors. You can see them here. Depending upon when you are reading this post, you may wish to check the date of the descriptors. Even if they seem to be out of date they will give you an idea of how it works.

Have a look through the descriptors and make sure you understand how they work. There is the number of the question, with the question, beneath which you have a description (the descriptor) of what a claimant may be unable to do. Underneath, in blue, are the points awarded for that descriptor.

You are now going to create a series of sentences from those descriptors and have a quick whizz through the form with them. Don't worry about anything else in the answer sections for the moment.

Look at question 1, regarding mobilising. Mobilising means walking. If you cannot walk 50 metres, your first sentence, which will go in the box under the first question, will be:
"I cannot mobilise more than 50m on level ground without stopping, reliably, repeatedly, safely and in a timely manner without significant discomfort or exhaustion."
If you cannot use steps your sentence in the next box would be:
"I cannot mount or descend two steps unaided by another person even without the support of a handrail reliably, repeatedly, safely and in a timely manner without significant discomfort or exhaustion."

Do you see the pattern? You go through the questions, find the descriptor that best fits you, then add "reliably, repeatedly, safely and in a timely manner without significant discomfort or exhaustion." You can alter it a bit to fit what is true for you. I have added "distress" to a few of the later ones for example, and left out "safely" or "in a timely manner" from one or two. Making sure you meet descriptors is the key to scoring points. You're basically using their game against them.

Step 5)
I hope you're remembering to take breaks and treat yourself. This step is the easy one. Go through each question and tick the boxes that apply to you. If you're using a Word version of the form you can insert a tick using Windings from 'insert symbol'. (Or you can find one on Google and copy it).

Try to avoid ticking "it varies" for many of the questions. I am lead to believe that it automatically scores you zero points. We don't want zero points. So, remember that you're filling in the form according to your worst days.

Step 6)
Forget the actual form filling for a while. If you've not already done so, get on to your GP and specialists about supporting letters. It has come to my attention that most doctor's don't really understand the whole ESA thing, and as such many practices have the policy of not giving supporting letters until a patient needs to appeal. If your practice is one of these I suggest printing out my previous blog post and giving it to your GP. It may help them to understand the importance of a supporting letter sooner, rather than later. It saves the government money after all, if they don't have to pay for you to go to tribunal.

If your GP is open to discussing supporting letters with you, here are a few tips:
- a GP needs to sound certain. "My patient is ####", not "I believe my patient is ####" and not "My patient tells me ####"
- the letter should include a simple list of your diagnoses, and how long you have had them.
- it is also useful for your GP to write a couple of short paragraphs about your pain / discomfort levels, and what your limits are because of your illness. It is best to discuss this part with them.
- if your GP believes that working will make you more ill, or prevent you from recovering, they need to state it clearly. This is important.

If you can't get supporting letters from doctors don't worry. There is other supporting evidence you can include. We'll look at that after we've finished the form.

Step 7)
My recipe for filling in each section is more or less the same. You will probably find that you repeat yourself a lot throughout the form. Don't be afraid to do so; even copy and paste the same sentences. The assessor will become familiar with you and your situation when they see the same things repeated.

Below our initial sentences I use three lots of bullet points. The first explains the reasons I have problems with whatever that section is about. The second I write how I cope with those problems. The third I write about consequences. So for example ...

I have problems with walking because:
- I have pain around my knees due to hypermobility.
- I have pain around my ankles due to hypermobility.
- I am unbalanced on my feet so stumble a lot, and fall sometimes. I frequently lose my balance suddenly and without warning.

As such:
- I use a stick to walk; it helps with the balance problem, can take pressure off my lower back and enables me to walk more gingerly when I have other pains.
- I frequently cannot walk more than a few yards without having to stop due to pain, discomfort, or fatigue.
- On outings I will use a wheelchair. I need someone to push me, as it is too exhausting for me to use the self-propelling ones.

These affect me:
- I find it embarrassing to use the stick. I hate that people stare at it and at me. This is partly why I avoid going out. I feel that people are judging me, that they assume I’m pretending to be ill.
- I find it even more embarrassing to use the seat on the stick. It is extremely necessary for me to be seated, but I’d rather sit on the ground than have people stare at me on the stick.

Bullet points keep it nice and simple for you to add more as and when you think of things. They also make it much easier for an assessor and the Decision Marker to find the relevant bits of information when they need them.

In some sections I have listed what I can and cannot do instead, for example in the reaching section. (But then I don't really understand that section). In the Mental Health part of the form I have simply only used the 'I have problems' bullet points and 'As such' bullet points, and left off the 'These affect me' ones. That is my recipe though; it may not be right for you. Make sure that you are comfortable with how you fill in the information before you send it off.

Something else you might like to do is add a short anecdote or two after the bullet points, describing situations that illustrate what the bullet points say. I've only done this in one or two sections because I am so aware of how little time they have to go through the form, but I know people who have used anecdote after anecdote throughout their forms.

It's not easy going through each section trying to think how you are affected by x, y and z. So get up and walk around. Do whatever that section covers; walk up the stairs, or move from one seat to another. Think about the situations in a work place where you may have to do these things, the problems that could arise. Think about different kinds of furniture, stairs. And remember, it's your worst days.

If there are things about your health that you don't feel are covered by the form then force them in to one of the sections. It is important to make sure that EVERYTHING is on there. There's no way that they can know without you telling them. For example, there isn't a section about how standing still affects you. I have severe problems standing still, due to Orthostatic Intolerance. It is possibly my biggest problem after pain, so I had to make sure it went on the form. I included it under walking and using stairs, sitting, and problems in social situations.

Try to think outside of their boxes too; they've given you leading examples in some sections, don't make the mistake of being hemmed in by them. For example, there's a point on the form that asks whether you can pick up half a pint of milk. You may think to yourself "Yes, that doesn't weigh very much. I can pick up half a pint of milk.". Can you? Do you have Fibro? When you have a really bad Fibro flare can you grip a pint of milk? I know I can't! Another such example would be those who have endometriosis. The severe problems with overflowing in that way are not covered anywhere in the form; so put it in the incontinence section, and add it to social problems.

If you have a problem that you really think cannot go anywhere on the form then write yourself your own covering letter. I have actually done that this time myself. The problem I cover in it does fit in sections on the form, but they play it down too much. So I've written them a letter, telling them my story. Just two pages mind; they have limited time after all.

And so, you have finished the form! Well done you :)

Step 8)
You still want to make sure that you have enough supporting evidence going in that envelope though. So:
- If you have any copies of test results from the last few years, put them in (make sure you keep copies too). Blood tests, scans, X-Rays, MRIs, etc.
- If you have called out emergency services for any reason, put a copy of the incident report in (or whatever it is they give you). Even if the police were called for a domestic row, still include it.
- If you have been to Accident & Emergency ask the hospital for verification that you did so. (The DWP will not accept your word without evidence).
- If you have M.E. copy the symptom section from the International Consensus Criteria for Myalgic Encephalomyelitis into a document. Explain at the top that the whole document is 25 pages long, so you're only sending them this part, and the symptoms that you suffer with on a daily basis have been highlighted. (Then highlight them).
- If you have Fibro copy the American College of Rheumatology Criteria for Diagnosis of Fibromyalgia to a document, again highlighting the bits that are relevant to yourself. If you understand how it works you can explain it to those reading your documents, but I didn't, because I don't understand it!
- If you have other main diagnoses, seek the relevant documentation and repeat the same exercise. Remember they have limited time though, so don't send them this for every single thing you suffer with. For example, I do not need to send them documentation explaining Cystitis or Eczema.
- Have your loved ones write supporting letters. A partner, spouse, parent, sibling, or best friend; whomever has seen you suffer the most. You don't want the letter to be long. Have a look through the descriptors with them, and ask them to write a little about those that affect you the most. If there's anything that they feel really strongly about writing, there's probably a reason they feel that way, so make sure it's included.
- If you left work through illness within the last couple of years and are still friendly with your manager, it can be useful to have a letter from them describing watching you go down hill, and how much of a hard worker you were.

Step 9)
Have someone go through your form and evidence to check it through. Preferably it will be someone who is familiar with the system. You can find groups on Facebook who are used to doing this. I am sure there are also forums and websites where you can get help. You can look up your local CAB or DIAL too if you are up to going out.

Step 10)
Tidy it up. Print it out. Put it in the post. Go to sleep.


And that, I believe, is that! For now.

Explaining the ESA Process

I had an appointment with my GP the other day. I noticed it written in my diary the day before, and for the life of me couldn't remember what it was for. It was the first thing in the morning however, too late to cancel it, so I went anyway. I sat down. He asked me how he could help. I looked at him and said 'I have absolutely no idea why I'm here'. He's a really nice GP, so thankfully wasn't cross at me. I hadn't wanted to not turn up, which he understood. We had a short chat, and I left, shortening the waiting time for the patients after me.

During this chat I mentioned to him that my ESA application had been turned down. They turned it down because they say I don't have enough National Insurance Credits. I may explain my personal case in another post at some point, but it isn't relevant to this post. He hadn't heard of National Insurance Credits being involved in ESA, so was thoroughly confused. I came home and wrote up an explanation of how the ESA process works for him. I left it at the surgery the following day when I had a blood test. The next day (I live at that surgery) he chased me out of the surgery to thank me for the description. He had found it very comprehensive, and had copied it for the other GPs. It has therefore occurred to me that other people may also find it useful. 

Below, you will find a (hopefully) simple explanation of how the ESA process works. If you spot any mistakes in it, please leave a comment and I'll make amendments.

Dear GP,

Since we were discussing ESA yesterday I thought I would put it in type for you so that the process is clearer. I hope it is of some help.

There are different phases to ESA.

The first phase starts when you give someone a ‘Fit Note’. If they are not in work, so can’t use it to claim statutory sick pay from their employer, they phone the DWP (Department for Work & Pensions) and fill in a form called the ESA1 over the phone with a DWP telephonist.

The DWP telephonist will establish whether your patient is suitable for:
•    Contributions Based ESA, or
•    Income Related ESA

To qualify for Contributions Based ESA your patient needs to have at least two years (in the last tax year) National Insurance Credits.

If they do not qualify for Contributions Based ESA, they may apply for Income Related ESA; but this is means tested – savings and partners income are taken into account.

If they qualify for neither, they can “claim” Income Related ESA without receiving any payments. The DWP will pay their National Insurance Stamp while they do so, so that two years later they can apply for Contributions Based ESA again (or sooner depending upon their shortfall).

When  someone succeeds in claiming Contributions Based ESA they are only able to do so for 12 months. After those 12 months are over, there must be a gap of at least another 12 months before they try to claim it again.

During this first phase of ESA they receive £70 a week basic rate. (I think, it may have changed again). They will then be sent the next form, the ESA50 (the one that gives everyone nightmares). This is the start of the second phase.

This is also the form I’m used to helping people with. If this form is filled in well enough, with enough supporting evidence, people can be put in the appropriate group (even the Support Group) without having to go for a medical. This is why I prefer GPs to give people supporting letters with their ESA50, rather than waiting for it to go to appeal.

The ESA50 is time limited; it must be filled in, and evidence gathered, by a certain date. Once the DWP receive it, a Decision Maker looks at it. (They have 20 minutes to go through it and the evidence, so the format in which the form is filled in is important). The Decision Maker will decide whether your patient needs to go for a medical, or whether there is enough convincing evidence to be put in one of the ESA groups; and if so, which group they go in.

Otherwise, your patient is then summoned to the Work Capability Assessment. A nurse, doctor, or other health professional will go through a series of questions and exercises with them to assess their abilities. Unfortunately they use a tick box system on a computer which does not allow for much flexibility, and thought they can input their own answers they usually do not. They have an unofficial target of 20% that they must fail on the assessment.

Once the WCA is over, the ESA50, your patients supporting evidence, and the results from the computerised assessment, once again go to a Decision Maker. A decision will then be made over whether your patient is fit for work, or whether they belong in the Work Related Activity Group (WRAG) or the Support Group.

People placed in the WRAG are expected to attend Job Centre interviews, and to participate in activity that moves them towards the goal of returning to work. This can mean going for counselling, doing voluntary work, or simply attending relevant medical appointments. It depends upon how understanding of their condition their advisor is.

People placed in the Support Group are not expected to return to work in the near future. They will be assessed again at some stage however. (At the moment they are assessing some people every three months).

I believe, but could be wrong, that if someone is on Contributions Based ESA and placed in the Support Group, that the year limit does not apply.

It is at this stage, that if your patient is found unfit for work, that they can appeal. They must appeal straight away, otherwise their payments will be stopped. Their case will go back in front of a Decision Maker again to assess whether a wrong decision was made, or whether the case should go in front of tribunal. Last time I went through the process mine was overturned at this point, so it does happen, though it’s rare.

At this stage I get lost. I’ve not helped anyone go through tribunal yet, because everyone I’ve helped has gone straight into the Support Group. I understand it’s an extremely stressful process, that they must gather even more evidence, that it’s best to have someone accompany them, etc.


So, to understand what happened to me [..].

Kind regards,

Olana

Journey; Part 1 update

Today I received a letter from the DWP. I was amused to see that they had used the stamped addressed envelope I included for them. They don't usually do so. At least my stamp did not go to waste.

They stated in the letter that I had been on Income Related Employment & Support Allowance.

The letter did not say so, but this will explain why they ceased my ESA when I received my divorce settlement. I should have been on Contributions Based Employment & Support Allowance. As such the money should not have affected my payments, and I should be able to reclaim a few months worth.

It seems they believe I started claiming in February last year however, so I only missed two months of payments. I believed I started claiming in April, I am however happy to assume that their records are correct. As such, if I fail in my endeavour to reclaim the money they owe me, I have not really lost all that much.

Journey; Part 1

Two weeks ago I invited you to start a journey with me, in my attempt to recover some money from the DWP.

Today I made my first move. I telephoned the DWP to ask them whether my claim had been Income Based ESA or Contributions Based ESA. I was told that because the claim is now closed they cannot tell me. It will not tell them that on the system. As such I have to write to the DWP and request the information. The lady I spoke to could however tell me the dates of my claim and that when I originally made the claim I applied for Income Based ESA.

As such I have written a letter, included a stamped self addressed envelope, and will post it the next time I leave the house.

The way their systems work seems very strange to me. This is not the first time I've discovered something strange like this. I found a few months ago that you cannot change your address with the DWP when a claim has closed. So they sent a letter to an old address of mine asking me to go for a medical assessment, and then another telling me I had automatically failed since I hadn't turned up. Surely, if the claim was closed I should not need to attend a medical assessment; if it was not closed they should have been able to change my address and send those communications to my current habitation. This however, is not relevant to my current endeavour ...

I invite you to start a journey with me.

It would seem that I may have been short changed by the DWP. As anyone who's been following my blog will know, I am fairly familiar with the benefits system having researched it for the last year. However, it seems that I may have missed something blindingly obvious, which has just been pointed out to me by someone on one of the benefits groups.

Let me lay it out as simply as I can:

• Since 2001 my National Insurance has been paid by me, out of 'pocket money' my husband gave me over the years.
• As such, when I started receiving ESA last April I should have been put on Contributions Based ESA. (I need to check whether I was or not).
• Contributions Based ESA is not means tested. They do not take into account the income of your partner, or your savings.
• Contributions Based ESA, is however, limited to 12 months.
• In November of last year I received a divorce settlement. At the time I was uncertain of whether it would affect my benefit, since it was more than £16,000, so I phoned the DWP for advice.
• I was informed that any savings over £16,000 meant I was disqualified from receiving ESA, but I would still receive my NI stamp.
• I discovered a few months ago that when I made that phonecall they closed my claim to ESA, which means that since November my NI stamp has not been paid either.
  
• The person I spoke to did not tell me they were closing my claim. I received no mail informing me that my claim was closed. I received no mail informing me that they would cease paying my ESA either.
  
• When I was informed, a few months ago, that my claim had been closed in November, they also told me that I should have been providing bank statements to the DWP since November, showing my spending. (This confused me).

There has been a mistake somewhere. Either I was not on Contributions Based ESA, which I should have been, and that is why my claim was closed ... or the person I spoke to at the DWP incorrectly assumed that I was on Income Related ESA and closed my claim when they should not have. I suspect the latter happened, as that would possibly explain why I received no mail (ie, someone covering their tracks just made the claim disapear).

So, my job now, it seems is to:

1. Check whether I was on Contributions Based ESA or Income Related ESA to start with.
2. Assuming I was on Contributionas Based ESA, I will need to collect together evidence for the DWP to claim back payments from November until April (as my claim would have been ceased in April anyway). With advice, the evidence I need is as follows:

• a timeline of date of claim,
• the decision letter,
• the time I was in receipt of payments and how much,
• when payments were stopped,
• my NI record showing payments not made,
• date received divorce settlement

Of these the only information I do not have is my NI records, but I am fairly sure I can get those from the DWP.

So, I invite you to follow me on this journey. I have no idea of what is to come, whether it will be very simple, or whether I will get absolutely nowhere. Let us see!

Another letter to my MP - an afterthought

I'm not sure why this suddenly occurred to me last night. I kept drafting it in my head and couldn't get to sleep for ages because I was itching to write it. I suspect that because it would be showing a lot of faith in the little sheep who claim ESA and DLA, the idea will be shot down before it even gets anywhere. I hope at least that my MP will read it though ... I want to plant a little seed.

Dear MP,

I am writing to you again in reference to Welfare Reform. Something occurred to me, though I am uncertain of how well it will be received by the minister concerned. When someone is called up for the medical assessment I think they should be able to have the option to postpone it under mitigating circumstances. If they are already going through a stressful life experience, they should be able to state it to the DWP, providing evidence.

I’ll explain why this occurred to me. While as you know, I do appreciate that you cannot comment on my personal experience, I can! And it makes a good example.

When I was called up for the medical assessment I was in the process of a divorce, putting the house up for sale, and recovering from an extreme relapse during which I thought I was going to die. I have read time and again that divorce and moving house are considered to be at the top of the list of stressful life experiences. It was actually the medical assessment I found most stressful. Because of the medical assessment I returned to self harming, and came extremely close to suicide. I apologise for being so blunt. Had I not already been going through three stressful experiences at the same time, it would probably not have affected me as badly as it did.

Obviously I do not believe someone can be excused a medical assessment due to illness. However, being in the process of divorce, or moving house can be easily proved, as also can various other stressful experiences. I am aware that the DWP would be placing trust in people to inform them when they were then available for assessment, however I do not see that this is any different from the trust placed in people to inform the them of when their circumstances change. Personally I am so afraid of being penalised by the DWP that I would not dare to not inform them if my circumstances were to change.

It would be a small almost human touch on the behalf of the DWP to a public who perceives them as treating us as numbers. I would be grateful if you would pass my comments on again.

Kind regards,

Olana.

Atos Complaint Form

I'll give them their dues. They got this to me immediately. If you wish to complain to Atos use the following email address: customer-relations@atoshealthcare.com

Say you wish to complain, and give them their name and address so that they can mail the complaints booklet to you.

Having had a quick read through I don't think we actually need the booklet to be honest. I've typed it up so that you can decide for yourselves.

---

Why do I need a medical examination?
The Department for Work and Pensions ask Atos Healthcare to arrange and carry out medical examinations if they need more medical information about people claiming benefits. The purpose of the examination is to provide a medical opinion about how your illness or disability affects you in everyday life. A fully registered, specially trained and approved health care professional will talk to you and, if necessary, complete a physical examination.


What happens following the examination?
The health care professional will complete a medical report for the office dealing with your claim and the Department for Work and Pensions will use this as one source of information when looking at your claim.


Are you unhappy about your benefit decision?
If you are unhappy about the decision made by the Department for Work and Pensions you may ask them to reconsider their decision. If you want to do this you should contact the office dealing with your claim, contact details will be shown on your decision letter.


Do you have any comments, complaints or suggestions about our service?
We will treat all people who undergo a medical examination fairly and equally. Your views on the service we provide are very useful in planning improvements, so if you have any comments, please do not hesitate to let us know. (Please use the form attached to this leaflet).

We are always very pleased to have appreciative comments, which of course we pass on to the staff concerned. Any suggestions you may have for improving services will be studied with care.


Are you unhappy about your medical examination?
Our responsibility is to arrange your appointment, ask a health care professional to conduct a medical examination and provide a report to the office dealing with your claim.

If you are unhappy with any part of our service, or simply feel we could do things better, please let us know.

We want to improve the service we provide and your comments will help us achieve this.


How do you complain?
> Please use the form attached to this leaflet or you can write or email us quoting your name, National Insurance number and the date of your medical examination.

> If you would like to discuss your complaint over the telephone, please contact a Customer Relations Manager who will be happy to call you back.

Customer Relations Manager
Tel: 0113 2309175
customer-relations@atoshealthcare.com



Who can help you make a complaint?
Anyone working for Atos Healthcare can advise you about making a complaint, including the health care professional conducting the medical examination.

In addition, other people who can help include:

> Citizens Advice Bureau
> Welfare Rights Workers
> A friend of family member.

If someone is to contact us on your behalf, please remember to give your signed consent to that person, either on the attached form or by separate letter.


What will happen to my complaint?
Our aim is to deal with your complaint fairly, consistently and in a timely manner. We will acknowledge your complaint within 2 working days and keep you update throughout our investigation.

We hope to respond to your complaint within 20 working days. However, our investigation may take longer. This is because to conduct a thorough investigation we may need to:

> Obtain a copy of the medical report from the office dealing with your claim.
> Obtain information from the health care professional or other employees involved.

On completion of our investigation into your complaint where it is found that the medical report may contain some inaccuracies, we will notify the office dealing with your claim. Please not that Atos Healthcare cannot change the decision on your benefit or request a further medical examination. This is for the decision maker in the Department for Work and Pensions.


What if I am not satisfied with your response to my complaint?
Please contact the Customer Relations Manager, explaining which parts of your complaint you feel have not been dealt with to your satisfaction. The Customer Relations Manager will arrange for a senior manager to personally review the investigation into your complaint and undertake a further investigation, if appropriate.


Is an independent review of my complaint possible?
Yes, when our investigations are complete, you may request that your complaint be referred to an Independent Tier.

The Independent Tier is independent of Atos Healthcare. Their role is to review how we have handled your complaint, how we conducted our investigation and ensures that we have responded to all the issues you raised.


Can I take my complaint further?
Atos Healthcare provide medical services on behalf of the Department for Work and Pensions. If you continue to be dissatisfied with the service provided by Atos Healthcare the office of the Department dealing with your claim can provide contact details of Departmental Chief Executives.


Please note: The Independent Tier is not able to comment on the outcome of your claim to benefit. However, where appropriate, the review will include a medical assessment by an independent medical practitioner about the quality of the medical report provided to the Department for Work and Pensions.


About you
(If you are a representative please provide details of the person you are representing, their authorisation and contact details for yourself.)

Title:
Surname:
Other Names:
Date of Birth:
National Insurance Number:
Contact Address:
Daytime Phone Number:
Representatives Name (if applicable):
Authorising Signature:
Your Signature:
Date:

Please tell us your comments, complaints or suggestions overleaf.



Tell us your comments, complaints or suggestions




Please continue on a seperate sheet of paper if necessary.

Tear off this form and hand it in or post to your Customer Relations Manager, Atos Healthcare, Block 1, WingG, Government Buildings, Otley Road, Lawnswood, Leeds, LS16 5PU