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While it is outrageous that they are using outdated evidence, that is not my point.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.

Support Group Descriptors

The previous post lists the point scoring system used with the descriptors for the ESA50 & WCA. As stated in that post, you need 15 points to get ESA. If you score 15 points in only one section you will be placed in the ESA Support Group, as opposed to the Work Related Activity Group. The other way to be placed in to the Support Group is to meet one of the descriptors below.

If you are unfamiliar with the terms used above, please see this post.

Support group descriptors

Qualifying for the support group of employment and support allowance (ESA) is not about scoring points.  Instead, if the decision maker accepts that any of the following descriptors apply to you, then you will be placed in the support group. 1.  Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used. Cannot either  (i)  mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion or (ii)  repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.  2.  Transferring from one seated position to another. Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person. 3.  Reaching. Cannot raise either arm as if to put something in the top pocket of a coat or jacket. 4. Picking up and moving or transferring by the use of the upper body and arms (excluding standing, sitting, bending or kneeling and all other activities specified in this Schedule). Cannot pick up and move a 0.5 litre carton full of liquid. 5. Manual dexterity. Cannot either: (a) press a button, such as a telephone keypad or; (b) turn the pages of a book with either hand. 6. Making self understood through speaking, writing, typing, or other means normally used. Cannot convey a simple message, such as the presence of a hazard. 7. Understanding communication by hearing, lip reading, reading 16 point print or using any aid if reasonably used. Cannot understand a simple message due to sensory impairment, such as the location of a fire escape. 8. Absence or loss of control over extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting) despite the presence of any aids or adaptations normally used.  (a) At least once a week experiences (i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or (ii) substantial leakage of the contents of a collecting device; sufficient to require cleaning and a change in clothing. 9.  Learning tasks. (a) Cannot learn how to complete a simple task, such as setting an alarm clock, due to cognitive impairment or mental disorder. 10. Awareness of everyday hazards (such as boiling water or sharp objects). (a) Reduced awareness of everyday hazards leads to a significant risk of:  (i) injury to self or others; or (ii) damage to property or possessions, such that they require supervision for the majority of the time to maintain safety. 11. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks). Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions.  12. Coping with change (a) Cannot cope with any change, due to cognitive impairment or mental disorder, to the extent that day to day life cannot be managed.  13. Coping with social engagement due to cognitive impairment or mental disorder Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual. 14. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace. 15.  Conveying food or drink to the mouth. (a) Cannot convey food or drink to the claimant’s own mouth without receiving physical assistance from someone else; (b) Cannot convey food or drink to the claimant’s own mouth without repeatedly stopping, experiencing breathlessness or severe discomfort; (c) Cannot convey food or drink to the claimant’s own mouth without receiving regular prompting given by someone else in the claimant’s physical presence; or (d) Owing to a severe disorder of mood or behaviour, fails to convey food or drink to the claimant’s own mouth without receiving — (i) physical assistance from someone else; or (ii) regular prompting given by someone else in the claimant’s presence. 16.  Chewing or swallowing food or drink (a) Cannot chew or swallow food or drink; (b) Cannot chew or swallow food or drink without repeatedly stopping, experiencing breathlessness or severe discomfort; (c) Cannot chew or swallow food or drink without repeatedly receiving regular prompting given by someone else in the claimant’s presence; or (d) Owing to a severe disorder of mood or behaviour, fails to— (i) chew or swallow food or drink; or (ii) chew or swallow food or drink without regular prompting given by another person in the physical presence of the claimant.

ESA Descriptors

When you apply for Employment & Support Allowance (ESA), you receive a form called the ESA50. This form, and the Work Capability Assessment (WCA - the Atos medical assessment) are scored on a point system. The DWP / Atos use "descriptors" to award these points. The descriptors are below. The points are in blue after each descriptor. I have explained in my previous blog post the best way to use them.

You need at least 15 points to get ESA.

Limited Capability for Work Descriptors

Points are indicated in blue beneath the descriptor

Descriptors and scores for each physical activity

Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used.

(a) Cannot either:

(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;

or

(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

15

(b) Cannot mount or descend two steps unaided by another person even with the support of a handrail.

9

(c) Cannot either:

(i) mobilise more than 100 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;

or

(ii) repeatedly mobilise 100 metres within a reasonable timescale because of significant discomfort or exhaustion.

9

(d) Cannot either:

(i) mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;

or

(ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion.

6

(e) None of the above apply

2. Standing and sitting.

(a) Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person.

15

(b) Cannot, for the majority of the time, remain at a work station, either:

(i) standing unassisted by another person (even if free to move around); or

(ii) sitting (even in an adjustable chair) for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion.

9

(c) Cannot, for the majority of the time, remain at a work station, either:

(i) standing unassisted by another person (even if free to move around); or

(ii) sitting (even in an adjustable chair) for more than an hour before needing to move away in order to avoid significant discomfort or exhaustion.

6

(d) None of the above apply

3. Reaching.

(a) Cannot raise either arm as if to put something in the top pocket of a coat or jacket.

15

(b) Cannot raise either arm to top of head as if to put on a hat.

9

(c) Cannot raise either arm above head height as if to reach for something.

6

(d) None of the above apply.

4. Picking up and moving or transferring by the use of the upper body and arms.

(a) Cannot pick up and move a 0.5 litre carton full of liquid.

15

(b) Cannot pick up and move a one litre carton full of liquid.

9

(c) Cannot transfer a light but bulky object such as an empty cardboard box.

6

(d) None of the above apply.

5. Manual dexterity.

(a) Cannot either:

(i) press a button, such as a telephone keypad; or

(ii) turn the pages of a book with either hand.

15

(b) Cannot pick up a £1 coin or equivalent with either hand.

15

(c) Cannot use a pen or pencil to make a meaningful mark.

9

(d) Cannot use a suitable keyboard or mouse.

9

(e) None of the above apply.

6. Making self understood through speaking, writing, typing, or other means normally used, unaided by another person.

(a) Cannot convey a simple message, such as the presence of a hazard.

15

(b) Has significant difficulty conveying a simple message to strangers.

15

(c) Has some difficulty conveying a simple message to strangers.

6

(d) None of the above apply.

7. Understanding communication by both verbal means (such as hearing or lip reading) and nonverbal means (such as reading 16 point print) using any aid it is reasonable to expect them to use, unaided by another person.

(a) Cannot understand a simple message due to sensory impairment, such as the location of a fire escape.

15

(b) Has significant difficulty understanding a simple message from a stranger due to sensory impairment.

15

(c) Has some difficulty understanding a simple message from a stranger due to sensory impairment.

6

(d) None of the above apply.

8. Navigation and maintaining safety, using a guide dog or other aid if normally used.

(a) Unable to navigate around familiar surroundings, without being accompanied by another person, due to sensory impairment.

15

(b) Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment.

15

(c) Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment.

9

(d) None of the above apply.

9. Absence or loss of control leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting) despite the presence of any aids or adaptations normally used.

(a) At least once a month experiences:

(i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or

(ii) substantial leakage of the contents of a collecting device sufficient to require cleaning and a change in clothing.

15

(b) At risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly.

6

(c) None of the above apply.

10. Consciousness during waking moments.

(a) At least once a week, has an involuntary episode of lost or altered

15

Consciousness resulting in significantly disrupted awareness or concentration.

(b) At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration.

6

(c) None of the above apply.

Descriptors and scores for each mental, cognitive and intellectual function assessment

11. Learning tasks.

(a) Cannot learn how to complete a simple task, such as setting an alarm clock.

15

(b) Cannot learn anything beyond a simple task, such as setting an alarm clock.

9

(c) Cannot learn anything beyond a moderately complex task, such as the steps involved in operating a washing machine to clean clothes.

6

(d) None of the above apply.

12. Awareness of 15 everyday hazards (such as boiling water or sharp objects).

(a) Reduced awareness of everyday hazards leads to a significant risk of:

(i) injury to self or others; or

(ii) damage to property or possessions such that they require supervision for the majority of the time to maintain safety.

15

(b) Reduced awareness of everyday hazards leads to a significant risk of:

(i) injury to self or others; or

(ii) damage to property or possessions such that they frequently require supervision to maintain safety.

9

(c) Reduced awareness of everyday hazards leads to a significant risk of:

(i) injury to self or others; or

(ii) damage to property or possessions such that they occasionally

6

(d) None of the above apply.

13. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks).

(a) Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions.

15

(b) Cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions for the majority of the time.

9

(c) Frequently cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions.

6

(d) None of the above apply

14. Coping with change.

(a) Cannot cope with any change to the extent that day to day life cannot be managed.

15

(b) Cannot cope with minor planned change (such as a pre-arranged change to the routine time scheduled for a lunch break), to the extent that overall day to day life is made significantly more difficult.

9

(c) Cannot cope with minor unplanned change (such as the timing of an appointment on the day it is due to occur), to the extent that overall, day to day life is made significantly more difficult.

6

(d) None of the above apply.

15. Getting about.

(a) Cannot get to any specified place with which the claimant is familiar.

15

(b) Is unable to get to a specified place with which the claimant is familiar, without being accompanied by another person.

9

(c) Is unable to get to a specified place with which the claimant is unfamiliar without being accompanied by another person.

6

(d) None of the above apply.

16. Coping with social engagement due to cognitive impairment or mental disorder.

(a) Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual.

15

(b) Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual.

9

(c) Engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to difficulty relating to others or significant distress experienced by the individual.

6

(d) None of the above apply.

17. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder.

(a) Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.

15

(b) Frequently has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.

15

(c) Occasionally has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.

9

(d) None of the above apply.