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ESA face to face

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10 years 8 months ago #124105 by marnie
ESA face to face was created by marnie
Hi
I've had to give up work due to severe schizoaffective disorder.I last worked(part time) in April 2014.
My pschyiatrist and CPN have written a joint letter for ESA covering the descriptors and giving full details of my condition and how it affects me.
They have also. Included a paragraph saying that a face to face assessment would cause me great psychological distress and I would be unable to answer questions as I have little insight into my illness.
I also have a letter from my GP and my care plan.
My questions are should I send all the medical evidence I with the initial claim form(I downloaded it)
and what is the likelihood of being called for a medical which. Will be impossible for me even with someone with me ?
Thanks

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10 years 8 months ago - 10 years 8 months ago #124106 by slugsta
Replied by slugsta on topic ESA face to face
Hi Marnie,

You should include all your evidence when you submit the form ESA50 which goes into detail about your illness and limitations.

I'm afraid I can't say whether or not you are likely to be asked to attend a face2face assessment. I have a friend who's son is in a very similar situation to you, his consultant has also written to say that he should not have to attend any type of interview. We are waiting to hear whether he is asked to attend a f2f!

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 10 years 8 months ago by slugsta.
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10 years 5 months ago - 10 years 5 months ago #126777 by marnie
Replied by marnie on topic ESA face to face
I have had help with this email.
I have a severe mental illness which meany I had to stop work a few months ago. Soon I will have to claim ESA. My CPN and my psychiatrist have done a letter relating to the descriptors and giving a detailed report on my condition. I also have a report from another doctor. My CPN and my psychiatrist have said in the letter that I cannot attend a medical due to severe overwhelming psychological distress and I am likely to be uncommunicative and become aggressive when I feel threatened or persecuted. It would not make any difference if someone was with me or if it was held at home.
I have seen the regulations on good cause for not attending a medical as I simply would't go if called. My CPN has said she would phone them and tell them I could not attend due to my disability and explain I was vulnerable and had suicidal ideology. I see that good cause depends on the nature of your disability and would require further medical evidence which I could provide.
What does good cause depend on? Thank you
Last edit: 10 years 5 months ago by .

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10 years 5 months ago #126781 by Gordon
Replied by Gordon on topic Esa good cause
Marnie

Good Cause covers a variety of situations, for example the claimant being ill on the day or even their being out of the country, however, all of these reasons are in the context of the claimant not attending an individual assessment, the vast majority will not be considered if the claimant fails to attend any assessment.

Your problem is that an assessment has to be carried out for an ESA award to be made. It is possible for an award to be made on what is called Scrutiny, this means that a recommendation is made purely on the claimants completed ESA50, any evidence attached and usually (but not always) information sought from the claimants GP.

However, if ATOS decide that there is insufficient information for a recommendation then an assessment will be required for an award to be made, further, failing to attend or participate in an assessment can and likely will result in your claim being closed by the DWP, you will be given two opportunities to attend.

Should this happen then you can lodge an appeal, this will be where any Good Cause is considered, however, the DWP defer all medical matters to ATOS, so whilst there will be an opportunity for you to explain why you were unable to attend, if ATOS still insist that an assessment is required you will back in the original situation.

This is obviously a worse case scenario, to avoid it you need to focus on showing that you meet the ESA criteria by completing the ESA50 in as much detail as possible and including all of the evidence that you have available. If you have not already done so, you should have a look at our ESA Claim guides which explain in detail how to complete the forms in relation to your problems.

www.benefitsandwork.co.uk/help-for-claimants/esa1

If you have any questions now, or when you apply for ESA then please come back to the forum and we will do our best to help.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
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10 years 5 months ago #126784 by slugsta
Replied by slugsta on topic ESA face to face
It might reassure you to know that the friend's son I spoke of up-thread was put straight into the Support Group without a face2face assessment. It does happen but there are no guarantees!

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10 years 5 months ago - 10 years 5 months ago #126786 by
Replied by on topic ESA face to face
Hi M,

It is not absolutely clear whether or not you have made the initial claim for ESA since your last post some 3 months ago.

If not, you need to obtain a Med 3 "fit note" from your G.P. practice, you, or someone else can then make your claim for ESA using The ESA 1 Claim Form, or over the telephone, see : How to claim ESA Gov.UK

The "fit note" should be sent into The DWP when you make your fresh claim, keep copies : Sending Documents to the DWP or ATOS

There is also a Guide to ESA entitled : "Understanding Employment and Support Allowance. Our 42 page introductory guide to ESA." 2nd link down this page :

ESA Claims Guides

Once your claim has been accepted and administered payment of The Assessment Rate of ESA should ensue. (currently £72.40/Week for a single over 25 year old.)

The next thing to happen should be that you receive an ESA50 Questionnaire through the post, which must be filled in and returned by the deadline date that will accompany it.

When the time comes, you might want to consider : Using The PDF Version Of The ESA50 Questionnaire

Whilst referring to the guides on this page :

ESA Claims Guides

The Mental Health Claims Guide is the 4th link down.

See also :

How long do I have to complete the ESA50?

ESA50 too big for the envelope

Although your CPN could provide evidence of your health issues and resulting limitations at an early stage, including your inability to have a Face to Face (F2F) "Medical", it is important that copies of any such supporting evidence are also included with The ESA50.

There is a section within the ESA50 regarding you having a F2F "Medical" it is here that you should give details of how and why you cannot go through a F2F "Medical"

The DWP/ATOS may send an : ESA 113 Questionnaire to your G.P. or treating HCP.

Having a F2F is covered at questions 6/7 and if one is issued it would be important that your G.P./CPN gave the correct supporting responses.

If you still receive an appointment for a F2F, you or someone supporting you, should contact ATOS ASAP :

Phone : 0113 230 9175. or 0800 2888 777

Or E-Mail : This email address is being protected from spambots. You need JavaScript enabled to view it. FAO : WCA Customer Service.

More information can be found : Here.

You are allowed to re-arrange a F2F once, and if you do need to contact ATOS regarding the above, they will probably insist that your G.P./CPN Faxes them in support of you not being able to go through a F2F.

If you can provide enough compelling evidence, there may not even be a need for a F2F, as an award can be made on paper evidence alone.

Regarding your query on Non attendance of a F2F, see the actual legislation below :

“Claimant may be called for a medical examination to determine whether the claimant has limited capability for work-related activity

38. (1) Where it falls to be determined whether a claimant has limited capability for work-related activity, that claimant may be called by or on behalf of a health care professional approved by the Secretary of State to attend for a medical examination.

(2) Subject to paragraph (3), where a claimant fails without good cause to attend for or to submit to an examination listed in paragraph (1), the claimant is to be treated as not having limited capability for work-related activity.

(3) Paragraph (2) does not apply unless written notice of the time and place for the examination was sent to the claimant at least 7 days in advance, or unless the claimant agreed to accept a shorter period of notice whether given in writing or otherwise.”

From :

www.legislation.gov.uk/uksi/2008/794/regulation/38/made

Disqualification of your ESA payments should only ensue, if you received an appointment for a F2F, you failed to contact ATOS, and did not take part in the F2F, and after receiving, filling in and returning a BF223 Form, you could not show good cause for non-attendance.

They are supposed to make allowances for claimants with MH issues.

Hopefully, they will take notice of your evidence, and will decide to make a decision without a F2F, therefore avoiding the potential problem of non-attendance.

I know this post is a lot to take in, hopefully someone who supports you will help.

You might want to Bookmark/Favourite this page in your Internet Browser. That way you can find it again easily and return to pose any further queries as/when they crop up.

Please do keep us updated.

bro58
Last edit: 10 years 5 months ago by .

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