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Failed esa assessment with 6 points

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9 years 7 months ago #141568 by R R
Replied by R R on topic Failed esa assessment with 6 points
Ive been really unwell for the past several weeks so havent been able to deal with this.

last week I called up for a mandatory recon... I should've asked advice here first but was running out of time.

anyway here is what my original report says....

At the medical assessment Mr ____ medically identified conditions were respitory problems, abdominal pain and anxiety.

no other conditions were reported.

Physical:

Getting around safely

In his ESA50 Mr ____ indicates that his ability to see cross a road on his own varies.He states that sometimes he has extreme light heaedness and blurred vision.

In his description of a typical day Mr ___ states that he had no difficulty completing the ESA50 form. He is able to climb and descend stairs independently. He states thathe reads the news on his telephone everyday and uses his telephone for the internet. he uses his smart phone to communicate with othersand for emergencies. He states that he gets a lift to attend appointments. He copes well with minor changes such as traffic delays and road closures. He deals with letters and bills without difficulty.

The HCP observed that Mr ____ had no difficulty negotiating doorways and furniture within the examination centre. He had no difficulty reading small prints on a letter. using both eyes he was able to read N8 print on a reading test test type chart from a distance of 25cm without correction. His visual acuity was 6/9 using both eyes without correction. Although he states that he gets dizziness and blurred vision with his symptoms he has never had any loss of conciousness. His vision tests were normal. Overall significant impairment in vision seem unlikely.

the evidence indicates that mr ____ would be able able to navigate around unfamiliar surroundings without being accompanies by another person. I have therefor not awared any points for navigation.

Mr ____ reported a respitory problem and abdominal problem at the medical assessment. He reports that he has been experiencing respitory and abdominal symptoms for one year. he has had several tests and scans which have all come back normal, He was advised that it could be anxiety and referred to a talking therapy. He istaking a standard dose of anti depressant.

Mental

Coping with getting around on your own

In his ESA50 Mr ___ indicates thathis ability to leave home and go out to places that he knows varies. He states that he has bouts of dizziness and at these times he stays in bed or if he is going out he makes sure he travels by cab.

in his description of a typical day Mr Zaman states that he is able to visit familiar places like local shops independently. He states that he is unable to visit unfamiliar places alone due to anxiety. He states that he gets his sister to accompany him to appointmets. He attended the examination centre with his sister. He stated he sees different Gp's , different consultants and specialists. He states that he has no problem talking to strangers.

the HCP observed that Mr ___ looked well. He had normal manner, adequate rapport and made adequate eye contact. He is unable to visit unfamiliar places alone due to anxiety. His sister accompanies him to the medical assessment centre. Overall, some impairment in getting about seems likely.

The HCP consider descriptor GAc reflected Mr ___ health condition (is unable to get to a specified place with which the claimant is unfamiliar without being accompanies by another person). (6 points). The decision maker had no evidence or opinion to the contrary.

the tal score for physical and mental descriptors is 6 points. Mr ___ does not hae limited capability for work.

overall, there is no significant impairments to justify limited capability for work. I have considered whether the exceptional circumstances in regulation 29 and 35 apply but there is no medical evidence or behaviour to support this.

A successful attempt was made today to contact Mr ___ to explain the decision. He stated he has a GP appointment tomorrow. Mr ____ was advised of the option of requesting a mandatory reconsideration and supplying further medical evidence if he disagrees with the decision. Mr Zaman was also advised regarding claiming Job seekers allowance. He stated it made sense.

I am satisfied that the descriptors have been fully justified with clinical findings, observations and extracts taken from the typical day history provided by Mr ___. The medical report of 14/08/15 was appropriate. complete and covered all the areas of incapacity described by Mr ____ as well as including a comprehensive typical day history and full set of clinical findings.

the decision maker has considered the healthcare professionals report and the limited capabilityfor work questionnaire and has decided that mr ___ has not achieved 15 points from the appropriate descriptors.

As a result mr ___ is no longer assessed as having limited capability for work therefore limited capability for work is not accepted from and including 08/08/15 and he is not entitled to employment and support allowance from that date. Mr ___ has not supplied medical evidence of his limited capability for work from 07/08/15


continued....

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  • R R
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9 years 7 months ago #141569 by R R
Replied by R R on topic Failed esa assessment with 6 points
so 3 weeks went where i was in a terrible state, my symptoms flared up like never before and i decided to hide my way from the world.

last Thursday (01/10/15) i finally decided to contact them for a mandatory reconsideration.

A lot of things written the report were plain outright lies which upset be so much that i felt physically sick.

I told the person on the phone That it stated in the report I can get around to familiar places on my own which is an outright lie as i cannot and have not gone out anywhere familiar or unfamiliar on my own and unless i really needed to.

the report stated that i had good manners and had adequate eye contact, I told them just because I'm unwell that does not mean i forget my education and manners.

It also stated that they had conducted a vision test which i passed which also did not happen.

I asked how they can judge me on "looking well" as it is a poor criteria to judge someones health especially not knowing someone.

I also stated that I cant go anywhere because I have alternating bouts of constipation and diarrhea and when I do have diarreah i need a toilet nearby all the time.

There was a lot more i could have added but i was anxious on the phone and couldnt think up much of it. some of the blatant lies really wants me to lash out. the part about the eye test which shows i have good vision... even if i wasnt ill I still have astigmatism and am terribly short sighted and would have failed any eye test conducted regardless of health conditions.

so they told me they would get back to me in 14 working days and I have 14 days to come up with anymore evidence if i would like to submit. I was just getting some more reports ready and this morning I receive the letter with the decision which i will write out in the nex post...

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  • R R
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9 years 7 months ago #141576 by R R
Replied by R R on topic Failed esa assessment with 6 points
The decision letter states

We have not changed our decision

the explanation is as follows...

The descriptors Getting around safely and getting about were considered by the healthcare professional and have been fully addressed by the original decision maker and points were awarded appropriately. Aside from personal testimony, you have not provided any additional evidence in support of your request for reconsideration which would allow for further revision, This is why i prefer the advice of the HCP.

Control of your bladder, bowels or stoma

This activity relates to maintain continence or bladder and/or bowel or prevent leakage from collecting device.

the minimum legal requirment for this activity is that a person, for the majority of the time, is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to rquire cleaning and a change in clothing, if not able to reach a toilet quickly.

In your request for MR you advised that you have adbominal pain and have to be in a place where you know the toilet will be.

You told us on your ESA50 that you have no problems in this area (WHAT!? i mentioned it in the assessment, is the ESA50 the original ESA application form?)

At your assessment you advised the HCP that you suffer from an abdominal problem, however you also stated that you do not have incontinence problem and do not wear pads. (I dont wear pads but i did mention i have incontinence problem!!)

In your typical day you stated that you can attend appointments but avoid public transport incase you need to use the toilet (isnt that contradictory to their previous point where they claim i never told them about incontinence?). You take walks alone and go to the local shops (WHATTT!? i did not say that nor have i walked to the local shops or gone anywhere for a walk in the last year!)

The HCP has not advised that you would have a significantproblem in this areaand i agree there is no evidence despite your medical conditions you would meet the minimum criteria to be awarded any points for this descriptor.

I acknowledge that in your request for reconsideration that you stated that you suffer from severe anxiety. This has been considered by the HCP and further considered by the decision maker. You have not provided any further medical evidence in support of your reconsideration which contradicts the findings of the asessment in relation to your functional abilities depite suffering from anxiety. This is why i prefer the advice of the HCP.

You have stated that some of the statements from the medical report are untrue. The HCP is trained disability analyst who will assess the functional effects of a condition. their role is to prepare a report based on their clinical asessment of an individual and may include an examination, information from a typical dayand informal observations. It will not necessarily be a re-statement of opinions given by you at the assessment. They have no interest in reporting the assessment innaccurately. The information that you gave the HCP at your assessment was specific and consistent with the findings of the physical and mental state examination. I have no reason to consider the medical report inaccurate.

The test for ESA is not the fact that a person has health conditions but how those conditions affect their ability to function on a day to day basis within the specific activities of the work capablity assessment.

I have also looked at another regulation (regulation 29). I have decided that you do not have a condition that is life threatening and uncontrolled or uncontrollable. This regulation also allows me to consider whether or not there would be a substantial risk to your health or that of others if you were found not to have limited capability for work. I have to consider this in relation to your journey to and from work in the work place itself.

I have decided that this regulation does not apply in your case because the evidence available indicates that you are capable of completing daily tasks and activities which can be transferable into a work place environment. Although you have problems with your health condition, reasonable adjustments could be made in the workplace. Therefore i have determined that this regulation does not apply as you are not suffering from a life threatening disease for which there is medical evidence that the disease is uncontrollable, or uncontrolled, by a recognized therepeutic procedure. Nor are you suffering from some specific disease or bodily or mental disablement which would cause a substantial risk to mental or physical health of any person if you were not to have limited capability for work.

I have considered your request for reconsideration and i can find no reason to change the original decision based on the evidence held. you have not provided any further evidence that would enable me to change the original decision.

it is not disputed that you have health problems, but it has been established that the medical conditions that you have do not limit your functional ability to the extent that you have limited capability for work.

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9 years 7 months ago #141581 by Gordon
Replied by Gordon on topic Failed esa assessment with 6 points
RR

I would have a look at our ESA Claim guides

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

based on the admittedly limited information you have posted, you do not seem to meet the criteria for an ESA award,

The guides contain the legal definitions against which you are being tested, you need to meet all of the elements for each Descriptor to be able to score points.

Come back to the forum when you have had a look 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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9 years 7 months ago #141585 by R R
Replied by R R on topic Failed esa assessment with 6 points
thank you gordon i will do so.

originally when i went to the asessment i took all my consultant reports, scans etc but they only kept a photocopy of my talking therapy letter and the the anti depressant i am taking.

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