SEVERE ME/CFS -ESA RECONSIDERATION

Apologies from the outset because this is a long post but I thought it would be better to put everything in and let readers think about it and advise rather than have to come back and ask questions and then advise - if you get my drift

I have severe ME and FMS and recently submitted and ESA 50 to ATOS when being migrated from IB to ESA. I followed the B+W guides and provided them with as much detailed information as I possibly could about my condition and disabilities; I also sent in a detailed specialist medical report from a consultant rheumatologist which substantiated a lot of what I put on my form. Completing the ESA 50 nearly killed me and I am still not recovered from the effect of completing it. I was put into WRAG without a medical. I asked for a written statement of reasons but all I got was a pro forma letter telling me that because I had not met the criteria for the SG I was being put into WRAG and would have to attend WFI's. I asked for the ESA 85A. This was a single sheet of A4 - there were no scores attached to the descriptors. I would imagine the nurse who did my "assessment" did it in the time it took for her to have her tea break [you will soon see why].

The key information from the ESA85A is limited to the following statements:

- The available evidence from the ESA50, Med 3 [there was no Med 3 - my GP filled in an ESA113] and specialist letter has been used to give advice in this case
- The available evidence suggests that the client has a significant level of disability due to ME, such that they would have limited capability for work
- On going pain and fatigue. Both upper and lower limb funtion affected. On moderate level medication and has rheumatology input. Problems ongoing with mobility, transferring, reaching, and picking up. SG not indicated from available evidence.
- The available evidence does not suggest that the client has severely restricted musculo-skeletal or carsio-respiratory function, such that they would be unable to mobilise more than 50 metres or transfer between seats without assistance from another person
- I advise that work is unlikely in the longer term
- The available evidence suggests improvement is unlikely in the longer term.

The rest of it is simply a print out of the SG descriptors stating in each case that the available evidence does not suggest that I have a problem with any of them

The sucker punch comes in the 85A - where the HCP writes "As the client is male, issues related to pregnancy are not relevant" - now 1. my GP and consultant refer to me as "she" thoughout their reports, my consulant specifically includes evidence on that specific issue on the seond page of his report and 3. I filled in my ESA50 as "miss" and 4. my GP mentions my ME and my FMS and my consultant dealt with both ME and FMS and gave evidence from the medical research that these are separate illnesses and that the level of disability in someone with both of them is more profound than the level in someone with only one of those illnesses . In my case the HCP only mentions ME - there is no mention of FMS . There is no mention of post exertional malaise or how it interferes with functioning. It seems to me that this HCP [a nurse] certainly didn't read the supporting medical evidence - or pay much attention to my form or else they would have spotted that I am female. The DM must not have read any of it either or would surely have spotted the HCP's basic mistake. It therefore seems to me that they have taken the view

" It's an ME case - this is how we think ME people are affected and what we think they can do - do it as a paper exercise - and put her in WRAG - see if she challenges it"

In his evidence my GP says:

"post exertional fatigue is a major problem and if she goes out she usually has to take several days to recover" "walking is limited by pain and fatigue" "she says she is unable to walk more than 50m without stopping"

THIS IS WHAT CONSULTANT SAID RE MOBILISING:

"She can walk for up to 50m at a slow pace but would then need to rest. Her balance and co-ordination are poor and she tends to stumble when walking. She has great difficulty trying to use stairs and tries to minimise occasions when she needs to do so. At times because of the severity of her pain and the level of her fatigue she has difficulty moving around the house and walking is reduced to a slow shuffle."

HE ALSO SAYS

"she experiences increased pain and fatigue when she exerts herself physically or mentally and she also experiences post-exertional malaise. The frequency of the migraines she suffers and their effect on her functioning means that she does not have the resources to function on a regular and sustained basis."

"She experiences post exertional malaise and has periods of flu-like illnes during which she has no energy, is nauseous, in pain and can only move around the house with great difficulty."

I also addressed the "imaginary wheelchair test" in my ESA50 - I wouldn't be able to mobilise a wheelchair due to fatigue pain and weakness and in my ESA50 I dealt with the "regularly reliably and repeatedly" stuff and pointed out that there was stuff to do with safety when walking because of dizziness, balance problems and have had several falls in the last 6 months sustaining injury. Long story short I thought that I had submitted enough information [substantiated by good medical evidence] to meet the SG criteria for mobilising

I have been advised to challenge this decision and ask for a reconsideration on the basis that HCP has not applied the rules on "fluctuating conditions" which I am going to do.

What I want to know is, in addition to that, can I also challenge on the grounds that the 1. the HCP mistook me for being male and obviously did not read the ESA 50 or supporting medical evidence which in turn must affect the validity of their assessment which the DM in turn rubber stamped and 2. the HCP seems to have assessed me on ME alone and there is no mention of the fact that I suffer from both ME and FMS which makes my disability worse?

I would welcome any advice anyone can offer on what to do in this case.

Many thanks
Steph