ib to esa transfer

Hello,

My wife had a bad industrial accident 22 years ago at the age of only 24. She went onto invalidity benefit which changed to "long term incapacity benefit in 1995." She was given medical severance from here work, after over 4 years of seeing top back specialists from Harley Street and a "Professor of Orthopedic Surgery" all of which her work payed for! The "SPECIALIST'S ALL AGREED" that her condition was permanent and that she would never work again.

She remained on Incapacity Benefit until August this year, when they sent her for a medical to transfer her across to ESA. But some idiot from "NURSE" from ATOS decided that all of the "EXPERTS" were wrong! And obviously all of the previous ATOS Dr's that my wife had seen were wrong as well.

She only awarded my wife 6 points on the work capability assessment test. Even though she had scored over 80 points on all previous assessments. In 1998 the DWP even sent a letter saying that they would not need my wife to send in any more med certs. She also had been for anymore medicals to the ATOS centre since then. (until last August's medical)

We obviously appealed against the decision to only award 6 points. We have just received a reply back from the DWP, saying that they agree with the ATOS nurse?? They also mention that they tried to phone my wife to talk to her, but the answerphone cut in. They did not leave a message and made their decision without even talking to her. In the "Professor of Orthopedic Surgery's Medical Report", he states that my wife's present situation fall's into the class of a "back cripples condition" which after 5 years since the accident should now to be regarded as "PERMANENT". How can a nurse from Atos + a some knob from the DWP make such a poor decision to overrule someone of such a HIGH PROFESSION'S "FINAL OPINION?"
Mt wife has also seen a psychiatrist about being depressed due to her long term condition and I also gave the nurse at the examination this report. (which states that she is a chronic depressive, due to her injury) but the nurse decided not to even mention this at all and said that my wife had not seen anyone about her depression!

Since we appealed against the DWP's decision, they have not paid my wife any money at all, we are now waiting to hear about a tribunal hearing date. But when I asked why they had stopped paying her anything at all while waiting for the appeal. They said that her "med certificate" ran out on the day of their decision in Aug 2013. I said that it was in 1998 that the last medical certificate was sent in to them. And that we have a letter from the DWP confirming that they do not require any more med certificate's ever again. So why are they now saying different to their own DWP officers decision of 1998?

Thank you for your advice and opinions in advance.

Just as an aside to Gordon's excellent advice -

The requirements for ESA are much more stringent than those for IB. For this reason it is perfectly possible for a claimant to have been claiming IB quite properly but be ineligible for ESA. As Gordon has said, the 'descriptors' that have to be met have little to do with the claimant's actual ability to work - and even less to do with whether there is anyone out there that would employ them!

DWP take the stance that only ATOS HCPs, of whatever grade, are trained to assess the claimant's ability to satisfy the descriptors as other medical professionals have a different, therapeutic, relationship with the patient. Thus the overturning of the evidence of your wife's consultants in favour of the opinion of the ATOS nurse.

When your wife was told that she no longer needed to submit further med certs, that was correct at the time but the rules have changed...

Hiya

Sounds very much like what I had re previous consultants/specialists etc etc following an accident at work.
You say it was an accident at work so I presume you are receiving Ind Inj Bnft too.
As you also received a letter from DWP Dr's who said no nee for further apts etc, did you include all these copies with your ESA?
I also was in contact with my MP who wrote a letter to accompany my reports from consultants etc and paid for some up to date private consultant repts to be included and a report from social services and my mental health nurse.

Suggest to get help with all your paperwork ready for the tribunal I presume you will be going to have with appeal and look at getting some of the things I have mentioned above in place to assist you with.

My wife bad industrial accident 22 years ago at the age of only 24. She went onto invalidity benefit which changed to "long term incapacity benefit in 1995." She was given medical severance from here work, after over 4 years of seeing top back specialists from Harley Street and a "Professor of Orthopedic Surgery" all of which her work payed for! The "SPECIALIST'S ALL AGREED" that her condition was permanent and that she would never work again. She remained on Incapacity Benefit until August this year, when they sent her for a medical to transfer her across to ESA. But some idiot from "NURSE" from ATOS decided that all of the "EXPERTS" were wrong! And obviously all of the previous ATOS Dr's that my wife had seen were wrong as well. She only awarded my wife 6 points on the work capability assessment test. Even though she had scored over 80 points on all previous assessments. In 1998 the DWP even sent a letter saying that they would not need my wife to send in any more med certs. She also had been for anymore medicals to the ATOS centre since then. (until last August's medical) We obviously appealed against the decision to only award 6 points. We have just received a reply back from the DWP, saying that they agree with the ATOS nurse?? They also mention that they tried to phone my wife to talk to her, but the answerphone cut in. They did not leave a message and made their decision without even talking to her. In the "Professor of Orthopedic Surgery's Medical Report", he states that my wife's present situation fall's into a "back cripples condition" which after 5 years since the accident should now to be regarded as "PERMANENT". How can a nurse from Atos + a some knob from the DWP make such a poor decision to overrule someone from such a HIGH PROFESSION'S FINAL OPINION? Since we appealed they've not paid my wife any money, when I asked why they said that her med cert ran out on the day of their decision in Aug 2013. I said that 1998 was the last med she sent in. And that she has not sent one in for over 15 years, as per there own DWP's request to stop sending further med certs!

Am feeling very confused!

Hi RW1,

I have merged today's post with the very similar one that you posted previously.

If your wife is appealing a fit for work decision, not only must she appeal in writing, she must also submit a fit note obtained from her G.P. to cover her from the date of the fir for work decision.

If she does not do both of the above, she will not receive assessment rate of ESA whilst the appeal is ongoing.

I am afraid that you must forget all that has gone on before the ESA transfer, there is no longer any exemption from assessment with ESA, as there was with IB. (PCA Exempt)

Further, the assessment and qualifying criteria are totally different.

May I suggest that you read :

"Being transferred from incapacity benefit to employment and support allowance.

A 22 page guide to the transfer process."

At the top of this page :

ESA Claims Guides

There is also a guide entitled :

"Understanding Employment and Support Allowance
Our 42 page introductory guide to ESA."

Below it on the same page.

Until you have an understanding of how your wife can qualify for ESA in The WRAG or The SG, you have little chance of being successful.

It may also give you a better understanding if you read the other guides on the same page.

It is a matter of showing how and why your wife's limitations as a result of the medical conditions qualify her under either :

WRAG (LCW)Schedule 2 Descriptors

By scoring at least 15 points cumulatively across all/any of the descriptors.

Or under Exceptional Circumstance Rules :

ESA Reg 29 for entry to The WRAG (LCW)

PLUS Post 28/01/13 Amendment of :

(3) Paragraph (2)(b) does not apply where the risk could be reduced by a significant amount by—

(a)reasonable adjustments being made in the claimant’s workplace;

or

(b)the claimant taking medication to manage the claimant’s condition where such medication has been prescribed for the claimant by a registered medical practitioner treating the claimant.”.

From :

www.legislation.gov.uk/uksi/2012/3096/regulation/3/made

To qualify for The Support Group, (SG) she must also show that she fulfills at least one of The SG descriptors :

SG (LCWRA)Schedule 3 Descriptors

Or under :

ESA Reg 35 for entry to The SG (LCWRA)

There is no other way for your wife to qualify for ESA, other than by fulfilling the criteria above.

In the first instance, you need to get a fit note from her G.P., preferably backdated to the time of the fit for work decision.

You will not receive any assessment rate ESA, until the DWP have a fit note to cover your wife.

Keep a copies of any fit notes or other documentation.

See :

Sending Documents to the DWP or ATOS

Where to get advice?

See also :

IB, IS, SDA, Migration to ESA FAQ’s

ESA FAQ’s

Appeals FAQ’s

You might want to Bookmark/Favourite this page in your internet browser.

That way you can return to it easily to pose any further questions by replying to your topic.

bro58