Exceptional circumstances regulations ESA

I recently posted here about my delight on getting through the medical first time and getting into the Work Related Group.

However I have just received my medical notes that I decided to send for and to my horror I may be reviewed in 3 months as this is the time given as the prognosis for me being fit enough to go out to work.

So ... I am already looking again at how the system works for next time. I have been looking at the Understanding ESA booklet where the basics are set out.

I see that you can be exempted on the basis of being covered by the limited capability for work exceptional circumstances rules. I have also seen on another discussion forum for Welfare Rights workers the use of this in winning appeals (usually called Regulation 29(2)b).

The exact wording is this in the booklet:
(b) you suffer from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if you were found not to have limited capability for work.

I have ME/CFs and I believe that for me, and many others with the same condition,(and others no doubt), that indeed our health would be put at risk if we were forced into work. Is it worth trying to argue this at the very first stage i.e. in the medical form that has to be filled in before the assessment?

If you have a good letter from your specialist (which I did last time), suggesting that your health would worsen if you were to go out to work, then would it be worth using this as well as doing the rest of the form of course?

It is proving very difficult for many people who have ME/CFS to get through the medical assessment and I just wondered if this was a way to avoid the tribunal. I do know of someone with ME/CFs who won his tribunal on this basis last time.

Hi Mermaid

That's exactly what I did on my ESA50. I didn't use the term 'exceptional circumstances' but explained in detail how I feel my health would worsen if I was back in work. It didn't work but it did not matter as I scored enough points to be found unfit for work.

I think ATOS use exceptional circumstances very sparingly and not many claimants will fall into this category following a medical. However, if you have to appeal the decision it would be very valuable to have made this claim from the outset, when you filled in the ESA50.

If your doctor or consultant also agrees with you, their written evidence should increase you chances of satisfying Regulation 29(2)(b), both at the decision, or on appeal.

Best wishes

Derek

That is a very good point Stephen ... the dreaded Graded Exercise Therapy!

However the NICE guidelines I think (haven't read through recently) would expect you to have GET with a proper therapist, and as you have indicated, this is not often forthcoming.

Also there are some interesting bits in the DWP A-Z of medical conditions with regard to ME/CFS which indicates that they are not expecting all of us to be skipping around after our GET exercises.
www.dwp.gov.uk/publications/specialist-g...gnosis-and-duration/

I think that it is clearly vital to have a letter maybe from your specialist, (if you have one) which indicates damage if you go back to work too early. Mine put that it would be detrimental to my health and my longer term improvement if I was to attempt a return to the workplace before I was able to in a sustainable way.

Sorry to hear that you don't even have a specialist Stephen.

... as current government recommendations for the treatment of ME/CFS encourage exercise and a return to work...

Shows how much they either know or care.