Help needed - appealing ATOS decision to put me in work focused group

[pipistrollers]

Hi everyone

 

I am carer for someone who suffers from uncontrolled grand mal epilepsy, osteo arthritis, COPD and asthma. He take a LOT of meds to try to control the epilepsy but the best it gets is between 6 and 8 seizures per week - can be more but never less than 6. His days are spent very drowsy through the meds, confused most of the time, memory is non existant. He is not safe to cook as he burns pans, he cant cut vegetables as he has cut himself through either confusion or having a seizure in the middle of trying to cook. He looses control of both his bowels and bladder when he has seizures, he has to sleep for 3 or 4 hours after each seizure. Just trying to give you a tiny bit of understanding what his life it like. On top of that, the osteo arthritis is bad enough that there are days he can't get out of his chair - I have to help him get to the toilet etc.

 

He is in the transition between IB and ESA. I helped him fill in the long form they sent him and returned it. He was then asked to attend for a medical though ATOS deemed that he should have a home visit as he would have had to go down 24 stairs in the event of a fire which he could not do. He had the home visit by their doctor at end November. She was actually really nice and was sympathetic to his disabilities. She asked me a lot of the questions as she fully understood that just before, during and after a seizure he is in a state of total confusion, doesn't know where he is or even who I am. She said she was satisfied but that it was down to the decision maker to decide what happens next.

 

He received the dreaded letter on 29th December but the letter is dated 17th December so that's 12 days gone of appeal to start with. The letter stated that he had been put into the work focussed group. neither of us could understand how this could be so he phoned ATOS. He spoke to a really helpful man who said that so many people are being put into the wrong group and that he should appeal. He said he would send the decision makers report so we could see how the decision was made and how to word the appeal. He in fact sent the report made by the doctor with her comments and ticks all through it. That turned up on Saturday 5th January so another load of days of appeal have gone. We both went to see his GP this morning who said that she supports his appeal and that he should have been put into the support group and not the work focussed group. She said that his disability will not get any better and that it is not feasable for ATOS to require him to attend work focussed interviews and even more so in that the time for the work focussed group is 365 days. Things are not going to be any better then, in fact they could well be worse through the stress of the work group. She is going to write a letter to this efffect in the hope it will help with his appeal. He also called ATOS and told them that they sent the doctors report but not the decision makers report which we need for appeal. He was told that would be with him by the end of the week (hopefully).

 

I was looking at the doctors report and all the ticks throughout it. It is full of contradictions. The doctor ticked the box that states that a return to work in the long term is highly unlikely and wrote that he is drowsy all day because of meds and has 6-8 seizures per week. She wrote that in her opinion he cannot return to work even in the long term. She wrote on the first couple of pages things which we had both told her which is all correct - cannot cook unaided, cannot go to new or familiar places as he gets so confused he forgets where he is going etc and walks into traffic when he is close to having a seizure so has no awareness of hazzards. Problem is that as I looked through all the different question numbers (I think they are descriptors??) she has ticked something totally different e.g., it asks for a box to be ticked about problems going to unfamiliar places and familiar places but instead of ticking that he cannot do this unaided, she ticked that NONE OF THE ABOVE APPLIES. She also did this on several other of these questions. She has said one thing in her written part yet the opposite in the ticked boxes under the numbered points. Everything she was told tallies with what was written on the long form we had to fill in at the beginning which resulted in being asked to attend the medical!

 

What on earth can be done about this?

 

1. How can we write an appeal that he has been put into the wrong group and should be in the support group and

 

2. How can we appeal against what has been done on the doctor's report?

 

Apologies that this is long but trust me this is very condensed - just needed to let you see exactly what is going on.

 

Thanks for any help and advice

[Invalidation]

Firstly youll need this

http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/@benefits/documents/digitalasset/dg_201702.pdf

 

As for the reasons for appeal you should state that full reasoning will be submitted once you have the reasons for refusal to be put in support group

 

Then you should contact the DWP and ask for the decison Makers score sheet and the Assessors report

 

You need to concentrate on each reason for the refusal to put him into the Support group by referring to the descriptors

 

I suspect someone else will be along soon with some more info but please get the GL24 sent back as soon as possible

[pipistrollers]

Thank you.

 

Can we appeal against what the doctor wrote in that it's wrong?

[honeybee13]

Thank you.

 

Can we appeal against what the doctor wrote in that it's wrong?

 

Hello there. I think you probably can.

 

The forum sticky on appeals has a template that you can use in conjunction with Atos's report and the descriptors. Here's a link.

 

http://www.consumeractiongroup.co.uk/forum/showthread.php?251737-Appealing-or-going-to-a-Tribunal-Some-useful-information%282-Viewing%29-nbsp

 

My best, HB

[pipistrollers]

Thank you so much. i will have a look at the sticky.

 

Have to pop into the jobcentre + to get a GL24 and will give a few days for the decision makers report to turn up - if it turns up before we start the appeal writing.

 

If anyone else has any thoughts, advice or experience it would all be appreciated.

 

thanks a lot everyone

[Invalidation]

Thank you so much. i will have a look at the sticky.

Have to pop into the jobcentre + to get a GL24 and will give a few days for the decision makers report to turn up - if it turns up before we start the appeal writing.

If anyone else has any thoughts, advice or experience it would all be appreciated.

 

thanks a lot everyone

 

Dont bother with the Jobcenter, Download the GL24 form. You can then work on it at leaisure on your computer before printing it off then you will also have a copy on your computer

 

Look at each of the assessors (doctors) remarks that you disagree with and calmly and concisely write your reasoning why you disagree with those points, using evidence if you have it. Use the descriptors to back up your point of view. Remember the decision isnt about how sick or disabled anyone is, its about how their respective disability affects their mobility and ability to work safely and do something repeatedly in a safe manner.

[honeybee13]

Hello again.

 

Make sure that you send them something in writing within a month, I forget exactly how many days. You don't need to go into huge detail if you don't have the info, but they need to know you want to start the appeal process.

 

HB

[estellyn]

Ok, first thing is to look at the list of support group descriptors and decide which ones apply to your friend.

 

http://www.tameside.gov.uk/esa/lcwra

 

He only needs to fulfill one descriptor, but the more that apply the better. This will be your grounds for appeal, that he meets x descriptor and so should be placed in the support group. You don't need to be more detailed than that at this point - it is more important to get the GL24 sent off within the time limit.

 

The other thing to mention when appealling is if being found fit for work could make his condition worse - for instance, does stress make him have more, or worse seizures?

 

Regarding the 365 day limit for WRAG, is your friend getting contribution based ESA or Income based ESA, and is he single or does he live with someone as husaband and wife?

 

Regarding the errors in the ATOS report, it is best at this point to make a complaint, pointing out the specific errors, and send a copy to both ATOS and the DWP. If it was a doctor who did the assessment (not all are) then you could also make a complaint to the GMC.

[pipistrollers]

Thank you so much everyone for your input.

 

Where descriptors are concerned - both he and I are very confused about this. We both thought it was the 17 questions where the doctor puts a tick in whichever box applies - there are 17 of these questions. I looked on the web to make sure and I have found descriptors for the support group - there are not 17 so I am assuming that the 17 questions which the doctor did are not the descriptors?

 

I can't understand why they don't count evacuating bowels and bladder are a major point. This only counts if the person is awake and fully functioning which means that because this happens to him while he is having a seizure, then it doesnt count. In all honesty, do they really expect him to get a job and take changes of clothing with him so that when he has seizures in work and looses control of his bowel and bladder he can change? It's madness in my view but who am I!

 

Yes pressure and stress causes a lot more seizures as does going to places he is not familiar with so that makes it even more harmful to him.

 

Where the 365 day limit is concerned, it says in the letter that he has been put on both contribution based and income related ESA if that makes any sense to you? He is single (divorced) and lives alone though he spends his days in my home. It's more convenient as I have a shower here whereas he doesn't and can't get into the bath.

[estellyn]

Thank you so much everyone for your input.

 

Where descriptors are concerned - both he and I are very confused about this. We both thought it was the 17 questions where the doctor puts a tick in whichever box applies - there are 17 of these questions. I looked on the web to make sure and I have found descriptors for the support group - there are not 17 so I am assuming that the 17 questions which the doctor did are not the descriptors?

 

I can't understand why they don't count evacuating bowels and bladder are a major point. This only counts if the person is awake and fully functioning which means that because this happens to him while he is having a seizure, then it doesnt count. In all honesty, do they really expect him to get a job and take changes of clothing with him so that when he has seizures in work and looses control of his bowel and bladder he can change? It's madness in my view but who am I!

 

Yes pressure and stress causes a lot more seizures as does going to places he is not familiar with so that makes it even more harmful to him.

 

Where the 365 day limit is concerned, it says in the letter that he has been put on both contribution based and income related ESA if that makes any sense to you? He is single (divorced) and lives alone though he spends his days in my home. It's more convenient as I have a shower here whereas he doesn't and can't get into the bath.

 

Yes the descriptor system can be confusing. Basically there are descriptors for WRAG, for which you score points - you need 15 to get into WRAG. Then there are descriptors for the support group but you only need to meet one of these descriptors to get in the support group. There is also another support group criteria, in that if being found fit for work would cause significant harm either physically or mentally then the person can be put in the support group - a worsening of seizures could be argued as significant harm, especially in a work place environment - does he fall when he has the seizure? Would he suffer mental health issues due to the fear of multiple seizures and incontinence in public?

 

Also the bit about only incontinence when awake counting is just from the WCA handbook, not from the regulations, and there have been appeals won challenging this, so it is also worth mentioning that - the regulations do not specify that incontinence during seizures is excluded, but were made to exclude bedwetting as a way of qualifying, as this doesn't affect ability to work. Unconciousness due to seizure and being asleep are NOT the same thing.

[pipistrollers]

Ok so he must have scored 15 points to be put into the WRAG - this would have been on seizures as he has between 6 and 8 per week on average but can be more.

 

Yes he does fall when he has seizures - he does the full monty falling on the floor, unconcious and shaking badly, has to be turned onto his side which isn't easy I can tell you and kept there till he stops fit shaking. When he starts to come round a bit he doesn't know anything - where he is, who I am, he doesn't even know that he has had a fit. He has to be kept on the floor for around 30 minutes giving him little sips of water until it's time to get him up which I have to do manually and yes I have the bruises to prove it! He then has to be changed and cleaned and then put to bed to sleep it off and for the rest of the day is confused and all over the place. That's how his epilepsy takes him and has done since he was around 18.

 

It effects him so badly that he doesn't have friends, doesn't communicate with anyone and no socialising as it gets to him really badly when he fits in public so how on earth could he cope with a work environment?

 

I can't seem to find a descriptor that he would fit into thats the trouble I am having.

Edited January 9, 2013 by pipistrollers
forgot to add something

[estellyn]

Ok so he must have scored 15 points to be put into the WRAG - this would have been on seizures as he has between 6 and 8 per week on average but can be more.

 

Yes he does fall when he has seizures - he does the full monty falling on the floor, unconcious and shaking badly, has to be turned onto his side which isn't easy I can tell you and kept there till he stops fit shaking. When he starts to come round a bit he doesn't know anything - where he is, who I am, he doesn't even know that he has had a fit. He has to be kept on the floor for around 30 minutes giving him little sips of water until it's time to get him up which I have to do manually and yes I have the bruises to prove it! He then has to be changed and cleaned and then put to bed to sleep it off and for the rest of the day is confused and all over the place. That's how his epilepsy takes him and has done since he was around 18.

 

It effects him so badly that he doesn't have friends, doesn't communicate with anyone and no socialising as it gets to him really badly when he fits in public so how on earth could he cope with a work environment?

 

I can't seem to find a descriptor that he would fit into thats the trouble I am having.

 

Firstly the incontinence descriptor does apply so certainly use that one.

 

Secondly, what you've described can be used as a good argument for being found fit for work would cause significant harm both physically and mentally, and so merits inclusion in the support group. The stress of working will induce increased seizures which are already 6-8 per week. He falls, so in a workplace environment he is at risk of injury, including head injury. As he is unaware of his surroundings or confused following a seizure (for how many hours) and needs to have significant care following a seizure, including intimate bodily care, and watching over to ensure safety, he certainly couldn't be trusted to safely get home from work following a seizure. Without being around a carer and his familiar environment he is at significant risk.

 

Anyone with any sense reading all of that would put him in the support group - so lets hope he gets a sensible decision maker. If not, I would say his chance of success at Tribunal is high as long as there is corroborating evidence from his doctor.

[pipistrollers]

Well you see what you said is what I am thinking also - that anyone with any sense would put him into the support group but this ATOS we are talking about.

 

Will get the appeal going - just waiting for the letter from his GP to support it. Unfortunately, if we asked for an appointment with his neurologist it wouldn't be in time for the appeal to be put in - the appointments can take a couple of months.

 

Thank you so much for your help and support and if you can think of anything else, it would be massively appreciated.

 

I feel under pressure myself as, and I know its not his fault, he has no concept of what is going on with this. He can't see the implications if he is kept in this work focussed group and I don't feel that I can sit him down and tell him that this is only for a year then he looses all his disability benefits. If I do tell him and it sinks in, his seizures will increase very badly so I feel it's all on me to sort this out for him.

[estellyn]

Well you see what you said is what I am thinking also - that anyone with any sense would put him into the support group but this ATOS we are talking about.

 

Will get the appeal going - just waiting for the letter from his GP to support it. Unfortunately, if we asked for an appointment with his neurologist it wouldn't be in time for the appeal to be put in - the appointments can take a couple of months.

 

Thank you so much for your help and support and if you can think of anything else, it would be massively appreciated.

 

I feel under pressure myself as, and I know its not his fault, he has no concept of what is going on with this. He can't see the implications if he is kept in this work focussed group and I don't feel that I can sit him down and tell him that this is only for a year then he looses all his disability benefits. If I do tell him and it sinks in, his seizures will increase very badly so I feel it's all on me to sort this out for him.

 

We're here to help when you need it. Getting something off of the neurologist would be good for the Tribunal, but that could be 6 months away, so not an urgent issue.

[pipistrollers]

Hi again

 

Writing the appeal right now and sending it overnight delivery and tracked and signed so they can't say they didn't receive it.

 

Also, he went to see his GP - I went along with him as his carer. His letter wrote him a letter which is something else. A few of the points his doctor hit on are that she supports his appeal, confirmed the reasons for his epilepsy in detail, confirmed then number of seizures per week, the fact that it can take him a day to recover from a seizure from start to coming round to going to bed and getting up again, he looses control of his bowel and bladder, its a very difficult situation for him to manage, confused and disorientated in the mornings as he has sleep seizures at night. She said that given all this impact on his daily life that it is difficult to see how he could engage in any structured activity including the work forcussed group and this is an unrealistic expectation. She would be very grateful if his appeal could be viewed favourably. I think this letter is really good and of course am sending it with the appeal.

 

Despite asking on the phone 2 or 3 times for a copy of the DM report, of course they never sent it so I have to base the appeal on the doctor's report and the ticks she put in boxes. Makes it very difficult to write an appeal when you don't know what decision you are appealing against. All I can do really is write that DM report has been requested several times but has never been sent so am basing the appeal on the doctors report.

 

They have sent him something though - he has had a letter turn up yesterday with an appointment for his first meeting at the jobcentre for work focussed interview. Now what should be done about that? If he doesn't go his benefit will be affected but if he does go they will say that he was able to go through the interview so will throw out his appeal to be put into the support group! To make matters worse, the appt is for 9.15 in the morning which there is no way he could do because of his disabilities. What should be done about this???

 

Thank you so much for your help.

[Nystagmite]

You might be able to rearrange the appointment?

[pipistrollers]

Phoned the ESA dept and was told to contact the number on the appt letter telling them an appeal had been put in as he should be in the support group and could they stop any appts until after appeal is finished. Was also told that he is in the work focussed group but to be reassessed for 2 years. I asked how this could be as surely he would loose his benefits after 365 days? The operator said that as he is in both contribution based and income based ESA, the 365 day rule does not apply. I don't know if this is right or wrong as to be quite honest I really don't trust information given.

[pipistrollers]

I am finishing going through the medical report form filled out by the doctor and using it for the appeal. I wrote further back in this thread that there are points in the doctor's form which are clearly wrong and which contradict. I have just found a really bad one so thought I would share it to show how bad this report really is. One of the questions on the form is about incontenance. The person I care for, as I have stated suffers from uncontrolled grand-mal epilepsy and has between 6 and 8 seizures per week. He loses control of his bowel and bladder when he has a seizure. Instead of the doctor ticking the box which reads 'at least once a month experiences i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder ..... sufficient to require cleaning and a change of clothing, the doctor actually ticked the box which states 'none of the above apply' yet on the very next page of the form she has written 'incontenant as part of grand mal fit'............... THE SCARY THING IS THAT THESE PPL ARE QUALIFIED DOCTORS AND ALSO HAVE THE POWER TO DETERMINE OUR FUTURES!!!

[Catwoman A]

Hello

Sorry to hear about what you are going through. I'm not sure if this will still be relevant to you now as it's been a fair few days since the last posting but hope this helps you:-

I have several conditions that have me mostly house bound now and getting anywhere or at given times (particularly if it's morning) are becoming more and more impossible at the moment.

They put me in the ESA WRAG and I have appealed the decision (8th August and still waiting to hear) and asked to be put in the support group. The Jobcentre interviews and other activities would have been extremely difficult and I was worried that it would be 'when' and not 'if' they would cancel my benefit because I couldn't do what they required.

I was, however, very pleasantly surprised. The jobcentre sent me a letter for attending an interview and then followed up with a call. I explained to the lady how difficult it would be and asked how I could manage it and she went and spoke to her supervisor. I was rung back to explain that because of my situation, they would conduct an over-the-phone interview instead and that was quite a few weeks into the future.

When the interview came around, I answered the phone and they were great. They were understanding and listened and simply told me that they would call back in 4 months, to discuss with me any types of work that I think I might be able to do but with no pressure. They said that if there was anything they could do to help, just to ask and they would do their best. I was shocked...in a good way.

After reading your thread on here, I thought I should pass on this information, in case it helps in some way and to suggest that if they insist on an interview, they may be able to use the telephone version, like they did with me.

Either way, the best of luck and I hope it can all be resolved for you.

[pipistrollers]

Hi there

 

Thank you so much for your reply. Yes the interview took place on the telephone. The WRAG advisor called me the day before and I explained the situation. she told me that govt directive states that she must carry out the interview with him. she said that she would do the interview by phone the next day mid afternoon. Good as her word she did call, spoke to him very briefly then spoke to me. I gave her a little background and she said he should never have been put into the WRAG. She said she can see no reason why appeal woud not be won. She said she didn't want to see him but if there was anything she needed to talk about, she would phone.

 

Please let me know how your appeal goes - I really would like to know.

 

Take care and thanks again

[BLUNTMAN1979]

I just have to say, you can also throw into your corner during your appeal that your human rights are being violated. You have the right under EU DISABILITY STRATEGY 2010-2020 to live your life life with dignity and without fear of poverty.

 

I would also check the UNCRPD directive also. That might help if you use that against them. Good look.

[BLUNTMAN1979]

I mean luck

[BLUNTMAN1979]

I have also managed to find their contract, check it out and see if you feel if they broke any of the terms set out in it http://www.whywaitforever.com/dwpatoscontract.html

[pipistrollers]

Hi bluntman

 

All I can say is wow that's excellent. Thank you so much will look into that

[Catwoman A]

Hi,

 

You're very welcome. I'm really pleased to hear that you managed to get the telephone interview too and it really helps that the WRAG advisor said that he shouldn't have been put into WRAG. I think even the advisors don't really want to have to put anyone through all of this!

Thank you. I will let you know how it goes, although I have no clue at all as to when that will be!

Take care and best of luck!