Severely Disabled - not offered medical but WRAG

[Debbielou111]

Hi Everyone

 

My partner is severely disabled with generalised osteoarthritis and limited mobility and he recently filled in an ESA50 questionnaire detailing the extent of his disabililty. He has now received a letter whose heading states Work Focused interview for Employment and Support Allowance and it would appear that he has automatically been placed in the Work Related Activity Group and not the Support Group. He has not had an Atos medical which I thought was the next step in the process after filling in the ESA50 if there was any doubt as to whether he can work or not. Could someone please tell me if they can bypass the need for a medical assessment in this way - what I have understood is that he should be having a face to face interview with an Atos qualified advisor for a Work Capability Assessment before he is placed in one of the two groups. Nevertheless as all the information relating to this new benefit is so confusing, maybe we have misinterpreted something along the way. After 12 years on incapacity benefit he was also recently sent a P45 - he quieried this with Job Centre Plus who knew nothing about it and referred him on to the Inland Revenue who couldn't explain it either. Obviously now it clearly relates in some way to the ESA process. We now have a GP letter giving evidence fo the nature of his condition and that he can't walk 50 metres without serious pain and discomfort which ought to automatically qualify him for the support group - whether it does or not remains to be seen.

 

I would welcome any advice and support on this matter.

 

Many thanks

 

Debbielou111

[honeybee13]

Hello debbielou.

 

I'll move this to the main benefits forum because your question isn't specifically about Atos. You should get more replies there.

 

My best, HB

[Debbielou111]

thanks

[Nystagmite]

Not everyone needs a face to face if there's enough evidence.

 

He would only qualify for the support group on the basis of mobility if he couldn't propel a wheelchair or use another mobility aid.

[Debbielou111]

He can't propel a manual wheelchair or other aid as the arthritis affects his fingerrs/wrists/shoulders - basically the whole of his body is affected

[abc123def]

Not everyone needs a face to face. If you feel he meets the descriptor for the support group print off the appeal form and send it off and say the reason you are appealing is because he is unable to mobilise 50 metres due to severe pain and exhaustion. If you send off the GP evidence you have saying that at the same time (a copy of it, never send the original as so many get 'lost') hopefully when it goes to DWP reconsideration stage they will reconsider rather than take it to Tribunal. Always send forms and evidence recorded and keep evidence of posting and of it arriving there.

[Debbielou111]

Thanks for the advice, we will appeal this and present a copy of the GP letter as evidence. He also fits the criteria for several other sections too which the GP has highlighted in the letter.

[**Margaret**]

: Debbielou111:

 

Yes Atos/Jobcentreplus can bypass face to face assessments when it suits them and conversion awards (specially for a work related activity award) without one, are an increasingly common scenario as they try to cope with the backlog of assessments. From what you've written they've bypassed (or Royal Mail has lost) the decision letter as well!

 

Now that decision letter is important cos your partner only has one month from when it's dated to lodge an appeal, so you need to chase a copy of it. But if your partner finds he's out of time, non receipt of the decision is a valid reason for a late appeal. You don't need to do anything with the P45 except file it safely in case it's needed for tax reasons.

 

CAG has a guide to appeals at;

 

http://www.consumeractiongroup.co.uk/forum/showthread.php?251737-Appealing-or-going-to-aTribunal-Some-useful-information

 

At his/her discretion a Jobcentre adviser can suspend work focused interviews pending the outcome of an appeal.

 

Best wishes, Margaret.

Edited July 6, 2013 by **Margaret**

[Debbielou111]

Margaret - many thanks for the advice - sadly my partner has now found the letter stating quite clearly that he is in the Work Related Activity Group and dated 7 May and he didn't think it necessary to bring this to my attention - possibly because I had just attended my mother's funeral 5 days earlier. I won't put what has been said between us over the last few hours as I have now also been informed that he is also receiving £160 less in benefits as a result of this. I have been looking at the appeals process and I am going to contact them on monday and see if they will reconsider in light of the fact that I have a GP letter which clearly states that he is not fit for work. I will hopefully be able to use our recent bereavement to our advantage when I contact them. Nevertheless I would welcome any advice with regard to approaching the DWP on this matter. What I can't understand is with the information presented to them of the ESA50 they have put him in this group without a medical when it clearly states the diffiiculties he has on a daily basis in detail. Disabled people are really being treated appallingly with no consideration whatsoever of their ailments. Talk about kicking a man when he's down.

[**Margaret**]

: Debbielou111:

 

Sorry to hear about your Mum.

 

The aftermath of a bereavement can be a valid reason for a late appeal. Especially if your partner relies on you for help with his paperwork. Does arthritis make it difficult for him to write or use a keyboard? Can he get an appeal to the post office without your help?

 

My personal approach to the present situation would be to complete sections 1 - 7 of a GL24 form and then type/write two separate responses to section 8 on word docs or separate sheets of A4, with the extra sheet being your partner's reasons for the late appeal. Should a Jobcentreplus decision maker not admit the appeal, it'll automatically get referred to the Tribunals Service for a second opinion from a judge.

 

'he is also receiving £160 less in benefits' Doesn't sound right. Unless his claim for incapacity benefit was linked to an earlier claim for invalidity benefit? Possibly Jobcentreplus've deducted from pension income despite highest care component of disability living? I'd ask for a copy of their calculations.

 

Sincerely, Margaret.

[Debbielou111]

Hi Margaret

 

Thanks once again for the invaluable advice given. You state:

 

My personal approach to the present situation would be to complete sections 1 - 7 of a GL24 form and then type/write two separate responses to section 8 on word docs or separate sheets of A4, with the extra sheet being your partner's reasons for the late appeal.

 

Does this mean you wouldn't contact the DWP by phone at all and just launch into the appeal with the reasons for it being late.

 

I have to do all the paperwork and everything else because in reality he is unable to read or write, which gives us another reason for a late appeal. He is very ashamed of this and we did not include any reference to this on the original paperwork because of this. He also wouldn't not be able to use a keyboard or hold a pen for any length of time due to the arthritis in his fingers.

 

Many thanks once again.

[Nystagmite]

DWP will also accept a letter stating you're appealing. As long as you write something like "I would like to appeal my ESA dated ".

[45002]

Hi Everyone

 

My partner is severely disabled with generalised osteoarthritis and limited mobility and he recently filled in an ESA50 questionnaire detailing the extent of his disabililty. He has now received a letter whose heading states Work Focused interview for Employment and Support Allowance and it would appear that he has automatically been placed in the Work Related Activity Group and not the Support Group. He has not had an Atos medical which I thought was the next step in the process after filling in the ESA50 if there was any doubt as to whether he can work or not. Could someone please tell me if they can bypass the need for a medical assessment in this way - what I have understood is that he should be having a face to face interview with an Atos qualified advisor for a Work Capability Assessment before he is placed in one of the two groups. Nevertheless as all the information relating to this new benefit is so confusing, maybe we have misinterpreted something along the way. After 12 years on incapacity benefit he was also recently sent a P45 - he quieried this with Job Centre Plus who knew nothing about it and referred him on to the Inland Revenue who couldn't explain it either. Obviously now it clearly relates in some way to the ESA process. We now have a GP letter giving evidence fo the nature of his condition and that he can't walk 50 metres without serious pain and discomfort which ought to automatically qualify him for the support group - whether it does or not remains to be seen.

 

I would welcome any advice and support on this matter.

 

Many thanks

 

Debbielou111

 

Debbieou111 .

 

Can I ask how long has your partner been placed in WRAG group for ?

[abc123def]

I would never contact the DWP by phone, simply because you have no evidence following it of what took place and was said during the call. Do everything in writing, sending everything recorded and keeping evidence of it being posted and of it having arrived there.

 

Appeal stating reasons for late appeal as death of close family member and bereavement.

[**Margaret**]

: Debbielou111:

 

For the reasons cited above, I wouldn't phone Work n Pensions. And it's unlikely that the contact centre (the staff who answer the phones), or waiting for a call back from an employment n support allowance processor will elicit anything more than 'appeal and see what happens'. However, if you and your partner would like confirmation of what we're saying a phone call can't do any harm.

 

Post bereavement, your partner's literacy problems are another reason for a late appeal. Could you have coped with funeral arrangements etcetera and helped with an appeal against an employment n support decision at the same time? If not, explain why not.

 

Best wishes, Margaret.

Edited July 7, 2013 by **Margaret**

[fedupandold]

:

Debbielou111:

 

 

 

Now that decision letter is important cos your partner only has one month from when it's dated to lodge an appeal, so you need to chase a copy of it. But if your partner finds

he's out of time, non receipt of the decision is a valid reason for a late appeal.

 

Yes it is a very important document.

 

I would totally disagree with your final sentence though. The failure or the delivery of a Decision Notice is NOT grounds for acceptance of a late appeal.

 

I have recently been through this argument with the DWP and the Tribunal. Owing to the Decision Notice not being received by me I asked for a copy. It took the DWP just over 6 months to send that copy to me.

 

The Tribunal ruled that the DWP are entitled to assume that the service of a Decision Notice was effected after they posted it. They accepted the argument put up by the DWP that according to the regulations they only have to show that 'the document was addressed and posted to the last known address'. Whether it actually arrives is of no concern to the DWP or the Tribunal.

 

I argued the opposite at the Tribunal that proof of receipt should be the operative date - I was chastised when the Tribunal told me that if they had to accept all late appeals on the basis of the claimant telling them that it must have got lost in the post - there would little time to hear any other appeals.

 

The Chairman pointedly told me that the DWP discharged their duty when they posted it. If there is any argument over the loss of any benefit then I should take it up with the Post Office.

[Debbielou111]

Thanks everyone for you help. I will not contact them but simply lodge the appeal and and letter explaining the difficult circumstances. We are going to attend the work focused interview on Wednesday as scheduled but will present a copy of the letter from the GP stating that he is not fit to work and see what happens there. Again many thanks for your help.

[fedupandold]

Thanks everyone for you help. I will not contact them but simply lodge the appeal and and letter explaining the difficult circumstances. We are going to attend the work focused interview on Wednesday as scheduled but will present a copy of the letter from the GP stating that he is not fit to work and see what happens there. Again many thanks for your help.

 

I can only reiterate what has already been said. The ESA50 gave enough information without having to seek anything else, to show that you have quite correctly been placed in the Work Group.

 

I would suggest that the fault lies with the fact that the ESA50 wasn't completed as fully as it should have been.

[Debbielou111]

The form was completed with similar information to that submitted when he applied and was award higher rate disability living allowance - the only think I can think of that was missing is that we did not include any medical evidence to back up the claim - now we do have a letter which hopefully will allow us to eventually turn things around. My partner is hardly able to walk and is in pain all the time - he is on high dose Buprenorphine patches, intra-articular steroid injections into his spine and shoulder joints. This whole thing is making him suicidal.

[Nystagmite]

The problem with writing similar information, is that the criteria is completely different for both benefits. It doesn't matter if he can't walk either.

[Debbielou111]

Nystagmite

 

Welll, maybe he should just go and hang himself and be done with it then. Really, If you can't provide some sort or an empathetiic response then maybe you would be better not replying at all. This is people's lives (what's left of them) that the DWP is playing sick games with.

[fedupandold]

The problem with writing similar information, is that the criteria is completely different for both benefits. It doesn't matter if he can't walk either.

 

Thanks I was going to say the same. People seem to get the idea that if they pass one benefit that is disability related, then they should more or less be awarded the equivalent for a sickness related benefit.

 

You can be seriously ill but not disabled and you can be seriously disabled yet not sick.

[fedupandold]

Nystagmite

 

Welll, maybe he should just go and hang himself and be done with it then. Really, If you can't provide some sort or an empathetiic response then maybe you would be better not replying at all. This is people's lives (what's left of them) that the DWP is playing sick games with.

 

When you are dealing with the DWP and DLA/ESA, you should remove all thoughts and emotions. They are a clinical claim, based entirely on clinical evidence. The fact that the claimant is suffering or stressed should have no place in your dealings with the DWP. Stick to facts and evidence only.

[Minibits]

I can only reiterate what has already been said. The ESA50 gave enough information without having to seek anything else, to show that you have quite correctly been placed in the Work Group.

 

I would suggest that the fault lies with the fact that the ESA50 wasn't completed as fully as it should have been.

 

Well, my wife's ESA50 was, and she was placed in the WRAG without a medical.

The appeal letter went in straight away, just stating that we believed that she fulfilled at least one of the descriptors for the Support Group. I didn't expand any further at that point, no further evidence was presented, nor asked for, and she was moved to the support group on reconsideration.

 

While we awaited the decision, she attended one work focused interview, and the adviser was happy to carry out all further interviews by phone, every six months. She also stated that she would have conducted the first interview over the phone but couldn't reach me on the number in my wife's file, so please Debbielou, try contacting the JC first. They might well postpone the first interview. Best of luck to you.

[Nystagmite]

They may allow the interviews to be done over the phones. (It's a reasonable adjustment if you have a disability which means you struggle to get out, etc)

 

Face to face assessments are only given if ATOS feel they need more information. Sometimes the ESA50 and supplied evidence (sometimes a GP may be asked to fill in a ESA113) is enough to decide which group someone goes in.