ATOS appeals: GP's charging £130

[estellyn]

And a heartfelt 'glad you're getting better, estellyn' from those of us who aren't around as often as we were.

 

Awwww, you guys are so sweet - makes me feel better just coming here! I think there are a few of us here who have the 'joy' of regular hospital stays due to our illnesses/disabilities - it's so nice to come back and try to be productive again (even if only in a voluntary, online advice giving, sort of way).

[Laird_Scooby]

Lucky they had your help then, as there really doesn't seem to be much easy to understand help out there.

 

Especially if you're disabled, with a disability that affects memory/how you process information.

 

All I could find was the guide below, which was not exactly the same as the internet version of ESA50, I had to complete recently- but seemed to have some useful hints that I wouldn't have thought of. Maybe it could be improved upon though.

 

http://a4e2aande.files.wordpress.com/2013/04/herts-county-council-esa50-guide.pdf

 

 

Thank you VERY much for that link! Based on the information i've just found in it (within the first few lines in fact!) i should never have been taken off ESA in the first place, let alone forced to claim JSA! That's without my current (as yet unconfirmed) additional condition and other things that my current GP doesn't yet know about (eg incisional hernia on appendectomy). Sort of makes me angry they "twisted my situation as i described it" to make me inelgible for ESA so again,

THANK YOU VERY MUCH INDEED!

[antone]

Awwww, you guys are so sweet - makes me feel better just coming here! I think there are a few of us here who have the 'joy' of regular hospital stays due to our illnesses/disabilities - it's so nice to come back and try to be productive again (even if only in a voluntary, online advice giving, sort of way).

 

Ah hell, we help each other, right? This is the thing - offering voluntary advice online is a great thing to do. The internet is where so many people look for help these days. Be assured that many folks have had their lives improved by your comments and assistance. We've missed you, and are glad to see you back.

[antone]

Lucky they had your help then, as there really doesn't seem to be much easy to understand help out there.

 

Especially if you're disabled, with a disability that affects memory/how you process information.

 

All I could find was the guide below, which was not exactly the same as the internet version of ESA50, I had to complete recently- but seemed to have some useful hints that I wouldn't have thought of. Maybe it could be improved upon though.

 

http://a4e2aande.files.wordpress.com/2013/04/herts-county-council-esa50-guide.pdf

 

Claire, we obviously have our differences, but thanks for posting that. It is very interesting.

[estellyn]

Ah hell, we help each other, right? This is the thing - offering voluntary advice online is a great thing to do. The internet is where so many people look for help these days. Be assured that many folks have had their lives improved by your comments and assistance. We've missed you, and are glad to see you back.

 

:-)

[antone]

:-)

 

I know, I was blushing too But credit needs to be given where it's due. You're a great help and we have missed you.

[citizenB]

Yay! I haven't checked with my colleagues, but I think I'm safe in wishing you all the best on behalf of the orange people.

 

Yes, thank you Antone. Wishing you a speedy recovery estellyn

[bedofweeds]

May I get back to the original question?

Personally I don't really understand why it is necessary to have a GP confirm these facts (a) a diagnosis (b) medication prescribed.

 

The information would be available from other sources which are free eg copy of the repeat prescription, letters from your consultant?

 

Then the other part of the request is for the GP to give their opinion on ability, needs, condition etc. That opinion has as much validity as the ESA50 or the DLA/AA application form - it is simply someone's opinion.

 

The system as I understand it is that you are supposed to give full details and explanations on the DWP application forms, you will possibly have an assessment by the DWP carried out and the claimant will have sent in what free information is available as above.

 

What else are people expecting a GP to do? Any opinion given by a GP is surely of less evidential value than say someone that knows exactly what the law and regulations are in respect of the benefit claimed. Would you seriously expect a GP to give an opinion that has more evidential value than the DWP's assessment if that GP has probably not seen the patient for 6 months or if the GP rarely comes across a condition that the claimant displays and even more to the point, would you expect the GP to give an opinion on how a patient's mental health affects his/her ability to work of what needs it creates. At best it would simply be a re-hash of what the patient may have told the GP in the first place?

 

What is important is to attend an assessment in the full knowledge of the rules of the benefit claimed and complete the application forms in much better detail.

 

Sorry, but if I can't get to see my GP for an important medical matter because 'John Smith' wants a report to say he can't work, then that would really upset me and a formal complaint would be lodged with the practice manager! What is more important? My health or young Mr Smith's ESA appeal?

[**Margaret**]

:estellyn:

 

back to CAG.

 

And your #115 was spot on. There's no statutory welfare rights provision in my borough. And hasn't been since 2010 when Citizens Advice moved across the borough boundary to cut costs.

 

No medical evidence either. Again since 2010, our local general practitioners are of the somewhat outdated notion, that Work n Pensions pay for any evidence that's needed through existing contracts. Or as for Starryeyes, the Tribunals Service pay. (Which you'll know is very much the exception.)

 

Got home with a box of choccies yesterday, as 'payment' for help with an ESA50. My only qualification being that I knew more about the 'unfit for purpose form' than the new claimant!

 

So CAG and self-help groups are clearly the way forward. Thanx for your contributions when I'm out of my depth.

 

But, lots of time on the between contributions, Margaret.

Edited August 31, 2013 by **Margaret**

[Nystagmite]

The information would be available from other sources which are free eg copy of the repeat prescription, letters from your consultant?

 

And what about those of us who have neither? Almost every consultant has discharged me because I'm incurable and there's no medication (although there is talk about beta blockers and a possible neurology referral) that will help me. The only consultant who sees me, sees me once a year, gives me a few eye tests and that's it.

 

I am sure I'm not alone in this. Actually, I know I'm not. My brother has neither a consultant or medication.

[mr_mastiff]

Lucky they had your help then, as there really doesn't seem to be much easy to understand help out there.

 

Especially if you're disabled, with a disability that affects memory/how you process information.

 

All I could find was the guide below, which was not exactly the same as the internet version of ESA50, I had to complete recently- but seemed to have some useful hints that I wouldn't have thought of. Maybe it could be improved upon though.

 

http://a4e2aande.files.wordpress.com/2013/04/herts-county-council-esa50-guide.pdf

 

Hi claire, Its a good guide but basic, I tend to elaborate more on the effects following a task, for example going to see the consultant/GP. Who takes you (support worker/ wife etc) Why do they take you (anxiety prevents me or I cannot understand or I lie to get away etc) what preparation is required (what medication do you take lorazepam etc)why do you take it. (to prevent agitation/violence/Panic etc) How long can you tolerate being out of the environment that you feel safe in (30mins 1 hour etc) What happens after this time(Violence/panic etc). How do you feel after going etc etc.

I break down each part like that. It can be used for both mental and physical activities I wrote one just for getting out of bed in a morning. Its detailed and takes time but provides a clear picture of the persons abilities. I tend to use a lot of extra paper than on the form but so far its worked.

[mr_mastiff]

And what about those of us who have neither? Almost every consultant has discharged me because I'm incurable and there's no medication (although there is talk about beta blockers and a possible neurology referral) that will help me. The only consultant who sees me, sees me once a year, gives me a few eye tests and that's it.

 

I am sure I'm not alone in this. Actually, I know I'm not. My brother has neither a consultant or medication.

 

Nystagmite, the only possible way is to give a full description of the effects of your condition on your day to day life. You have a diagnosis and prognosis. Even if you have been discharged your condition and its effects remain.

[estellyn]

May I get back to the original question?

Personally I don't really understand why it is necessary to have a GP confirm these facts (a) a diagnosis (b) medication prescribed.

 

The information would be available from other sources which are free eg copy of the repeat prescription, letters from your consultant?

 

Then the other part of the request is for the GP to give their opinion on ability, needs, condition etc. That opinion has as much validity as the ESA50 or the DLA/AA application form - it is simply someone's opinion.

 

The system as I understand it is that you are supposed to give full details and explanations on the DWP application forms, you will possibly have an assessment by the DWP carried out and the claimant will have sent in what free information is available as above.

 

What else are people expecting a GP to do? Any opinion given by a GP is surely of less evidential value than say someone that knows exactly what the law and regulations are in respect of the benefit claimed. Would you seriously expect a GP to give an opinion that has more evidential value than the DWP's assessment if that GP has probably not seen the patient for 6 months or if the GP rarely comes across a condition that the claimant displays and even more to the point, would you expect the GP to give an opinion on how a patient's mental health affects his/her ability to work of what needs it creates. At best it would simply be a re-hash of what the patient may have told the GP in the first place?

 

What is important is to attend an assessment in the full knowledge of the rules of the benefit claimed and complete the application forms in much better detail.

 

Sorry, but if I can't get to see my GP for an important medical matter because 'John Smith' wants a report to say he can't work, then that would really upset me and a formal complaint would be lodged with the practice manager! What is more important? My health or young Mr Smith's ESA appeal?

 

 

 

A medical diagnosis of ANY illness (apart from terminal within 6 months) doesn't confer an automatic 'unfit for work' decision, though some treatments can.

 

The idea behind medical evidence is that it gives (or should give) a 'framework' within which to place fitness to work findings. The assessor is supposed to look at the diagnosis and test results etc, and make a determination whether the answers given during the assessment are consistent with medical findings.

 

For instance, a doctor provides medical evidence (med cert) which states the patient suffers simply from 'back pain'. At the assessment the claimant claims that actually he has serious and painful spinal problems which he's been told may require surgery. In my experience some claimants have a poor understanding of what their illness/disability is, and also a poor understanding of what the ATOS assessment is really about, combined with a tendency to 'play down' the effects of an illness. The ATOS assessor will ignore the person being assessed and view any symptoms within the framework of simple 'back pain', and the claimant is found fit for work. On preparing an appeal, a more thorough report from the GP then shows that the patient was indeed telling the truth and has had investigations which show severe damage and surgery is being arranged. A consultant confirms that given the level of damage, severe pain would be expected while walking and the patient is unable to propel a wheelchair.

 

People don't always have documentary evidence of their conditions, even though consultants should send a copy of the letter to GP, also to the patient, in my experience this happens infrequently - I have several medical conditions, relevant to a fitness to work assessment, and verified by tests, and yet have never been sent any documentation confirming the results or diagnosis - but it is there in my medical records. A GP's evidential value can be very important, and a person who needs to be regularly assessed for ESA needs to make sure they have regular contact with a health professional that can speak to their condition. That way a picture can build up for the GP of the person's issues. A good example of this is pain caused by a condition. I've met lots of people who suffer lots of pain due to their condition and were originally given a mild painkiller. They think that they need to manage with just that painkiller, and so in their daily life avoid doing things in order to limit pain, and never go back to the doctor to say that the initial pain relief wasn't sufficient. So the person goes to their ESA assessment and is seen to be on just a mild painkiller, so reports of pain are dismissed by the assessor as exaggeration, and the GP has no basis to give evidence on the patient's behalf that the pain is severe, because the patient was just trying to 'manage' and never saw the GP about their deteriorating condition - I used to see this most often with conditions like arthritis.

 

The reality is that the people struggling with this system, are those that don't understand the benefit rules and are unable to complete application and assessment forms very well - not everyone is well educated, literate and able to advocate for themselves. What are those people supposed to do? Or are you advocating that only the able, or those in a position to secure assistance should have a fair assessment?

 

What's more important, you or Mr Smith? Well that's hard to say isn't it? How many people having to go through ESA appeals are dying - with the added stress of appeal contributing to their death? How many people's conditions are worsened by having to through an appeal which they eventually win because they were wrongly assessed? Getting the medical evidence is more than just having enough info to win an appeal - these people who are appealing are suffering serious health problems too - it's why they win the appeal in the end.

 

So if someone's state of health can be so closely tied to whether they can get good enough evidence to win at appeal, and doctor's want to make them pay for evidence, making wealth (yet again) a determining factor in health, what does it say about you, that you don't want doctors to give reports at all, as you feel it may affect your own health?

[estellyn]

 

Got home with a box of choccies yesterday, as 'payment' for help with an ESA50. My only qualification being that I knew more about the 'unfit for purpose form' than the new claimant!

 

So CAG and self-help groups are clearly the way forward. Thanx for your contributions when I'm out of my depth.

 

But, lots of time on the between contributions, Margaret.

 

I think the work we all do to try to guide people through the process is very important, and you certainly should be applauded and get lots of choccies for sharing experience with others.

 

And no worries, I'm lying down using the laptop, so resting while making contributions.

[Nystagmite]

Then the other part of the request is for the GP to give their opinion on ability, needs, condition etc. That opinion has as much validity as the ESA50 or the DLA/AA application form - it is simply someone's opinion.

 

It's not always opinion. I was born with a condition which means I have serious visual loss, I am colourblind and my balance is affected. That's not the doctors opinion. It's fact.

[mr_mastiff]

Bedofweeds/Estellyn, Both of your points prove that the system is wrong. Atos have to prove you fit to work, Based on your own subjective assessment and their own (?) objective assessment. On appeal a G.P from a practice who may have never seen you is then asked to provide an opinion on your fitness to work. He can only make this assessment based on the notes received by him from other GPs/consultants, he then as one consultation (10 minutes for physical assessment).

 

If you look at what happens when a patient is discharged from hospital, they will be reviewed by the Consultant,their nurse,physiotherapist,occupational therapist, pharmacist, social worker, community worker all to ensure that they are safe to go home.

 

The G.P is expected to preform the role of a multidisciplinary team with none or few of its resources and I am sorry to say that ATOS is in the same position. Nobody can make a safe assessment under the system that the Government as imposed.

[bedofweeds]

Nystagmite, the only possible way is to give a full description of the effects of your condition on your day to day life. You have a diagnosis and prognosis. Even if you have been discharged your condition and its effects remain.

 

Fully agree. Whether someone still sees a consultant or not you will generally have a diagnosis and prognosis. There is no need to see a consultant or a GP if you have a stable chronic condition.

 

The way forward is to complete the forms in as much depth as you can go + read up and fully understand what the rules & regulations are for the particular benefit before you have the assessment. Forewarned is forearmed.

[bedofweeds]

It's not always opinion. I was born with a condition which means I have serious visual loss, I am colourblind and my balance is affected. That's not the doctors opinion. It's fact.

 

That's a diagnosis and a prognosis.

 

The type of opinion I was talking about that people are asking of their GP is - is ** fit for work? If not, why not? What are * needs and disabilities? etc etc. None of that can ever be in the GP's mind unless the patient tells the GP and the GP tells the DWP that 'my patient has informed me that ........'

 

GP's at best can only confirm what they know and not what they have been told. They can give an opinion about what they have been told.

 

My GP knows what my medical conditions are, he knows what I have been prescribed with. He doesn't have a clue how I live my life, what I can and can't do for myself or how the symptoms of my conditions affect me - he can only make it known that he has been told about them by me. Hence why his opinion is of little evidential value. However where facts do come alive as to how I cope or how I am affected are through regular contact with other professionals - CPN, Social Worker, OT etc - their evidence is of extreme value - they are the ones that you should be seeking reports from - not the GP.

Edited August 31, 2013 by bedofweeds

[estellyn]

Fully agree. Whether someone still sees a consultant or not you will generally have a diagnosis and prognosis. There is no need to see a consultant or a GP if you have a stable chronic condition.

 

The way forward is to complete the forms in as much depth as you can go + read up and fully understand what the rules & regulations are for the particular benefit before you have the assessment. Forewarned is forearmed.

 

As I said, many people lack the ability to understand the regs and competently complete the forms themselves. The government has withdrawn legal aid funding for benefit matters and many welfare rights centres are having to close down. Difficulty and pressure is being heaped on the most vulnerable if they need to make an ESA/PIP claim.

[estellyn]

However where facts do come alive as to how I cope or how I am affected are through regular contact with other professionals - CPN, Social Worker, OT etc - their evidence is of extreme value - they are the ones that you should be seeking reports from - not the GP.

 

Yes, reports from OT's and CPN are indeed far more valuable than a GP report, however, few people have input from these services, and even if they need them, resources are low and waiting lists long.

[Nystagmite]

Nystagmite, the only possible way is to give a full description of the effects of your condition on your day to day life. You have a diagnosis and prognosis. Even if you have been discharged your condition and its effects remain.

 

For one of the conditions I have, I don't have a prognosis. And they can't tell me if I still have one of the conditions I have as a child. Not good when said condition can and does kill / leave people disabled.

[bedofweeds]

Yes, reports from OT's and CPN are indeed far more valuable than a GP report, however, few people have input from these services, and even if they need them, resources are low and waiting lists long.

 

I would advise everyone that if they believe that they need help due to an illness, injury or disability they must self refer and prepare a self assessment for their local social services.

 

Once that has been lodged SS have a duty to investigate, assess and provide help.

 

I was given the run round for ages (months) and it was only after an off the cuff comment from my CPN that I was told that the quickest way was to self refer. Within 2 weeks a case manager was appointed and a week later they turned up to carry out the first of many assessments. Help quickly followed on!

[estellyn]

I would advise everyone that if they believe that they need help due to an illness, injury or disability they must self refer and prepare a self assessment for their local social services.

 

Once that has been lodged SS have a duty to investigate, assess and provide help.

 

I was given the run round for ages (months) and it was only after an off the cuff comment from my CPN that I was told that the quickest way was to self refer. Within 2 weeks a case manager was appointed and a week later they turned up to carry out the first of many assessments. Help quickly followed on!

 

Yes, this is true. But as you initially found out, getting help is difficult, and many vulnerable people aren't aware that this help may be available to them. These are the types of people struggling to get medical evidence for their lack of fitness for work, and who are more likely to suffer deterioration of condition due to the anxiety and stress.

 

This is what I've been saying - those that can get themselves help will likely have more evidence anyway. Those who are least able, vulnerable, in financial hardship are the ones who suffer most from a fee requirement.

 

These people are already at a disadvantage when it comes to assessment, and this is just another obstacle for them.

 

It would be nice to live in a perfect world where everyone is treated well, and the same and get all the help they need, but sadly this isn't true. I've come across people who have finally been referred for benefits help, after years of not getting the help they need - we would then ensure that they get all the services input that they need - however for every case that came across our desks, I expect there were hundreds in our area who needed help, but didn't know to access it.

[Nystagmite]

I would advise everyone that if they believe that they need help due to an illness, injury or disability they must self refer and prepare a self assessment for their local social services.

 

Once that has been lodged SS have a duty to investigate, assess and provide help.

 

I was given the run round for ages (months) and it was only after an off the cuff comment from my CPN that I was told that the quickest way was to self refer. Within 2 weeks a case manager was appointed and a week later they turned up to carry out the first of many assessments. Help quickly followed on!

 

SS are useless where I am. Social worker left in May and I've just got a new one. I also had to email them a few times to get referred again because my "support worker" refused to see me again because I won't meet in noisy places with strange people with less than 24 hours notice.

[Laird_Scooby]

Estellyn - you said :

 

"The reality is that the people struggling with this system, are those that don't understand the benefit rules and are unable to complete application and assessment forms very well - not everyone is well educated, literate and able to advocate for themselves. What are those people supposed to do?"

 

(Apologies for not using the normal quote button, taking that particular paragraph out of context etc but it's relevant to my point)

 

Without blowing my own trumpet, i'm reasonably intelligent, had a fairly good education and am reasonably erudite.

 

However, i know from bitter experience that ESA has been turned down on the grounds there's nothing wrong with me (slight exagerration) because i couldn't communicate the various symptoms and difficulties i have thanks to the fact i spend most of my time in a painkiller-induced fog and only get odd moments where my brain is anywhere near what it used to be capable of.

 

While i'm obviously biased, it hardly seems fair to any claimant that is rejected because they can not articulate their condition/side-effects/difficulties etc effectively, whether that is (like myself) down to side effects of the medication or through accident of paternity, birth location or whatever else it may be.

 

Even with medical corroboration from the GP, if the claimant can't explain to the GP the problems they face, the GP isn't going to know so can't provide that corroboration. Something i have faced is the "I've not seen you for ages so assumed you were fine" attitude from a GP.

 

He was quite shocked when i said i had been too poorly to get to see him and unable to walk to the car to drive to the surgery! But how many more are there like me that continue to struggle because of the ill-thought out system and why are ATOS "Healthscare Professionals" always apparently so out of touch with medical procedures, treatments, drugs etc?

Edited August 31, 2013 by honeybee13
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