Refused ESA 4 times - on job seekers but can't work - help!

paul1961

Hi just a few words about myself i am a 56 year old male i have had rheumatoid and ostio arthritis plus a few other medical problems first of all i have worked hard since i was 16 however the last few years i have not due to my severe arthritis i need a double knee replacement and currently awaiting surgery i have been on ESA employment support however i have now been told for the 4th time that i do not qualify for ESA and now been put on job seekers allowance my mobility is very poor and the pain is constant even tho i am on medication to try to alleviate the pain but as anyone knows who as this condition this is on going pain and frustration i totally feel let down by the very system put in place to help anyone who are unfortunate to have health problems i also feel the point system used by health care professionals are really unfair stereotyping people who have disability and mobility problems noting that i turned up to the assessment as normal clean and tidy but this is a part that points are awarded so basically if i had turned up unwashed and unkempt they would award you points i am totally frustrated and dont know what to do next please any advice would be gratefully appreciated kind regards Paul.       
           

tomm

i turned up to the assessment

That alone can make a world of difference to being successful or not,

As someone who suffers with stage 4 O/A of one knee and moderate O/A in the other knee, as well as O/A in one forefoot (big toe joint) and my hands have early onset  (thumb joints) as well as other diagnosed medical conditions

And in the past 5 or more years since ESA replaced IB, i have been like you failing  the farce aka wca, and also at tribunals too,(rinse and repeat)  this has been mainly because supporting evidence from specialists like orthopaedic surgeons in  way of their reports, as well as  having a GP who supported me, several previous GP's didn't help me  was lacking  and was a bit vague

Sometimes the fact that you were able to travel to and from the place where the WCA was carried out is enough for them to find you FFW If they can find inconsistencies as well  then  the result is predictable, by attending you as far as they were concerned are not as bad as you say  otherwise how could you get here?  can use public transport,  they don't consider if you could repeat  this action without issues more than once (several times in a week)

I this time after  originally changing the venue  due to it being located on the 1st floor of the building  (can't do stairs) the journey time using public transport would have exceeded the  max 90mins journey time rule, because i can't mobilise more than 50trs repeatedly without being in so much pain that i have to stop etc it would have taken 3 bus journey's, in order to cut the walking distances  at either end of the journey, ( their rules say that is such cases they must offer a taxi on account or a home visit if a taxi wouldn't be appopriate)

Which i didn't surprisingly have to use,

I was told that in order to get a taxi authorised  i would need a letter from my GP  stating why i could not travel using public transport, and due to them not offering   pre-paid taxi's on their account, it was unreasonable for me to pay  as the fare would have been as much as 1 weeks ESA assessment rate , So they offered me a HV which i accepted after advice from the CAB adviser , i also had that wca audio recorded 

 

The HCP from maxifarce / CHDA had made his mind up that i met the criteria early on  and after he read the consultants report that confirmed Stage 4 O/A changes  and other specialist reports, he couldn't wrap up quick enough, after implying that he should not have even been sent out to me, (should of been done on paper)  currently in the SG 18mths, evidence is key, and so is being consistent and clear  in what you write on the ESA50 and what you tell them at the WCA or tribunal hearing, as well as your actions,

 

Geoark

Hello @paul1961 and welcome to the community.

As you haven't mentioned it did you ask for a mandatory review and then went to appeal?

You can find out more about the point system at https://www.disabilityrightsuk.org/work-capability-assessment

For the mandatory review you should ask for a copy of the report, which will set out the points awarded for each criteria, and you should focus on why you meet the higher criteria, rather than concentrating on what is wrong with you - that should be available through the evidence you provided.

In many cases the mandatory review will simply rubberstamp what the assessor has put, but success at appeal is around 65%. This is a lot higher if you can attend the hearing rather than having a paper appeal.

edited as part of the post was not relevent.

Topkitten

The problem with ANY form of arthritis is that the large majority of people who suffer it DO manage to work and have relatively normal lives. Therefore you are faced with the task of proving that your is SO serious that it has become debilitating. If you do manage that then you become compared to others who have a debilitating condition in ALL cases. All this makes it more difficult for them to treat you as you wish to be treated. Mobility plays a large part in this and, whilst many manage to keep relatively mobile, they find it 100% impossible to use normal methods of transport at all. It isn't that they prefer not to, they simply cannot. It was a discussion I had regularly with an older lady I used to know who could not appreciate the difference between her preferring not to use public transport even though she could whereas I simply could not use it at all.

Pain is pain and is evaluated based on levels of medication, what you feel is strong medication others might not. All you can do is to keep trying to prove your point and hope that the medical opinions bolster that belief.

TK

tomm

The problem with ANY form of arthritis is that the large majority of people who suffer it DO manage to work and have relatively normal lives

Depends on how severe it is   Mine is bone on bone  i certainly can't lead a normal life or work  (stage 4 O/A)  it doesn't get any worse , the only option as far as treatment goes for me is a TKR, and as i'm not as old as the op of this post, ther's no way i will be having that proceedure yet, because it's not something i wish to have to repeat in 10 years time

mikehughescq

4 claims is a problem. Were all 4 pursued to mandatory reconsideration; appeal or Upper Tribunal? If they were then the answer may well be that you simply don't qualify.

So, 1st thing to do is to self assess. There are often posts on here from people who assert that they ought to qualify for a specific benefit but when it comes to it they have no idea why or the specific circumstances in which the benefit is paid. I'm not saying that is you but 4 claims without MRs or appeals of any sort would be a red flag to some extent.

So, start with your latest claim. When was the decision? If it was within the past month then you need to do a mandatory reconsideration. If you are outside that but within 13 months of the decision then you can do a late one but will need to explain why you're late as well as explaining which points you do think you qualify for. If you've already done one of these then you're at the appeal stage and again you have one month but up to 13 months.

The key question is whether or not you have self-assessed? Have you used, for example, the resources available at places like Benefits & Work to establish the points you think you're entitled to and, if you fall short of 15 points, then have you an argument for regs 29 and 35?

When you completed the ES 50 questionnaire did you answer the questions thinking about whether you could perform each activity repeatedly, safely and in a work context or did you just go down the "Yes/no" road?

If the answer is "no" to any of the above then you're part way to getting to grips with why 4 claims have failed. Lots of people talk about conditions being variable as though that were an unusual thing rather than the norm. However, with any form of arthritis you are, as has been observed, up against it as the starting point for a HCP will be that most people with it are capable of work and thus their only issue is pain management. You need to make a case in that context.