Appealing ESA assessment - What to ask from GP?

Jabba101 · October 2017

Hi, sorry that my first post is begging advice, but I'm not sure I'll be able to get an appointment at Citizen's Advice Bureau before I need to get my appeal form sent in.

Date on my Mandatory Reconsideration Notice is 16 October 2017

I need advice please on what I should be expecting from my GP. I asked for a letter for the mandatory reconsideration, but my GP looked at me with a blank face, saying he's not keen on these types of letters and wouldn't know what to put in it. All he did was give me a print copy of his notes for that specific appointment, which did not confirm anything other than that my mental health conditions do exist.

When asking for a letter from my GP, what do I actually ask to be included? My doctor is either not used to this process or is expecting me to say some magic trigger-word before he'll be willing to help.

Should I also ask for a copy of my medical record? I've never needed any of this stuff before, but it's quite clear that despite what was acceptable in the past, more is now required.

***
Below is a brief summary of my condition and what has happened so far in the lead-up to me needing to apply to the appeal tribunal.
***
I have a combination of mental health conditions - O.C.D. (the most debilitating on a daily basis), depression and PTSD. I had always been declared unfit to work for the past decade.

My condition is chronic with little chance of improvement (at least for the O.C.D.), but suddenly I get awarded zero points at my work-capability-assessment. This is the first time my claim has ever been rejected, so I sent a letter in good faith, asking for mandatory reconsideration, detailing errors in original conclusion. They double-down and more or less told me they think there isn't much wrong with me at all.

I'm under the impression they felt I appeared too "normal" at my face-to-face assessment, and I suspect that they have not referred to my medical records either (which the original form said they had a right to access, which I don't have a problem with).

I have not made a sudden and miraculous recovery, and so if I was unfit to work for the past decade, I think I am still unfit to work. Naturally, I am taking this matter to the appeal tribunal.

Any advice would be greatly appreciated.

Thanks

P.S. I have not had any CBT therapy since 2007/2008, and I believe assessors feel this means I must be fine.
I explained that I am not allowed any more CBT on NHS funding because the remaining issues do not respond to therapy, and so I would only get more therapy for new problems, not the existing ones.
The decision makers have either ignored this or don't believe it's true (I was told this verbally at end of my therapy, I don't know if it's actually written down anywhere).

CockneyRebel · October 2017

Hi Jabba and welcome

First thing is that you don't need any more evidence to send with your appeal request, your submission should be made later when you receive the bundle ( more later ) You need form SSCS1 which you can download

https://formfinder.hmctsformfinder.justice.gov.uk/sscs1-eng.pdf

you need to tell them the basics reasons for your appeal but you don't need to go into detail at this time. You should have received two copies of the MR decision , one of which you will also need to send.

You will then receive back from the clerk a letter to say that your appeal has been accepted.

This will give you time to get an appointment with CAB for help with your submission

Next you will receive the bundle from the DWP which is a copy of all the evidence so far in your claim and the reasons for their decision. This is what you will use to make your submission. You should check that all the evidence you submitted is included.

This is just an over veiw to give you a quick idea of what goes on

There is plenty of info on here and the CAB site so please have a look around and come back with any questions

CR

BenefitsTrainingCo · October 2017

Jabba101,

First of all, I'd agree with CR - you don't need additional evidence at this stage, and you shouldn't delay your appeal to get evidence, as it's important to put it in within the month. You can always put more evidence in to the tribunal (and the DWP) once your appeal is lodged.

If you haven't already done the ESA self-test give it a go so you have some understanding of what you should have scored and which activities are most relevant to your conditions.

As regards your GP, one problem is that they don't have to do anything....but it sounds as if your GP doesn't know much about ESA, rather than being unwilling to help. So, once you have a better idea of which activities are affected by your condition, ask him specifically to comment on these - for example, can he talk about whether you struggle to complete personal actions (get things done), struggle to cope with change, or find it difficult to engage with people (these are just examples of activities which might be relevant - I would do the test and decide for yourself).

Another thing to ask your GP to comment on is whether work and/or work-related activity (attending courses or writing a CV) would be a risk to your health. If he thinks so, can he say more about this? You can get ESA on the basis that work would be a risk to your health even if you don't score enough points.

You can ask for a copy of your medical records (usually for a small fee). Bear in mind they may not all be helpful, but the tribunal might notice if there is anything missing. Don't be too put off by not having had any recent treatment. The tribunal are much more likely to be understanding about this than the DWP are. You don't have to be having treatment to have an ongoing condition. The law doesn't require that you are having current medical intervention at all. It just requires that you have problems with the activities which are due to your mental or physical condition.

Good luck!

Will

Jabba101 · October 2017

Thank you, I'll get my form sent back ASAP and work with CAB once I get an appointment. Thanks

Jabba101 · July 2018

Hi, I thought I'd post a quick update, and it is good news...

I went through my case with CAB, they got me to do a detailed diary, get a copy of my medical record. In the CAB's covering letter, they reckoned I should have been awarded 30 points instead of the zero they had awarded.

My appeal hearing was scheduled for 23 July, but just as the date came through, DWP withdrew their objection and reversed their decision.

I have now received backdated payments and have been returned to the Support Group.

Thank you for pointing me in the right direction - I was incredibly stressed and your advice to contact CAB in the first place undoubtedly helped achieve a favourable outcome.

April2018mom · July 2018

Thanks for the update. Glad to hear you ultimately won your appeal.

susan48 · July 2018

Great news, c

audigirl · March 2019

Great news
jabba101
im in this situation now
when you received your acceptance to appeal did you send sick notes in

poppy123456 · March 2019

audigirl said:

Great news
jabba101
im in this situation now
when you received your acceptance to appeal did you send sick notes in

Once the Tribunal accept your appeal you can then go back onto assessment rate with the sick notes but as previously advised they will need to be backdated to the date you were found fit for work. You can of course send in the sick notes at anytime, you don't have to wait until you contact DWP to go back onto assessment rate.

audigirl · March 2019

Ok so i received my MR for esa and theres no change although now im seeing a council advisor do you think i should still contact dwp to let them know im appealing im so confused now there so much to look into any advice please

poppy123456 · March 2019

audigirl said:

Ok so i received my MR for esa and theres no change although now im seeing a council advisor do you think i should still contact dwp to let them know im appealing im so confused now there so much to look into any advice please

Your next step is to fill out the SSCS1 form with the reasons why you're appealing the decision, send the MR decision letter with the to HMCTS with in 1 month of the date of the decision. No need to tell DWP you're doing this.

https://www.gov.uk/government/publications/appeal-a-social-security-benefits-decision-form-sscs1

Appealing ESA assessment - What to ask from GP?

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