Benefits: Essential information for ESA claims, assessments and appeals

Here is some exceptional information that will be very useful for British people who are on benefits and have been undergoing some very concerning pressure and irresponsible assessing from the governments new Benefits ‘bulldog’ ATOS, in the rush to get millions off benefits and into work. Sure we agree that work is good for most people, giving one a sense of achievement, usefulness, purpose and contribution to their communities -and of course to help lift people out of poverty (well that’s the idea).

However, there are many thousands of people who have been railroaded and unfairly treated who have dire health and mental health issues, who are suffering intensely, even to the point of committing suicide, such is the stress (there are agencies counting the numbers of these related and growing death stats). Here is some essential information from a terrific group of people who have provided us here with a very succinct account of appeal points, what to look out for, where your rights lie etc. If you or someone you know are undergoing a benefit review and are terrified of what might happen to you, I urge you to have a read of this. The blog it has come from can be found here http://kittysjones.wordpress.com/2013/04/21/1560/ and I urge you to have a look at it, if only for the 47 comments posted after the article (we have reprinted it fully on this website -partly here on the blog but again fully under Benefits, in our A-Z of Health.

 

There are three essential ideas to keep in mind when claiming Employment Support Allowance (ESA) because of the nature of the ESA50 form, and the fact that Atos are seeking to deny benefits, and NOT assess disability: this will not be a fair investigation of your health issues.

This information needs to be shared widely so people are made aware of them, and can use them when claiming ESA or appealing.

These very helpful ideas are:

  •  Reliably, repeatedly and safely

  •  Exceptional circumstances – Regulations 25 and 31, 29 and 35

  •  Atos assessments and pitfalls – how they try to deceive you

1. Reliably, repeatedly and safely. 

‘Lord’ Fraud made this statement in the House of Lords:

“It must be possible for all the descriptors to be completed reliably, repeatedly and safely, otherwise the individual is considered unable to complete the activity.”

You might be able to go up three steps *once* – but if cannot do it “reliably, repeatedly and safely”, in Fraud’s own words you CAN NOT do it at all.

Apply the phrase “reliably, repeatedly and safely” all through your ESA50 or appeal form, use it on each of the descriptors. Make sure you state clearly which activities you can not do reliably, repeatedly, safely and in a timely manner, because Atos will otherwise assume you are consistently capable of them all.

2. Exceptional Circumstances – Regulations 25 and 31 for Universal Credit and Regulations 29 and 35 for current and ongoing ESA claims and Contribution-based ESA.

Regulations 25 and 31 will replace the old Special Regulations 29 and 35 from April 2013 for Universal Credit. This is in preparation for the abolishment of income-related ESA only, and not contribution-based ESA.

However, the old Regulations 29 and 35 still apply to ongoing cases that are not yet affected by Universal Credit, and will remain in place indefinitely for all Contribution-based ESA. So there are two sets of Regulations in place for Exceptional Circumstances.

Income-based ESA will be replaced by Universal Credit, as (or if) it is rolled out, but there will be the same additional financial components added as we currently have for ESA – you will be able to claim either the work-related activity or the support component.

The contents of both sets of Regulations are essentially the same. They are applied in the same way. 25 and 29 are for those who are not capable of work, and would usually be placed in the Work-Related Activity Group, and 31 and 35 apply to those not capable of work-related activity, and would normally be placed in the Support Group.

Because of the tick-box nature of the ESA50 form, it is likely that people will fall below the number of points required to be declared incapable of work – it doesn’t take into account variable illnesses, mental illness, or the effects of having more than one illness.

However, the Exceptional Circumstances Regulations may cover us – they both state that the claimant should be found incapable of work (Regulation 29 for ongoing ESA claims, 29 for Universal Credit) or work-related activity (Regulation 35 for ongoing ESA claims, 31 for Universal Credit) if:

  • they have an uncontrolled or uncontrollable illness, or “the claimant suffers from some specific disease or bodily or mental disablement and

  • by reason of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work/work-related activity”.

If you feel this is your circumstance, then we suggest adding something like this, where you put “other information” on the ESA50:

“If the scoring from my answers above is insufficient, then I believe applying the Exceptional Circumstances Regulations would be appropriate due to the severity and interaction of my conditions, and my inability to reliably, repeatedly and safely encounter work-related situations and/or safely perform work-related tasks.

I am taking all available and appropriate medication as prescribed by my doctor(s), and there are no reasonable adjustments to a workplace which would mitigate my medical condition(s).

Therefore I believe being placed in the Support Group would be appropriate, because there would be a serious substantial risk to mental and/or physical health if I were placed into a workplace environment or in the work-related activity group.”

Please change the wording to fit your situation, delete “mental” or “physical” if appropriate, leave both in if necessary. If your illness cannot be controlled at all, or medication can’t be used to control it, add that instead.

Regulations 29 (for ESA) and 25 (for Universal Credit) cover people who might be put in the Work-Related Activity Group (WRAG), which has work-focused activities, sometimes it has workfare placements, and sanctions may apply, while Regulations 35 (for ESA) and 31 (for Universal Credit) cover people who are not well enough for any kind of work activity. This is for people who might be placed in the Support Group. There are no conditions placed on you for getting your ESA, such as workfare, if you have limited capability for work-related activity.

You can ask your doctor to support you with this claim, as it is stated in the regulations:

“(b) evidence (if any) from any health care professional or a hospital or similar institution, or such part of such evidence as constitutes the most reliable evidence available in the circumstances” may be presented to support your case.

Here are some links so you can download and print off documents to give to your GP to support your claim or appeal. You ought to submit copies of these to the DWP as soon as you can. (Make sure that you keep a copy)…….NOTE: This article goes on in some length and detail and we thought it was so relevant and useful for British people who use drugs/ have mental health issues/ disabilities etc, we just had to save it under Benefits, in our A-Z on Health Section. To go direct to that page, click link here:

For the rest of this brilliant piece of work, click here

Or for added Further reading Chosen by Kitty Jone’s blog writers; Robert Livingstone and Sue Jones.

More on questions you may be asked at assessment: dwpexamination forum 

How to deal with Benefits medical examinations: A Useful Guide to Benefit Claimants when up against ATOS Doctors


More support and advice here: How to deal with Benefits medical examinations


Step by step guide to appealing a ESA decision: Good Advice Matters

With many thanks to Joyce Drummond for contributing such valuable information about the Work Capability Assessment.With many thanks to The Black Triangle Campaign for sharing their work on the GP support letter template, and covering legal and explanatory documents
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1 Comment

  1. ATOS physiotherapists cannot give opinions on mental health assessments – official. | Atos Victims Group News

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