Found fit for work! will I lose PIP as well?

[tinacarroll27]

Hi all!! Having a stressful time at the moment!! I have just been found fit for work and lost my ESA but I didn't actually have a medical. Originally I asked for a home assessment because traveling is a nightmare and I am bed bound most of the time. I also sent them a note from my GP saying I couldn't travel but they did not except it. I tried to go but I had to eventually cancel the appointment due to severe dizziness, so they give me a second appointment. I couldn't get to that appointment either as I just couldn't get out of bed even with help and I missed the second appointment. I phoned them to explain and they said they would re look at my claim and the reason I missed the appointment but today I have received a letter saying my ESA was stopped and they have decided I am fit for work. I do receive PIP as well (standard level for care and mobility) and I am scared this will stop as well! I don't know if I should appeal or not. I was thinking maybe I could cope on just PIP but I am worried I may lose this as well now, I am not sure I could cope with having to appeal both.. too much stress!!

 

[Esther12]

I'd appeal. You won't automatically lose PIP, but it's possible it could trigger an earlier re-assessment. I think it's normally harder to get PIP than ESA, so planning to rely on PIP alone is a risky strategy.

Good luck with everything.

 

[charles shepherd]

Tina

Firstly, from what you say, it sounds as though you have a very good case to take to an ESA reconsideration and to an appeal if necessary - but it is important to obtain as much supportive medical evidence as you can if you decide to do so

As you are probably aware, there is a high rate of success in relation to ESA appeals (around 40%) which demonstrates just how often the DWP decision makers are producing inaccurate decisions on fitness for work in relation to people with ME/CFS

Secondly, PIP relates to care and mobility needs and NOT fitness to work. You can, in fact, still be in work and claim PIP. So just because someone is deemed to no longer be eligible for ESA by the DWP does not mean that the DWP will apply the same reasoning to PIP

I will include below some basic information on PIP applications and appeals from the MEA

Good Luck!

Dr Charles Shepherd
Hon Medical Adviser, MEA

 

[charles shepherd]

Basic information from the MEA on PIP applications, reconsiderations and appeals:

Notes on (2016) House of Lords meeting with Dr Ian Gargan, Chief Medical Officer at Capita, to discuss DWP medical assessments:

http://www.meassociation.org.uk/201...use-of-lords-next-tuesday-21-october-2016/MEA


Notes on PIP Applications, Medical Assessments, Reconsiderations and Appeals:

PIP checker from the DWP

As we are currently dealing with a lot of queries and news items about PIP, including the difficulties people are facing when transferring from DLA to PIP, it's worth noting that the DWP has produced a useful website checker that you can fill in to find out if you can claim PIP and what will happen if you apply for PIP
You can use this tool to check:

• if PIP affects you or someone you care for
• how PIP will affect your child
• when you can make a new claim for PIP or you are transferring from DLA to PIP

https://www.gov.uk/pip-checker

2 FILLING IN THE APPLICATION FORMS
Firstly, we have a very comprehensive MEA guide to filling in the PIP application forms

The MEA guide goes through ALL the PIP questions and how to answer them in relation to ME/CFS

It also emphasises some of the key points that we have been discussing with the DWP in relation to PIP - eg that you are able to carry out the activities being assessed in a way that is reliable, repeatable, safe to yourself and others, and carried out in a timely manner

People have found this guide to be very successful in relation to obtaining this new benefit
MEA guide to PIP and other DWP benefits:
http://www.meassociation.org.uk/shop/benefits-leaflets/


3 ATTENDING A MEDICAL ASSESSMENT

The CAB have a very useful guide to all aspects of the medical assessment with Atos, Capita or Maximus:
https://www.citizensadvice.org.uk/b...p-with-your-esa-claim/esa-medical-assessment/

If you are unable to travel to an assessment centre, the medical assessment can be carried out out in your home.

Contact the assessment centre, explain your situation, and obtain written support from your GP if there is a reluctance to do a home assessment.

Please note that this assessment is not carried out by the DWP - the report on your condition is then sent to the Decision Maker at the DWP

4 RECONSIDERATION PROCESS

Thirdly, if your application has been refused there is an initial mandatory reconsideration process

5 GOING TO APPEAL

Fourthly, in relation to an appeal, there are several things people can do to increase the chance of winning an appeal. These include:

a Obtaining good supportive (written) medical evidence to support your case. In relation to PIP, this can come from people involved with your care (eg a care or social worker if one is involved) and any health professional who is involved with your care (eg OT, physio, nurse) in addition to your GP and/or consultant
b Turning up in person at the appeal
c Getting feedback from people with ME/CFS who have been through the appeal process - you could do this by using MEA Facebook where we have over 6,000 regular members who are always willing to pass on this sort of practical feedback

6 USEFUL VIDEOS

This is a useful source of information on preparing for an appeal from the MInistry of Justice:
http://hmctsformfinder.justice.gov.uk/courtfinder/forms/sscs001a-eng.pdf

This video, made by the Ministry of Justice with an introduction by Dr Jane Rayner, Senior Medical Adviser, First Tier Tribunal. Dr Rayner is a very kind and helpful doctor whom I have met at the House of Lords, is also useful - although it refers to ESA:

Minutes for meeting at House of Lords with Dr Rayner:
http://www.meassociation.org.uk/201...-me-group-minutes-of-meeting-26-january-2011/

Dr Charles Shepherd
Hon Medical Adviser, MEA

 

[Barry53]

I also sent them a note from my GP saying I couldn't travel but they did not except it.

I do not fathom this. How can they not heed a person's own GP letter that clarifies their unfitness to travel?! Talk about being a law unto themselves.

 

[62milestogojoe]

Hi all!! Having a stressful time at the moment!! I have just been found fit for work and lost my ESA but I didn't actually have a medical. Originally I asked for a home assessment because traveling is a nightmare and I am bed bound most of the time. I also sent them a note from my GP saying I couldn't travel but they did not except it. I tried to go but I had to eventually cancel the appointment due to severe dizziness, so they give me a second appointment. I couldn't get to that appointment either as I just couldn't get out of bed even with help and I missed the second appointment. I phoned them to explain and they said they would re look at my claim and the reason I missed the appointment but today I have received a letter saying my ESA was stopped and they have decided I am fit for work. I do receive PIP as well (standard level for care and mobility) and I am scared this will stop as well! I don't know if I should appeal or not. I was thinking maybe I could cope on just PIP but I am worried I may lose this as well now, I am not sure I could cope with having to appeal both.. too much stress!!

Hi, did you ever get a referral to a NHS CFS treatment clinic? I think we all know what a joke the treatment philosophy is but my therapist prevented me from losing my job by waving disability law at my employers. I am a union member and they offer free legal advice. you can join a union very cheaply, you don't have to be employed. Find the name of your local MP surgery and email your MP if you need to. Protect yourself! Good luck

 

[TedBakerBoy]

Just Collapse in the Examination room and do a dying swan act.

 

[trishrhymes]

Do appeal if you possibly can. The fact that they ignored your doctor's report is awful. You should not be expected to attend a medical if you are too ill to get there.

The Citizens Advice Bureau has people who help with benefit applications and appeals - can you phone your local one and ask them if they can take on your case.

Best wishes.

 

[TreePerson]

I've got all this coming up in the next few weeks and I am in a similar physical state. And I'm likely to miss my first appointment due to shingles. And am in the process of working out if I can get to the second appointment or will need a doctors letter. Which incidentally I have to pay for!
I think the fact that they can take benefits away from you and ignore a doctors letter is outrageous. Please write to your MP if you can summon the strength.
It's possible it's administrative and that it's been automatically taken away because of the missed appointment and could be reinstated. I once had something similar happen although it was not connected to a health assessment. And after a lot of telephoning it got sorted out.

 

[Molly98]

@tinacarroll27 this is just truly awful and must be so stressful and distressing for you.
It is terrible that they have not acted on the doctors letter and given you a home visit. I would be surprised if this was not an error either in their computerised system or human error on their part rather than an actual decision. The amount of admin errors by the DWP while trying to get PIP or ESA is bordering on the ridiculous.

I had to have a doctors letter to ask for a home visit. They did do a home assessment so I can not see how this has happened unless like I say they have messed up.

Do you have family or friends who could help you deal with this? I know the stress of it all can take an enormous toll on our health. As I think Trish mentioned above, do get help from the Citizens Advice and appeal this decision. If possible get someone ( with a lot of patients but who can also be very assertive if required) to phone up and see what exactly has gone wrong, because whatever it is, its not right.

They mess up so much it is just exasperating and infuriating, but then it's deliberately designed so that as many of us fall by the way side as possible.

 

[slysaint]

It's possible it's administrative and that it's been automatically taken away because of the missed appointment and could be reinstated. I once had something similar happen although it was not connected to a health assessment. And after a lot of telephoning it got sorted out.

similar thing happened to me; after a lot of phone calls they told me they had not received the letter from the GP (even tho the GP had sent it to them directly).
Question everything they tell you (particularly if it's by standard letter) as they will only check things if you push them.

 

[charles shepherd]

Hi, did you ever get a referral to a NHS CFS treatment clinic? I think we all know what a joke the treatment philosophy is but my therapist prevented me from losing my job by waving disability law at my employers. I am a union member and they offer free legal advice. you can join a union very cheaply, you don't have to be employed. Find the name of your local MP surgery and email your MP if you need to. Protect yourself! Good luck

I have just been dealing with one of our MEA members who used to claim both components of DLA and has now been told that she does not qualify for either component of PIP

She is, not surprisingly, appealing against this decision

And I think she has a very good case

As can happen, which illustrates the very positive help that can be obtained from some of the NHS clinics for ME/CFS. she now has a four page medical letter of support from a specialist nurse practitioner involved in her care

The letter outlines the various components of PIP in relation to care and mobility and what sort of difficulties this person has with each descriptor

If you can find a health professional who can produce this type of supportive medical evidence it can be extrememely helpful with both applications for PIP and appeals against refusals

CS

 

[trishrhymes]

@charles shepherd I think it was ESA @tinacarroll27 said she had just been refused. The advice on PIP is useful. Perhaps you also have something on ESA for her.

 

[charles shepherd]

@charles shepherd I think it was ESA @tinacarroll27 said she had just been refused. The advice on PIP is useful. Perhaps you also have something on ESA for her.

Basic info from MEA on ESA and WCA:

Ten Important things you should know about the Employment and Support Allowance (ESA) and the Work Capability Assessment (WCA) if you are:


·Applying for ESA


·Asking for a reconsideration of a decision


· Appealing against a decision


(1) Feedback to The MEA indicates that a significant proportion of people with ME/CFS are finding it very difficult to qualify for ESA - the long-term sickness benefit for people who are unable to work. Entitlement to ESA is assessed by using what is called the Work Capability Assessment (WCA). The WCA does not determine entitlement to ESA on the basis of the named medical condition (eg ME/CFS) a person has. Your entitlement to ESA is supposed to be based on the effect that the disability or health problems resulting from having ME/CFS has on your functional capability to work.


(2) The situation regarding ESA appears to have been made even more difficult for people with ME/CFS following legislation to bring in a revised set of WCA descriptors. This legislation also removed some of the original WCA descriptors (eg the one on cognitive dysfunction – problems with short-term working memory and concentration) that are very relevant to people with ME/CFS. More information on the WCA descriptors can be found at: www.meassociation.org.uk/?p=4534 (>> pdf of Statutory Instrument)


(3) People who were claiming ICB have also being re-assessed to see if they are eligible for ESA. Feedback to The MEA indicates that they are having very similar difficulties.


(4) The WCA descriptors are a list of questions relating to various aspects of disability and ill health along with point-scoring answers. The MEA believes that the current set of descriptors are not a fair or effective way of assessing capability for work in people who have long-term fluctuating medical conditions such as ME/CFS. Our reasons for coming to this conclusion can be found in our submission to Professor Malcolm Harrington’s review of the WCA:www.meassociation.org.uk/?p=1639. Since then, The MEA has been involved with a group of charities representing people with fluctuating medical conditions in the production of a report that contains recommendations on how the WCA descriptors could be made fair and effective for people with fluctuating medical conditions. The recommendations in the report, along with recommendations covering mental health descriptors, have been assessed by the DWP in an evidence based review. The results of the review can be found here:


http://www.meassociation.org.uk/201...-and-statement-from-the-mea-17-december-2013/



A copy of the Fluctuating Conditions Group report can be downloaded on the MEA website:


http://www.meassociation.org.uk/wp-content/uploads/2011/05/Fluctuating_conditions_report_FINAL.pdf


(5) So if you are applying for ESA, or appealing against a refusal to grant ESA, or trying to move from the WRAG to Support Group, it is very important to give careful consideration to the way you provide answers to the WCA descriptor questions.


(6) During a House of Lords debate, which sought to annul the legislation which revised the WCA descriptors, a number of useful contributions were made which relate to people with ME/CFS and other fluctuating conditions. Lord Freud (DWP government minister) made the following important statement which is very relevant to people with fluctuating medical conditions:


“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.”


A Hansard transcript of the debate can be found on the MEA website: www.meassociation.org.uk/?p=5180


(7) There is a high rate of success on appeal involving ESA refusals – with around 40% of DWP decisions being overturned. So anyone who believes they have not been treated fairly should consider going to appeal.


(8) The chances of success at appeal are often increased by appearing in person and providing good supportive medical evidence from health professionals (and any other professional – including care workers) who are involved in your care – especially if this was not provided at the time of the application.


(9) Useful information on benefit appeal procedures can be found in a presentation given by Dr Jane Rayner (Chief Medical Member of Social Security tribunals) to the Forward ME Group at their meeting on 26 January 2011. The minutes of this meeting can be found here: www.meassociation.org.uk/?p=4569.


Dr Jane Rayner has also produced a video on the appeal process. This can be found on the MEA website: http://www.meassociation.org.uk/?p=13201


The Tribunal Service has produced a useful booklet called ‘How to Appeal – A Step by Step Guide’. This can be downloaded from the Tribunal Service website:

http://www.justice.gov.uk/downloads...s-and-how-to-appeal/HTA_English_Final_rev.pdf



(10) The MEA has a fully comprehensive list of leaflets covering all aspects of the benefits system – including applications for individual benefits and appeals.


Three helpful videos have also been produvced by Maximus on what happens during the process of claiming ESA,, including the medical Assessment:


https://www.chdauk.co.uk/updates/2015/09/helpful-videos-now-available


Information updated in July 2016 by Dr Charles Shepherd - Hon Medical Adviserr, MEA


Please note that regulations relating to DWP benefits are constantly changing and that this information is correct at the time of publication.

CS

 

[Barry53]

I imagine that one of the huge hurdles for some sufferers, is that although the information above is incredibly valuable and helpful, it must be like wading through treacle trying to convert it to practical use. It is like pwme need a dedicated service to try and do some of that spadework for them.

 

[tinacarroll27]

Thanks everyone for your support and encouragement!
I am going to appeal! I know it will be difficult and stressful but I am determined to not give in. I am not sure where I can get more medical evidence (I sent a letter from Dr Myhill and my GP, as well as a letter from my boyfriend who looks after me). The only other medical evidence I could get is if I go to the NHS cfs clinic and I have tended to avoid them in the past but maybe they might be able to help me with this, although travelling to them will be difficult but I can talk to my GP over this.

 

[ladycatlover]

Good luck! I'm waiting for PIP Tribunal at present, so know how worrying it all is. Guess I might start my own thread if I have time - we're trying to get evidence together right now as we got the DWP bundle about 3 weeks ago (I think). Have sent some, but OH is still working on his Witness Statement. It all takes up so much time and energy, even for spouse who is old (as am I) but healthy (as I am not).

 

[tinacarroll27]

Hi all just thought I would update. I put in a mandatory reconsideration and I just got a replay back to day and to my surprise they have given me the ESA back, I will still have to go to a medical but at least that is the first part sorted and I am relieved I won't have to go to appeal. They are basing the reconsideration on the letter I sent them from my GP back in October 2016, saying I could not travel very well but why are they only recognising it's existence now!? Why not before they stopped my ESA. I still have a long way to go, as have to go through the work capacity assessment but at least they except my reasons for not been able to get to the assessment in February.

 

[ladycatlover]

Very glad you've got your ESA back @tinacarroll27. Hopefully they will do a home medical in line with what your GP says. Good luck with it all.

 

[trishrhymes]

@TreePerson that is so awful. You should not be forced into anything at a medical, and should be listened to with respect. I am so sorry you have been refused the benefit you are entitled to.

Sending hugs