PIP and ESA: what IS considered good medical information? (UK)

[markielock]

Hi guys!

I'm currently claiming Universal Credit (yay...). They have sent me a "Limited capability for work" questionnaire to fill out because I have been sending them endless medical certificates to say I can't work (although they insist I can do a job search of 1 hour a week lol). This is the ESA50 form.

One thing you're always asked for is any medical evidence and to supply as much as you can.

I have applied for ESA and PIP in the past and I have sent them medical evidence in the form of my complete medical history, which also included correspondence from NHS specialists saying their only conclusion is a post viral fatigue etc... However, this evidence has never proved effective (it's unclear if it's even been taken into consideration due to the glaring lies, assumptions and misinformation on all previous "Decision Maker" reports).

I thought this time I should be better prepared. What IS considered good medical information? What are the most succinct and effective ways to present my relevant medical history? I don't want to overload them to the point where they don't look through my evidence. Not only that, but:

• most of my medical history is just lots of blood tests etc. from over the years saying that they can't find anything wrong. I think most of us know what the DWP is like: this could so easily be spun by the DWP to say I have no mental or physical condition.
• I also don't know if the letter that gives me my diagnosis is clear and definitive enough. AND,
• I was working (very nearly out the door) at the time of my diagnosis. My diagnosis letter said I was going back to work because I felt a bit better, which ended up not being true and I was even made redundant on the grounds of ill health despite my fight against it (I was in fierce denial about my limitations at the time). I'm worried that the wording will count against me (the pantomime is everything to the DWP after all).

Do I need to speak to my doctor and ask them for a letter summarising my medical history, situation and to definitively say that chronic fatigue syndrome is their best diagnosis? Should I provide accounts from my previous employers of my sickness records, occupational health reports and reasons for termination? (an embarrassing mess not even I would want to look at again). What other important medical documents am I missing or don't know about?

Also, another concern is my doctors hardly know me. They do have a history of me over the years coming home to my parents after my "experiments in my limitations" because i'm too sick to work/study/support myself. They have supplied mountains of medical certificates. However, I don't have a GP who is familiar with me personally because they come and go all the time at the surgery's I've been to. I have to re-explain my situation/position each time. This is even more the case for the doctors in Dundee, where I had recently lived. I don't know how comfortable they would be vouching for my health.

I am deeply disenfranchised and jaded about ESA and PIP and I have absolutely zero expectations. However, this ESA50 seems mandatory, so I might as well punch them as hard as I can!

Any help would be greatly, greatly appreciated! Thanks guys

 

[ukxmrv]

My experience that it's a huge lottery.

Previous experience was that a report from a good NHS consultant, made absolutely no impact on the DWP, when applying for the old DLA. I went through 2 tribunals and eventually gave up when they awarded me the bare minimum. Other earlier attempts with a basic report from my GP and from a NHS ME/CFS clinic all failed on the initial attempts and I was too sick to fight them every time.

On my most recent PIP attempt I was awarded low rates of both when I submitted my POTS report from a Cardiologist and a printed copy of the TTT straight away with no fight.

The problem with my earlier reports from consultants, clinics and GP is that none of them actually reported on what I could / could not do i.e. mobility or prepare a meal. The POTS report and TTT showed what happened when I stand up.

I've never had an exercise test before, apart from one decades ago from a Cardiologist and this was one obsessed with hyperventilation and as I didn't have this the report was vague. I don;t even know if I could get a 2 day exercise test close to me but when my next PIP comes up I may consider it.

 

[boombachi]

I think the ME association have info on filling out benefits forms or read this website.

https://www.disabilityrightsuk.org/work-capability-assessment

If you understand the descriptors you will be able to collect the right evidence. Being dismissed on mecical grounds is evidence if you have documents stating what you were not able to do at work (i am guessing because you were off sick too much).

If there is an advice service near you like citizens advice they might be able to go through the forms with you and the process for appealing if necessary. If you attend a medical, get someone to go with you, get them to drive or take a taxi. Use lifts, not stairs. Their first question will probably be 'how did you get here?'

 

[char47]

The medical evidence has to speak directly to the descriptors (criteria) that points are awarded for. So, for example a consultant's letter saying 'this person has severe ME & cannot work' will have no effect whatsoever, because it's a tickbox system, there are boxes that must be ticked & if the letter doesnt speak to those boxes then it will be next to useless. They dont care about your diagnosis, only about whether you can prove that yr condition affects you in the ways that the criteria says you get points for. Test results mean very little because they're not interested in discovering whether you are actually capable of work, they are only trying to find out if there is a way they can avoid paying out.

More info can be found at www.benefitsandwork.co.uk. You will need to pay a £20yr subscription but their downloadable guide to filling in the ESA50 is worth 10 times that in my experience. It tells you exactly what you are judged on so you can tailor your replies to the specific criteria you're being judged on - which are not always what one thinks. Not so you can lie of course but so that you dont fill in a bunch of stuff that in their eyes is completely irrelevant because there isnt a tickbox for it, and so you dont miss out info that you wouldnt think to include even though you would tick the box if you told them about it.
I highly recommend that site - they also have a forum where you can ask specific personal questions & it's manned by people who are extremely knowledgeable about the whole process.
The ESA50 form's wording is designed to manipulate you into saying what they want to hear, i honestly dont see how anyone could possibly be assessed fairly with it, without knowing what you are being judged against. It's manipulatory & devious. The B&W guide takes you step by step through the whole process.

wishing you the best of luck with your application.

 

[char47]

• I also don't know if the letter that gives me my diagnosis is clear and definitive enough. AND,

• I was working (very nearly out the door) at the time of my diagnosis. My diagnosis letter said I was going back to work because I felt a bit better, which ended up not being true and I was even made redundant on the grounds of ill health despite my fight against it (I was in fierce denial about my limitations at the time). I'm worried that the wording will count against me (the pantomime is everything to the DWP after all).

Personally i wouldnt send that letter because it says innaccurate info about your state of health. You need a letter from your GP that says 'this person has CFS, it affects them in xyz ways', better no letter than one that says the wrong thing. Only my opinion but they will pick up on anything. If you could just ask yr GP to confirm your diagnosis & that you had to give up work becuase of it, it would be better than one saying you're better & returning to work. I think even a GP that doesnt know you well could do that because it's factual & not based on their opinion.

 

[alkt]

I have asked my doctor for a letter of support regarding the farce that is called the all work test he refuses on the grounds that it is not his job to deal with the dwp. on the one hand I cant really blame him because like many doctors today he does way to many 12/14 hour days and his own health is suffering on the other hand of course I am angry that I have to appeal the decisions made on the basis of the parasitic industries getting fat of tax payers monies whose contracts must be based on just how many sick people they can deny benefits to. I have been pushed into two major crashes by this process and my previous energy level show no signs of returning after 7 years. sorry must be ranting time but this situation is hellish for everyone . I wish you luck wiyh your claim and of course I wish you were not in this position in the first place.

 

[Corazon]

It was back in 2008, but the benefits and work website that has been suggested made all the difference when I applied for DLA. I was awarded the highest level on my first application. I left the UK in 2010 though and it is my understanding things have changed quite a bit in terms of DLA v. PIP etc, but the advice I have read is on par with what I was given back then. Good luck with it all. I'm back in the US now and have not enough credits with Social Security to qualify after being sick and unable to work for so many years so not even any point in applying for me here. At least I only have 15 or so years until I can "retire" and collect on the work I did before I became disabled. Chances are at this rate I will still be sick then. lol. (a little gallows humor there!)

 

[PracticingAcceptance]

Loving your thorough approach @markielock !

I've been well enough today to do some googling about benefits (yay, finally, it's only taken me 8 weeks).

I went to a Citizen's Advice appointment in August to see if I'm eligible for PIP. She said I need to get a letter from a specialist before coming back to her for help to make the PIP application. I've been wondering today if I should try and apply without it, but reading this thread, it's clear I should wait to make my best chance! I've been chasing this specialist appointment for 5 months. Still haven't got a date yet... and a bit worried about money, considering how little I've been earning.

The medical evidence has to speak directly to the descriptors (criteria) that points are awarded for. ... there are boxes that must be ticked & if the letter doesnt speak to those boxes then it will be next to useless. They dont care about your diagnosis, only about whether you can prove that yr condition affects you in the ways that the criteria says you get points for.

I'm afraid you might be right. My main symptom that stops me from being functional is concentration/sustained energy to think/interact with people. This does also affect my ability to cook, shower, get dressed, travel etc on bad days. I'm so frustrated that PIP have a section on communication, but it looks like they might not accept memory loss, lack of ability to concentrate, needing to rest for a day after an hour's meeting, and inability to mentally take in information - their criteria is more about if you're deaf. When I met with the Citizen's Advice lady I was trying to communicate my communication problems but I didn't understand that these problems are irrelevant because they're outside of the tick box system.

So, I guess the system is stacked against me/us.

One helpful tip for you @markielock . At the Citizen's Advice appointment, she told me to keep a diary of my symptoms against the symptoms that they care about. I kept it every day for a couple of weeks then I got too ill to do it! I'm going to see if I can start doing it again. That way, I can build my own evidence to supplement doctors' evidence.

Diary template if you click through this page: https://www.citizensadvice.org.uk/b...elp-with-your-claim/your-supporting-evidence/

@char47 how does this compare to the benefits and work website?
https://www.citizensadvice.org.uk/b...carers/pip/help-with-your-claim/fill-in-form/
This seems quite helpful to me, is the benefits and work website worth paying for if this info is free?

 

[char47]

PIP have a section on communication, but it looks like they might not accept memory loss, lack of ability to concentrate, needing to rest for a day after an hour's meeting, and inability to mentally take in information - their criteria is more about if you're deaf. When I met with the Citizen's Advice lady I was trying to communicate my communication problems but I didn't understand that these problems are irrelevant because they're outside of the tick box system.

Well the inability to understand information presented to you would be a factor I think. But it depends how bad it is...& it's helpful to understand the terminology that they use to judge things.

@char47 how does this compare to the benefits and work website?
https://www.citizensadvice.org.uk/b...carers/pip/help-with-your-claim/fill-in-form/
This seems quite helpful to me, is the benefits and work website worth paying for if this info is free?

Well i dont have the wherewithall to read it all through & the whole thing makes me so anxious I'd rather avoid doing a like for like comparison so i just had a quick look at one of the questions - cooking - & although it looks similar, the B&W is i think much more detailed. It alerts you to traps for example & tells you exactly what you're being judged against. Not sure of the length of the PIP one but the whole ESA guide is 84 pages long! It's quite a read & i dont do it myself, although i did read it through (took me a few mnths) initially so i could familiarise myself with the info. Plus the forum is a godsend for the housebound, so yes personally i would still say its well worth the subscription.

I've been wondering today if I should try and apply without it, but reading this thread, it's clear I should wait to make my best chance! I've been chasing this specialist appointment for 5 months. Still haven't got a date yet... and a bit worried about money, considering how little I've been earning.

If it were me I would get the B&W guide now, read it thoroughly BEFORE you meet your consultant & then you can ask you consultant to speak dierctly to the 'descriptors' you feel are relevant that you should qualify for. Not telling him what to say of course but you can focus on the most important bits. Good luck with yr claim & your specialist appointment.

 

[char47]

This topic is so anxiety provoking for me so i will bow out of this thread now. wishing you all the best of luck

 

[Pyrrhus]

Related discussions:

Pip UK disabilty ...just got awarded
https://forums.phoenixrising.me/threads/pip-uk-disabilty-just-got-awarded.84694/

Do I or don't I appeal PIP?
https://forums.phoenixrising.me/threads/do-i-or-dont-i-appeal-pip.61206/

 

[Emmarose47]

I got awarded enhanced rate for both areas of pip ...
With the limited capacity for work I didn't give too much evidence just standard letters from medical profs ... But I did have mental health evidence too ..

In my experience I'm not sure there too focused on the diagnosis ...it's the functioning on daily tasks thats the focus and what support someone has ..

Benefits and work is a good forum