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DWP inventing diagnosis: problematic consequences?

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8 years 6 months ago #158467 by mpckelly
Hi, many thanks for all the helpful advice that's given on the forum and the site generally.

Having been on ESA in the Assessment stage for over 2 years, I finally had my WCA medical a few weeks back. I've now had the response - the DWP say |I'm fit for work, so the ESA has been stopped. Needless to say, it's all extremely upsetting and stressful. I disagree with the decision, and will request Mandatory Reconsideration, then appeal if necessary.

I have a particular difficulty relating to what the DWP Decision Maker has written in their report. I have a chronic pain problem and my fit notes have always recorded just this as being the reason for my being unfit for work - nothing else. However, recently I have been wondering if I should also be diagnosed with anxiety, as I am having increasing difficulty in coping with even the slightest of everyday stresses (let alone the ESA decision and stoppage).

I'm aware that I could reclaim ESA if I have a new condition, or if my current condition deteriorates. I was thinking, therefore, that it might be legitimate for me to reclaim on the basis of my now also experiencing anxiety, if my GP agrees that this is an appropriate diagnosis.

However, I now find that the Decision Maker's Report states that I suffer with "chronic pain, anxiety and depression". This is despite the fact that, whilst I did refer in my WCA to having seen a psychologist regarding coping with my pain issue, and that this psychologist did discuss social anxiety with me, I have never had anxiety as a diagnosis on a fit note (nor anywhere else, as far as I am aware). Furthermore, I was asked in the WCA about depression and clearly stated on two occasions that I do not consider myself to be suffering from depression!

Could the fact that the Decision Maker has now concocted diagnoses of anxiety (and depression) disallow me from reclaiming on the basis that anxiety is a fresh condition?

Thanks in advance for any guidance anyone can offer.

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8 years 6 months ago #158481 by Gordon
hablitza

Sorry to hear that you were unsuccessful.

Anxiety is not a condition that appears overnight so it's perfectly possible that you were struggling with this when you were assessed and this is why the assessor included it in their report.

The DM referring to anxiety does not preclude you making a new claim on the basis that this is a new condition, you could argue that you did not include details of this on your ESA50 as you did not understand that you were suffering from the condition at the time or if your ESA50 was completed some time ago, that you were not suffering from the condition.

However, I think your chances of success are low as the assessor will likely argue that despite the information not being include in an ESA50, it was considered as part of the assessment. Of course the worst that they can do is refuse a new claim.

Another factor is whether this anxiety is sufficient to result in an award, do you see yourself being able to score the 15 points needed through this new condition? This will certainly be something that the DM will look at in deciding to allow a new claim.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: mpckelly

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8 years 6 months ago #158518 by mpckelly
Many thanks Gordon.

So is it the case then that the DM can assign me with a condition, so to speak, purely on the basis of how the examining HCP perceives me as presenting during the WCA? The diagnosis doesn't have to be on a fit note from my GP, or reports or correspondence from any other medical professional?

I'm not sure whether my anxiety would merit me scoring 15 points (it varies). Is it the case then that, if I reclaimed ESA on the basis of the new condition of anxiety, the DWP would only consider the effect of my anxiety and not the combined effects of anxiety and chronic pain, since they have already dismissed a claim on grounds of chronic pain? ...

(albeit would they still have to consider the chronic pain if it deteriorates?)

Thanks again to you and your fellow mods in advance.

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8 years 6 months ago - 8 years 6 months ago #158557 by Gordon

hablitza tamnoides wrote: Many thanks Gordon.

So is it the case then that the DM can assign me with a condition, so to speak, purely on the basis of how the examining HCP perceives me as presenting during the WCA? The diagnosis doesn't have to be on a fit note from my GP, or reports or correspondence from any other medical professional?

I'm not sure whether my anxiety would merit me scoring 15 points (it varies). Is it the case then that, if I reclaimed ESA on the basis of the new condition of anxiety, the DWP would only consider the effect of my anxiety and not the combined effects of anxiety and chronic pain, since they have already dismissed a claim on grounds of chronic pain? ...

(albeit would they still have to consider the chronic pain if it deteriorates?)

Thanks again to you and your fellow mods in advance.


The DM is not medically trained so any reference they might make derives from the assessor and one of their task is to evaluate the claimants level of anxiety.

You haven't posted what points you scored if any, but I would expect the DM to accumulate your points when making a decision on whether a new claim is likely to result in an award or not, you'll only know by making a new claim and seeing.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 8 years 6 months ago by Gordon.
The following user(s) said Thank You: mpckelly

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8 years 5 months ago #159238 by mpckelly
Thanks again Gordon. I'm continuing to post in this thread for the sake of continuity, though things have moved on a bit.

I requested and have now received the ESA85 report of the WCA. I'm very concerned about it. During the WCA, the HCP was typing constantly at a million miles an hour, so I was expecting some level of detail in the report. However, there isn't much at all: what I said has been radically pared back to a string of short sentences and phrases, some of which don't fully represent what I said - for one example, I told the HCP that, while I like to read, I find it difficult to concentrate and tend to have to re-read something 4 or 5 times to get any understanding; this has been recorded simply as "he likes to read".

Whilst the odd bit of the apparent 'editing' may go in my favour, many important things I said have not been represented, either fully or at all.

Is there anything I could, or should, so about this?

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8 years 5 months ago #159253 by Gordon
hablitza

An award of ESA will only be made by your showing that you meet the criteria for one, I'm not saying that you should ignore the assessment report but arguing about the content will no in itself result in that award. If you do feel that there are points you want to raise then try and stick to matters of fact rather than disputing the opinions of the assessor which the Decision Maker is likely to accept without issue.

As to the level of the detail, much of the report is produced by the computer program that the assessor will have used during the fact to face, so it's not that unusual.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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