Is there such a thing as too much evidence?

Newbie here!

I have CFS / ME / Fibromyalgia / Osteoarthritis of Cervical and Lumbar Spine / IBS / Anxiety & Panic Attacks / Glycosuria / Adenomyosis

I have been living with these conditions for years and managed to stay off benefits by going self employed and working from home as an analyst when I finally had to give up my employed position in 2007. However at the end of 2009 I had a major relapse and my GP signed me off work in March 2010.

My first ESA50 placed me straight into the Support Group without a medical. I then applied for DLA and was awarded the higher rate for both components, again without a medical. I also now hold a blue badge. With both my applications I sent an extensive diagnostic report from a CFS Specialist (Myhill) which had been written based upon my private lab tests. In December I received a 2nd ESA50 which I completed and returned, but did not attach the Myhill report again.

I was then summoned to an “ATOSment” which I had on the 27th Jan. I actually thought it had gone well, and the lady Assessor was very pleasant and sympathetic. But… you’ve guessed it… wolf in sheep’s clothing! I’ve been booted out of SG and put into the WRAG despite a score of 36 (all physical. I wasn’t asked any mental questions). So, low and behold… here I am!

I am awaiting the confirmation letter of my WRAG status and the written explanation. I received a copy of the ATOS medical report last week and could tell I’d been screwed so got straight onto my Local BDC, hence how I know the decision without the confirmation letter. I will of course appeal as I’m utterly incapable of attending any type of work interview or activity and the stress of the WRAG decision has already flared up all my symptoms and put me into a manic spin of anxiety, panic and insomnia.

The BDC advised me to send in the GL24 and highlight every aspect of the medical report that I did not agree with and accompany it with any supporting evidence, so I have spent the weekend and today starting my appeal document with my husband.

My questions are these:

1. So far, we have run to 27 pages of written response to every aspect that was inaccurate, wrong or not asked on the report. Is this too much?

2. I have letters from GPs, Consultants and of course the Myhill report that all confirm diagnosis and corroborate what I say in these 27 pages – but none are current. Does that matter or should I just throw them all in?

3. To qualify for SG on appeal, do I have to actually meet a Page 25 descriptor, or is it more a case of collectively proving my inability to work from everything else? Reading the guides, I am certain I have missed the SG based on the Assessor’s speculation I can walk more than 30m, despite her scoring me 15 for unable to walk 50m. Should I just concentrate on disproving this, or go all out and actually address everything that was wrong?

3. I have not been to see the GP who deals with my CFS problems, but have seen my female GP due to a lot of gynae probs for which I am having surgery on the 25th March. Should I now go see my CFS GP and request him to write a letter in support of my ongoing physical and mental problems or do you feel my 27 page statement and historical evidence will be sufficient. (I’m guessing there will be a charge for a GP letter so will avoid if I can as hubby has just been made redundant for the 3rd time in 19 months – smashing!).

4. Will this decision have a negative effect on my DLA which is currently awarded indefinitely with no review date?

5. Will I be able to avoid attending the work focused interviews just by calling up and advising I am no well enough to attend, or do I have to get some sort of note from my GP?

6. I have read on another post that phone interviews are offered if you cannot attend in person. Are these offered straight away or only after several rescheduled interviews?

7. Can you request telephone interviews right from the start?

8. And finally - my BDC strongly advised me to make a formal complaint to ATOS about the medical report and gave me their complaints line to call. I thought it interesting how supportive the BDC were of my comments that the report was like reading a totally different person. Has anyone actually done this and if so, what was the result?

Thanks for any forthcoming advice, and sorry for so many questions in one hit!

Hi RatRoom, welcome to the forum.

We can't give advice on individual claims; you need to seek face-to-face advice. Please see

Why can’t you answer a question about my specific claim?

I'll just try to give a general answer to your query.

Firstly, you say that you are 'awaiting the confirmation letter of my WRAG status'. Does this mean that you have not yet been informed of the decision in writing? A decision is not legal until it has been sent to you in writing and you cannot appeal until you receive this letter.

It is not necessary to write an appeal submission when you send the GL/24, as you have not yet been informed as to the reasons for the decision. The medical report is just advice to the decision maker. It would be preferable to look at the decision maker's arguments that you will receive after an appeal is lodged, and challenge these.

It's worth pointing out flaws in the medical report to prove it's unreliability, but the danger of writing 27 pages when appealing is that you could have valid arguments that are buried in a heap of unnecessary information, and as a result they go unnoticed. You don't need to address every error/inaccuracy in minute detail.

The tribunal will only consider your circumstances at the time the decision was made.

To qualify for the support group you have to either specifically meet one of the descriptors on page 25, or satisfy the exceptional circumstances on page 29.

Hope this is useful

Derek

Hi Derek, thanks for your quick reply. Yes it was useful.

I'm aware that you don't give advice on individual cases and didn't realise my questions would fall into that category so my apologies. I know I need to wait to have everything confirmed in writing (due today) but, as I explained, my BDC have told me what the decision is so I’m just trying to get prepared now. The whole thing is causing me so much stress that I feel I’m on the verge of a meltdown and can’t stop shaking. Pathetic I know, but I just can’t control how my brain over reacts to things nowadays and I’m unable to sleep more than half an hour or so at a time again, even on melatonin. It's a total nightmare.

You have confirmed my suspicions about the need to be succinct and relevant, rather than disprove every inaccurate, missing and contradictory element of the report.

Without a doubt I qualify for SG under the 1st and 2nd descriptors. Would a GP letter in support of this be sufficient rather than sending in evidence of my actual illness in the form of all my historical medical documentation that is all over 6 months old? I don’t think my diagnosis is in question – more a case of proving my physical inabilities and that I am not getting better so as to disprove the assessor’s assumption I can walk more than 30m without pain or stopping which is what was written under "evidence to support the opinion that the person does not meet the descriptors for limited capability."

Besides having to attend work focused interviews, my other concern is that the ATOS medical report does not support my level of DLA and I just can’t bear the thought of losing that and having to fight that battle as well. I’m not expecting personal advice on this I just need to know if it is standard DWP practice to look at DLA when someone is moved from SG to WRAG even if it has been granted indefinitely? If so, would this be a sufficient reason to be more explicit in my GL24 response and ensure I repeat everything that I previously wrote in my DLA1?

Thanks

Hi RatRoom

A letter from your GP confirming (in his or her opinion) that you meet the relevant support group descriptors would certainly be very helpful and add weight to your case. Although your historical medical evidence over the last couple of years (such as GP computer printout) does not relate to the time of the decision, it's not entirely irrelevant and there is no harm in including it when you appeal.

Also consider whether you meet the exceptional circumstances and if so, you can make a case on appeal.

I'm not knowledgeable on DLA but I understand that the DWP use ESA medical evidence for DLA purposes. I'm not sure if they do this automatically when an ESA award is reduced.

I can't say for certain but I doubt the DWP, if they were to review your DLA, would consider evidence from you that is part of an ongoing appeal. They would probably look no further than your ESA85 medical report and not be aware of your GL/24 evidence, so you may be better off following the advice in the guide and keeping the GL/24 reply brief.

Good luck, I hope it doesn't get too stressful.

Derek

hey i thought if u got high rate care arnt u exepmt from atos medical and the dreaded medical forms

IB claimants can be exempt due to their DLA award, but not ESA claimants.