ESA claim stopped : I was wondering if... - British Heart Fou...

British Heart Foundation

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ESA claim stopped

Fish60 profile image
31 Replies

I was wondering if anyone else has encountered anything similar? Back in January 2023 while I was unemployed and receiving JSA i was diagnosed with coronary heart desease and subsequently referred for a triple heart bypass of which I am currently awaiting. Due to this I was moved over to ESA. After providing medical evidence to support my claim. In June I had to undergo a "work capability test" of which the findings I have been informed of recently. To match the criteria to continue claiming ESA benefit you need to be awarded 15 points..... I scored 0! I have now been informed that I'm fit for work and payment has been stopped. An advisor has told me to claim JSA again even though my fit note does not expire until 29th October... Obviously I will appeal against this decision. My main query is, can the dwp disregard a medical certificate? I feel I am being penalised for being" ill" and enduring undue stress whilst awaiting the operation. Any advice much appreciated

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Fish60 profile image
Fish60
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31 Replies
10gingercats profile image
10gingercats

While people here maybe able to help iwould contact The Citizens Advice Bureau.They have people with expertise in how to deal with this kind ofproblem.

Thanksnhs profile image
Thanksnhs

Hi the same happened to me a few years ago. I was forced to leave my job of 30years due to severe heart failure, I was recieving ESA then DWP after an assessment decided I was fit to work! and I would have to claim job seekers allowance as if I would have left my work to sign on 😡 I told my "work coach" I was too ill to meet with him and I re applied for ESA getting help with the form from my council's advice centre, they told me to get a letter stating that I was unfit to work. I spoke to my consultant and he wrote the letter for me, I submitted it to DWP and then I had to go a meeting which for once was fine, they re instated my ESA and put me in a support group in which you get a higher amount and you do not need anymore reviews. It was a lot of hassle but worth it. I hope you can get something sorted out. Take care char

Fish60 profile image
Fish60 in reply toThanksnhs

Thank you "char" you have been a great help, still awaiting the official letter, may I add three days after the phone call, but going to get a letter from my consultant hopefully on Monday, I didn't state but I'm 63 so a few more years yet... Once again thank you. Ian

Thanksnhs profile image
Thanksnhs in reply toFish60

I just hope you get it all sorted out it's ridiculous the way they try and get out of helping genuine people yet the scammers get away with it all the time. I am so bad at dealing with them, I just crumble and go to pieces I wish I had some backbone, I never appealed when they cut my pip I couldn't face it but that's what they want, I felt so intimidated. I am going to re apply and hope I can manage it this time, my occupational therapist had kittens when I told her what they had done she will back me all the way 🤞🤞char

Fish60 profile image
Fish60 in reply toThanksnhs

Thank you once again for your concern, it's good to be able to chat and know I'm not alone on this, well it's Saturday morning and I guess the post still hasn't got to me out here, I live in a small village just outside Brighton, so it's another wait till Monday now, I will keep all informed how things progress, and hopefully help others as well Ian

Hi, Please see attached link.

I'm not an expert so can't help with your question, but, it may be worthwhile looking at, Appendix 2 - Exceptional Circumstances in your appeal.

As 10gingercats has said, Citizens Advice should be able to advise.

disabilityrightsuk.org/reso...

Blearyeyed profile image
Blearyeyed

Good advise above , try looking at the advice on the Citizens Advice website and also researching the best way to write an ESA appeal by doing a Google search.

It would be worthwhile speaking to someone from the CAB and even making a local appointment with one of their advisors to see if they can help you with your claim.

From recent experience of the PIP system I know that unless you have written or stated your comments specifically and have clear evidence to prove what you say they will use anything you say to try to downgrade the points you receive.

So , if you say that you can walk 250 metres without breathlessness because you do it occasionally on a good day they will write you can walk without breathlessness in their notes , even if you have told hem that the majority of the time you must sit or rest because if breathlessness when you walk that far.

For example , the letter received from PIP showed I had been deducted points for help with dressing because I had said I used a long handle sponge as a washing aid in the bathing section. This was used as evidence that I had enough dexterity to get dressed. I , therefore, had to point out that the reason I need help dressing is not to do with dexterity but dizziness and the risk of falling and cannot stand to dress or bend down to put on shoes and socks to get the points I deserved.

I discovered that you need to use very simple, "red flag" language based on their points system when being interviewed . They cannot ignore this in their assessment and even if it makes you feel like rubbish you should only describe what you are able to manage on your worst days not your best.

Words like " it is "unsafe" for me to do ....because of....."

" I cannot do .... because it is "dangerous" for me to do that as I am at "risk" of ...."

I cannot do ...."safely".

....... effects my " abilities" and my " quality of life".

My " condition is triggered by" ........ so it is " unsafe" for me to do this and I am " anxious" because if this.

Also remember that mental health issues linked to your condition count.

If you do not feel confident to do things because you are anxious about how it will effect your symptoms tell them.

If you are feeling nervous , fearful or depressed tell them.

If you suffer from loss of concentration or fatigue tell them.

Mental Health related difficulties also receive points.

If you get any symptoms triggered by physical activity tell them.

If you can it would be worth contacting your Cardiology Department and requesting a letter from them to use in your appeal specifying that you are still awaiting treatment , detailing your symptoms and specifying that they agree that you are not fit for work at this time. Or requesting a letter from the GP reminding them that you are still entitled to ESA until the end of October on medical assessment and will still be entitled after that point until you have had the correct treatment.

Good Luck , Bee

Captain_Birdseye profile image
Captain_Birdseye in reply toBlearyeyed

This is excellent advice, I applied similar thinking when applying for my gran's attendance allowance... I was advised to think of her worst days, as these are likely to become more frequent as time goes on.

Blearyeyed profile image
Blearyeyed in reply toCaptain_Birdseye

Yes , it's the way you need to be unfortunately, you get penalised if you mention the positive, it's a very depressing and demoralising system to have to negotiate.I , helped my daughter through her PIP mandatory reconciliation because they gave her 0 points first time around.

I managed to get enhanced mobility and standard daily living first time around , but after ringing to query various things that had clearly been manipulated and marked wrong both are now enhanced. Thank goodness , I didn't want to have to go through the whole process again!

in reply toBlearyeyed

As you've seen first hand it's a minefield designed to catch you out.

I gave up on ESA as I retired due to ill health so wouldn't play game with the commitments they wanted from me to look for work. I kept on saying I was looking at the Support element, but, got nowhere, apparently my Local Government Pension was above the cut-off. I actually had letters saying I had it and then didn't and then paid me for a week and took it back. They did say try PIP though.

I was constantly being told I had no chance with PIP, but, I used ESA as a learning curve, invested a lot of time in the application and picked the right time time to apply following three hospitalisations and a couple of chest infections. I got the standard rate for both, took the view that it wasn't worth trying further for the enhanced at this time. Maybe I should have taken it further, but, the whole process puts you off.

scentedgardener profile image
scentedgardener

It's a ridiculous system, apparently designed to be punitive. I could never understand how a medical certificate from a qualified doctor can be disregarded by someone with maybe a smattering of medical knowledge but who certainly lacks the competence and insight of the writer of the med cert.Do the powers that be who designed the system never think that not only are they implying that the patient is lying but also the doctors whose care they are in.

Nes71 profile image
Nes71

Hi, I am sorry to hear on top of everything you are going through you are now having to navigate the complex benefit system, you can make a claim for universal credit and ask at that time for a work capability assessment under universal credit, there are 2 elements to it, one for people able to look for work which is the first group you get put in on application then the support group for those unable to look for work due to having an underlying heath condition, if you contact your local authority and ask who is the provider for the housing related support group in your area, you can self refer and they can help you claim welfare benefits and appeals, it is a long process but financial impact puts housing at risk so hopefully you can get some agency support, my son has just won his appeals for both UC work capability and PIP after a 2 year battle, do not give up, it is your entitlement to be supported financially whilst unfit for work, keep getting GP certs as they will help with appealing if UC find you fit for work, ESA only last for 12 months and is contribution based, I hope that helps

Thanksnhs profile image
Thanksnhs in reply toNes71

Hi if you are in a support group for ESA you get it till the date of your state pension. I have had it for five years, I get my pension next year when I am 66, mine is contribution based, they deduct a small amount off the full benefit as they take my private pension into account. Char

Nes71 profile image
Nes71 in reply toThanksnhs

As the benefit stopped though it will be considered a new claim and now unless 12 months contribution payment everyone has to claim UC - I may be wrong but is my understanding all benefits are paid through UC except PIP

Thanksnhs profile image
Thanksnhs in reply toNes71

Hi it's probably changed in the five years since I was awarded it. When my sick pay from work stopped I received ESA then I went for an assessment and they took it off me and said I should apply for job seekers allowance, ridiculous since I had to give up my job due to ill health, I told them I was too ill to attend any meetings and with help I reaplied for ESA and got a letter from my consultant to say I was too ill to work, thankfully I got the support group award. I don't get universal credit maybe that's how my claims were treated differently. Benefits are such a minefield and any dealings I have had with DWP have caused me so much stress, I cried for two days after a pip review they were so horrible, not good for the ticker! I so wish I didn't rely on them. Char

Nes71 profile image
Nes71 in reply toThanksnhs

It is so wrong that people who are poorly are put through additional stress, sorry to hear about your experience, hopefully one day it will change everything crossed

Thanksnhs profile image
Thanksnhs in reply toNes71

It was the worst experience ever, I could not believe it, it's really put me off trying again, with it getting transferred to the Scottish government no one really knows how it will work or what the process will be. Char

Adhtz21 profile image
Adhtz21

Looking at the recent news, it looks like the treasury are going to target disabled people. Personally, I have a brilliant pension so does not affect me. Amazing as the migrant numbers seeking ‘asylum’ from France 😂are clearly swallowing up all the funds. It’s totally wrong!! I sincerely hope that you get what you should be entitled to. I suggest writing to your MP. Good luck.

Thanksnhs profile image
Thanksnhs in reply toAdhtz21

Hi from next year Scotland will have its own social security system, I am being moved from PIP to adult disability payment. I have no idea how this will affect us. I had a terrible time with DWP this year and when I got advice about it I was told to reapply once I have been changed over to the Scottish system. Will it be less traumatic? Only time will tell. Char

Adhtz21 profile image
Adhtz21 in reply toThanksnhs

Hi, I hope it’s better for you. I read your bio and it’s incredible what you have gone through. My late Dad was Scottish, originally from Penpont in Dumfriesshire.

Thanksnhs profile image
Thanksnhs in reply toAdhtz21

Hi thank you, the care I received from my wonderful cardiac team at the jubilee was just amazing they have been there for me since diagnoses and I can contact them at anytime. I wish they could fix all the other stuff 😄at the moment things are ok.Dumfries is such a beautiful part of Scotland the rugged coast down that way is amazing it must have been lovely growing up there. Char

Cat04 profile image
Cat04

When DWP ask a question "Can you........?" Never say "yes" to any of the questions say "no, not without help, pain, rest, breathlessness etc etc."

I also found this site very helpful

benefitsandwork.co.uk/

Silverfox2 profile image
Silverfox2 in reply toCat04

Yes, I've been a member of that site for years and they've helped with excellent advice countless time.

Fish60 profile image
Fish60 in reply toCat04

Thank you have downloaded the link, looks useful

fishonabike profile image
fishonabike

I agree with Cat04 and Silverfox2 - Benefits and Work produce excellent guidance on how to fill in the forms and also on how to appeal decisions

the official line is that the tests focus on what you CAN do - but you have to focus on whether you can do things regularly, repeatedly, reliably and safely, if you can't say yes 100% to those then you need to say that you cannot do this regularly, repeatedly, reliably and safely in every text box they give you for extra info, and add examples of how frequently you can't as well as what you need to help you do it

it is very draining to fill in the form as you are constantly focusing on negative stuff, but do it in stages and give yourself a little treat every time to help you through

Fish60 profile image
Fish60 in reply tofishonabike

Thank you have downloaded the link now. Looks useful

Qualipop profile image
Qualipop

It's pretty standard. I had DLA for a lifelong condition for 20 years and got turned down every two years; had to appeal and 7 times went as far as tribunal which I won every time. It was only 10 years ago I got PIP indefinitely. Do join the Benefits and work website. It tells everything you need to say and do. There's a small charge but it's well worth it. The initial application is only dealt with by kids with a tick sheet and if you don't happen to use the correct words you lose out.

Thanksnhs profile image
Thanksnhs

Thanks I will definitely check that site before I have another go. Char

Rogo23 profile image
Rogo23

I suppose that you should appeal on the grounds that although on a good day you will probably be ok, the cardiac surgeon who wants to keep you alive was fairly insistent that you don't do stuff that could interfere with that.And point out that tropoinin dosent show up on his form and you are going to write to his supervisor pointing out that you are on the waiting list for major keep you alive surgery.

Basically appeal, because this is bloody stupid behaviour from a petty burocrat, I had something similar when the cancer raised its ugly head, Chuck in a appeal and ESA arrived.

You are entitled, claim it.

Dan

MaggieSylvie profile image
MaggieSylvie

Something similar happened to my ex. He had been sick for ages and was, during that time, made redundant. So, I think he was claiming a sickness benefit of some kind. Then he received a letter inviting him to his doctor' s review and he went along, actually feeling and looking as if he was at death's door. He was ashen. And it definitely wasn't "put on". Guess what? The doctor signed him back to work. So he was a sick man with no job and no energy or health to look for work. Ironically, all the time he had been receiving the sickness benefit and going along to see the doctor, he was always continously signed off.

Just to let you know you are not the only one. Not much advice, but do get help to fight this. It's cruel and unwarranted.

Jazz100 profile image
Jazz100

Get in touch with Citizens Advice. You have to describe your very worst day…not your best. We all have up and down days but you have to tell them just how bad things can be.

Have you considered PIP. Again it’s a very long form..and you will need help filling it in.

When you do…photocopy everything so you have a reference. It’s easy to forget just exactly what you said.

Good luck and don’t give up…get advice and try again.

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