Fibromyalgia Action UK
39,665 members51,791 posts

A must read if you are going to ESA appeal

I would just like to share with all of you a slight “loop hole” in the legislation regulation 29 (b) exceptional circumstances, of the ESA regulations 2008.

(b) the claimant suffers from some specific disease or bodily or mental disablement and, by

reasons of such disease or disablement, there would be a substantial risk to the mental or

physical health of any person if the claimant were found not to have limited capability for

work.

So in laymen’s terms IF ATOS finding you fit for work is going to make your condition or mental health condition (I.E. Depression) worse then your GP could deem that their decision in itself is detrimental to your health and would therefore make you come under the exceptional circumstance rule.

I composed a letter for my doctor and just asked her to sign it,I listed all my conditions and ended it with……

Although this person has been deemed “fit for work” I am of the opinion that exceptional circumstances regulation 29 may apply.

“Because of your physical or mental health conditions or disability there would be a substantial risk to the mental or physical health of any person, including you if you were found not to have limited capability for work or work related activity”

I disagree with the outcome of your assessment and support my patient in their appeal against your decision.

I am sorry this is a little long winded and I hope I have explained in a way that you can understand my point….hope it helps, it’s definitely worth trying.

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Copied and pasted in my notepad very useful thank you

VG x

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Thanks! That's really useful. A lot of doctors are happy to read and sign a letter like this, so long as it's accurate - they are so bogged down with paperwork that it makes life a bit easier for them.

Moffy x

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I worded my letter to my doctor very carefully saying something like "I realise how incredibly busy you are so I thought I would enclose a letter I completed on your behalf" It worked :-)

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Very interesting thanks x

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I had also put this on here last week, Ive sent in my appeal to be put into the support group,and included this as well, as it would be detrimental to my health if I was made to attend wrag group.Just have to wait and see what the outcome is now,

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excellent,many thanx

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this piece of information is essential and most inportant to all of us who are appealing ESA.Try to get your GP/Consultant to include/state these words (if not exactly) in any reports or supporting evidence needed. Wish I had had this information some weeks back before I seen my consultant.

He kindly did a letter "To Whom It Concern" for me to send to the DWP in support of my appeal. However, it just stated all my pains/aches I had updated him with. He did not have a clue what was required of him to support me, although he wanted to. Also, in the letter, he did not state how my problems would more than likely cause me harm/injury (to myself or others) if I was found "fit for work" This is truly vital information needed to help anyone in their case/appeal. Please bear this in mind.

Also, do not forget to include any private details (ie bowel etc) as these will count for more points. I did not do this as I was embarrassed to put the details on paper. My mistake. Hope this helps someone. xx New girl on the block

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Yes, Downeygirl,

It's essential that the statement says how-and-why aggravating one problem may result in significant harm.

"Significant Risk" means that the potential Harm is severe. It has nothing to do with the likelihood of the Risk materializing, because the Harm is so significant it cannot be ignored.

I've written a detailed explanation of How to Claim ESA using Regulations 29 and 35. It's on this forum.

John

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Its called Rule 27

Liam Carter

Case Manager

My Benefit Claim

Manchester

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Citation and commencement

1. These Regulations may be cited as the Social Security (Incapacity for Work) (General)

(Amendment) Regulations (Northern Ireland) 2005 and shall come into operation on 10th

February 2005.

Amendment of the Social Security (Incapacity for Work) (General) Regulations

2. For regulation 27 of the Social Security (Incapacity for Work) (General) Regulations

(Northern Ireland) 1995(d) (exceptional circumstances) there shall be substituted the following

regulation –

“27. A person who is not incapable of work in accordance with the personal capability

assessment shall be treated as incapable of work if –

(a) he suffers from a previously undiagnosed potentially life-threatening condition;

(b) he suffers from some specific disease or bodily or mental disablement and, by reason

of such disease or disablement, there would be a substantial risk to the mental or

physical health of any person if he were found capable of work;

(c) he suffers from a severe uncontrolled or uncontrollable disease; or

(d) he will, within three months of the date on which the doctor examines him, have a

major surgical operation or other major therapeutic procedure.”.

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In England in 2018 the applicable regulations numbers are:

ESA Regulations 29 and 35, or their Universal Credit equivalent 25 and 31.

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I'm struggling both not clue now tribunal date come January so low pain like all suffer any help advice on the matter b so helpful not clue min or what how Wat to do on own struggle rock bottom depressing emotional personality disorder anxiety disorder fibromyalgia had claimed jsa jus av form money got such mess not goin out house laid up now stress worry Wat do now this tribunal date thru were I appeal as say fit work me lady five did hit it off rude abrupt try say dun shoe bag also rt start that stress jobs claim get the bak cause horrendous anxiety health problems all got worse er I rock bottom it all in good place on own no help support any help me advice be great plz x

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Hi Kasia,

I've just posted a detailed description of How to Claim ESA using Regulations 29 and 35.

It's aimed at people who are just about to fill in their ESA50 claim form. There are a lot of mistakes people make in submitting a claim for ESA (and it's replacement in Universal Credit). Hopefully, by understanding what's going on, more people will be able to submit successful claims and avoid the traps.

My post is very long, because it explains where the traps are and how to avoid them. But, hopefully, it'll explain what you should and shouldn't do in claiming ESA.

All the best,

John

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