THE FULL FACTS

Amended information Feb 13th 2013

I found a more recent and relevant FOI request after a recent post on this thread.

http://www.whatdotheyknow.com/request/h ... isors_call

The response here clearly shows the updated list supplied in the request linked below is ONLY for DLA

http://www.whatdotheyknow.com/request/1 ... a.pdf.html



As this has been confirmed in August 2012, readers should disregard the list below applying to ESA WCA.




2010 original post.

This list is from my claim form guide (which you should have read throughly by now!)
In the subscribed members only section you can access indepth information on each specific illness/condition and how the DWP view diagnosis, treatment, prognosis and how serious the illness is considered to be

This list is not to be thought as written in stone: For example Bronchiectasis is listed in group 4 "invite for medical". Yet if the form of the disease is serious enough a doctor can state that the patient is too ill to attend a medical. The DWP can then decide on a home visit or may place the patient in the support group.


For the purposes of administrative scrutiny of cases to determine suitability for inclusion in the DLA in Medical Examination Centre project, 5 categories of case have been devised:

In 2005 the Welfare Reform Bill, which introduced the Employment and Support Allowance (ESA), had not yet been enacted hence the reference to the Disability Living Allowance (DLA).

1. Unsuitable for calling to a Medical Examination Centre.
2. Reference to Medical Advisor required for advice.
3. Tentatively invite to Medical Examination Centre.
4. Invite to Medical Examination Centre.
5. Any other Diagnosis.


For each category a list is attached.
1. Unsuitable for calling to a Medical Examination Centre.
Age >75 years


Age <12 years

Both Blind and Deaf
Registered Blind (needs to be seen in own environment)
Cases accepted under the Special Rules defining Terminal illness.
Alzheimers
Amputation of both legs
Asperger's
Autistic Spectrum Disorder / Autism
Cerebral Palsy
Dementia
Hemiplegia
Huntingdon's Chorea
Korsakoffs Psychosis
Macmillan Nurse attending.
Motor Neurone Disease
On oxygen
Paraplegia
Quadraplegia
Renal Dialysis
Severe Mental Impairment
Severe Learning Difficulty
Spastic Diplegia
Tetraplegia
Total Parenteral Nutrition
Unstable Angina
Wernicke's Encephalopathy

2. Reference to Medical Advisor required for advice.

AIDS
Astrocytoma
Bone Marrow Transplant
Brittle Bone Disease
Cancer
Cystic Fibrosis
Dermatomyositis
Glioma
Guillane-Barre Syndrome
Hodgkin's Lymphoma
Leukaemia
Liver Failure
Mental Retardation
Mental Subnormality
Multiple Sclerosis
Muscular Dystrophy
Non Hodgkin's Lmphoma
On Morphine / MST
Osteogenesis Imperfecta
Parkinson's Disease
Poliomyelitis
Polymyasitis
Registered partially sighted
Respiratory Failure
Rheumatoid Arthritis
Schizoaffective Disorder
Schizophrenia
SLE
Spinal Injury
Systemic Lupus Erythematosis
Scleroderma
Severe Depression
Thallassaemia

3. Tentatively invite to Medical Examination Centre.

Agoraphobia (offer taxi)
Anorexia Nervosa
Ataxia
Bipalar Affective Disorder / Bipolar Disease Manic Depression
Burns
Cardiomyopathy
Cerebrovascular Accident / CVA
Cerebrovascular Disease
CFS
Chronic Fatigue Syndrome
Crohn's Disease
Diabetic Neuropathy
Eating Disorder
Fibromyalgia
Haemopphilia
Heart Transplant
Hemiparesis
Learning Difficulties
Leg Ulcers
Myalgic Encephalomyelitis / ME
Obsessive Compulsive Disorder
Peripheral Neuropathy
Phobic Anxiety
Sickle Cell Anaemia
Social Phobia
Spina Bifida
Stroke
Subarachnoid Haemorrage / SAH
Ulcerative Colitis
Varicose Ulcers

4. Invite to Medical Examination Centre.

Alcohol Dependence
Anaemia
Angina
Ankylosing Spondylitis
Anxiety
Arrythmia
Asthma
Atrial Fibrillation
Back Pain
Bronchiectasis
Bulimia Nervosa
Cardiac Arrythmia
Cervical Spondylosis
Chronic Bronchitis
Chronic Obstructive Airways Disease
Chronic Obstructive Pulmonary Disease
COPD
Coronary Artery Disease
Coronary Heart Disease
Depression
Dermatitis
Diabetes
Diverticular Disease
Diverticulitis
Dizziness
Down's Syndrome
Drug Dependence
Eczema
Endometriosis
Epilepsy
Hearing Impairment
Hernia
HIV
Hypertension
Hyperthyroidism
Hypathyroidism
Hysterectomy
Incontinence
Ischaemic Heart Disease
Irritable Bowel Syndrome / IBS
Joint Pain
Kyphosis
Kyphoscoliosis
Labyrinthitis
Liver Transplant
Lumbar Spondylosis
Meniere's Disease
Migraine
Myasthenia Gravis
Neck Pain
Osteoarthritis
Osteoporosis
Overactive Thyroid
Panic Attacks
Pelvic Inflammatory Disease
Peripheral Vascular Disease
Personality Disorder
Prolapsed Intervertebral Disc
Psoriasis
"Registered Alcoholic"
Renal Transplant
Rheumatic Heart Disease
Scoliosis
Slipped Disc
Underactive Thyroid
Valvular Heart Disease
Varicose Veins
Visual Impairment

5. Any other Diagnosis.

Not listed above should be referred to a Medical Adviser for advice

_________________
IMPORTANT FILES TO HELP UNDERSTAND HOW ESA WORKS
The Full Facts ESA50 Claim form and Guide (pdf download)
This guide is the most important file at site.including what illnesssess do not have to attend a medical
download/file.php?id=66

ESA SUPPORT GROUP CRITERIA
viewtopic.php?f=7&t=321

What to write if you think you should have a home visit
viewtopic.php?f=31&t=620&hilit=home+visit#p1871

5. Any other.

Would that be someone who is not physically ill, (would fail the medical given by Atos); and although not mentally ill and a danger to society, (that is - Normal), has been told by the staff of the Jobcentre, to apply for ESA, because the staff were worried that what the customer was saying, (somewhat loudly), would be worrying to the staff, and especially if the rest of the customers who were signing on, heard what that customer was saying?

Not unexpectedly, it shows pitifully poor - dangerously poor, in fact - medical knowledge, and I really don't think Item 5 is an adequate get out of jail free card. Mind you, a system that will routinely re-assess congenitally blind people (at home, at least), in case they magically gain their sight is clearly hugely defective.

Take my case - hell, why not, I know it intimately. Plus a few tips.

From age 2 I had asthma and bronchiectasis. Eventually (1996), they resulted, with the development of emphysema, in COPD (emphysema is the defining condition for a diagnosis of COPD). But here's the kicker, which mostly gets ignored - I still have asthma and bronchiectasis - they don't go away, they simply carry on their merry way getting worse, as does emphysema.

There is no justification for summoning anyone but a newly-diagnosed patient with mild to moderate COPD for a medical - anyone else is deep in the mire, and getting deeper with every year that passes. Every month, in some cases - COPD can drag on for years, but in rare cases it can go fast, diagnosis to death in a few years. COPD kills. Always, unless something else gets you first, like congestive heart failure. Which isn't on the list at all. It goes hand in hand with COPD in most cases, because it's caused by it, and is a frequent cause of death in COPD. Cretins!

Why am I telling you all this? Because they gave me an argument about my IB in 2008 - when I asked for a home assessment. Eventually I won, they waived the assessment, but it dragged on for months. And then they reserved the right to review my entitlement this year (clearly they don't have calendars, as I hit 65 in 2009). I'm now at COPD Stage 4, based on the GOLD classification which your GP should be using by now (just End Stage to go), but I now have congestive heart failure along with aortic valve calcification and stenosis (narrowing), with the life-expectancy of a mayfly (well, OK, maybe a year if I'm lucky).

(I also have ME/CFS, widespread osteoarthritis, and a whole mess of damage caused by being struck by lightning, in case I get bored, yet the DWP is convinced I'll somehow sneakily recover.)

But, on the off chance that I'm still around long enough, there's no doubt my DLA will be reviewed, along with everyone else's. I'm over 95% housebound (totally, at times), have been for over a year, a wheelchair user, and while according to the list they'll expect me to turn up for a medical, I certainly won't be. I am not going to put myself at even the most minimal additional risk by attending a medical assessment. For one thing, I don't have the strength to get my wheelchair up the access ramp.

I've argued them to a standstill once, I can, maybe, do it again (though I sure as hell don't need the stress), and if you are too ill to attend, list or no list, I advise you to make a stand.

Don't do it just to be bloody-minded, though, that just causes problems for the rest of us, but if you feel that attending is too great a risk to your health - I don't even visit my GP, the risk of contracting something in the waiting room (patients sit facing each other), that will polish me off is just too great, and in the flu season I barely go beyond the door - then don't be afraid to ask for a home visit, and stick to your guns if they try to bully you out of it.

Here are a few points that should come in useful, especially if you're new to the benefits system and/or your GP won't support you (some GPs just don't like getting involved in benefits claims).

1) Make sure you have all your ducks in a row - be 100% sure of your medical facts, and be prepared to cite sources if necessary. (Tip: don't rely on Wikipedia unless the sources are verifiable, and then cite the sources, not Wikipedia!) If you have a computer, bury them in paper in support of your claim, and for a home assessment, especially if your condition is life threatening - nobody has the right to put you at risk.

2) Do everything in writing (get your local office's fax number if you have the facility - Windows XP has a fax applet for example), never talk on the phone, because you'll have no record of it.

3) Read this http://ronsrants.wordpress.com/2009/07/ ... some-tips/ Type IB50 in the search box too - the info is still relevant for ESA and DLA. Read comments, too - even more info there.

4) Always be civil, it's not the fault of the poor sod in the office that the system is dishonestly administered and, anyway, you really don't want to antagonise them. Never be flippant.

5) If all else fails tell them that if they force you to attend, and you suffer any illness, exacerbation, or injury, either directly or resulting from it, you will sue all concerned, and claim punitive damages. And be prepared to carry out your threat. DO NOT BLUFF.

6) Finally, please - don't ask me anything. Sorry, but I'm too ill to answer questions and everything I know is on my blog anyway.

Ron.

God keep you Ron (I dont believe but if I did I'd wish him to)

_________________
IMPORTANT FILES TO HELP UNDERSTAND HOW ESA WORKS
The Full Facts ESA50 Claim form and Guide (pdf download)
This guide is the most important file at site.including what illnesssess do not have to attend a medical
download/file.php?id=66

ESA SUPPORT GROUP CRITERIA
viewtopic.php?f=7&t=321

What to write if you think you should have a home visit
viewtopic.php?f=31&t=620&hilit=home+visit#p1871

Thank you. I don't believe, either, but what the hell!

Hi I'm now confused-my brother passed away 4 days after having his assessment from an aortic dissection brought on by high bp-I believe raised fatally by the stress of the assessment and the possible outcome. I was devastated to find the information you have given several days after his death-he had aspergers, and there was no suggestion that he did not have to attend. However, someone said that it depended on whether he was going for a WCA (being on incapacity benefit) or to do with DLA-the former not having the same rules applied ('anything goes')-can you confirm that these rules applied in his case (he was on incapacity benefit), that he did not have to attend? I have asked twice for copies of the original questionnaire we sent in (I helped him to write it), the meeting notes and the outcome (I attended the assessment with him) but have not received anything-any ideas on how I should proceed? Thanks.Lynn

I am so sorry to hear of your loss.

You need to ask for the esa85 - Phone or write - this will show how they came to the decision. It should be an accurate record of the assessment. Mine was but many aren't.

Have you thought about getting a meeting with cab perhaps to help you?

Also mp can be helpful - mine has been. Contact them thro www.writetothem


You are grieving too so be kind and patient with yourself during this very sad time.

_________________
Forms:

• GL24 (February 2012) - Download pdf
• ESA50 2013 NEW - Download pdf
• ESA113 (03/11) - Download pdf (DWP Form sent to Dr to complete for ESA)

Information:

• Claim Form and medical guide - (Download pdf)
• The Full Facts - Advocacy support list
• Support Group Criteria
• ilegal guide to ESA50 questionnaire
• Turn2us - access to Benefits and Grants
• Contact your local MP
• 2012 WCA handbook pdf
• ATOS official complaints procedure pdf

Hi Lynn, My sincere condolences for your recent loss.

Regarding the rules above, I believe you would need to cite the correct/original source of this list
which is in the contract between the DWP and ATOS which was obtained by a Freedom of Information 2009 request by the website author at the following link
http://www.whywaitforever.com/dwpatoscontract.html the list is nearly at the bottom of this linked page.

Make a copy of everything you send to the DWP, try and avoid talking to them on the phone, write whenever possible, and send everything signed for, they are experts at losing paperwork

I presume you are seeking or have retained a benefit specialist legal advice in this matter?
They would be the best people to ask the question regarding if the above list of illness's exempt from WCA applied in your brothers case, you can now cite the source of the information as per link above, the DWP / ATOS contract, for their perusal.

To assist finding legal representation.
http://legaladviserfinder.justice.gov.uk/AdviserSearch.


Do you have lasting power of attorney for your brothers affairs? If you so, you could also request a SAR (Subject access request) to the DWP using the form below, you'd need to tick both clerical and computer records on all the relevant benefits. The additional paragraph on the form 2nd page mentioning any 3rd party should cover all aspects of dealing with ATOS and the DWP and or information, if any requested from named medical practitioners. This should cover all your brothers benefits records, including all the paperwork you have already requested.
Take or send the completed form to the office that dealt with your brothers claim for the attention of the "Data Protection Officer" It's free of charge for a SAR from the DWP. They have 40 days to comply, they should acknowledge your request upon receipt, if posting it can take up to ten days to arrive on the DPO's desk.

Good luck Lynn

_________________
Forms:

• GL24 (February 2012) - Download pdf
• ESA50 2013 NEW - Download pdf
• ESA113 (03/11) - Download pdf (DWP Form sent to Dr to complete for ESA)

Information:

• Claim Form and medical guide - (Download pdf)
• The Full Facts - Advocacy support list
• Support Group Criteria
• ilegal guide to ESA50 questionnaire
• Turn2us - access to Benefits and Grants
• Contact your local MP
• WCA handbook pdf Revised 2013
• ATOS official complaints procedure pdf

Keep calm and carry on.

Thank you so much for all this information. We are currently also looking at negligence on the part of the A+E department that he went to on the night he died as they sent him away with a diagnosis of indigestion but put on the notes that he needed an urgent aortiogram due to a probable aneurysm (the aortiogram would have been performed at the same hospital after his gp had referred it!). They sent him away with antacids. Unfortunately, we can't get anyone to fight for us due to him not having any dependants and no future loss of earnings-therefore not worth it for them :-( My sister has contacted ICAS and has her fingers in other pies as she is a nurse at the said hospital. So, we have a lot to put in place at the moment and so much information to digest. I really appreciate your help. Thank you.

I have unstable angina, and i have to go to a medical on the 14th! Yet again, the rules where they should apply, clearly don't. I have debated whether i should ring them (medical services or DWP) telling them that i have this medical problem. I haven't bothered because let's face it, they couldn't give a s**t.

Well unstable angina is a dont ask in for wca illness It cant hurt trooper to inform them and request a home assesment.

Well, i had my WCA today with a nurse, which lasted all of 20 minutes. I mentioned to the nurse assessing me that i have Unstable Angina, and that being called in for a WCA is not right. And no sooner had i said it, it was brushed off like it was never said.
I submitted every piece of medical evidence i could, so now i just await a decision which could take up to four weeks. Either way, i used Miss Ben E Fit's Claim guide which was very helpful indeed, so many thanks to you for that. ;)
But i agree with Nura, anyone that has Unstable Angina should not go for a WCA, and you should contact them in the first instance to arrange a more suitable way to get yourself assessed.
In the mean time, fingers crossed!

it would help anyones case better if you stated it on esa50 and also that you need home visit that way if something did happen they couldnt say they werent informed about it

I did state that on the ESA50, as well as informing Medical Services that i have Unstable Angina. All of this was ignored by them, and by the nurse involved in my examination.

I'm a little confused. I come under the 'Tentatively invite to Medical Examination Centre' section. What does that mean in layman's terms?

I only did the ESA50 form (I'd been on it a year so I assume that was why) a few months ago, then I moved in with my partner in August and now we have a joint claim. Rang ESA and they said that our money will go up (the 14 week thing) after I'd had a medical. But I was put in the support group in July? I'm really confused about the whole thing.

_________________
Tell me you're crazy, maybe then I'll understand - Tori Amos

If you're in the Support Group, and they sent you another ESA50, look back to the original decision re. Support Group : does it say how long you are in it before reassessment? I would ring the DWP to clarify, as they are so disorganised now that they send out ESA50s to some people when they are not required (my sister sent her 2nd ESA50 back a few weeks ago, and now they've sent her a 3rd one before she even got a decision on the 2nd).

_________________
Forms:

• GL24 (February 2012) - Download pdf
• ESA50 2013 NEW - Download pdf
• ESA113 (03/11) - Download pdf (DWP Form sent to Dr to complete for ESA)

Information:

• Claim Form and medical guide - (Download pdf)
• The Full Facts - Advocacy support list
• Support Group Criteria
• ilegal guide to ESA50 questionnaire
• Turn2us - access to Benefits and Grants
• Contact your local MP
• 2012 WCA handbook pdf
• ATOS official complaints procedure pdf

My apologies if my posts seem brief and for typos as i have M.E

I applied for ESA as appointee for my son whos diagnosed Autistic spectrum disorder /aspergers ( on the list mentioned above in category 1 not suitable for face to face assessmtne.

My son was asked to attend a centre I wrote to ask why and quoted the list & contract between atos and DWP and the correct source etc .... Atos seemed not to think it applied to esa and directed me to their handbook via their website which has no mention of the list of conditions . The autistic society also felt that this list applies to DLA claimants only as the legislation came in before ESA . My common sense would say that the same criteria /list should apply to ESA claimants but it seems not ?

I would be interested to hear if anyone has been sucessfull in using this list to obtain home visit or non face to face assessment ? And if anyone has found it quoted anywhere in actuall ESA legislation / guidlines ?

My heartfelt condolences to the family who lost someone ,,i hope you get your answers
x

This question lead to further digging as this post is fairly outdated now, and due to the points mentioned in your post I found a more recent FOI request

http://www.whatdotheyknow.com/request/h ... isors_call

And the response here clearly states the updated list supplied in the request is in Donna response document
http://www.whatdotheyknow.com/request/1 ... a.pdf.html



As this has been confirmed in August 2012, readers should disregard the list above applying to ESA

Hope this helps clarify what you have been told, and thank you for your question which lead to this information.

_________________
Forms:

• GL24 (February 2012) - Download pdf
• ESA50 2013 NEW - Download pdf
• ESA113 (03/11) - Download pdf (DWP Form sent to Dr to complete for ESA)

Information:

• Claim Form and medical guide - (Download pdf)
• The Full Facts - Advocacy support list
• Support Group Criteria
• ilegal guide to ESA50 questionnaire
• Turn2us - access to Benefits and Grants
• Contact your local MP
• WCA handbook pdf Revised 2013
• ATOS official complaints procedure pdf

Keep calm and carry on.

Thankyou so much for the quick reply and direction.
That information helped a great deal & made things much clearer for me.

I have had an email from atos this morning stating my son does not now have to attend the medical centre....(i had cancelled 2 appoints already) and I had wrote a letter asking who looked at the ,esa50 and decided my son was able to attend and on what medical grounds , i also asked what qualified them over his own gp whos known him for years. I included a supporting letter from his mental health worker . I think the extra medical info helped so my advice to anyone interested & for what its worth would be to obtain & include this with the esa50 as much of this as possible.

I await to hear what happens now ....