Thursday 31 January 2013

Tips for completing an ESA50

That day when the brown envelope of terror falls through the letterbox, seems to be the most feared of the entire ESA process. Considering the competition it was, I can't overstate how much this scares people.

I get messages almost daily, written in the kind of panic you can taste and hear and smell. They ask if I have any tips or advice on filling in their ESA50 form (the form you must complete if applying for out of work sickness support.)

Rather than wear my keyboard to a nub typing the same words in a Groundhog Day loop, I thought I would share them here :

1) If you know you will be getting a form at some point to transfer you from the old IB (Incapacity Benefit) start planning now. You only have 4 weeks to fill the form in once it's arrived, and health professionals can take that long just to return the evidence you will need.

-You might want to write a letter yourselves ( no more than one page of A4) as this will help your GP ( or physio, CPN, consultant etc) and make sure nothing gets missed. When you give it to her, suggest she use it as a basis and give permission for her to simply sign it if she is happy with everything you've written. It will save the GP time and might just possibly save you a fee.

2) Complete the form concisely. Don't waffle. Lots of people make the mistake of thinking the more they write, the more likely they are to succeed. The opposite is true. Atos HCPs ( Health Care Professionals, who carry out "fit for work" assessments ) are under enormous pressure to get through as many cases in a day as possible. They simply do t have time to read through reams of evidence and will almost certainly just call you in for a WCA ( Work Capability Assessment ) to save themselves the trouble. Make every last word count. You shouldn't need to attach more than one extra side of A4 - 2 at the most. 

3) Use terms medics will recognise. So don't say "I get blockages in my bowel" say "I get fibrotic structuring causing chronic sub-acute obstruction". Don't say "my stomach doesn't work very well meaning I'm often sick" say "I have gastroparesis causing regular reflux and vomiting.

4) List your medical interventions and treatments, with dates, clinically and unemotionally. Eg "Surgery, 2005, laparotomy to resect section of jejenum. MRI, 2008, showing anal fistula, Endoscopy 2011 showing perforation"

5) List all symptoms, however trivial or embarrassing. 

6) List all medications, aids and appliances you use to get through a day, even if you aren't using them that particular week. 

7) If the answer to a question is "I can sometimes do that on a good day, but not on a bad day" say "I cannot do blah reliably/repeatedly/safely/in a timely fashion" (use one or all of these as appropriate. 

8) Finally, NEVER lie or exaggerate on the form. If you can't walk very far, measure HOW far ( most  people usually underestimate. If an HCP thinks your evidence sounds implausible, he will doubt other things you say.

If you follow all of these tips, you have the best chance of success. Good luck and most of all DON'T PANIC. It wont help, it will only make the form harder to fill in. 

a goo

8) Finally, NEVER lie or exaggerate. If you can't walk very far, measure HOW far (most ppl underestimate) If the HCP thinks you've exaggerated on the form it makes you look dishonest. 


  1. Darn. I think I may have done it slightly wrong. You were very good on Radio 4.

  2. After Atos lied about my turning up to my WCA I sent a copy of the whole form to the decision maker in case Atos decided to not pass it on/pass on select bits.

    I had to add lots of pages because I can only write a couple of words (spaz hands). In the text boxes I could literally only write "see appendix 1, page 6" where I'd typed what I would have written in the text box if only I could write.

    I also included several photos to illustrate for the DM what Atos may not have passed on. E.g. I included a photo of all the joints in my hands bending backwards as I tried to grip a pen. I also included a photo of the mount of mail on my sideboard that I've been too depressed to deal with.

  3. Just heard the You and Yours piece Sue - you were tremendous!! You got the key points across despite hardly any time and stupid 'balance' questions; meaning that anyone listening would have realised there is something very much not true about what the government is saying. Fantastic job Sue, particularly love the point about the £20,000 wheelchair. (And what serious health conditions are helped by standing all day at work? Pah.)

  4. Just wanted to add something about form filling. When I applied for DLA I didn't mention tons of symptoms, because I had no idea what was 'normal' and what I was supposed to be experiencing or able to do. So if possible, it might be good to talk through an average day with someone and ask them how long it would take a 'normal' person to do various tasks, and which things a 'normal' would do easily without thinking about it.

  5. I like the letter idea - seems very simple and ingenious (and saves me having to find a crate to put all my medical evidence in!)

    Does the GP simply need to countersign it and print their name or should people include a phrase?

    1. And by phrase I mean: I certify this information is genuine or something.

    2. And presumably you should include your name and NI number on the form?

    3. My guide in much of my info about ESA etc has been the Benefits and Work site. They would advise against this - note the last sentence:

      "For a letter or report to be effective, it should reference your capabilities in the context of the ESA descriptors, a letter that simply says you are not Fit for Work, will have little value, however, you need to be careful not to direct the doctor as to how to fill out the letter, as this can count against you."

      I think that you can see forum material without membership, but could be wrong.

      The logic is quite simple. The whole philosophy of the assessment by Atos is that the GP can't be relied upon to be impartial, because they are too close to their patient. And the claimants are, by definition, unreliable to the point of lying. Thus any hint that the patient has dictated the doctor's replies might well make a Decision Maker simply discount what is being said.

      I'm sure I've seen elsewhere another gotcha. The DWP will also ignore anything where the doctor says, "Mr X tells me that he cannot walk more than ..." or "Ms Y says she is in pain every night." Again the doctor seems to be endorsing the patient's report which is - to the DWP mind - no better evidence than what the patient writes themselves.

      So I would suggest telling a GP, at most, which descriptors you think might apply and asking them to write about those.

      I put together some info for my specialist about what the WCA actually looked at - not about me at all - and he said, "Well, it's a great deal more than I've had from any other patient." I THINK it was a great deal more than he'd had from the DWP either and I THINK that he was pleased to get it.

      Nevertheless, he said that he would wait for the DWP to request information before he would send it. I believe that the DWP send a very brief form which provides no guidance and simply asks, "Can he walk x metres" or "Can she bend down?" with nothing at all about being able to do it "reliably, repeatedly" etc which is crucial to medical conditions with varying effects from day to day.

      So, even doctors who will only reply when the DWP approaches them may benefit from some information from you. But the DWP may ignore completely something which - for all the Decision Maker knows, you may have written, shoved in front of your doctor and said, "Sign!" And the GP, whether they don't want to annoy a patient, or are just glad to have their job made simple, has signed.

      So I'd be careful about how precisely you "direct" your GP.

  6. maybe daniel could look at this and it probably explain why people love the benefits system so much?


    also nick why shouldnt they pay the bedroom tax when the room is empty?! working people would get a lodger why shouldnt they? please explain. about time such legislation was bought in to stop people in their free social housing funded by others wasting space other people could use.

    sue's idea would give the impression you have a medical degree and the assessor would be even more suspicious you are trying to pull a fast one.

    I hope the GP charges the appropriate fees for all these letters that are coming his way and request. A solicitor charges £250 per hr plus vat so I hope so a pro-rata rate is charged by the GP for the time to fill all this stuff in.

    1. "You can claim Housing and/or Council Tax Benefit in a number of circumstances, for example if:

      you are on income support or job seekers allowance
      you are on a low income
      you are employed or self employed
      you are in receipt of pension credit "
      (Local authority guidelines)

      So there are those in work, as well as out of it, who receive housing benefit. IIRC, there are more of this in work, but low paid, who get HB than out of work.

      And many of the arguments are about the bedroom tax are not about empty room, but ones which the law is describing as "under-occupied".

      For example, if you have foster children they don't count. There is a chronic shortage of foster parents and they take on children who, as a general rule, would otherwise be housed at the expense of the public purse. So you send the foster child back into a Home, saying, "Sorry, but the state has decided that the room are using is to be considered empty." Cruel and bad economics.

      Take a couple where one of them works and the other stays at home to look after a severely disabled teenage son. He needs a hoist to get him into and out of his (large) special wheelchair. At night both the chair and the hoist need to be stored. There is barely room for them, his specially adapted bed and basic storage in his single bedroom. As the law stands his other brother is supposed to fit in there as well - there's no room for a second bed on the floor and you can't use bunk beds over a hospital-type bed. The only answer - put the disabled son into care or send his younger brother away. Is that economic sense?

      There are many more similar cases, where this law seems to be just daft from a financial point of view.

      But the law is not really designed to maximise the use of social housing. It is there to give people like you, C2, the feeling that you are making people receiving housing benefit really suffer - including those many who are working. It feeds your hate in order to garner your vote.

      Have you ever read "Lord of the Flies"?

    2. You seem to misunderstand the way the benefit system works (again).

      The incoming under occupancy rules do not by definition apply to rooms that are actually empty but that the government believes could be occupied.
      For example a disabled adult who requires a spare room in which his carers sleep when he needs overnight support, that room would be considered empty.
      There are other examples in which a room would be considered spare such as a disabled adult who requires the room for equipment such as a wheelchair or dialysis equipment.
      If a couple have medical issues and cannot sleep in the same room, the room one of them uses is considered spare.
      Disabled children do not warrant their own room, even if medically required, and if the same sex as a sibling will be required to share with them until 16 years old. If opposite sex until they are 10.
      As Carruthers has pointed out, foster children do not count. Even though by definition many are vunerable and coming from damaged homes or are coming for respite care due to disability they do not apparently warrant a room of their own.
      Disabled people who have had their homes adapted to meet their needs are not exempt and will face a charge or be forced to move somewhere without adaptations. Some councils have limited budgets to help but this is temporary.
      Divorced or separated couples can no longer have a spare room in which their children sleep when they share custody. Recently when Lord Freud was asked by a gentleman who has shared custody of three children where he would put them, he was told they should all sleep on the couch.

      What are the suggested courses of action to fix this? All overnight carers should be made to sleep on the sofa if there is one? Vunerable disabled people forced to take in lodgers? My severely autistic sibling will be subject to these rules due to needing a room for his carers - a lodger would be in danger due to my sibling's issues. No more foster parents? Couples with medical issues forced to separate? Single parents forced to give up custody of their children?

      There are of course some people who have a spare room that they do not need. Unfortunately smaller properties are incredibly scarce. Some people will be faced with a charge if they cannot move to a smaller property knowing that there are none to move into. The result will be moving into a smaller private rented property which will be far more expensive - this is going to increase the HB bill, not lower it.

      I suggest you visit the DWP website where this information is in order to prevent future misunderstanding.

  7. Ah crap, I wish I'd seen this before I sent mine off. Put into the WRAG without a medical :(

  8. Just heard your interview on LBC with Nick Ferrari. A very good engagement - you actually managed to talk over him which is quite something! Well done Sue.

  9. Just wanted to say thank you Sue, very very much. I got my IBM01 just over a week ago and it has had me in an absolute state of panic. My mental health issues have gone bananas so much that my GP has had to intervene with medication and a call out to the local mental health hospital for support.
    I havent even had the ESA50 or the WCA yet and Im falling to pieces. The information youve given makes me feel calmer and more certain I can make the HCP and DM understand.

    Thanks so much.

    On a side note one of our family friends has had a disability all his life. Due to there being such a level of illness and disability in my family my younger sibling was sent to a local special school so as an adult his retained friends are mostly disabled folks.
    He has an incredibly rare disease, much like yourself. His is called Mucolipidosis Type 3 and has very pronounced effects on his body and mind. He can never recover from a genetic illness and has progressivelt worsened over the years. His first WCA when migrated from IB was pretty bad. He told me 'they said there was nothing wrong with me!'. His family fought pretty hard to make sure he got the proper award and he was still being phoned about 'volunteering' for unpaid work experience. They finally got assured that he it was clear he wouldnt get better, and near immediately after theyve called him in for another WCA. His family are furious. He is exhausted and depressed.
    To get an idea how fragile he is - he broke his wrist a couple of days ago in his sleep. Just moving round in his sleep often leaves him bruised and injured.

    Anyone who thinks this is about giving disabled people the right support is lacking any insight. This isnt about seeing if he has suddenly recovered in a matter of months.
    There are two things at play here - harassing him and his family by forcing him through an invasive and unnecessary assessment repeatedly until they just give up and the fact that ATOS get paid for every WCA they carry out. It is in their financial interest to subject as many people as possible to the WCA repeatedly even if theres bugger all evidence of change.

  10. I seem to be near the end of the process, as I have spent most of today trying to sort historic medical letters out for the Tribunal I will have to attend.
    What I am disappointed about is that all notes I asked for from the doctor is in the form of letters to and from consultants etc. No sign of any discussions I had with my own GP.
    I presume when one visits the GP notes are generated, but none here?
    Any advice on appeals would be welcome. I am way out of my "dis"comfort zone!!

  11. What I find so depressing is that by rejecting without even ever meeting, or having a medical, means that the Health Professional appointed has in effect said "I don't believe you" and yet she doesn't even have the decency to see me.
    I wonder if any of the people involved realise how much upset, grief, tears, and depression, is being actually caused by them.
    If they knew, would they care......... One has to wonder if they have any human emotions or feelings at all.
    The one who signed my assessment said she was a nurse! Certainly not a nurse I would want caring for me!

  12. They can fly in a Girl from Pakistan, or Afghanistan who had a head injuries who had not paid into the system and was given first grade care, and a house in the UK She can't be so dumb or had a TBI she wrote a thesis, and nominated for a Nobel Peace Prize!, with all the benefits, whilst people who have paid into the system and am denied medication on the grounds of cost. I have been buying medication from the black market in the post code lottery. Some people who clearly do not need the drugs are selling them to people like me. I ma in the fortunate position I made it into the lancet and press. But am damn angry when they will pay for people who have not contributed into the system. SOme have had heart transplants, other even afforded non essential medication. If they want a fight than give them hell. They are formed by the people, paid for by the people and should be for the people who paid into the system are citizens. This country will not supports its own! I have seen people who fought for Queen and Country and had become disabled and traumatised and they have been denied benefits. Shame on you MPs and DWP. But more so shame on the people who vote for this criminal cartel! You get more for being involved in whiplash than loosing your legs or seeing your best friend's brains been shot out on active duty. Yet an MP get a golden hand shake for his feelings being hurt!

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