Employment Support Allowance (ESA) Medical Examinations

This is the actual response:

DWP Central Freedom of Information Team

e-mail: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx@xxx.xxx.xxx.xx

Our Ref: FoI 595/09

22 April 2009

Dear Mr Gardner

Freedom of Information Request – 595

I am writing in response to your request for information about Employment and Support Allowance (ESA) which you asked for on 2 April 2009.

You have asked for copies of the legislation which gives effect to the handling, acceptance and rejection of applications for ESA. I have attached copies of the Welfare Reform Act 2007, the Employment and Support Regulations, 2008, and the Social Security (Medical Evidence) Regulations, 1976 (as amended).

You have also requested details of how a medical examination and opinion of an individual’s health, performed by a Doctor (or other medically qualified person) working on behalf of the Department for Work and Pensions (or agents), takes precedence over the medical examination and opinion of an applicant’s own General Practitioner or Consultant.

The decision on whether or not someone has limited capability for work and is entitled to ESA is made by a decision maker on the basis of the available evidence. This evidence includes medical opinion, or advice resulting from a Work Capability Assessment (WCA) carried out by a healthcare professional employed by Atos Healthcare to carry out medical examinations for the DWP. It also includes information provided by the customer in a questionnaire before the WCA is carried out.

A decision maker may also consider evidence provided by an applicant’s General Practitioner or Consultant. Though the General Practitioner or Consultant may know their patient very well their primary role is to diagnose and treat a condition. This is not the same as advice provided by independent healthcare professionals designed to help decision makers decide whether or not someone has limited capability for work for benefit entitlement purposes.

The WCA has been designed as a positive assessment, focusing on what an individual is capable of as well as their limitations with regard to work. Healthcare professionals are trained in disability assessment which enables them to provide advice to decision makers.

For these reasons it is possible that a decision maker may give more weight to the evidence of the Healthcare Professional than to the evidence of the applicant’s GP or Consultant or to the evidence of the applicant. However each decision is made on the basis of the available evidence and it is also possible that a decision maker may give greater weight to the evidence of the GP, Consultant or customer.

If you are not satisfied with my handling of your request or reason for not giving you all the information you asked for please tell me why within two calendar months of the date of this letter. I will then arrange for someone to conduct an internal review of your request and my handling/decision. The review will be conducted by another officer, usually of a more senior grade to myself. This person will have taken no part in my original decision. You will be advised of their decision in writing.

If you are still not content with the outcome of the internal review you have the right to apply directly to the Information Commissioner to look into the way your request has been handled. Please note that generally the Commissioner cannot make a decision unless you have first exhausted DWP’s own complaints procedure. The Commissioner can be contacted at:

FoI Complaints Resolution
Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Fax: 01625 545 510

email:xxxx@xxx.xxx.xxx.xx

If you have any queries about this letter, please contact me. Please remember to quote the reference number above in any future communications.

Yours sincerely

DWP Central FoI Team

To whom it may concern.

I, David Cartwright confirm the following to be true:

I attended a medical examinination by Dr Madhuri Khurana at Albert bridge House, Manchester on 03 June 2009. My friend Mr. Howard Woolley came with me as a witness.

The examination was brief and consisted mainly of computer generated questions which were highly irrelevant to my medical condition. I was sat to the side of the Doctor and little eye contact was made between us.

I blew in to a cardboard tube which was supposed to demonstrate my lung capacity which is extremely poor as my left lung does not function very well after it collapsed. This was the only part of the examination that was physical.

I received a letter 11 July from Job Centre Plus explaining that i was no longer entitled to Employment Support Allowance and National Insurance credits. I felt overwhelmed with stress as I am struggling financially and I am fearful of returning to work in case I suffer a reoccurence of spontaneous Pneumathorax which first occured in February 2009.

I asked for a copy of the medical report and the following is my response to the itemised points within it:

1. My condition - spontaneous pneumathorax - is not named

4. I was not in hospital for three months. Breathlessness is not bearable. I do not attend a respiratory clinic. Did not attend out-patient clinic or receive any treatment from any such place. I find dealing with bills and letters to be stressful. It is difficult for me to go shopping and to do housework. I am not planning a trip to Southport soon.

8. when walking, standing, sitting, bending or kneeling I have a problem with the lung capacity required.

12. when reaching and lifting I have a problem with the lung capacity required.

28. I do have a problem in getting about.

33. Yes my condition is life threatening and there is medical evidence to support that it is uncontrollable. I am suffering from mental and physical disablement. I have limited capability for work.

34. death is likely due to my respiratory problem causing cardiac arrest. There is substantial physical and mental risk if I were found capable of work related activity.

35. I have contrary advice from my GP. that a return to work should be considered within one year and not within three months.

It is clear to me from the report that I was not listened to when I described the difficulties I have experienced with my health condition.

When dealing with the Department for work and pensions you will find the managers and staff are very good at being economical with the truth.

Howard Woolley

ATOS and the Medical Assessment Team who make the decisions on ESA are not only economical with the truth but with information, action and facts. My husband was meant to attend a medical on 29th December, a day that Mann Island was actually closed, in thick snow, a few days after Christmas, when he was still recovering from prostate cancer.

He is also urinially incontinent and could not stand the embarrassment of sitting around for three hours at Mann Island. He was not well enough to leave the house and both of us had recently had surgery and were not allowed to drive at the time. These facts had been informed to the DWP and they were more than aware of his condition.

I tried to get them to at least send a doctor out to the house. The latest appointment they had on their books was 7th January. The DWP and the doctor were closed until 4th January and my doctor came out to see my husband but she said that the DWP would have to write for the medical information that they now said they needed to arrange a medical visit at home. They would not get it back in time for the 7th.

I could get no answer from either ATOS or the DWP for the next three weeks and tried to make an appointment after 11th January as he had to go for more treatment all that week. We got to the managerial people at ATOS and they were meant to be sorting it out. Also we got ignored by the DWP.

We got four appointments made for 6th January, four more made for the 7th January, and a letter on 23rd January telling us that all of the medical appointments were cancelled and another on 24th telling me that the appointment on 22nd was cancelled. What appointment on 22nd? We never had any notification of such an appointment. Then on 26th January we got a letter, dated 15th January telling is that we did not need to have a medical at this time and that our benefits would be unaffected. This was as Stephen was still having and recovering from extenside medical treatment. He was in the Support Group and the DWP confirmed he would remain in this and a medical was not needed. He should never have been sent for one to begin with!

Now, on Monday I got another letter, a standard change to payments letter, dated 15th February, but received eight days later and this was showing a change in the money, it had gone down by 20 a week, and reason; he has moved from the Support Group to the Work Activity Group. No explanation, no nothing.

I had to email and they phone the Medical Referral Team and they could not give me an answer. They did not know why the benefits had changed, on what basis it had changed, who the decision maker was, who had made the decision and what information had been used. All the records showed that this was the advice given to them from ATOS. This, turns out from my investigations to be lies and rubbish.

Diane Foley, the Medical Referral Team Leader in Liverpool said that she did not know why the decision was made. She asked me what information ATOS had, as if I was going to know that and told me to find our what information they had used, to send it to them and asked me questions about the information and the letter. What could I tell her but that we had the letter that said we did not have a medical and did not need one? This was bad enough, but she did not know any information and did not know what basis the decision maker had made the decision. The decision maker did not know either. I had to find out the information and send it to them.

I have had to contact ATOS who tell a totally different story to the DWP, they wanted to defer any medical for the time and that no decision should be made to change anything and told the DWP this. No change should have been made to the benefits. They have confirmed what our letter says.

But they do not know what information they had and saidI have to contact the DWP and ask to see the file as they cannot help me. They did not have any medical information as they did not ask my doctor for it. They decided that as he is having treatment still to accept that he still has a prognosis of several months and that the decision should be deferred. I am still unsure as to what they mean, but it sounds that the DWP have made a fatal error.

I have spent the last three days, writing to doctors, copying medical information, sending emails to DWP and ATOS and making calls everywhere and getting more up to date information. I have also asked on what basis the decision was made: ATOS do not know. The DWP do not know on what basis it was made and refuse to give me the information that they or ATOS have. I have now asked to see the file. I have a right to know why my husband's benefits have been changed and for a review and we are doing this. But I just feel that these bl**** ba****ds, swines, have caused me a lot of upset for no reason.

We cannot live on what we have and already have two appeal tribunals on 15th March; another one would kill us!

But these people do not provide information; they only lie and cause chaos and hell in peoples lives. I would also like to know the direct mobile number of this woman and the name of the decision maker. That would be fun; to put them through the hell that they have caused me and thousands of others.

To everyone on this site trying to get information; good luck and I hope you use it to bring these bastards down!