My ESA has been stopped after medical assessment. Should I appeal?

[JoJo2106]

Hi (Apologies if this is a bit long but really need some help/advice)

I have been on ESA benefit for quite a while now, I have had numerous problems with my health for the last few years and been unable to work. I had breast cancer a few years ago (lumpectomy, mastectomy, chemotherapy etc) recovered slowly after this horrible time in my life. Then about a year or 2 after this I developed endometriosis and adenomyosis which was diagnosed during a laparoscopy. Unfortunately I can't have treatment for this the way they would treat it normally with trying various hormone treatments as my breast cancer was positive for hormones so not allowed anything for the rest of my life containing hormones. I have suffered a great deal of pain with this for quite a while now and it rules my life. I have had surgery a couple of times to try and excise it but still been left in pain. I very very unexpectedly fell pregnant at the end of 2016 and had my little boy Sept 2017. He is a real miracle baby as due to all my health issues he really by rights shouldn't be here buy somehow he is .

My endometriosis returned a while after giving birth and am still in a lot of pain with it. And a lot of the time I do need help from my mum as I'm in a great deal of pain an struggle to do things or sometimes even move.

Anyway I have been exactly the same and nothing has changed in my condition at all in fact it's slightly worse since I've had my son. But I attended a medical assessment for my ESA last month and the man who done this was not nice at all. He wouldn't really let me elaborate on anything to explain how my condition affects my life on a daily basis. He seemed to think he knew more than my gynaecologist who is a specialist in his field. Told me my medication I take wasnt good enough and "isnt really a painkiller" even though this has been prescribed by my gynae? I came away very frustrated. I had a phone call on Wednesday to tell me the decision, the man on the phone basically told me I had been awarded ZERO points at my assessment (you need 15 to be on ESA). How can I be awarded 0 points when my condition is still the same if not worse now? I was also told the assessor had ignored a lot of stuff I had tried to say, changed things I had said and also said I got up onto the couch to be examined. This didn't happen and I wasn't examined.

The man on the phone then asked if there was anything I disagreed with so obviously I told him the things I've just explained above. He said give me an hour I will phone you back with the decision. Phoned me back and he then said he had awarded me 9 points as the assessor seemed to have missed that part. Bearing in mind I was awarded 0 points by been seen in person then all of a sudden I am awarded 9 points over the phone? I needed 15 points to stay on ESA so am 6 short so they have stopped my ESA now.

I would just like to know if this mockery of an assessment and the fact I've gone from 0-9 points just over the phone is good grounds to appeal this decision? I am getting a written letter from my gynecologist am also something from mental health team as I suffer with anxiety and depression also. I am now on my own with a 2 year old with barely any money 9 weeks before Christmas and dont really know what to do. How likely Is it I could win my appeal if I do appeal this.

Thanks so much for reading x

Always, Always appeal. The percentage of refusals that are overturned on appeal is huge.

@WhoWants2Know really? I'm just gobsmacked to be honest. Even just the fact they awarded me 9 points over the phone makes a mockery of the whole thing doesnt it.

The first stage of the process is to request what's called a "Mandatory Reconsideration" which, if unsuccessful, is followed by an "Appeal"

Did the person that awarded you the nine points say it was a Mandatory Reconsideration he'd done? If so then yes, your next stage is to Appeal.

I would ring them ASAP to check which stage you're at. Unfortunately appeals are considerably backlogged at present and no ESA is reinstated until the appeal is heard and won (it is backdated if successful)

I would absolutely appeal as many, but not all, decisions are overturned.

Are you claiming UC?

@dontdoxmeeither no it wasn't a mandatory reconsideration over the phone he just awarded me the 9 points due to the health care professional ignoring the things i had tried to say to him. I have just received my decision letter in the post this morning and it even says in the letter I was awarded the 9 points by the decision maker due to the area been ignored by the health care professional. Not claiming Universal credit at the moment, I have posted this same thread over on lone parents and was advised not to by a CAB worker until I go through the mandatory reconsideration, as once you are on UC you cant go back onto ESA. They also said once you log an appeal your ESA is reinstated on the lower amount until your appeal is heard. They also advised I try and apply for PIP as I have help from my mum with self care etc when I am.in extreme pain.

@joyfullittlehippo yes I am seeing someone from citizens advice on Wednesday so hopefully they can help me apply for the mandatory reconsideration..and if i have to appeal I will seek help from my local benefit advice centre I think as I've been told that's a good next step and they can help massively when it comes to appealing.

Ask for a mandatory reconsideration asap, if that fails then mount an appeal. You absolutely have to appeal, do not be put off, they are absolute clowns and you do need to fight back.

Appeal. Do it. Don’t doubt yourself & your specialist Drs.
Governments do this on purpose to reduce costs. They know if they disapprove a good chunk of people entitled to a disability benefit on the first application, close to half will give up and drop the claim, saving them money. It also means they can delay paying the benefit as long as possible because another % will get better during that delay and no longer be entitled to the benefit.
That’s why they make it a difficult and long process.
We have the exact same crap here in the US.

Always appeal and always get help to do it. Because the ones that need the benefit the most (like you) rarely have the energy and mind to get through it on their own because their conditions limit them so devastatingly.

My SIL appealed and she now receives it again.

Thank you all. Yes I am going to appeal it definitely. I'm just actually still gobsmacked by the whole thing. That whole thing of awarding zero points at the assessment then getting awarded points during a phone call is a complete mockery of the whole system and how it operates. The assessor completely ignored and blanked what I was trying to say to him, even lying saying I got up off the chair and onto the couch with no difficulty, he didn't even examine me.

Well I was told they would send a copy of my assessment out but I havent received it so I will be on the phone first thing tomorrow chasing it up. Want to know what other lies and things hes ignored is in there.

I really can't cope with the stress of all this at the moment but I guess I'm gonna have to fight for it. Pisses me off as I know people on these benefits and there is nothing wrong with them they are just milking the system and drink all day morning to night. It's all wrong!

They do reinstate ESA at the assessment rate following Mandatory Reconsideration but only if the appeal is accepted. Unfortunately this isn't always the case. So sorry you're going through this.

As an aside, with UC, if you have a medical certificate from your GP the (DWP) medical assessment process to determine fitness for work starts again. Whilst in possession of a medical certificate, the requirement to be actively seeking work is "switched off" until the result of the medical. Although there may be some requirement to undertake some work related activities. Like sourcing support for conditions and the like. This is dependent on the work coaches and your capabilities.