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Verifying Mental Health on ESA



When it comes to mental health, trying to get onto ESA is uniquely difficult. Of course it’s difficult, period. But I think, and I’ve seen, that mental health is peculiar in this.

The CAB needs me to get a letter from my GP to underline how my conditions affect me. Specifically this has to pertain to what the ESA descriptors require to qualify for the points awarded. It’s like a terrifying game show. Turns out, however, that my GP received a letter from the CAB asking for this already and she has responded – but, I fear, not in the way the CAB and I need. I tried to explain that the process requires she verify my explanation in response to these descriptors. Here’s an example:

ESA Brucey Forsythe: “Now for 6 points, can you tell me whether or not you can cope with small unexpected changes to your daily routine.”

This is the specific requirement for the descriptor ‘coping with changes’; in other words this is what the ESA system needs to know about in order to qualify.

Contestant Ghost Whistler: “no – change to an appointment time would be upsetting and uncomfortable (I also said to the CAB adviser that had she changed this appointment I would have struggled).

What the CAB needs is for my GP to rubber stamp this with a letter or document I can take to the tribunal. Unfortunately for me my GP doesn’t quite understand this. Again there is the lack of appreciation for what is actually required of the claimant according to the system. According to her she can’t actively verify this. Unlike, say, a broken arm (something tangible and visible), she can’t know that’s true. She can’t diagnose this.

Herein lies the problem; it seems that for mental health issues people in her position require a diagnosis. She’s happy to facilitate that (though god knows when or even if that will happen locally – never mind in time for a tribunal), but she can’t directly verify my description as above. That’s not to say she doesn’t agree, though of course we all know that’s how it will be seen. So she has sent off some evidence to the CAB sort of answering the questions. Unfortunately she couldn’t get me a copy of her answers so I have to wait for the CAB to receive her report (posted Friday) and get in touch to see whether it meets with their approval – i.e. whether they think it’s going to help. It might, but then again I fear it will not do so directly and that is the problem.

The great irony is that while GP’s speak in the language of diagnosis, the ESA assessment system does not. In her mind a diagnosis of ADD/Aspergers (or whatever) is answer enough, but to the DWP a diagnosis is irrelevant. You could present them with a diagnosis for terminal cancer and three months to live and they would only pass you for ESA if that condition triggered 15 points worth of descriptors, regardless of how you feel. When it comes to mental health, which is largely invisible and poorly understood, even by GP’s (who thus rely on diagnoses, as here), this approach is woefully inadequate: conditions fluctuate and are difficult to explain or pin down. This leaves individuals caught, once again, in the zone of uncertainty this deficient system creates.

I hope I have explained this well enough. It’s difficult to really parse because it’s subtle. In many ways it makes sense to assess what a person can or can’t do, but the problem is how. By editing the descriptors and setting the goalposts how you like you, as architect of this system, have free reign to determine who passes and who doesn’t. But remember, ESA is meant to be for people who need help – even if they can, or are even in, work. It is called Employment SUPPORT Allowance; not Incapacity Benefit.

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Well that's that for pursuing a diagnosis for Aspergers or anything remotely similar.

I contacted the Patient Advisory Liaison Service (PALS) to try and sort this out after being lied to by the clinician regarding referring me to the ADD (Attention Deficit Disorder) people. That never happened and she continues to deny saying she would. Of course I cannot prove this and so the patient-doctor dynamic kicks in: I'm the lowly patient, she's the expert doctor, her reputation versus mine and so who wins?

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