Template to the tribunal, once you have received DWP submission
[Heading: name, date and venue of hearing] National insurance number Introduction I, (name) am appealing against the decision made on (date) to decline the award of Incapacity Benefit/Employment and Support Allowance (delete as appropriate) on the grounds that I have not attained 15 points from the combined Physical and Mental Health descriptors following my Personal Capability Assessment (for IB)/ Work Capability Assessment (for ESA) on [date]. I believe and I will demonstrate below that by scoring the descriptors relevant to my condition correctly that I do attain the required threshold of 15 points. [This link will take you to the DWP's own Pdf document about the assessment and 'descriptors' scoring system they use. From page 18 onwards, there are descriptions of all the conditions they or Atos can look at and the number of points allotted for each, depending on the severity of the symptoms. We allocated the points we thought they should have been done by Atos, then itemised it all in the letter below.] http://www.direct.gov.uk/prod_…..177366.pdf I hope that the Tribunal will support my appeal and that the Tribunal will authorise the reinstatement of my award. _____________________ I would like to refer the Tribunal to Item (number) in the Appeal Submission – Form IB85/ESA85 Medical Report. I shall now explain where the report’s content is inaccurate. Item insert number – IB85/ESA85 Medical Report (Appeal Submission pages insert page numbers) The report does not reflect accurately those matters discussed and assessed at the medical examination that I attended on [date]. Referring to the content of the Medical Report Form, on: In here, insert bullet points referring to what the report stated, followed by what the accurate assessment should have said, for example: Page *insert page number: Standing: the report stated that I am unable to stand for more that 30 minutes without having to move around. This ability was not tested as part of the Assessment, most of which was undertaken in a sitting position, so I find it difficult to understand how the doctor can disagree with my opinion. In addition, my
enclosed letter of support from my consultant of (name hospital) NHS trust clearly contradicts the ATOS assessment in this area. And continue like this in bullet point form, pointing out the contradictions throughout the report and scoring. When scoring the Personal Capability Assessment/Work Capabilities Assessment I feel that both the Medical Services doctor and Decision Maker have over-estimated my level of ability. By revising the Score card to take account of my actual Physical and Mental Health conditions, I am of the view that I satisfy the threshold of 15 points required for the award. Conclusion In conclusion, I believe that the scoring of my Personal Capability Assessment/Work Capability Assessment should be revised to take account of my actual Physical and Mental Health abilities. I hope the Tribunal will support and find in favour of my appeal, determining that I am incapable of work from [date]. _________________________ _________________ I declare that the content of this Summary forms the basis for my appeal and that the information is correct and complete as far as I know and believe. _________________________ _________________ Signed [Appellant] [date]