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Psychotic Big Brother

ATOS medical assessments

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I have to have a medical in August. They say their staff are widely trained. Would they be? Really? How do they deal with autistic people?I do not speak much and certainly not to people I don't know. Also I make no eye contact with people. How is that going to be viewed, they probably will just put me down as ignorant or rude.I am asking my social worker and someone from my autism group, like a keyworker, to go with me.Has anyone gone through this, what are your experiences? What people are saying on the link is very scary, thanks.


Things people are saying about ATOS medicals...





Edited by Psychotic Big Brother

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Firstly I would like to say that these boards are not 'dead' rather I feel they are now dead in respect to certain sections of the ASD community and that is what happens when the opinions and beliefs of one particular section tend to overpower those of other sections.


I am not an expert on the ATOS process Psychotic Big Brother but I have been through it and come out of the other side and so I have one experience of it. It may be the case that people who currently contribute to these boards don't have that experience. I also feel more people will come to this post through general searches i.e. ATOS & ASD and so something should be here, so here goes.


There are a few things I would like to start with because I feel these are important in respect to others understanding my own experiences. The reality for me going into the process is that I received 10p per week of Incapacity Benefit and coming out of this process I would either receive 10p per week regardless of which group I was to be placed in JSA, the Activity Group or the Support Group. I say this because I didn't have anything to lose regarding the decision at a financial level and I was also open to any of the outcomes and wasn't aiming for one particular position. I think this is important because at no point in the process was I playing games though I can start to understand why people might feel that game playing is something they should or have to do. My advice is don't play games be open and honest and have some self respect.


Another factor in respect to myself is that there are two sides to my case a mental health side and a physical side due to spinal issues. The reality is that I would have reached my final position if I had present just one half of things but so people are aware there are other aspects to my case besides mental health and autistic elements.


Whilst you will have already filled in your form Psychotic Big Brother for other people who might not be that far into the process I will talk about this stage to give a complete picture.


I made the decision firstly not to put a great deal of information onto the form which I was asked to fill in. I gave an indication of my conditions using the medical terms and indicated the level of the individual who diagnosed me. When it came to providing evidence I wrote a short sentence in the boxes provided but made the conscious decision not to include anything else when I sent the form in.


I likewise researched into things and looked at evidence related to the ATOS process. From what I found out the levels at which you have been diagnosed are critical to this process. To explain this I am going to take another aspect of my own case my 'bad back'. Now one aspect of this is I suffer from Sciatica as do many other individuals who will have gone through these assessment processes. From what I understand if someone is diagnosed with Sciatica by their GP and only diagnosed at that level then their Sciatic condition is not taken into consideration. In a way I suspect ATOS are saying it can't be that serious if the individual is only that far into the system. In my own case I didn't use the word Sciatica at any point in my form what I said was this;


Disc and endplate degeneration present at L5 - S1

Disc dehydration moderately large broad based herniation impacting on S1 nerve roots.

L4 - L5 dehydration and degenerative bulging

L3 vertebra sizeable simple haemangioma

Main symptoms low back pain radiating into legs


I gave the name and contact details of the consultant surgeon who made the diagnosis and left it at that. I know from my own research that the key in this sort of area is that any diagnosis has to have been made off the back of an MRI scan. Now I don't want to go into the mental health aspects of my own case not because I have anything to hide rather I feel people reading this would simply start to compare themselves and I do not feel that is very constructive for themselves. I have however used this back example to bring out a point.


When you go to the medical assessment you will be seen as far as I understand at one of two levels. ATOS receives funding and pays its assessors at these two levels. It is very evident if you sit in an ATOS centre that one set of individuals are going in and out every 10 minutes or so because they are being seen at the first level normally by individuals drawn from the nursing sector. When I was sitting in the centre, I was half an hour early, I was quite concerned by this if I am honest. My point is if my 'bad back' and sciatica was diagnosed 'only' at a GP level then I suspect I would have found myself in this group to be seen by a nurse, to have a quick medical examination and that would have been that. I am not sure but if for example I had a GP letter to say they suspected a diagnosis of Asperger's and only that then I might well have experienced a quick in and out type of thing.


There is however a second level where the fees are higher and it is for ATOS to make a decision as to who to feed in at that level based on what they see on the form.


Now in my experience my assessment lasted around 55 minutes. I was seen by an individual who had worked at a high level within the NHS who would have had good specialist knowledge of some of my conditions. After a while it was also obvious that ATOS had contacted the relative consultants as she was feeding things back to me which I hadn't given to them in the form. So my advice is don't worry about sending in loads of information because ATOS will collect it and if GP's and consultants want to charge a fee for writing a report for ATOS then I think they should.


Throughout the assessment my assessor was friendly and very professional, she was also understanding. We talked for about 10 minutes regarding the state of mental health services in my area. A concern of mine was that I don't get much in terms of mental health support, I don't have a care plan let alone a care co-ordinator on paper let alone someone to go and see. She was fully understanding of this and understood that was a reflection on the local mental health services and not a reflection on myself. She asked me about medication and why I have come to the decision not to take anything such as anti-depressants and was also understanding about my position. My point here is in my experience there isn't a need to back everything up with stuff such as professional support and medication regimes rather in my experience the assessor was open minded.


When it comes to how I presented at the beginning of the interview I said "I will try my best but if I get a bit knackered along the way I hope you understand". The assessors response was take your time and have a break if you need it. I have to say at no point in the assessment did I feel under any pressure.


We got towards the end of the interview and she asked me did I want her to do a physical assessment or not which really surprised me. I questioned her about her statement and she told me I was through the 15 point mark in both the mental health and physical aspects of the process so the examination was not relevant if I didn't want it. For fullness of process I went ahead with things and the examination focused on my back and that day some things were good and some things were poor but that is normal.


As I got dressed and things wound down I chatted to the assessor as to how she felt about doing the job and she was very open. Her opinion was things are getting better and 'they' are learning from the process. She said no two people are alike and that they were trying to give a balanced and fair report. She told me there and then that she would be recommending me to the Support Group and that I would hear from the DWP in the within 4 to 6 weeks in reality it was about 4.


As I said at the beginning I am no expert rather these are the experiences of one individual. Since being placed in the support group I have contacted the local job centre had an interview and exploited my options and as such being in the support group or the activity group doesn't make any real difference. If I was in the activity group I would have to go for six interviews but what is on offer which isn't much is on offer to me anyway rather I can choose to access it.


So what are my own conclusions having been through the process.


Firstly I would say the process is a lot tighter than some of the old ATOS process surrounding things like Incapacity Benefit. Now I am not saying it is fair rather it is tighter. Because of that I think trying to be manipulative even when the motives are genuine is a bit pointless and can only be harmful to the individual concerned in the long run. So regardless of an individual's approach to the process I think the outcome would pretty much be the same.


A big determining factor in the outcome is the level at which you are seen. In my experience the assessor was highly respectful of any decision made by a consultant in her field. When it came to mental health issues her default position was one of respecting her colleagues in those fields who were at similar or a higher level. And that is the critical point. For example she knew my diagnosis for AS was from the Sheffield service and she said to me "that is a centre of excellence isn't it" and I had to say "yes I guess so". Throughout the process I got a feeling of I am a 'consultant' level case. At one point she commented that I was about to see a consultant psychotherapist as I had given the date of the first meeting, which in reality was three meetings which led to nothing, however I suspect her rationale was not everyone gets to see a consultant psychotherapist and therefore that was good enough for her.


Now at a personal level I don't know what it is like to go in with a collection of letters from a GP or an old educational psychologist report or the fact I am taking lots of medication. What I can also say I didn't set about embellishing things along the line of "oh you don't know how bad my bad days are", if anything I did the opposite. And at the end of the day I was put in the support group based on acquiring at least 30 points with 15 being the threshold. So has that made any difference to me, no not really it was just a case of the government said I had to go through a tick box process and the outcome is the outcome, at the end of the day the thing that I can effect is how I feel about myself and nothing has changed there.


Likewise I went and looked at forums and stuff like that and it is hard not to have your concerns Psychotic Big Brother and that will be true of others entering into this process. What I would say is I didn't and don't know the issues these forum contributors have and importantly what their mindset is regarding those issues. My own feelings about the system is there has to be a line somewhere and that will mean people on either side of that line may not be happy about being labelled with something but at the end of the day it is just a label. I don't like the label of being in the 'support group' but for others that may be a target though an unrealistic one. I was surprised to find out that I was the first person in my area to contact the Job Centre asking for a voluntary interview from the support group. And the guy who interviewed me said a lot of people from the 'activity' group sit in front of him moaning that ATOS have got it wrong and they should be in the support group and not there, so is the line in the wrong place?


At the end of the day it is a process based on ticking boxes against fixed criteria. Personally I don't think it is a case of whether ATOS are fair or not, rather they are doing a job and as my assessor told me it is not pleasant at times and she is doing it short term for her own reasons related to family, at the end of the day these assessors are human and not robots. The real issue of fairness is about who has been able to acquire diagnosis throughout their lives at certain levels and who is not. The position I guess the government makes is believing that the most needy will have been seen at the right levels and that is a big mistake to make in many ways. I suspect one of the difficult things for many individuals is they might have been seen lots and lots of times, but the professionals who have seen them may have felt no need to get them seen higher up the system, and they may well be right in that decision. I think the issue is if people are seen a lot at lower to mid levels then they start to feel their conditions must be significant


For example I have seen my GP about 16 months ago regarding my 'bad back' and I have not seen him since after he referred me on. Now I have gone through a system where a consultant specialist surgeon is happy to do pretty extensive remodelling surgery when I am ready, and as I am 48 years of age I am going to try and push it out a bit longer because they can't do it a second and third time and we want to see how the tumour develops. That is the level of my back and there is a note which sits on the system related to the surgery. Now I guess some people see their own GP's once a month about their bad back's and go to classes and see a physiotherapist all things I don't do so are their bad backs significant because of their 'bad back activity'?


The problem for ATOS is that they then come along and draws a line and individuals feel they are on the wrong side of it because in their minds they see their conditions as highly significant possibly based on the 'activity' they have with services. And that is what this process is really all about cultural change and people are entitled to have their own views on that as do I as to where I think I fit. But I understand the government pays my 10p per week and so it is their prerogative to put me somewhere isn't it?


In response to the issues in your initial post Psychotic Big Brother, I would say just go to the interview and be yourself because there is little if anything you can say or do which will influence things. My assessor told me she had done the majority of her work on my case even before meeting me and that could only have been about the evidence ATOS had acquired. So I would say try not to view this as a personal thing on the day of the assessment. I would also say that post this process what difference does it make in reality and for a lot of people that difference is five quid a week which will only exist until the activity group catches up to the support group in about five years time. So do you sell your soul for five quid a week I wouldn't. If you are placed into the activity group and feel you are not capable of much as my supervisor said there is little they can do besides sit there month after month and try and explain why trying something might actually be a better option, as he said if people reject that what can he do? It might be the case that you are placed in the JSA group and if you have any evidence at any sort of 'reasonable' level that is unlikely.


As I said these are my experiences and conclusions people may have experienced different things and they are free to express them. I am not an expert so feel free to take or leave these comments, if someone finds this useful then it will have been worth the effort in writing it. At the end of the day I feel it is more important how we look at ourselves than how the world decides to look at us because they will have very mixed opinions anyway.



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I'm just going through the process having just sent my ESA50 back. I got my social worker to fill in the forms for me and will definitely be taking him along to any medical, I told him I was really worried and he says he nows of nobody who as lost benefits. But this is with the learning disability team in Brixton. What team are you under?

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To LancsLad a long read but well worth the time, thank you, to others I did not mean to be rude, just I was surprised at how slow the board was, comparison to others that's all, apologies!


Meanwhile, a friend who knows me quite well has said that this is actually the wrong way round. She says I need to write to the DWP, having cancelled the ATOS for now, to find out why I need an assessment in the first place. This decision can be withdrawn in fact, if there can be a way around giving more information, as if they did not have enough already, rather than put me in a position where I probably would not interact and avoid a horrible situation like Steel Maiden went through on that course. You need to speak to the organ grinder and not the monkey, she said.

Edited by Psychotic Big Brother

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