Employment and Support Allowance:

reconsiderations and appeals

August 2015

Background 2

Asking for mandatory reconsideration 3

Making an appeal 4

Preparing your reconsideration or appeal 5

What happens to your benefit when you have asked for a mandatory
reconsideration? 6

What happens to your benefit while you are appealing? 7

In the wrong group? 8

The Exceptional Circumstance rule 9

Preparing your case 14

Going through the paperwork 16

At the hearing 18

What to do if your appeal is not successful 20

Useful contacts 21

Appendix I: example of an appeal letter for those aiming to get into the
Work-Related Activity Group 22

Appendix II: example of an appeal letter for those aiming to get into the
Support Group 23

Appendix III: the Work Capability Assessment regulations/descriptors 24

Appendix IV: Limited Capability for Work-Related Activity Assessment 33

Background

The Work Capability Assessment (WCA) is the test used to assess whether you
are fit for work or as the DWP call it whether you have limited capability for work.

• If you are found fit for work you will not get Employment and Support
Allowance (ESA).
• If you are found to have limited capability for work you will be put in the
Work-Related Activity Group (WRAG).
• If you are found to have limited capability for work related activity you will
be put in the Support Group.

If your claim for ESA has not been successful and you have not been awarded
any ESA, you have a right to challenge this decision.

If you have been placed in the WRAG and you think that you should be in the
Support Group, you can also challenge this decision: see ‘In the wrong group?’
on p 8.

You can also challenge a decision that you did not have “good cause” for failing
to return a Capability for Work questionnaire or for failing to attend a medical.

If your claim for ESA has not been successful or you have been placed in the
WRAG and you think that you should be in the Support group and you wish to get
the decision looked at again you will need to ask the DWP for a mandatory
reconsideration first: you must do this before appealing. You have a calendar
month from the date of your decision letter in which to do this.

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Asking for mandatory reconsideration

You can ask for a mandatory reconsideration either over the phone or in writing.
We would suggest putting it in writing so there is a record of it. You will probably
not be able to go into much detail at this point as you may not have been sent the
medical report yet and will not have seen all the papers relating to the decision.

You need to request the medical report and any other reports that were used
when making the decision as soon as you can (see below for more information
about this). If you intend to send in further evidence after you have submitted the
reconsideration request make sure that you explain that you intend to do this.

If further evidence is required, you should be given a month within which to

supply it but make sure you confirm this with the DWP.

If you intend to send in further evidence you will still need to stick to the
deadline for submitting the mandatory reconsideration request. Do not
delay in doing this.

However, you will not get paid your ESA whilst in the mandatory reconsideration
process (UNLESS you are in the Work-Related Activity Group and are appealing
to get into the Support Group*). So you may not wish to prolong this period, and it
may be better not to submit further evidence at this stage to avoid delays.

*If you are appealing to get into the Support Group, you could send further
evidence in at this point as your benefit will not be stopped in this situation.

The DWP are not intending to introduce a time frame within in which they must
process a mandatory reconsideration request. They have said that it will vary
from case to case.

When asked in parliament in November 2013 about how long the process would
take, Esther Mcvey, then Minister for Disabled People, said:

“If the case is straightforward and no further evidence is required the mandatory
reconsideration process for ESA could be completed relatively quickly. We would
usually expect this to take around 14 days, but it could take longer. For example,
if further information is needed, the law states that DWP have to give people one
month to provide it and this may be extended further at the decision maker's
discretion, so cases like this may take longer.”

Once your reconsideration request has been received, a different decision maker
will look at all the evidence again to see if they can change the decision. DWP
guidance states that as part of the mandatory reconsideration process they will
make a telephone call to the person to clarify any matters that they are unsure
about and to explain their reasons for the decision. It is not clear if everyone will
be contacted by phone.

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The guidance published October 2013 can be viewed online, but it may be
subject to change over time:
www.gov.uk/government/uploads/system/uploads/attachment_data/file/264915/a
ppeals-process-changes-q-and-a.pdf

As of January 2015, the DWP are reviewing their use of phone calls in the
mandatory reconsideration process but at the time of writing there is nothing
conclusive about this. The best policy is probably to think you may get a phone
call and think in advance about whether you are happy to talk about your case
over the phone and the main points you would like to cover.

The guidance also says that if they are not able to contact you by phone they will
go ahead with the mandatory reconsideration using the available evidence.

The DWP may advise you to send in further evidence and may suggest what
evidence is needed. DWP guidance states that if the DWP agree that a certain
piece of evidence is required the DWP may be able to pay any costs that arise
from this. You would need to check with the DWP about this and ensure that they
would meet any costs before agreeing to pay for evidence yourself. Again, if
evidence is not easily available you may not wish to cause delays by trying to get
it and may prefer to wait and submit it at the appeal stage.

You can submit further evidence even if the DWP have not stated that it is
needed and the DWP should allow you time to do this. They usually allow a
month but do check with them about dates and try to make sure you stick to
them. If you do intend to send in more evidence do not delay in getting the M.R
request in within the deadline and send in the further evidence afterwards if you
need to.

If the decision maker does not change the decision you will receive another letter
(the mandatory reconsideration notice) and will then have one calendar month
within which to appeal to Her Majesty’s courts and Tribunals Service (HMCTS).

Making an appeal

An appeal must be lodged directly with Her Majesty’s Courts and Tribunals
Service. This is known as direct lodgement. You will need to enclose a copy of
the Mandatory reconsideration notice with the appeal. When the Tribunals
service receives your appeal they will write to the DWP for their response. The
DWP are meant to respond to this within 28 days.

The form to use when appealing is called the SSCS1 form and is available at
www.justice.gov.uk/downloads/forms/tribunals/sscs/sscs1.pdf

There is also one included with this guide (if you have ordered a paper copy from
us).

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Preparing your reconsideration or appeal

You will need to look at all the descriptors to ensure that you meet the 15 point
threshold, that one of the Support Group descriptors applies or that the
Exceptional Circumstance rule (see p 9) applies and this will then form the basis
for your appeal.

You will also need to see all the medical reports that have been used in deciding
your claim. You can request these at the same time as asking for an appeal or
reconsideration. The reports that you may wish to request to support your case
for appeal are:

• ESA85 medical report form: this is the form that will have been completed
by the Atos assessor if you had a face to face assessment.
• ESA85A form: this is completed by an Atos assessor if you did not have a
medical
• ESA113 form: this may have been sent to your GP or consultant but it is
quite likely that this will not have been sent out.

If you have not kept a copy of your ESA50 form (ie. the questionnaire you used to
apply for ESA) you can ask for a copy of this at the same time as you ask for a
reconsideration or appeal.

If you do not receive an acknowledgement within 14 days, phone and make sure
that your appeal has been received.

For sample letters that you can adapt to suit your own situation, see Appendix I
of this factsheet if you are aiming to get into the WRAG, or Appendix II if you are
aiming to get into the Support Group.

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What happens to your benefit when you have asked for a mandatory
reconsideration?

If you are in the Work-Related Activity Group and have asked for a mandatory
reconsideration to try and get into the Support Group, you will continue to receive
your ESA.

However, if you were not awarded any benefit at all you will not be able to get
ESA paid while you are waiting for a decision on your mandatory reconsideration.

Depending on your circumstances it may be possible to claim other benefits while

you are waiting for the decision on this.

Jobseekers Allowance

The most likely one is Jobseekers Allowance (JSA). Claiming JSA should not
prejudice your ESA case but it can put you in a difficult situation as you do need
to be available and actively seeking work.

It is possible to put disability related restrictions on your job search agreement

when claiming JSA. Restrictions could include limiting the hours that you are
available for work, restricting travel time to and from work and restricting the type
of work that you are looking for.

Jobcentre Plus offices are meant to have been issued with guidance about
“flexible conditionality” for people who have failed the Work Capability
assessment and have asked for a mandatory reconsideration. This means that
people can be treated more flexibly than a usual jobseeker. The DWP say that
comprehensive guidance has been issued to all Jobcentre Plus staff so that they
are fully aware of how JSA conditionality can be adapted and modified for
claimants with health conditions.

It means that JSA claimants with health conditions can restrict their availability for
work as long as the restrictions are reasonable in their particular circumstances.
If it is accepted that the restriction is reasonable and is connected to their
condition they do not have to be available for 16 hours per week and
they do not have to show that they have a reasonable prospect of getting a job.
There are no time limits associated with this as long as the restrictions continue
to be reasonable.

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Universal Credit

Some people may have to claim Universal Credit instead of JSA. This will
depend on where you live. You can find out more information about the areas in
which you can claim Universal Credit at www.gov.uk/jobcentres-where-you-can-
claim-universal-credit

When claiming Universal Credit you should be able to put limitations on your
work availability. If you have a “physical or mental impairment”, you can limit the
hours that you can work to less than the usual 35 hours per week, you can also
limit travel time and the type of work that you can do. If you have any medical
evidence to confirm that you are unable to carry out certain types of work or to
work in certain places submit this to the DWP.

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What happens to your benefit while you are appealing?

Once you have had the decision on your mandatory reconsideration and you
have lodged your appeal you can usually (see below for exceptions to this)
continue to claim ESA at the assessment rate (this is the basic amount that you
will have been getting if this is a first claim. However, if this is a renewal claim
and you have been getting the additional component, your payment will be
reduced).

You have to put your appeal in to restart your payments of benefit. You will also
need to continue to provide fit notes (formerly they were called sick notes or
medical certificates) from your GP while you appeal. If your appeal is successful
you will be repaid any arrears of benefit that you are owed.

If you haven’t claimed JSA or another benefit during the mandatory

reconsideration period and you then appeal, the DWP should put your ESA back
in payment when they get your appeal request from HM courts and Tribunals
service, as long as you provide fit notes covering you for the whole period whilst
you are appealing.

You should be able to get any backdated ESA owed if your appeal is successful.
If your appeal is not successful you will lose out on being paid any benefit for the
mandatory reconsideration period unless you claim an alternative benefit.

If you claimed JSA during the mandatory reconsideration and you go on to

appeal you will need to ask the DWP to put you back onto ESA. You will not have
to make a new claim for ESA but you do need to make it clear you want to
change back from JSA to ESA.

If you are being migrated from Income Support or Incapacity Benefit and you
appeal you will also get paid at the ESA assessment rate and will need to provide
fit notes. You may not have had to get fit notes for a long time and it is likely that
the rate that you will be paid while you are appealing is less than what you have
been getting. If your appeal is successful you will be paid any arrears that you
are owed.

If you have been put in the WRAG and are appealing to try to get into the
Support Group you do not need to send in fit notes while you appeal. You will not
be paid at the assessment rate in this situation and will get ESA with the work-
related activity component or the equivalent amount of benefit that you got on
Incapacity Benefit or Income Support if that is more.

In some cases you will not get paid ESA while you are appealing. If you failed to
return an ESA50 Capability for work questionnaire or you failed to attend a
medical and the DWP have not accepted that you had good cause for these
failures, and you are appealing against this decision, you will not get paid ESA

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whilst waiting for the appeal to be heard. You can put in a new claim but you will
not get paid until you have had a face to face medical.

When you have already had a year’s payment of Contribution based ESA whilst
in the Work Related Activity Group and you are not eligible for IR ESA, you may
not get paid ESA whilst appealing.

ESA claims made on or after the 30 March 2015 will be subject to new rules. The
new rules mean that if previously, at any time, you have been found not to have
limited capability for work, you will not get a payment of ESA pending appeal.
This doesn’t apply if, since that decision was made, you have been found to have
limited capability for work, or if the appeal is about a claim made before 30 March
2015.

In other words if your last ESA claim/appeal was unsuccessful and you then put
in another claim (on or after the 30 March 2015) which is unsuccessful you will
not get paid ESA whilst waiting for the appeal to be heard.

If you can show that you have a new condition or that your condition has got
significantly worse (and this is accepted by the DWP) you should be able to get
ESA paid at the assessment rate on a repeat claim/appeal.

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In the wrong group?

Perhaps your claim for ESA has been successful but you think you are in the
wrong group, ie. if you have been placed in the WRAG but think you should be in
the Support Group.

You can appeal this decision but there is a risk attached. A new decision maker
or tribunal could find that you are not entitled to ESA at all. Although this is
unlikely, it can happen, so you need to make sure that your case is strong.

Another possible outcome is that if you were not asked to attend a medical
before because the decision was made based on paper evidence, the DWP or
tribunal could decide to ask you to attend a medical assessment (carried out by
the Centre for Health and Disability Assessments-the name that Maximus is
operating under when carrying out these assessments) if they feel that they need
further medical evidence.

You will need to consider whether you meet one or more of the Support Group
descriptors and/or whether the Exceptional Circumstance rule (see p 9 of this
guide) applies.

If you think you meet the Support Group criteria you may decide it is worth
appealing. Supporting medical evidence would be very helpful in this situation so
you may wish to discuss the Support Group criteria that you think applies to you
with your GP or consultant to see if they will write a letter of support.

See Appendix II for an example of an initial appeal letter. This is to give you an
idea of the type of information that you need to submit.

You may also wish to include references to where in your original claim form you
gave relevant information that shows how you meet the Support Group criteria. If
you submitted medical evidence that demonstrates this you could also refer to
this in your grounds for appeal..

If you think that the Exceptional Circumstance rule (see p 9) applies to you it
would be helpful if you could include an example of where work related activity
,education or an appointment has had an adverse effect on your health.

If you were called for a medical face to face assessment and this affected your
health you could give details of what happened in your appeal letter. If you have
tried voluntary work or training and this has led to a serious deterioration in your
health you could describe what happened here. You may have had to attend
Work-Focused interviews in the past and if they affected you adversely you could
describe what happened.

While you are appealing to get into the Support Group you will usually still be
called in for Work-Focused Interviews.

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You can ask for the interview to be deferred but this is at the discretion of the
adviser that you have been allocated to. You would need to tell them about how
attending a Work-Focused Interview would affect your health and the problems
that participating in one would cause for you. When you have explained your
circumstances it may be decided that it is not appropriate for you to participate
but this will be down to your personal adviser.

You could also be asked to do other work related activity and if you are not able
to participate you could have your benefit sanctioned (ie. reduced). If you can
show that you have what is known as “good cause” for non-attendance you
would not be subject to sanctions. The DWP must take into account all your
circumstances including your health when deciding whether you have good
cause but there is no guarantee they will accept your reasons.

If you are asked to attend Work Focused Interviews you could request an
appointment with a Disability Employment Adviser at your local Jobcentre Plus,
they may have more of an understanding of the problems that you face.

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The Exceptional Circumstance rule

If you do not satisfy any of the descriptors you can still qualify for ESA under the
Exceptional Circumstance rule. The regulation that may apply to some people
with M.E. is Reg 29 (2)(b) of the ESA regulations.

This says that someone who is “suffering from some specific disease or bodily or
mental disablement and consequently there would be a substantial risk to the
mental or physical health of any person if they were found not to have a limited
capability for work” is unable to sustain physical or mental activity without
experiencing serious consequences.

This could include increased fatigue with progressive deterioration and a

worsening of symptoms if s/he continues to be active above his/her own level.
This could lead to a serious deterioration in health or a relapse.

You may need to explain that you have a ceiling and that if you have to do any
activity above this ceiling this will result in deterioration in your health and that if
exertion is continued this could lead to a complete relapse. You may like to
consider what would be involved if you were found fit for work and what impact
this could have on your health.

Under previous Incapacity Benefit law there was a very similar regulation (Reg
27) and over time various commissioners have considered the meaning of Reg
27 and 29. This has resulted in case law that sets out how decision makers and
tribunals should approach these rules. The case law that applies to Reg 27 is
also relevant to Reg 29.

The most influential case is a Court of Appeal case, Charlton V Secretary of

State for Work and Pensions (this case actually relates to Reg 27 but as the
wording is the same it can be applied to Reg 29). This case and subsequent case
law sets out four situations in which finding someone capable of work may cause
a substantial risk to their health:

1. The actual communication of the decision

This could apply in cases where the person gets a letter or phone call telling
them that they are fit for work and the anxiety and stress that this causes leads to
a deterioration in physical or mental health and possibly a relapse.

2. Having to claim Jobseekers Allowance (JSA)

It has been established that the potential effect of the person having to claim JSA
should be taken into account. So consider the effects that having to sign on
would have on you. There has also been a case that has suggested that if
someone is not likely to find employment (due to age, health and perhaps not
having worked for a long time) this should be taken into consideration. This case

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suggests that having to keep looking and applying for work without hope of
success could have a detrimental effect on the person’s mental well-being.

3. Actually having to attend work

It has been established that the decision maker needs to assess risk taking into
account the type of work that a claimant may be able to do. It should be
considered what kind of work the claimant could do taking into account their
individual background and current circumstances. Think about the type of work
that you have done and the risks that could be associated with being employed
again.

4. Travelling to work

Think about the effect on your health if you had to get up too quickly and get to
work by a certain time rather than having the time to pace yourself. There may
also be issues with safety, for example, driving or using public transport when
feeling ill and perhaps lacking in concentration. Some people with M.E. have
sensitivities to chemicals etc so using crowded public transport could pose a risk.

Additionally, there is another very similar rule (Reg 35)(2)(b) that allows entry to
the Support Group for any person that is: “suffering from some specific disease
or bodily or mental disablement and consequently there would be a substantial
risk to the mental or physical health of any person if they were found not to have
a limited capability for work-related activity.”

This looks at the risk that could occur when someone is found fit for work-related
activity. This can be harder to establish as it is not always known what type of
work-related activity may be available or offered to an individual. We know that
most people will be asked to attend work-focused interviews and may be asked
to attend further meetings with an adviser, people may be asked to attend to
workshops or group meetings and some people will be referred to the Work
Programme. The Work Programme lasts for up to two years and could involve a
variety of activities designed to prepare someone for work.

Think about the effect that doing any of the above may have on you. If you are
housebound getting to appointments may not be possible, think about the
consequences to your health from having to attend appointments etc.

More information about this decision can be viewed on the Disability Rights UK
website at www.disabilityrightsuk.org/charlton-v-secretary-state-work-and-
pensions-2009-ewca-civ-42

Changes to the ESA rules in January 2013 mean that, if an employer could make
a reasonable adjustment and as a consequence the risk was reduced, tribunals
and decision makers can now take this into consideration.

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Preparing your case

You will need to look closely at the descriptors that are used when determining
whether you have limited capability for work/work-related activity. Each descriptor
has points attached to it and you will need to score 15 points in order to pass.

You need to work out which descriptors you think apply to you and how many
points you think you should get. If you think that you should be in the Support
Group you need to look at the Support Group descriptors and if one of these
apply you need to show this.

You also need to consider the exceptional circumstances rule (see p 9).

Changes to the ESA rules from 28 January 2013 state that you can only score in
the ‘Physical functions’ section if you have a physical health diagnosis and you
can only score in the ‘Mental, cognitive and intellectual functions’ section if you
have a mental health diagnosis.

This may mean that you may not be able to score in both sections unless you
have a secondary diagnosis of a mental health issue (eg. anxiety, depression) in
addition to M.E. (which the DWP classes as a physical diagnosis). However even
if you do not have a mental health diagnosis you could still score points if you
have anxiety or cognitive problems resulting from your M.E.

The ESA50 form says: “By mental, cognitive and intellectual functions, we mean
things like mental illness, learning difficulties and the effects of head injuries or
other brain or neurological conditions.” So it may be that symptoms such as brain
fog will be considered under this neurological banner.

As this area is still under some debate and we are talking to people with M.E who
are scoring points in both categories, we strongly suggest that you complete both
the ‘Physical functions’ and ‘Mental, cognitive and intellectual functions’ sections.
It has been recognized that some conditions that are physical in origin have both
physical and cognitive symptoms and in these cases it could be appropriate for
people to score in both sections

If your condition varies, as is very likely with M.E., the DWP should consider how
you are over a period of time. You may find that your condition changes from
hour to hour and is unpredictable. The decision maker should consider whether
you can do an activity reliably, repeatedly and safely.

There is not a clear definition of what these terms mean so we do not know how
often repeatedly is in this context. It is important that you consider whether you
can do something whenever you need to and throughout the day. Also carefully
consider the impact that carrying out the activity may have on you. If carrying out
an activity results in a worsening of your condition or you need to rest having

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carried the activity, you should argue that you cannot do it reliably, repeatedly
and safely.

They should also take into account difficulties that you have with managing
activities such as pain, exhaustion and other symptoms that you may experience.

DWP guidance states that when assessing claimants under the Work Capability
Assessment (WCA), the healthcare professional must take account of factors
such as pain, fatigue, stress and possible variability of the condition. It has been
established that it must be possible for someone to be able to carry out the
activities reliably, repeatedly and safely.*

*This guidance is on page 66-67 and 69-70 of the WCA handbook used by
medical assessors which can be accessed at www.dwp.gov.uk/docs/wca-
handbook.pdf

Case law relating to Incapacity Benefit and ESA can also be relevant when
considering these matters and Disability Rights UK highlight several cases
dealing with reasonable regularity at www.disabilityrightsuk.org.uk

More generally, it states on p 7 of the ESA50 claim form that to answer yes to
any of the questions, you must be able to do the activity:
• safely
• to an acceptable standard
• as often as you need to and
• in a reasonable length of time.

It is likely that you experience some symptoms and are restricted in what you can
do all the time so if this is the case make this clear. You may well have adapted
since you have become ill and got used to how you are and this may mean that
you underestimate the difficulties that you have.

It can be helpful to talk this through with someone who knows you well and knew
you before you became ill.

You need to think about examples and how you will present your evidence to the
tribunal.

Getting help

If you can, it would be helpful to find a representative who can help you prepare
your case. This would usually be a welfare rights worker. Unfortunately it can be
difficult to find this – we offer some suggestions in the ‘Useful contacts’ section.

If you are not able to find a representative, it is still worth appealing, though this
will mean more work for you.

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Going through the paperwork

You will get sent a lot of paperwork about your appeal and will need to go
through this carefully. If you have a representative they will also need to see this
paperwork.

This is where you can really start to see why the decision has been made and if
there are statements that you disagree with contained in the evidence. There
may be factual errors that you need to correct as well as opinions or assumptions
that you wish to challenge.

Gathering medical and other evidence

If you have a representative from an organisation supporting you, they may be

able to request the medical reports you need on your behalf. This obviously takes
the pressure off you.

It is important that you try to obtain supporting evidence yourself. Hopefully your
GP will be prepared to help with this by writing a letter or report. You may also
have a consultant or specialist who can help. If you are seeing anyone else in
connection with your M.E., such as a complementary therapist or physiotherapist
for example, you could see if they would be willing to write a letter of support.

We have produced a factsheet for you to share with your healthcare professional,
to help them understand how important this evidence can be. A copy of it
(Supporting medical evidence for people with M.E./CFS) should be enclosed.

Friends, carers or relatives can also provide written statements that may give
useful information about how you are affected.

The evidence that you get needs to be relevant to your claim so ask people to
specifically refer to information relating to ESA. Ask them to comment on the
activities that you have difficulty managing that are covered by the WCA. You can
either write to or talk to the people that you would like to get evidence from. If you
write, the tribunal may wish to see copies of any letters that you have sent.

You need to try to get your medical evidence sent in before the hearing. If you do
have late evidence it is still worth submitting it or even taking it on the day, but
the tribunal may not accept it.

Medical and supporting evidence needs to be relevant and not too lengthy. You
do not need a lot: one or two pieces of strong evidence should be sufficient.

It is important to note that the tribunal can only take into account how you were at
the time the decision was made, so make sure the evidence reflects this. If you
have deteriorated since the decision was made you may need to consider putting
in a new claim whilst the original appeal continues. This can get complicated so

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we would advise seeking advice if you feel that your condition has got worse
since the date of the decision you are appealing against.

Upper Tribunal and commissioner’s decisions

You do not have to use commissioner’s decisions or upper tribunal decisions as

supporting evidence, but if there is a decision that is relevant to your case you
may wish to do so. Because ESA is still a relatively new benefit there are very
few cases so far. Some Incapacity Benefit decisions may be relevant.

Commissioner’s decisions arise when someone appeals against a First Tier

tribunal decision. A commissioner will either support the tribunal’s decision or
make a new ruling that subsequent tribunals will have to take into account.

Commissioner decisions are not binding on other commissioners so you may find
conflicting decisions exist and the tribunal will have to decide which one to follow.

You can find commissioner’s decisions that may be useful at

www.disabilityrightsuk.org/how-we-can-help/benefits-information/law-pages/case-
law-summaries

Even if you do not actually wish to quote or use case law, you may find it useful
to look at the case law about ESA, for example, the sections on doing an activity
reliably and repeatedly as it will give you an idea of how tribunals may view
things.

There is also quite a lot of case law covering the exceptional circumstances rules
(both under Incapacity benefit law and ESA law) and there are summaries of
cases on the Disability Rights UK website.

If you do decide to use a commissioner’s decision make sure you read it all to
ensure that it is wholly supportive.

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At the hearing

You do have a better chance of success if you attend so we would advise you to
go if you possibly can. If you are not able to go, we would suggest that you write
explaining why and also submit a written submission to support your case.

In some cases tribunals can be held in your home: this is called a domiciliary
hearing. If you request a domiciliary hearing you will usually need to include a
letter from your GP stating that you are unable to travel at all, even by taxi. You
may have to wait longer for a hearing if you ask for a domiciliary hearing.
You can take someone with you, for example a partner, friend or carer. It would
be useful for them to have an overview of your case and the grounds of your
appeal.

They could also take notes for you throughout the hearing and if you have
forgotten to say something they may be able to prompt you by saying something
like: “Do you think the tribunal would find it useful if you told them about what
happened when you...”

The Free Representation Unit (see useful contacts) can help people who have a
hearing in London, the South East and Nottingham, by referral only.

At the hearing you will usually be greeted by the clerk to the tribunal. The clerk
may be in the room whilst your appeal is being heard but they are there in an
administrative capacity and are not a part of the decision-making process.

The actual panel is composed of the Judge, who is legally qualified and a doctor.
Sometimes a presenting officer will also be there; they are from the DWP and are
there to explain why the original decision was made.

The Judge will welcome you and introduce everyone present and explain why
they are there. Tribunals vary in the way that they are conducted but generally
even if you have a representative it will be you that the tribunal will want to
question.

Your representative will sometimes be able to put your case forward at the
beginning of the hearing or may do so at the end. They will also be able to
prompt you and ask you questions if they feel that you have omitted information
that is important. It is worth talking to your representative about how they usually
work at the hearing and what to expect as there are variations in the way
representatives work and Judges conduct hearings.

In addition to questioning you, the tribunal will also observe you and are likely to
ask you questions about how you got to the hearing

18
It would also be a good idea to tell the tribunal panel what kind of a day you are
having. In order to be able to attend you may have rested for several days before
the hearing. You may wish to tell the panel about how you will be affected after
the hearing.

If you are feeling very unwell on the day you may not be able to express yourself
as well as you would like to. In this case you may wish to explain that you may
have problems with concentration and may be too exhausted and unwell to
answer fully. If you feel like this, having a representative or someone else with
you can be a big help as they will hopefully be able to fill in the gaps.

It is a good idea to take a list of all the points you wish to raise so you can make
sure you have covered everything.

Once the panel has collected all the information that they need you will be asked
to leave the room whilst they make their decision. Usually you will be called back
in and given the decision on the day; sometimes the tribunal will not be able to
reach a decision on the day and will write to you informing you of the decision a
few days later.

19
What to do if your appeal is not successful

If you are not happy with the outcome of the hearing you have two choices:

1. You can ask for a set aside. The First Tier tribunal can set aside a
decision when there has been a procedural irregularity. For example if
someone wasn’t present at the hearing or a relevant document was not
available at the hearing. The tribunal judge can in cases such as these set
aside the decision if it they believe that it is just to do so.

2. You can appeal to the Upper tribunal. This must be on the grounds that
the first tier tribunal made an error of law. The first thing that you need to
do is to ask for the statement of reasons from the tribunal. The statement
of reasons is their reasons for why they have made the decision that they
have.

If you are given a negative decision on the day of your hearing you can
request the statement of reasons from the Judge straight away. If you do
not ask for this on the day you have a month within which to request this
and we would suggest even if you do ask the Judge on the day following
this up with a written request.

You may be eligible for free legal advice if you do appeal to the Upper
tribunal. You can check your eligibility at www.gov.uk/check-legal-aid

We would advise you to seek further advice if your appeal is not successful and
you wish to consider either of the above options. Make sure that you stick to the
strict time limits for asking for a set aside or appealing to the Upper tribunal.

Disability Rights U.K publish a very useful guide to appealing to the upper
tribunal which is available at www.disabilityrightsuk.org/appealing-upper-tribunal-
against-first-tier-tribunal-decision

20
Useful contacts

Action for M.E.

Information and support for people with M.E. and their carers
General enquiries: 0845 123 2380 or 0117 927 9551 (Mon-Fri 9am-5pm)
Enquiries email: admin@actionforme.org.uk
Welfare Rights Line: 0800 138 6544 (times vary)
Online M.E. Centre: www.actionforme.org.uk

Citizens Advice Bureau

Offers advice on a range of issues and may complete a benefits check for you
www.citizensadvice.org.uk

Civil Legal Advice

Help with some benefit appeals for eligible people.
www.gov.uk/civil-legal-advice

Disability Information and Advice Line (DIAL)

To find your local DIAL office, contact Scope, 6 Market Road, London N7 9PW
Tel: 0808 800 3333
www.scope.org.uk/help-and-information/dial-groups

Disability Rights UK
Factsheets on benefits, tax credits and independent living. They produce a very
useful guide to appealing to the Upper tribunal and they also have a case law
section on their website.
www.disabilityrightsuk.org

Local councils
Some local councils employ welfare rights workers and/or may also have
information about other services in your area.
www.gov.uk/find-your-local-council

The Free Representation Unit (FRU)

You will need to be referred to the FRU by a referral agency and they can only
help people who have a hearing in London, the South East and Nottingham.
www.thefru.org.uk

If you have found this factsheet helpful, please consider making a donation
and help us help more people like you. Go to www.actionforme.org.uk or
call us now on 0845 123 2380 or 0117 927 9551. Thank you.

21
Appendix I: example of an appeal letter for those aiming to get into the
Work-Related Activity Group

You will need to look at all the descriptors in Appendix III to ensure that you meet
the 15 point threshold. We have picked out activities that may be relevant to your
situation to give an idea of the type of examples you could include.

I am appealing against the decision that I do not have limited capability for work. I
feel that the full impact of my condition has not been taken into account and I
believe that I score 15 (or more) points in the Work Capability Assessment.

For example, the symptoms of my M.E. mean that most of the time I am not able
to walk more than 75 metres without experiencing severe and debilitating fatigue,
muscle and joint pain and dizziness. After walking 75 metres I need to rest and
could not repeat this activity again that day. I do not have the energy or sufficient
upper body strength to self propel myself in a manual wheelchair so cannot
mobilise 75 metres in this way either.

I also experience post-exertional fatigue which I do not think has been taken into
account when making this decision. Occasionally I can walk a little further but
could not do so repeatedly or regularly and I often experience a worsening of my
symptoms after walking slightly longer distances. Often I am not able to leave the
house due to the effects of my M.E.

I also have problems with the activities of sitting and standing and am not able to
stand or sit for 30 minutes. I would need to lie down after short periods of sitting
or standing.

I have many cognitive difficulties and this means that that I often start an activity
but am not able to complete it due to mental fatigue and concentration problems.
Mental fatigue can be overwhelming and I am often forgetful as a result and this
leads to problems with planning and prioritising activities as well as seeing them
through to completion.

It is very important that I pace my activities and if I push myself this has serious
consequences for my health. I use my very limited energy just doing the basics
and many days I am not well enough to even carry out basic activities like
washing and food preparation. If I have to do something that is over my base line
activity I experience severe and debilitating exhaustion and a worsening of my
symptoms.

Please send me all the medical reports that have been used in making this
decision. I will send in further information once I have had the chance to examine
these documents.

22
Appendix II: example of an appeal letter for those aiming to get into the
Support Group

You will need to look at the descriptors in section Appendix IV to ensure that you
meet at least one and/or that the Exceptional Circumstance rule (see p 9)
applies. We have picked out activities that may be relevant to your situation to
give an idea of the type of examples you could include.

I am appealing against the decision that I do not have limited capability for work
related activity. I do not feel that the full impact of my condition has been taken
into account and I believe that I meet the criteria for entry to the Support Group.

For example, my M.E. means that most of the time I am not able to walk more
than 50 metres without experiencing severe and debilitating fatigue, muscle and
joint pains and dizziness. Once I have walked 50 metres I need to rest and could
not repeat this activity again that day. I do not have the energy or sufficient upper
body strength to self-propel myself in a manual wheelchair so cannot mobilize 50
metres in this way either.

I experience post-exertional fatigue which I do not think has been taken into
account when making this decision. My M.E means that I am often confined to
the house and rarely go out. All aspects of daily living are very difficult and I have
to conserve all my energy to carry out basic tasks which cannot be done as often
as I would like.

I also think that the exceptional circumstance rule (Reg 35)(2)(b) applies to me
because if I try to carry out any extra activities above my base line this poses a
serious risk to my health.

It is very important that I pace my activities and if I push myself this has serious
consequences for my health. I use my very limited energy just doing the basics
and many days I am not well enough to even carry out basic activities like
washing and food preparation.

If I have to do something that is over my base line activity, for example if I need
to attend a medical appointment this has a serious impact on my heath. I suffer
debilitating exhaustion afterwards and experience a worsening of my symptoms.
If I had to keep doing things like this my health would deteriorate substantially
leading to a complete relapse.

Please send me all the medical reports that have been used in making this
decision. I will send in further information once I have had the chance to examine
these documents.

23
Appendix III: Limited Capability for Work assessment

These descriptors are used to assess whether a claimant has limited capability
for work, covering physical disabilities (part one) and mental, cognitive and
intellectual function (part two).

If you score 15 points or more you will be placed in the Work Related Activity
Group.

Please also consider the exceptional circumstance rule (p 9). You may think you
would score enough points and meet the exceptional circumstance rule or you
may think that you would only qualify via one route. You need to try and give
enough information to show how you meet this rule and/or information to
demonstrate how you would score enough points or which of the Support Group
criteria apply.

Activity Descriptors Points

Part one: physical disabilities

1. Mobilising unaided by 1(a) Cannot either: 15

another person with or
without a walking stick,
manual wheelchair or
other aid if such aid can
reasonably be used.
(28 January 2013
amendments state that
aids that could
reasonably or are
normally used will be 1(b)
taken into account)
(i) mobilise more than 50 metres on
level ground without stopping in
order to avoid significant discomfort
or exhaustion;
or
(ii) repeatedly mobilise 50 metres
within a reasonable timescale
because of significant discomfort or
exhaustion.
Cannot mount or descend two steps 9
unaided by another person even
with the support of a handrail.

1(c) Cannot either: 9

(i) mobilise more than 100 metres
on level ground without stopping in
order to avoid significant discomfort
or exhaustion;
or
(ii) repeatedly mobilise 100 metres
within a reasonable timescale
because of significant discomfort or
exhaustion.

24
Activity Descriptors Points

Part one: physical disabilities

1(d) Cannot either: 6

(i) mobilise more than 200 metres
on level ground without stopping in
order to avoid significant discomfort
or exhaustion;
or
(ii) repeatedly mobilise 200 metres
within a reasonable timescale
because of significant discomfort or
exhaustion.

1(e) None of the above apply. 0

2. Standing and sitting 2(a) Cannot move between one seated 15

position and another seated position
(28 January 2013 located next to one another without
amendments make it receiving physical assistance from
clear that either another person.
standing or sitting or a
combination of the two 2(b) Cannot, for the majority of the time, 9
will be taken into remain at a work station, either:
account when deciding (i) standing unassisted by another
how long you can person (even if free to move
remain at a work- around); or
station) (ii) sitting (even in an adjustable
chair) for more than 30 minutes,
before needing to move away in
order to avoid significant discomfort
or exhaustion.

2(c) Cannot, for the majority of the time, 6

remain at a work station, either:
(i) standing unassisted by another
person (even if free to move
around); or
(ii) sitting (even in an adjustable
chair) for more than an hour before
needing to move away in order to
avoid significant discomfort or
exhaustion.

2(d) None of the above apply 0

25
Activity Descriptors Points

Part one: physical disabilities

3. Reaching 3(a) Cannot raise either arm as if to put 15

something in the top pocket of a
coat or jacket.

3(b) Cannot raise either arm to top of 9

head as if to put on a hat.

3(c) Cannot raise either arm above head 6

height as if to reach for something.

3(d) None of the above apply. 0

4. Picking up and 4(a) Cannot pick up and move a 0.5 litre 15

moving or transferring carton full of liquid.
by the use of the upper
body and arms 4(b) Cannot pick up and move a one litre 9
carton full of liquid.

4(c) Cannot transfer a light but bulky 6

object such as an empty cardboard
box.

4(d) None of the above apply. 0

5. Manual dexterity 5(a) Cannot either: 15

(i) press a button, such as a
(28 January 2013 telephone keypad; or
amendments state that (ii) turn the pages of a book
the ability to use a with either hand.
mouse or keyboard
single-handedly is what 5(b) Cannot pick up a £1 coin or 15
is being considered in equivalent with either hand.
5(d)
5(c) Cannot use a pen or pencil to make 9
a meaningful mark.

5(d) Cannot use a suitable keyboard or 9

mouse.

5(e) None of the above apply. 0

26
Activity Descriptors Points

Part one: physical disabilities

6. Making self 6(a) Cannot convey a simple message, 15

understood through such as the presence of a hazard.
speaking, writing,
typing, or other means 6(b) Has significant difficulty conveying a 15
normally used, unaided simple message to strangers.
by another person.
6(c) Has some difficulty conveying a 6
(28 January 2013 simple message to strangers.
amendments state that
means of 6(d) None of the above apply. 0
communication includes
those that are normally
used and those that
could reasonably be
used)

7. Understanding 7(a) Cannot understand a simple

communication by both message due to sensory
verbal means (such as impairment, such as the location of 15
hearing or lip reading) a fire escape.
and non-verbal means
(such as reading 16 7(b) Has significant difficulty 15
point print) using any understanding a simple message
aid it is reasonable to from a stranger due to sensory
expect them to use, impairment.
unaided by another
person. 7(c) Has some difficulty understanding a 6
simple message from a stranger due
(28 January 2013 to sensory impairment.
amendments state that
understanding 7(d) None of the above apply. 0
communication includes
being able to
understand both verbal
and non-verbal
communication or a
combination of the two
and includes any aids
which are normally or
could reasonably be
used).

27
Activity Descriptors
Part one: physical disabilities
8. Navigation and 8(a)
maintaining safety,
using a guide dog or
other aid if normally.
(28 January 2013 8(b)
amendments state that
using a guide dog or
other aid if either or
both are normally, or
could reasonably, be
used is what is being 8(c)
taken into account)
8(d)
9. Absence or loss of 9(a)
control leading to
extensive evacuation of
the bowel and/or
bladder, other than
enuresis (bed-wetting)
despite the presence of
any aids or adaptations
normally used.
9(b)
(28 January 2013
amendments state that
it is any aids that are
normally or could
reasonably be used will
now be taken into
account. states that it is 9(c)
any aids that are
normally or could
reasonably be used will
now be taken into
account)
Points
Unable to navigate around familiar 15
surroundings, without being
accompanied by another person,
due to sensory impairment.
Cannot safely complete a potentially 15
hazardous task such as crossing the
road, without being accompanied by
another person, due to sensory
impairment.
Unable to navigate around 9
unfamiliar surroundings, without
being accompanied by another
person, due to sensory impairment.
None of the above apply. 0
At least once a month experiences: 15
(i) loss of control leading to
extensive evacuation of the bowel
and/or voiding of the bladder;
Or (ii) substantial leakage of the
contents of a collecting device
sufficient to require cleaning and a
change in clothing.
At risk of loss of control leading to 6
extensive evacuation of the bowel
and/or voiding of the bladder,
sufficient to require cleaning and a
change in clothing, if not able to
reach a toilet quickly.
None of the above apply. 0
28
Activity Descriptors Points

Part one: physical disabilities

10. Consciousness 10(a) At least once a week, has an 15

during waking moments involuntary episode of lost or altered
consciousness resulting in
significantly disrupted awareness or
concentration.

10(b) At least once a month, has an 6

involuntary episode of lost or altered
consciousness resulting in
significantly disrupted awareness or
concentration.

10(c) None of the above apply. 0.

Activity Descriptors Points

Part two: mental, cognitive and intellectual function assessment

11. Learning tasks 11(a) Cannot learn how to complete a 15

simple task, such as setting an
alarm clock.

11(b) Cannot learn anything beyond a 9

simple task, such as setting an
alarm clock.

11(c) Cannot learn anything beyond a 6

moderately complex task, such as
the steps involved in operating a
washing machine to clean clothes.

11(d) None of the above apply. 0

12. Awareness of 12(a) Reduced awareness of everyday 15

everyday hazards (such
as boiling water or
sharp objects)
hazards leads to a significant risk of:
(i) injury to self or others; or
(ii) damage to property or
possessions
such that they require supervision
for the majority of the time to
maintain safety.

29
Activity Descriptors Points

Part two: mental, cognitive and intellectual function assessment

12(b) Reduced awareness of everyday 9

hazards leads to a significant risk of
(i) injury to self or others; or
(ii) damage to property or
possessions such that they
frequently require supervision to
maintain safety.

12(c) Reduced awareness of everyday 6

hazards leads to a significant risk of:
(i) injury to self or others; or
(ii) damage to property or
possessions such that they
occasionally require supervision to
maintain safety.

12(d) None of the above apply. 0

13. Initiating and 13(a) Cannot, due to impaired mental 15

completing personal
action (which means
planning, organisation,
problem solving,
prioritising or switching 13(b)
tasks)
function, reliably initiate or complete
at least 2 sequential personal
actions.
Cannot, due to impaired mental 9
function, reliably initiate or complete
at least 2 personal actions for the
majority of the time.

13(c) Frequently cannot, due to impaired 6

mental function, reliably initiate or
complete at least 2 personal actions.

13(d) None of the above apply. 0

14. Coping with change 14(a) Cannot cope with any change to the 15
extent that day to day life cannot be
managed.

30
Activity Descriptors Points

Part two: mental, cognitive and intellectual function assessment

14(b) Cannot cope with minor planned 9

change (such as a pre-arranged
change to the routine time
scheduled for a lunch break), to the
extent that overall day to day life is
made significantly more difficult.

14(c) Cannot cope with minor unplanned 6

change (such as the timing of an
appointment on the day it is due to
occur), to the extent that overall, day
to day life is made significantly more
difficult.

14(d) None of the above apply. 0

15. Getting about 15(a) Cannot get to any specified place 15

(J28 January 2013
amendments mean that 15(b)
there is also a change
to the wording of the
‘Getting about’ activity
for mental health,
making it clear that for 15(c)
15(a) the specified
place must be outside
the claimant’s home).
with which the claimant is familiar.
Is unable to get to a specified place 9
with which the claimant is familiar,
without being accompanied by
another person.
Is unable to get to a specified place 6
with which the claimant is unfamiliar
without being accompanied by
another person.

15(d) None of the above apply. 0

16. Coping with social 16(a) Engagement in social contact is 15

engagement due to always precluded due to difficulty
cognitive impairment or relating to others or significant
mental disorder distress experienced by the
individual.

31
Activity Descriptors Points

Part two: mental, cognitive and intellectual function assessment

16(b) Engagement in social contact with 9

someone unfamiliar to the claimant
is always precluded due to difficulty
relating to others or significant
distress experienced by the
individual.

16(c) Engagement in social contact with 6

someone unfamiliar to the claimant
is not possible for the majority of the
time due to difficulty relating to
others or significant distress
experienced by the individual.

16(d) None of the above apply. 0

17. Appropriateness of 17(a) Has, on a daily basis, uncontrollable 15

behaviour with other
people, due to cognitive
impairment or mental
disorder
17(b)
episodes of aggressive or
disinhibited behaviour that would be
unreasonable in any workplace.
Frequently has uncontrollable 15
episodes of aggressive or
disinhibited behaviour that would be
unreasonable in any workplace.

17(c) Occasionally has uncontrollable 9

episodes of aggressive or
disinhibited behaviour that would be
unreasonable in any workplace.

17(d) None of the above apply. 0.

32
Appendix IV: Limited Capability for Work Related-Activity assessment

If one or more of the following descriptors apply to you and this is accepted, you
may qualify for entry into the Support Group.

Please also consider the exceptional circumstance rule (p 9). You may think you
would score enough points and meet the exceptional circumstance rule or you
may think that you would only qualify via one route. You need to try and give
enough information to show how you meet this rule and/or information to
demonstrate how you would score enough points or which of the Support Group
criteria apply.

Activity Descriptors

1.Mobilising unaided by another Cannot either:

person with or without a walking
stick, manual wheelchair or other
aid if such aid can reasonably be
used.
( Jan 28 amendments states that
aids that could reasonably or are
normally used will be taken into
account)
(a) mobilise more than 50 metres on level
ground without stopping in order to avoid
significant discomfort or exhaustion; or
(b) repeatedly mobilise 50 metres within a
reasonable timescale because of significant
discomfort or exhaustion.

2. Transferring from one seated Cannot move between one seated position
position to another. and another seated position located next to
one another without receiving physical
assistance from another person.

3. Reaching. Cannot raise either arm as if to put something

in the top pocket of a coat or jacket.

4. Picking up and moving or Cannot pick up and move a 0.5 litre carton full
transferring by the use of the of liquid.
upper body and arms (excluding
standing, sitting, bending or
kneeling and all other activities
specified in this Schedule).

5. Manual dexterity. Cannot either:

(a) press a button, such as a telephone
keypad; or
(b) turn the pages of a book with either hand.

33
Activity Descriptors

6. Making self understood Cannot convey a simple message, such as

through speaking, writing, typing, the presence of a hazard.
or other means normally used.

(Jan 28 amendment states that

means of communication
includes those that are normally
used and those that could
reasonably be used

7. Understanding communication Cannot understand a simple message due to

by hearing, lip reading, reading sensory impairment, such as the location of a
16 point print or using any aid if fire escape.
reasonably used.

(Jan 28 amendment states that

understanding communication
includes being able to
understand both verbal and non-
verbal communication or a
combination of the two and
includes any aids which are
normally or could reasonably be
used)

8. Absence or loss of control over At least once a week experiences:

extensive evacuation of the (a)
bowel and/or voiding of the loss of control leading to extensive evacuation
bladder, other than enuresis of the bowel and/or voiding of the bladder; or
(bed-wetting), despite the (b)
presence of any aids or substantial leakage of the contents of a
adaptations normally used. collecting device
sufficient to require the individual to clean
themselves and change clothing.
(January 28 amendment states
that it is any aids that are
normally or could reasonably be
used that will now be taken into
account and for 9(b) stating that
the risk of loss of control must be
for the majority of the time)

34
Activity Descriptors

9. Learning tasks. Cannot learn how to complete a simple task,

such as setting an alarm clock, due to
cognitive impairment or mental disorder.

10. Awareness of hazard. Reduced awareness of everyday hazards,

due to cognitive impairment or mental
disorder, leads to a significant risk of:
(a)
injury to self or others; or
(b)
damage to property or possessions
such that they require supervision for the
majority of the time to maintain safety.

11. Initiating and completing Cannot, due to impaired mental function,

personal action (which means reliably initiate or complete at least 2
planning, organisation, problem sequential personal actions.
solving, prioritising or switching
tasks).

12. Coping with change. Cannot cope with any change, due to
cognitive impairment or mental disorder, to
the extent that day to day life cannot be
managed.

13. Coping with social Engagement in social contact is always

engagement, due to cognitive precluded due to difficulty relating to others or
impairment or mental disorder. significant distress experienced by the
individual.

14. Appropriateness of behaviour Has, on a daily basis, uncontrollable episodes

with other people, due to of aggressive or disinhibited behaviour that
cognitive impairment or mental would be unreasonable in any workplace.
disorder.

15. Conveying food or drink to (a) Cannot convey food or drink to the
the mouth. claimant’s own mouth without receiving
physical assistance from someone else;
or

35
Activity Descriptors

(b) Cannot convey food or drink to the

claimant’s own mouth without repeatedly
stopping, experiencing breathlessness or
severe discomfort;
or
(c) Cannot convey food or drink to the
claimant’s own mouth without receiving
regular prompting given by someone else in
the claimant’s physical presence;
or
(d) Owing to a severe disorder of mood or
behaviour, fails to convey food or drink to the
claimant’s own mouth without receiving:
(i) physical assistance from someone else; or
(ii) regular prompting given by someone else
in the claimant’s presence.

16. Chewing or swallowing food (a) Cannot chew or swallow food or drink;
or drink. or
(b) Cannot chew or swallow food or drink
without repeatedly stopping, experiencing
breathlessness or severe discomfort;
or
(c) Cannot chew or swallow food or drink
without repeatedly receiving regular
prompting given by someone else in the
claimant’s presence;
or
(d) Owing to a severe disorder of mood or
behaviour, fails to:
(i) chew or swallow food or drink; or
(ii) chew or swallow food or drink without
regular prompting given by someone else in
the claimant’s presence.”

Copyright Action for M.E. August 2015. Registered charity in England and Wales no. 1036419.
Registered in Scotland no. SC040452. Company limited by guarantee, registered in England no.
2906840. Disclaimer Welfare benefits law is complex and subject to change and the information
is correct at the time of writing. We are updating this factsheet as changes occur. While every
care has been taken to ensure accuracy at the time of writing, this fact sheet can only be a
general guide as the process will vary depending on the severity of the claimant’s condition.
Action for M.E. cannot accept responsibility for any loss experienced as a result of this document.

36