ESA and PIP advice

FlyingDutchman · 8 January 2018 at 10:59AM

Hopefully this is the right place to raise this. If not, I apologise.

A long term friend of mine has a few issues with regard to ESA and possibly, PIP.

A bit of background first. My friend is in her mid-forties and lives in a flat in Sutton, whom she used to share with her sister. Due to ill health she had to give up her position in the Civil Service and has been unemployed now for 10+ years. Therefore she's had no regular income n this time, outside of the benefits that she received. She applied for, and received, after some time, ESA and PIP, which included a Freedom Pass.

Last year she was reassessed, as is custom every year, and was told that she no longer qualified. She disputes this but then is in no position, financially, to take it any further.

Her medical history reads like an A-Z, with many problems acquired, or inherited, the main one being her chronic asthma. When walking with her, she can managed about 200 yards before needing to stop and use her inhaler. On top of this is IBD (Irritable Bowel Disease) and water retention in her legs.

She has had many different treatments prescribed to her over the years, some of which have nasty side effects. She has diligently taken all of these. Some helped. Some didn't.

So, to her current problem. She is worried that without ESA she will become effectively, homeless. She still receives PIP payments but she fears that too will stop.

She has been to her local jobcentre who have advised applying for Universal Credit (the new JSA). When they saw her they, rather ironically, agreed that she wasn't fit for work! Maybe they should tell the ESA assessors that! Another issue with applying for Universal Credit, apparently, is that you cannot then reapply for ESA. Also, as you are probably aware, there's a six week waiting period, by which time she may have been evicted for non-payment of rent.

She has made an appointment to see Citizens Advice Bureau on Thursday, who will hopefully be able to point her in the right direction.

My question is: is there any else she can do in the interim? Are you aware of anyone else is a similar predicament? If so, what did they do?

I'm really worried that my friend will end up on the streets, begging for change and sleeping in shop doorways. Let's hope that this doesn't happen.

Thanks in advance for you help.

FlyingDutchman · 8 January 2018 at 11:57AM

Thanks. I've spoken to my friend and she agrees with this. My mistake.

FlyingDutchman · 8 January 2018 at 2:09PM

It's within the month's deadline. I've told her to appea?l but she will see what CAB advise.

Alice_Holt · 8 January 2018 at 8:26PM

FlyingDutchman wrote: »

It's within the month's deadline. I've told her to appea?l but she will see what CAB advise.

In which case she should write and ring through her Mandatory Reconsideration request NOW.
Here is a proforma template:
https://www.leicester.gov.uk/media/178163/mandatory-reconsideration-request.pdf

This is the first stage of an appeal.

The DWP are very unlikely to change the decision, so she will then need to appeal to the Tribunal Service (TS). Once the TS appeal is lodged your friend can ask for her ESA payments to be resumed.

Her HB can continue if she completes a NIL income form at her housing benefit dept. She need to do this NOW

This course of action may be preferable to claiming UC.
(For instance - ESA has disability premiums which are not available in UC).

When she has her CAB appointment, she may want to discuss the advantages / disadvantages of claiming UC vs reclaiming ESA whilst her ESA tribunal is pending.

Bit of info here:
http://www.cpag.org.uk/content/benefit-during-employment-and-support-allowance-dispute

"Where an ESA disallowance is confirmed following an MR, ESA is payable pending an appeal against a decision that a claimant does not have limited capability for work, unless this was due to the claimant's failing to return the ESA50 questionnaire or attend a medical assessment.

It is important to submit an appeal following an unsuccessful MR as soon as possible. The appeal should be submitted directly to HM Courts and Tribunals Service (HMCTS) on form SSCS1 accompanied by the MR notice (although an appeal can be accepted without a notice, this will delay matters).....the DWP is unlikely to restore ESA until it is notified by HMCTS that an appeal has been lodged. It may be worth claimants sending a copy of their appeal to the DWP, requesting restoration of ESA including arrears."

She should chase up the Mandatory Reconsideration Notice from the DWP, so she can get her TS ESA appeal in asap, and payments resumed asap.

FlyingDutchman · 9 January 2018 at 10:08AM

Thanks Alice and to all those that have commented so far.

I will keep you up to date on what's happening.

scarlett216 · 14 January 2018 at 10:35AM

Hello.

I found this post and have been going through a similar situation very recently and asking for a mandatory reconsideration. it's very stressful.

I was claiming ESA and PIP at the enhanced rate for several mental health conditions.

I have recently attended both assessments and both deemed me fit to work so my benefits all gone now. i did ask for a mind advocate to come with me but I only had one weeks notice for the appointment. both assessments were rushed and i did not have any moral support. I have a little boy so already changed the time of appointment to fit around him. I could not make two changes to appointment.

things went against me such as turning up on time, getting to the assessment without company, apparently being overweight, (i was pregnant at assessment) and answering questions without prompting.

I am in process of appealing the PIP, after noting various inaccuracies on their medical report and waiting for reply. I am about to start the appeal for ESA with the same evidence (note from G.P and recent referral letter) but I have heard from various forums that the mandatory reconsideration is not usually upheld in our favour. I intend to take this to tribunal but I will be putting in a claim for income support while this is being considered and incase my claim is rejected.

In your friends case, I do recommend a mandatory reconsideration ASAP. You cant take them to tribunal without this first.

Ask the DWP for a copy of the medical report and go through the points you disagree with and why- even better, to provide a new GP letter or report.

Take them to tribunal- this costs the DWP money not us!

I am waiting to hear my outcome- i will be calling them again on Monday morning.
Keep us updated with any news and
Good Luck

epitome · 14 January 2018 at 12:40PM

FlyingDutchman wrote: »

Last year she was reassessed, as is custom every year, and was told that she no longer qualified. She disputes this but then is in no position, financially, to take it any further.

The DWP Mandatory Recon is free of charge and the subsequent appeal to Tribunal is also free of charge.

Her medical history reads like an A-Z, with many problems acquired, or inherited, the main one being her chronic asthma. When walking with her, she can managed about 200 yards before needing to stop and use her inhaler.

Look at leaflet ESA214, word your appeal and evidence according to the descriptors, the only thing you might not see in that document (but they are mentioned in it) is qualifying for WRAG on Risk or qualifying for Support Group on Risk, WRAG on risk is regulation 29 and SG on risk is Regulation 35. If you want these to be considered you would need some evidence pertaining to risk from a health care professional.

So, to her current problem. She is worried that without ESA she will become effectively, homeless. She still receives PIP payments but she fears that too will stop.

You should phone Shelter for advice on the Housing Benefit. It may or may not stop in the coming weeks, but once she has started to appeal ESA, the HB will be reinstated and backdated. Nothing to worry about really. She could not be evicted in such a short time.

She has been to her local jobcentre who have advised applying for Universal Credit (the new JSA). When they saw her they, rather ironically, agreed that she wasn't fit for work! Maybe they should tell the ESA assessors that!

They are not ESA Decision Makers, their opinion is irrelevant.

Another issue with applying for Universal Credit, apparently, is that you cannot then reapply for ESA. Also, as you are probably aware, there's a six week waiting period, by which time she may have been evicted for non-payment of rent.

She will not go back to ESA if she claims UC, hence she should look at how much she would be eligible for on UC if she was to win her ESA appeal and decide which is better UC or ESA (it is usually ESA that is better so I would say don't bother to claim UC)

My question is: is there any else she can do in the interim? Are you aware of anyone else is a similar predicament? If so, what did they do?

There is a deadline of one month to start a Mandatory Reconsideration, but it is not really a deadline, late applications more than 1 month are readily accepted, it is the DWP policy to accept them late as the preferred option.
However since she wants this sorted as soon as possible it is in her interest to get the MR started as soon as possible. To start an MR all she needs to do is phone ESA, ask for an MR request to be sent in a handover. She does not have to say anything as to why she thinks the decision is wrong. She does not need to put anything in writing, just a request by phone that a handover is sent to start an MR. (what I would then do is then phone back after 10 mins and ask the next person to search the handover application (HOTT) to confirm a handover has been sent by the previous person.)

Once that handover has been done, she can then move on to preparing a letter and any doctors evidence to explain in detail why she thinks she fits the descriptors or risk category. She does not have to do this. But if she does, then... when it is ready, have it scanned to ESA by appointment at the jobcentre.

I'm really worried that my friend will end up on the streets, begging for change and sleeping in shop doorways. Let's hope that this doesn't happen.

If she phones to start an MR now I don't see how it is possible that she could be on the streets.

If she loses her tribunal, then she will need to claim UC straight away from the day after the tribunal hearing...I assume the jobcentre has told her she is in a UC Full Service Area.

ESA and PIP advice

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