Confused with ESA claim

Gemstar30

Hello,
I have tried to get an answer from the DWP but they keep saying the same old same old.

My problem is that whilst I am happy with waiting for my turn at the Tribunal Court (had my medical in December 2009 and appealed against the decision in Januray 2010), my health has since taken a nose dive.
Not only have my previous conditions deteriorated but I have now been diagnosed as having something else wrong with me.
I have a progressive disease which will, if I look at the statistics, result in my early death (anytime after 2011). In addition I have a worsening of a previous problem which is my mental health.

Having said that, what I cannot get an answer to is do I notify the DWP of my current condition which as I mentioned earlier, is now a lot worse than at the time of the medical and how do I go about doing it?

The DWP say that I must wait until my Tribunal has been heard, and if I fail, I should then make a new claim. They say I can't make a new claim based on what my problems are now as I already have a claim ongoing through the appeal system. They did however give me some hope in that I can ask the Court to consider my current health condition and give a ruling on that as well.

At the moment they say I am fit for work, which I am not.

I know I am looking at the worse case scenario, but what would happen if something happened to me before the hearing and I die? (high risk category of developing terminal cancer with a 5% chance of survival)

I can understand a constant illness but there does not seem to be a way of them keep reviewing my ESA claim as I get progressively worse.

Thank you

[Deleted User]

you can as they say only appeal the decision based on the original claim,if the appeal fails then submit a new claim for esa based on the facts at that point.
have you approached anyone for help with the appeal process?

NASA_2

My understanding is that you can report the deterioration and that they should restart the WCA process again while the appeal is ongoing.

Gemstar30

woodbine wrote: »

you can as they say only appeal the decision based on the original claim,if the appeal fails then submit a new claim for esa based on the facts at that point.
have you approached anyone for help with the appeal process?

Hello,

Thanks.

So I have to wait for a decision on my claim before I can tell them that I am worse. I just hope that I am around to make that claim!

No, I don't have anybody helping me, CAB helped with the appeal form, but they won't do anything else. There are no Welfare Rights people at the council anymore. I have a DIAL but that is over 60 miles away.
I'm just waiting to go to court to tell them as it is.

Gemstar30

NASA wrote: »

My understanding is that you can report the deterioration and that they should restart the WCA process again while the appeal is ongoing.

Thanks for that, that is different to what the other person said.

Can I? I had the news from the consultant in April.

But the DWP clearly said that I can't have two claims going at the same time.
How do I report it? I tried using the telephone claims service but they wouldn't carry on with the new claim.
I rang the DWP direct and they said that I must wait to see if I win at the Court first. If I do, then it doesn't matter how ill I become. Something about them wanting to review me after a period of time to see how I am anyhow.

It is only if I fail that I could put in a new claim and explain my new circumstances at that time.

This whole thing is driving me mad.

stazi

If you are being paid ESA at the appeal rate now, then I think that you will have to wait until your appeal hearing.
If you are not being paid ESA, then just make a new claim.

Gemstar30

stazi wrote: »

If you are being paid ESA at the appeal rate now, then I think that you will have to wait until your appeal hearing.
If you are not being paid ESA, then just make a new claim.

Hello, yes I am being paid at the basic rate.

Right I understand what you are saying which is what the DWP have said.

What I am trying to understand is that the Court is there to see if the right decision was made in December 09. And that no matter how bad my health gets in the meantime, no one is there to review it.

I know I shouldn't say this, and it might be tempting fate but, if between now and the Court date I am diagnosed with terminal cancer, have I just got to wait to see if I win or lose?

Even if I win, that decision will have been made on the facts as at December 09, what happens then? My health has deteriorated since that date, am I to wait for a review that the DWP said they would do some time later? I might be dead by then!

I am still no nearer trying to understand when and how do the DWP get to know how ill I have become since the last medical.

Why is this so complicated?

NASA_2

I disagree with woodbine and stazi.

Deterioration of a condition is a relevant change of circs. At the minute you are only 'treated' as having limited capability for work. If you now 'have' limited capability for work then that needs to be assessed again.

speedfreek1000

I agree with NASA.

You have a new/deteriorated condition therefore should be assessed again

see here in the section "ESA awarded following appeal" http://www.dwp.gov.uk/docs/m-33-10.pdf

Example 2
Denise’s award of ESA is terminated after 20 weeks following application of the WCA,
and she makes an appeal. She is awarded ESA from the date her previous
entitlement ended. Several weeks later Denise produces evidence that her condition
has deteriorated, and she is referred for the WCA. The DM determines that she has
LCW, and is placed in the WRAG. The WRAC is paid from the first day of the award
made after the appeal was lodged, even though her appeal has yet to be heard.

Gemstar30

Thank you, Nasa & Speedfreek. Both of your opinions are to me, the most logical ones, especially with the link and the example.

I have been having this argument since April with the DWP, and I resigned myself to accepting that nothing could be done until after the appeal.

However, it does now seem possible that I can get them to re-look at my health condition.

Am I right in downloading a new claim form, sending it to the DWP and enclosing the evidence?

Many thanks once again for your help.

PS. Thanks Speedfreek for the same answer on the other website.

Gemma

NASA_2

Gemma, my opinion is you don't need a new claim, just need to get past telephony and speak to the decision makers. Speedfreaks link is excellent.