1st Time claiming ESA for Husband

nad1611

Considering your husband's disabilities, I believe he should qualify for the Support Group. If he doesn't you'd have a strong case for appeal as this would affect both his sitting and standing abilities, I would presume.
Fortunately if he's put in the Support Group then his benefit would be paid and wouldn't be income related. He also wouldn't be expected to do any work related activities, but could if he chose which might be good later and after his surgeries.

As has been said, the work related activities group is just that, he would be expected to attended work based interviews, he would be assessed on income after receiving it for 12 months, (if the plans go ahead) and it would be likely he wouldn't qualify after that,given your income.

Anyway,it doesn't sound like that will be an issue for you, but if the decision is the WRAG and you feel it's wrong come back again as there's lots of advice on here for Appeals. It's a worrying time at the beginning of an illness and your world is turned upside down for a while, but you adapt. It sounds like he'd definitley qualify for DLA too. We only bring in about 18000 and we don't qalify for free prescriptions, so I think it's unlikely, unless he comes into a particular group outside of the Income ones.Good Luck

CouponWoman

Cookiee wrote: »

Hello fellow MSE forum

This is my very first post. I need some advice. (sorry if it is long)

My husband has worked since he was 15. He only has ever had 2 weeks sick in that time for a car accident and up till recently worked for his previous employer for 8 years.

Unfortunately, whilst at work my husbands back went into spasm and he has to go sick. His back did not get any better with painkillers or a back support. The doctor just gave him painkiller after painkiller until I had enough and DEMANDED!! that he is refered to hospital. He went for an MRI in February and the surgeon follow up appointment diagnoised dics degenerative desease, a crumbled lumbar spine block and 2 bulges in his spinal cord which is restricting his spinal fluid on his left side of his body. He has now been refered to a specialist back surgeon who deals with this type of "injury" (normally its only gymnast who get this type of injury in this area of the back). My husbands work paid SSP until the 31st April when he then had to apply for ESA. He recieved a part payment of £32 for 1st till 4th May then nothing. We have had no money and unfortunately meant I had to use our credit card (which I have no way to pay back) to pay for food.

He went for his ATOS medical and the nurse at the interview was lovely but at the end said that we could request the results from Monday? I thought it took 2-3 weeks. Also the last comment she made was if we "fail" to get enough points then we should appeal but this could take 9-12 months.

My worry is my husband is facing some serious surgery soon, will have to be on strong painkillers for the rest of his life and physio but we wont get any money.

We called the ESA helpline and they said they were waiting for the report before issueing money?? I thought they had to pay us the waiting rate until this decision was made?

I am the only imcome in our home at the moment, which is under £20k year. I would appreciate anyones advice on what additional things we can try and claim or help with advice.

We are not spongers and just want some help to be able to buy food.

Best wishes Cookiee

Your husband could try and claim Disability Living Allowance if his problems affect his walking ability etc. This is non means tested so would be in addition to any other benefit he is entitled to.

If your husband needs a lot of prescriptions it might be worth him buying a pre payment certificate, this works out much cheaper as long as you need more than 4 prescriptions in 3 months. Collect the application forms from the chemist or apply online, its really simple and saves a fortune on medication.

Good luck
CWxx

Cpt.Scarlet

Cookiee wrote: »

We only just found out through this website also they we dont have to pay for prescriptions which trust me helps LOADS!! as £21.60 every 3 weeks is a struggle.

As others have said, if you are receiving Contribution Based ESA then you are not entitled to free prescriptions. however, you can purchase a Prescription Prepayment Certificate, which should still save you money, see the following site.

http://www.nhsbsa.nhs.uk/1127.aspx

Morglin

Here is some info about how the ESA process works:

http://www.benefitsnow.co.uk/esa/index.asp

This is the criteria for getting a medical exemption certificate (income doesn't matter with this):

http://www.disabledinfo.co.uk/dis/123-nhs-prescriptions-exemptions-for-the-disabled.asp

Many people, including myself, get one on the basis of getting high rate DLA mobility, and needing another person with me when I go out.

If your husband's disability is likely to be permanant, or at least last a good while, it's worth claiming DLA - this benefit is a passport to many other things, and is non means-tested.

More info:

http://www.benefitsnow.co.uk/decisions/dladecision.asp

http://www.benefitsnow.co.uk/apply/dlaapply.asp

Lin

Cookiee

Hi All
After a bit more digging and all your advice I have checked and he wont be entitled to free prescriptions He must have been really jammy when he got his morphine and nerve tablets.
Will look into the prepayment certificate as this hopefully will save us some money:)

We applied for DLA (through the help with my husbands doctor) and we were refused. Do you think it's worth appealing? My husbands condition will get worse before it gets better.

Also another thing, should my husband be put in WRAG, he already has a job waiting for him from his old job. The plan is to adapt his role so he is able to do it after all the surgeries so will the WRAG people take this into account? What happens after 1 year? as he has been told he would have only had 1 possibly 2 surgeries by this time next year ....

As it's been mentioned a few times about my wages... I earn £600 more than the threshold. Our income, up to my husband was poorly, was £30k per year before the usual tax/NI. Now this has dropped to just over £18k before tax/NI. As you all can appreciate this is very difficult. I am hoping with this site I will be able to reduce all my outgoings etc by doing this on another forum. We are looking at claiming benefit for the shortest time possible. We actually feel embarressed claiming but my husband has worked all his life, like me, and we just need that little bit of help now to keep us going.

Thank you all for your advice. :T

suelees1

Yes yes and yes again - to your query about whether you should appeal the DLA decision.

Try to find an agency which will give free advice and assistance you with all the benefit issues.

http://legaladviserfinder.justice.gov.uk/AdviserSearch.do

MrsManda

When did he get turned down for DLA? I think you only have a month after receiving the decision to ask for a reconsideration/appeal unless there is special circumstances which prevented you appealing during that time (though I haven't a clue which these are).

If it's too late for an appeal it is worth applying again. I'm not sure if you have to leave a certain amount of time between an application failing and applying again but I'm sure someone on here will be able to tell you or else contact the benefits line to ask.
http://www.direct.gov.uk/en/MoneyTaxAndBenefits/BenefitsTaxCreditsAndOtherSupport/Disabledpeople/DG_10011925

You can request a copy of the decision maker's report to see what they used to make the decision to turn down the application which should help you when applying again. It could be that the consultant put a prognosis which said that he expected the mobility needs to last less than six months.

If you're put in WRAG on CB ESA you will be assessed for income based after 12 months and if your income is too high you'll just receive national insurance credits. If you're put in the Support Group there is no 12 month limit. I think a lot of the time the reason someone gets put in WRAG or the Support Group has do partly with what the person's consultant/specialist say is their prognosis.

Hammyman

Cookiee wrote: »

My worry is my husband is facing some serious surgery soon, will have to be on strong painkillers for the rest of his life and physio but we wont get any money.

We called the ESA helpline and they said they were waiting for the

I had the same operation for the discs twenty years ago. I was back at work within 6 weeks and no pain. Unfortunately I was only 20 years old at the time and it made me feel even more immortal so I took the mick. Disc above those two went a decade later, its inoperable and I work self employed as I cannot guarantee when I can or cannot work.

What I'm saying is that the operation should cure the pain and he'll be fit to work fairly quickly albeit restricted. And as long as he doesn't take the mick like I did (I was dragging 24 one tonne pallets out of the back of a truck 5 nights a week), he should be OK. He will get more back aches than normal people but he shouldn't need to be on pain killers all the time. Even as bad as mine is now, I don't bother with pain killers.

In regards to DLA, it is a real fight to get it.

sunnyone

Cookiee wrote: »

Hi All
After a bit more digging and all your advice I have checked and he wont be entitled to free prescriptions He must have been really jammy when he got his morphine and nerve tablets

You will get a bill for these tablets, pharmasists have to tick a box if they havnt seen proof of entitlement for free prescriptions and these prescriptions are checked and bills sent if its a one off fraudulently claiming free scripts or worse for serial offenders.

£10 per month for the first 10 months of the twelve months covered by a prepayment certificate is a bargain when you consider how much multipul script can cost per month.

Cpt.Scarlet

Cookie

It is always worth while considering an appeal, providing you have not exceeded the the timescales for doing so, however a tribunal can only consider evidence that was relevant to the time of the original decision, so if your husbands condition worsens, this would out of scope.