ESA Appeal...

Cpt.Scarlet

rogerblack wrote: »

As I understand it, a fresh determination of capacity cannot be made while you are under appeal.
However, they can in principle gather evidence for later use after the appeal.
I'd need to reread the relevant regulations though.

This is only the case when it is a Fit for Work decision being appealed, the OP is appealing from the WRAG to the Support Group.

Muttleythefrog

Trying to get my head around all this for clarity..lol.

So you've been historically in WRAG and had several reassessments. The last reassessment was around April and included a face to face medical. Payments haven't altered... like many you were never informed of outcome but payments continued as was... so suggests you were found to be eligible for WRAG again... probably some time in April or May that decision was taken.

You've now got another ESA50 which would imply another reassessment has begun. It does seem slightly early if the prognosis being used is 6 months... but perhaps only by a matter of few weeks since they probably aim to start the process before the 6 months are up... and decision could have been made say end of April... 4 months ago.

So I'd be happy to conclude the above is all probably true reflection of events regarding the claim. However your JC advisor seems to have taken the most bizarre course and helped you fill in ESA50 (very kind of them.. great) and appeal... appeal against what... no decision has been made. If the appeal is against the previous decision then it is late (and therefore wouldn't be accepted unless good cause is shown for late appeal). The only obvious advantage to you of pursuing an appeal against the previous decision now.. that's assuming it is accepted and you win your case would seem to be small amount financially. Surely the best course of action would be to focus all efforts on this reassessment to get Support Group award if that is what is what is desired. Rather than tying yourself up in battles over previous assessment focus on current... especially since as others have raised.. the issue of reassessment could still be applied anyway... a successful appeal will be time limited and possibly limited by this reassessment. Don't get the JCP advisor tactics here... seems irrational to me unless I'm missing something or they feel you get a kick out of legal battles and receiving brown envelopes in the post.

You obviously have looked at the S.Gp descriptors and feel a couple apply. My advice is focus efforts on this reassessment... ideally evidence send with ESA50 but now may not be too late to get some supporting medical evidence... get it to ATOS HC (as well as DWP) if ATOS haven't by then already provided advice to DWP.

To clarify what happens as standard it is this:
DWP instruct assessment to medical services (ATOS Healthcare)
ATOS HC send you ESA50 to complete.
You return ESA50 along with any evidence you want considered.
ATOS HCP studies your ESA50 along with any other evidence supplied to them by DWP and you.
ATOS HCP determines one of 3 things -
a) Sufficient information available to provide advice in relation to you and the WCA. ESA85A report sent to DWP with your evidence so DWP can take decision
b) Insufficient information available to provide advice but could be with some facts from GP. They send GP a form to complete and if they return it with sufficient information then they can follow process in 'a' above.
c) Insufficient information to provide advice and face to face medical required. That medical done and ESA85 medical report supplied along with your evidence to DWP to take decision.

Largely the DWP will rubber stamp the ATOS advice so it is advisable to get evidence in to the process ASAP so that ATOS (should) consider it. The closer that medical evidence is to the descriptors and why they apply the better probably. So this is where having a helpful medical pro involved in your situation can be invaluable.

Your question regarding assessment phase.. no.. no actions or matters discussed would place you in this... assessment phase is for new claims.

The issue of reassessment timing. 6 months is towards the lower end of the scale of possibilities... but common especially for those in WRAG it would seem.

Fit notes are mentioned on the thread but you shouldn't be needing any of them... you've been found to have limited capability for work and therefore even if appealling you shouldn't need them. Fit notes are required when in assessment phase and if wanting to get assessment rate while appealling a fit for work decision... you've not been found fit for work at any assessment it would appear.

By the time you read this you probably have seen your advisor again. I hope they've been able to give some clarity and sensible advice... I suspect you may not have been getting much of the latter which raises concern you might not have submitted an entirely clever ESA50 via their help (the fact they appear not to have raised issue of supporting evidence suggests they may be acting with some blindness of strategy). I notice on the news that some kind old lady decided to use her artistic skills to restore an old picture of Jesus in some Spanish religious building... no doubt all well intentioned but the result is not good. *cringe*. There's a lot of people getting a lot of poor advice regarding ESA and it almost always seems to come from DWP staff.

Ellejmorgan

Thanks everyone,

I get it now it's a long game, in no way shape or form geared to getting me into work..

Torry, I obviously need to wear my glasses more, I swear your name was Tony..oops.. sorry..

I will concentrate on this next assessment, it's too late to get together all evidence..
Couldn't see advisor as she had no time slots..
What I don't get is why was the appeal filed, it was her suggestion, and she was really genuinely trying to help..

I have never been found fit for work at any assessment, I don't see how they could ever, I am not even driving currently as my arm is so compromised, among other things

Thank you all for trying to help I knew you would all know what to do...
If you have any further pointers or ideas I would welcome them gladly..

Thanks..

Muttleythefrog

My only advice in light of what you say is when you do speak to them ask them what exactly they're appealing against (presumably the previous WCA decision made in springtime) and why they think it is a good course of action at this time given it would be a late appeal and you've got a current assessment to focus on... I think she needs to give some tactical reassurance to justify what otherwise would seem at best a long shot at a little bit extra money until the new assessment. Sometimes I think state beaurocrats have this almost tunnel vision of if x then y... if not x then z... they seem often unable to think about real people and real events and therefore construct good tactics. In fact sometimes I wonder if it was the 4 weeks I spent working for the NHS BSA that finally saw an end to my working life.. I couldn't believe the stupidity of the processes and people I was having to engage with..lol.

epitome

As I understand it...

You are in the WRAG now and have been for some time, you keep being reassessed and you want this to stop.

You have been advised to appeal the last WRAG decision.

You want to know if you appeal will you be on assessment rate?
No you won't, you will remain on WRAG rate until you fail a medical

You want to know if you appeal will you continue to be reassessed
Yes you will, all conditions of being in the WRAG will continue including assessments and going to the jobcentre

Even if your appeal is successful and you go into the Support Group you will still be reassessed. People in both groups are reassessed, the period between reassements varies according to your condition can be from 3 month to 3 years for both groups....there's nothing you can do about reaassessments it's all part and parcel of ESA.

If you send in an appeal now (before being given the most recent WCA result) you will be appealing the previous WCA to keep you in the WRAG, this appeal will be more than 1 month since the decision and so could easily fail at the first hurdle and be rejected as "late". Better to wait for the letter informing you of the most recent WCA decision and appeal that letter within a month.

If you move onto IS you will lose £28.15 per week WRAG component......assuming you are eligible for IS.

Ellejmorgan

Does the fact that I never got a letter informing me of the decision have any bearing on it at all ??

epitome

Not really, it's your word against theirs, they will say a letter was sent you will say no letter was received.

You can call them and say I never got a letter, I'd like you to send me one, then appeal that letter, time will tell if they accept the appeal, if not, wait for the next one.

Like I said, even in the support group you will be reassessed (and probably put back into the WRAG after every assessment, so you can appeal after every WRAG decision.

Ellejmorgan

epitome wrote: »

Not really, it's your word against theirs, they will say a letter was sent you will say no letter was received.

You can call them and say I never got a letter, I'd like you to send me one, then appeal that letter, time will tell if they accept the appeal, if not, wait for the next one.

Like I said, even in the support group you will be reassessed (and probably put back into the WRAG after every assessment, so you can appeal after every WRAG decision.

Thank you, this benefit is crazy, I'm not up to the fight at the moment, that's how they are getting away with it we don't have the strength to argue...

I can't see me being able to go to the next medical, so will keep the claim going until I have no choice, then wil have to accept less money..
It's not worth having another mental health crisis and losing the children as a result..

I suppose I can always re open it when I'm in a better frame of mind and able to gather all the evidence together, at the moment I just can't..

Muttleythefrog

Ellejmorgan wrote: »

Does the fact that I never got a letter informing me of the decision have any bearing on it at all ??

What they regard as the decision letter seems to be extremely variant... the letter they insisted was mine was actually a standard 'we are changing the amount we pay you' type letter and the very last thing it would appear to be communicating was the outcome of reassessment... in fact it appeared to be communicating the annual increase in benefit rates. I think you'd face an uphill battle trying to demonstrate you never received a decision letter.

Muttleythefrog

Ellejmorgan wrote: »

Thank you, this benefit is crazy, I'm not up to the fight at the moment, that's how they are getting away with it we don't have the strength to argue...

I can't see me being able to go to the next medical, so will keep the claim going until I have no choice, then wil have to accept less money..
It's not worth having another mental health crisis and losing the children as a result..

I suppose I can always re open it when I'm in a better frame of mind and able to gather all the evidence together, at the moment I just can't..

This is why I just cannot get my head around the apparent course of action taken by the advisor... it appears to absolutely run counter to any sense at all given your circumstances. What you want to achieve seems to be support group and less frequent assessment and preferably fewer or no face to face medicals. The logical thing to do to achieve that is not to try to fight a battle of the past that will achieve little even in the unlikely event it succeeds.... but to absolutely focus on this reassessment.. to get supporting evidence in ASAP (ideally with the ESA50 that I just hope hasn't been sabotaged by a good samaritan with cognitive defect) to reduce the chances of being called for medical and increase the chances of Support Group decision. I'll be interested to see how all this plays out... I really hope they know what they're doing.