Esa , how to request claim to be looked at again

lulugirl

I was trasferred from incapacity benefit straight to wrag withought a medical. After a year I am no longer entitlted to esa or income related esa as I receive a small pension.

After seeking advice from cab, I want to ask the Dwp to look at my claim again as my pychiatrist feels that I fit one of the descriptors for the support group & also my mental health would detiorate & put my life at risk if I was found capable of work. He has stated both of this in a letter which I want to send to them. Is there a form to request them to look at my case again.

My contributary esa ended on 30th November I then applied for income related which I wasnt entitled too.

rogerblack

Ok.
Starting from the beginning - you cannot appeal the original decision - assuming that your original award was in November 2011. It's been over 13 months.

You need to either:
If your condition has not changed.
Find a reason the original decision was in error - due to ignorance of a material fact that they could have known at the time. (for example, if you had been called to a medical).

If your condition has changed, report this change and ask for a form.
This will allow you to get a fresh determination of your condition, which if you are found to be in the support group would resume payment.
The stress of not being paid, and the uncertainty worsening your condition may be a valid change.

I assume that the application for IR-ESA was not a full form detailing your condtion?

lulugirl

rogerblack wrote: »

Ok.
Starting from the beginning - you cannot appeal the original decision - assuming that your original award was in November 2011. It's been over 13 months.

You need to either:
If your condition has not changed.
Find a reason the original decision was in error - due to ignorance of a material fact that they could have known at the time. (for example, if you had been called to a medical).

If your condition has changed, report this change and ask for a form.
This will allow you to get a fresh determination of your condition, which if you are found to be in the support group would resume payment.
The stress of not being paid, and the uncertainty worsening your condition may be a valid change.

I assume that the application for IR-ESA was not a full form detailing your condtion?

I have the medical report form which stated that there was no evidence to suggest there would be a risk to my mental health if i was found capable of work but my pychiatrist has put in a letter that there would be a risk to my mental health.

Also on the medical report there was no evidence to suggest I couldnt engage in social contact but again my phchiatrist has put that I have severe probems with this .

My condition has deteriorated with the stress of this & my antipchotic medication had to be increased.

The form for income related was just a short form with no request to detail my condition.

Is is just a letter that I write myself to ask this to be looked at again, what for m do I need to ask for. Thanks for your help

Cpt.Scarlet

You need to write and request a SuperSession on your claim due to a deteriorated condition, send the letter to the DWP office that deals with your claim.

I have to warn you that in at least one aspect your psychiatists letter in insufficient, even though your payments have stopped you remain in the WRAG and by definition already have Limited Capability for Work so their stating there is a risk to your health by your working is of no extra value. The letter needs to say there would be a risk if your carried out Work Related Activity.

Hopefully, the other areas that he has referenced will be sufficient

lulugirl

Thanks for the imformation, very helpful. I will ask for the letter to be amended to include work related activity to improve my chances.

Glen_Clark

rogerblack wrote: »

Ok.
Starting from the beginning - you cannot appeal the original decision - assuming that your original award was in November 2011. It's been over 13 months.

In that case contribution based ESA will have ended after 12 months, and contribution based ESA can only be reinstated by another period of contributions? - i.e 2 years working and paying contributions?
Unless I have got this wrong?
The OP has indicated their pension disqualifies them from income based ESA?

benefitbaby

Glen_Clark wrote: »

In that case contribution based ESA will have ended after 12 months, and contribution based ESA can only be reinstated by another period of contributions? - i.e 2 years working and paying contributions?
Unless I have got this wrong?
The OP has indicated their pension disqualifies them from income based ESA?

The OP's CESA has not ended/closed she is merely no longer entitled to receive payment as she has received the maximum 365 days. Her claim should still be live, she will still be receiving NI credits and still have to attend WFI and WCA's when required. Therefore no new claim needed and no issue with NI conts for another period.

Glen_Clark

benefitbaby wrote: »

The OP's CESA has not ended/closed she is merely no longer entitled to receive payment as she has received the maximum 365 days. Her claim should still be live, she will still be receiving NI credits and still have to attend WFI and WCA's when required. Therefore no new claim needed and no issue with NI conts for another period.

Thanks for the reply.
But will the OP receive payments again if/when she is moved to the Support Group?
(Bearing in mind her pension apparently disqualifies her from income based payments)

Cpt.Scarlet

Glen_Clark wrote: »

Thanks for the reply.
But will the OP receive payments again if/when she is moved to the Support Group?
(Bearing in mind her pension apparently disqualifies her from income based payments)

Their ESA(CB) will be re-instated in they are placed in the Support Group.

Pensions are treated differently for ESA(CB) than they are for ESA(IR), so it is possible to payments for ESA(CB) when you would not do so for ESA(IR).

rogerblack

Glen_Clark wrote: »

In that case contribution based ESA will have ended after 12 months, and contribution based ESA can only be reinstated by another period of contributions? - i.e 2 years working and paying contributions?
Unless I have got this wrong?
The OP has indicated their pension disqualifies them from income based ESA?

To address this point, without regard to the OP.

If you stop claiming ESA for 12 weeks, and then re-claim, your new claim does not link to the old.
(please check this exact time).
In some circumstances if the claimant is entitled to ESA-CB - it would be advantageous for them to do so.

Taking for example, someone who has just had their ESA-CB stop payment.
They made the claim on falling ill from wellpaid fulltime work, on the 13th Jan 2012 that they'd been in for ever.
Their claim was based on their contributions in the last two complete tax years before the claim - so 9/10 and 10/11.
They break their claim now by phoning up and saying they want to terminate it.
In twelve weeks (or thirteen is probably safer), they re-claim.
Their new claim is based on the last two complete tax years.
This is 10/11 and 11/12.
In 10/11 they have adequate contributions from their earnings, as they were earning all that year.
In 11/12, they also have adequate contributions, as they were earning up until January.

A new claim made does not link to the old, and is paid (again for up to a year)
I am unsure that a hypothetical further claim made sometime in March 2014 would succeed - even neglecting universal credit.
They would have adequate contributions in the 11/12 year, but the 12/13 year would rely on the credits from ESA.
As I understand it, this is possible.

However, please note.
This is all irrelevant if you can get into the support group.
Also, if you screw up and are moved onto IB-ESA, due to not having adequate contributions for the second claim - if you are later eligible for the support group, payment _WILL_NOT_ resume.

Ideally you should seek expert advice.

Glen_Clark

Cpt.Scarlet wrote: »

Their ESA(CB) will be re-instated in they are placed in the Support Group.

Thanks for the Reply.
As I understand it, their ESA(CB) was never taken away - it is still running but with no payments except the NI Stamp.
So I think what she wants to know is will the payments be reinstated if she gets into Support Group.