ESA and errors by the DWP

Stiggy

Some background: my wife is 60 and hasn't worked for 30 years. She has a congenital heart/lung condition which leaves her breathless all the time. She was on all the previous benefits such as IB and DLA before the change to ESA.

I believe there have been some serious mistakes by the DWP in this process, and I'd like some advice as what to do about it.

We filled in the long form in July 2012, and got the appointment for the medical assessment by ATOS for October. In the meantime, the GP wrote a very stroppy letter basically saying 'this woman cannot work, you are crazy to even ask'. Then we got a letter saying our assessment has been cancelled. Mistake #1; are they allowed to cancel an assessment without asking us?

Then, we hear nothing. We are told we should have had a letter saying my wife had been placed in the work related activity group (WRAG) but we never received it. I know that sounds unlikely, but we were waiting eagerly for the result and would never have ignored it. Mistake #2; no letter.

We get called to the Job Centre in December. A lady who was filling in for a colleague basically told us 'you don't want to work do you? Never mind'. We were told we wouldn't have to got back to the Job Centre for 18 months, for just a routine chat. No mention was made that my wife was in the WRAG group, and we were still unaware of the decision. Mistake #3; clueless Job Centre staff.

We have another appointment at the Job Centre in July 2013. We don't really know what it's about. We are finally informed that my wife is in the WRAG as she has been found fit to work in October 2012. We say this must be a mistake as we haven't heard anything. We ring the DWP and they confirm this.

Still reading? This is the important bit: we say we want to appeal, but at this point we have no detail as to the decision that has been made, as we haven't seen the paperwork. So we send in the appeal form, asking for a copy of the original decision so we can make an appeal on specific medical grounds. We hear nothing. Then, in late October 2013 we hear that they have reconsidered our case, and as we have submitted no new evidence they have upheld the original decision! Mistake #4; we have effectively been denied the first appeal.

As it now goes to tribunal, we have finally been given a copy of the paperwork, although I still think some bits are missing. My wife was given 15 points back in October 2012.

We are going to the CAB for advice, and will prepare specific medical evidence. However, can I challenge the DWP over failing to follow their own process? I cannot believe how badly this has been handled. How would a person with mental or emotional problems cope with it all?

Any comments appreciated.

Dunroamin

Being put in the WRAG does not mean being found fit to work.

Stiggy

Dunroamin wrote: »

Being put in the WRAG does not mean being found fit to work.

So, what does it mean? I confess that after reading all the paperwork I don't understand whether "limited capacity for work" means they think you can work or can't work!

epitome

Stiggy wrote: »

Some background: my wife is 60 and hasn't worked for 30 years. She has a congenital heart/lung condition which leaves her breathless all the time. She was on all the previous benefits such as IB and DLA before the change to ESA.

I believe there have been some serious mistakes by the DWP in this process, and I'd like some advice as what to do about it.

We filled in the long form in July 2012, and got the appointment for the medical assessment by ATOS for October. In the meantime, the GP wrote a very stroppy letter basically saying 'this woman cannot work, you are crazy to even ask'. Then we got a letter saying our assessment has been cancelled. Mistake #1; are they allowed to cancel an assessment without asking us?

Yes they are, this is not a mistake

Then, we hear nothing. We are told we should have had a letter saying my wife had been placed in the work related activity group (WRAG) but we never received it. I know that sounds unlikely, but we were waiting eagerly for the result and would never have ignored it. Mistake #2; no letter.

Ok missing letter, what date was the decision made? and how long is she in WRAG for? You can ask them on the phone when the next assessment will be.

We get called to the Job Centre in December. A lady who was filling in for a colleague basically told us 'you don't want to work do you? Never mind'. We were told we wouldn't have to got back to the Job Centre for 18 months, for just a routine chat. No mention was made that my wife was in the WRAG group, and we were still unaware of the decision. Mistake #3; clueless Job Centre staff.

The staff were not clueless, only people in WRAG are invited to the jobcentre there was no reason from their POV to tell your wife what she should already know.

We have another appointment at the Job Centre in July 2013. We don't really know what it's about. We are finally informed that my wife is in the WRAG as she has been found fit to work in October 2012. We say this must be a mistake as we haven't heard anything. We ring the DWP and they confirm this.

Ok, so you found out in July 2013
How did you find out?
Not "fit for work", she has been found to have a "limited capacity to work"

Still reading?

Yes.

This is the important bit: we say we want to appeal, but at this point we have no detail as to the decision that has been made, as we haven't seen the paperwork. So we send in the appeal form, asking for a copy of the original decision so we can make an appeal on specific medical grounds.

Excellent move, submitting the appeal without waiting for the detailed reasons.... and I really mean that, I'm not being sarcastic, that was the best thing you could have done.

We hear nothing. Then, in late October 2013

So you left it more than 2 months without checking they had received your appeal and without asking them why they had not sent you the original decision (its called a statement of reasons)? That wasn't very clever.

we hear that they have reconsidered our case, and as we have submitted no new evidence they have upheld the original decision! Mistake #4; we have effectively been denied the first appeal.

No, this is not a mistake, this is excellent news because it means they have accepted your appeal late, and you will now have a chance to go to an independent tribunal.

As it now goes to tribunal,

See what I mean?

we have finally been given a copy of the paperwork, although I still think some bits are missing. My wife was given 15 points back in October 2012.

That's why she was awarded WRAG "15 or more points"

We are going to the CAB for advice, and will prepare specific medical evidence. However, can I challenge the DWP over failing to follow their own process? I cannot believe how badly this has been handled. How would a person with mental or emotional problems cope with it all?

They have not failed their own process, the only thing you have so far is a missing letter which could be down to Royal Mail. And the DWP have accepted that as a valid reason for your very late appeal.

• You did not keep in touch with ESA or ATOS to check on why her WCA decision or appointment was taking so long, when infact the decision had already been made.
• You would have had a P45 when the IB ended.... you didn't question that either?.
• She would have started to be paid her benefit on the next working day whereas before she was paid IB on a Tuesday (or whatever) she would have got ESA on a Wednesday (or whatever) you didn't notice this and question it?
• When she went to the 1st jobcentre interview she didn't ask "Why am here? Why are you asking me about going back to work?"?

You need to look at this leaflet
https://www.gov.uk/government/publications/esa214-a-guide-to-employment-and-support-allowance-the-work-capability-assessment

The Support Group criteria are on pages 26 - 28 she needs to fit one of them, focus your appeal and appeal evidence on those. She should get a letter from tribunal to ask if she wishes to carry on with the appeal and if she will be attending in person... she should attend as the % of people who win is higher in those that attend.

You can contact the Tribunals by phoning
http://www.justice.gov.uk/contacts/hmcts/tribunals/social-security-and-child-support
To ask them if they have sent her this letter yet or not, because if she does not reply to the letter the appeal will be closed.

The appeal is now entirely between her and the tribunal it has nothing to do with DWP anymore, if you do submit further evidence you should submit it directly to the tribunal service and you might want to submit a copy of it to the DWP for them to look at aswell as there is a slim chance that the further evidence will make the DWP change their decision.

You should also note that the Tribunal will only look at her condition as it was in July 2012 any deterioration since then will be ignored by tribunal.

Any comments appreciated.

You're welcome.

McKneff

Damn good post there, epitome:T

Dunroamin

Stiggy wrote: »

So, what does it mean? I confess that after reading all the paperwork I don't understand whether "limited capacity for work" means they think you can work or can't work!

It means what it says - your capacity/ability to work is limited. Put simply (simplistically?) it means that there might be some kind of work she can do or might, with support, be able to do in the furure.

wildwestfan

Op do you work? Could be important if your wife is in the WRAG.