ESA Claim

nannytone_2

so this is your original claim still.
. in that case you have never been accepted onto ESA ( just accepted for assessment)

i have mild aspergers and so understand what you mean by not understanding the problems it causes because to you it is 'normal'
but that statement in itself won't help you in asking to make a new claim.if the ASD is the 'new condition' you want to claim for.
a diagnosis doesn't make the condition any better/worse than it was before diagnosis.
you have 2 choices.
appeal the original claim or hope that a DM will see the ASD as a new condition ( where earlier in a post you state that you know you have always had it)
you're going to have to be extremely careful how you word things because you do your case no favours at times

epitome

If I were you, I would appeal.

If you make a new claim it is likely to be disallowed from outset on the available evidence which will mean your 6 months will start afresh from the date of the new descision. (However the 6 month rule is soon to be abolished so it's not really an issue)

If you appeal you might go back onto payments (see post #18 below) and be paid from the date they last paid you.

If you make a new claim, likely outcome will be disallowed and you will be stuck with having to appeal the MR that you have now.

Your diagnosis of autism is obviously a lifelong condition and therefore the appeal tribunal will be able to take that into consideration when determining which descriptors you consider yourself to qualify under. The diagnosis does not give you a right to ESA but does allow the tribunal to accept that it might affect you in various ways and thus qualify for ESA.


If you make a new claim now, if it was allowed, it would not link to the previous claim for WRAG and SG arrears. (because you were found fit for work).... I think it would not even link for the waiting days, which would have to be served again.


If you had been found to be in WRAG or SG then the Oct 14 claim would have linked to the April 14 claim and your WRAG/SG arrears would have gone back to July 14. If you win appeal this will still be the case.

SJI85

nannytone wrote: »

so this is your original claim still.
. in that case you have never been accepted onto ESA ( just accepted for assessment)

i have mild aspergers and so understand what you mean by not understanding the problems it causes because to you it is 'normal'
but that statement in itself won't help you in asking to make a new claim.if the ASD is the 'new condition' you want to claim for.
a diagnosis doesn't make the condition any better/worse than it was before diagnosis.
you have 2 choices.
appeal the original claim or hope that a DM will see the ASD as a new condition ( where earlier in a post you state that you know you have always had it)
you're going to have to be extremely careful how you word things because you do your case no favours at times

I've always suspected Aspergers/Autism. Since the age of 21 anyway. Just unsure whether I really met the full criteria for the diagnosis or if my difficulties were better explained by dyspraxia alone which I was diagnosed with at 22.


So just to clarify the two claims I've made (April 2014 - September 2014, and October 2014) won't be linked, were I to go to tribunal and win, because I was never awarded ESA in the April - September claim, only accepted for assessment? My WRA group payment will only be backdated to the 13th week of the second claim, so early Jan?


I know those are my two options at the moment so I think I'll likely go to tribunal but I'll get some advice from CAB first.


I haven't helped myself all the way through the process. But when living and dealing with it alone, with no support, and have depression (bipolar actually) and personal difficulties, it's hard



It's like in the WCA I was asked how the dyspraxia affects me (which is fair enough) but I only had the opportunity to discuss organisational difficulties before the assessor moved on. She commented that I came across as "tense" in the assessment, but otherwise had good recall. Nonsense. I struggled recalling several things and made a couple of mistakes, and my "tenseness" was the fact that I struggled with organising my thoughts and speech/communicating. I'm deeply disappointed by the whole process and the WCA was not a fair method of assessment at all. But then I know of many similar cases and I'm not alone.

SJI85

epitome wrote: »

If you had been found to be in WRAG or SG then the Oct 14 claim would have linked to the April 14 claim and your WRAG/SG arrears would have gone back to July 14. If you win appeal this will still be the case.

So it is the case that if I appeal, and get awarded ESA, the April 14 and Oct 14 claims will be linked. Despite the fact that I was still waiting assessment, so not yet awarded LCW, in April - September's claim?


If so this makes me feel a little better as I'm reasonably confident of going to tribunal and being successful. The one thing that might let me down is lack of medical evidence to back up my claim of how my conditions affect me (and result in LCW), but I'm hoping Autism Services will provide further evidence.


Feel free to ignore the PM, then! Thank you!

epitome

SJI85 wrote: »

So it is the case that if I appeal, and get awarded ESA, the April 14 and Oct 14 claims will be linked. Despite the fact that I was still waiting assessment, so not yet awarded LCW, in April - September's claim?

Yes

If so this makes me feel a little better as I'm reasonably confident of going to tribunal and being successful. The one thing that might let me down is lack of medical evidence to back up my claim of how my conditions affect me (and result in LCW), but I'm hoping Autism Services will provide further evidence.

Are you hoping to get LCWRA?

Feel free to ignore the PM, then! Thank you!

No worries...

SJI85

epitome wrote: »

Yes
Are you hoping to get LCWRA?

I'm hoping to get into the WRA group. Realistically there is no chance I qualify for the Support Group.


Thanks again!

epitome

Have you had a previous claim for ESA before April 2014?

Was that claim disallowed?

From March 30th if you have had 2 consequetive disallowances you won't be paid on appeal.

If you were previously in WRAG or SG then you will be paid on appeal,
If you were previously disallowed you won't be paid on appeal.

If you make a new claim now, you might get another disallowance (like I said above) that would be a consequetive disallowance and you would then not be paid on appeal.

SJI85

epitome wrote: »

Have you had a previous claim for ESA before April 2014?

Was that claim disallowed?

No. Well, not really.


I begun a claim in August 2011, when still a student. However, I never returned the Questionnaire as I decided not to proceed with the claim (studies and personal difficulties got in the way, and I didn't need the money - I would have saved it). My claim was eventually closed in the summer of 2012 when I claimed JSA. As I failed to send the questionnaire no WCA took place, and no decision made regarding my capability for work.

epitome

SJI85 wrote: »

No. Well, not really.


I begun a claim in August 2011, when still a student. However, I never returned the Questionnaire as I decided not to proceed with the claim (studies and personal difficulties got in the way, and I didn't need the money - I would have saved it). My claim was eventually closed in the summer of 2012 when I claimed JSA. As I failed to send the questionnaire no WCA took place, and no decision made regarding my capability for work.

That would be ok then. This new law is going to make life very different for ESA claimants after a disallowance.

I'm not sure if this forum is aware of this yet? As I have not been around for a while.

However, on first reading, I believe it is not a retrospective law and will only apply to new claims made on or after March 30 2015, however it will still take into account a previous "No LCW" decision made before March 30 2015

In other words If you are appealing a decision made on a claim made before March 30 2015 you will be paid on appeal, even if there was a consequetive previous "No LCW" decision previous to that claim.

SJI85

This is only a draft, but would this seem a reasonable way of presenting my case RE: Autism and why the Autism difficulties should be considered as part of this claim, at appeal?


"It was stated in my Mandatory Reconsideration notice that in order for difficulties associated with my Autism Spectrum Condition to be considered, I should make a new claim as the Autism is a “new condition”, diagnosed less than three weeks after my Work Capability Assessment. I don’t believe I would be justified in doing this and I feel the difficulties, some of which were still referred to in the ESA50 without a diagnosis, should be considered in this claim. The National Autistic Society describe Autism Spectrum Condition as a “lifelong disability”. It is therefore not a “new condition” that I have developed during, or after, the ESA assessment process. When completing my ESA50 I clearly gave information about some of the difficulties I face as a result of my dyspraxia and suspected Autism Spectrum Condition, including difficulties with a change in routine and social engagement. In the Work Capability Assessment I also mentioned that I’m awaiting an Autism assessment, and was prepared to discuss my difficulties with social engagement and change of routine. However, I did not go into great detail in certain aspects of Autism-related difficulties as it was not until the diagnosis, and the opportunity to discuss my history and difficulties in the autism assessment with healthcare professionals, that I was given greater insight into my difficulties.


In short, I feel the diagnosis of Autism adds credibility and highlights the severity of my difficulties as well as providing me with further insight into problems that I have had throughout my life. Though I have considerable insight when it comes to my mental health, I did not have as great insight into the difficulties I face as a result of my Autism Spectrum Condition prior to the diagnosis. I can easily compare how I am now to how I was before I developed the Bipolar Disorder and anxiety. This is not the case with the Autism Spectrum Condition. I therefore hope that the difficulties I face as a result of the Autism Spectrum Disorder, relevant to several descriptors, will be considered as part of this appeal."