ESA mandatory reconsideration

julie237

HiI recently failed an ESA medical after getting 0 points. My esa stopped immediately, housing benefit has been suspended and i have no money. I have bills waiting to be paid and direct debits coming out still.
Im a single parent and suffer with depression, anxiety, panic attacks and IBS. I realise some people do fake these conditions, but i feel so insulted and like they think im lying about it all. Before my esa medical i took propranolol, because i knew if i didnt, i wouldnt have been able to sit through it all due to anxiety and most likely having a panic attack. I think this gave the assesor the impression that i was totally fine. On the letter i received back from them some of the descriptors i scored 0 on, but wasnt even asked questions about! I know people who have less things wrong with themselves than me, but passed the medical. I would love to be earning my own money and i hate being on benefits, but my life is such a mess at the moment and i need the help without the immense pressure of being on jsa. I recently
Signed on for jsa as it is my only option whilst i ask for reconsideration. I now have to print copies of 2 months worth of bank statements and take them into the council, have to ring and find out if and when i will be getting any money, log job search and apply for jobs everyday, and also will be looking to start some counselling. Also i look after my child, with virtually no support from anyone. And to top it off i have strained my back and have been in agony the past few days. Sorry for whinging, i just cant believe how stressfull it all is.
My question is, can i just write the mandatory reconsideration letter myself, and would that do any good? Or would i be better of getting some outside help from CAB or a drs letter?
I have 3 weeks left to get it sent off. All i want to do right now is sleep, and cant even do that because of the back pain:(
Thanks for any help

pmlindyloo

If your child is under 5 years old then you can apply for Income Support rather than JSA whilst you are doing your mandatory reconsideration.

If your child is over 5 years old then you will need to continue on JSA. if your doctor will give you a fit note then you can present this to Job Centre Plus and they will suspend your job seeking requirements during this time.

Your HB and CT reduction will be granted and backdated but you may have a little wait whilst they check your finances.

In the meantime contact any creditors and tell them what is happening and cancel any DDs that you have so that you do not get interest charges added. You can then put them back in place when your money comes through. Ditto with your landlord.

As for your mandatory reconsideration I suggest you get some help from CAB/welfare adviser as they will be able to tell you what extra information you need to provide. They may suggest that you just challenge the mandatory reconsideration and then put in an appeal as this can be quicker rather than waiting to get extra medical information. If your MR is turned down then once the appeal is lodged then you can go back on the assessment rate of ESA (you will need fit notes). CAB/welfare officer can help with the appeal.

Basically your money will not change when on JSA (am presuming you do not claim DLA/PIP) so in time everything will go back to as it was before.

I am also presuming that you are receiving child tax credits, child benefit and child support?

If you are struggling with debts then you may wish to contact Stepchange or CAB for further help.

Alice_Holt

If you can get access to a CAB caseworker then they will be able to take you through the process and do most of the legwork.

This may help explain the appeal process:

http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-appeals
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/while-youre-getting-esa/challenging-an-esa-decision/


The appeal process is now 2 stage.

The first stage is to ask the DWP for a Mandatory Reconsideration (MR) of their decision.
http://www.leicester.gov.uk/media/178163/mandatory-reconsideration-request.pdf


My experience is that the DWP rarely change their decision on MR, so my judgement (others may take a different view) is to get the MR completed ASAP using medical evidence and information you have readily to hand. Go through the ESa descriptors carefully and set out fully the case for why you should have been awarded the necessary points. See:http://www.benefitsandwork.co.uk/med2/indexxx.php

(Be aware of the time limits - 1 month from the date of the decision letter for the MR, and then 1 month from the date of the MR Notice to srart the appeal to the Tribunal Service (TS). Having meet these deadlines, you can then send further follow appeal information to the TS.)

At the next stage (appeal to the Tribunal Service (TS) ) your ESa payments can be re-instated pending the TS hearing. Specific Info here: http://www.cpag.org.uk/content/benefit-during-employment-and-support-allowance-dispute

Stage 2 is the appeal to the TS.
This is done on a SSCS1 form (http://s3-eu-west-1.amazonaws.com/hmctsformfinder/sscs001-eng.pdf)
A copy of the DWP response to your MR has to be attached. DO opt to attend the hearing, then you can explain fully to the panel.

Once this form is submitted and the DWP have it logged then you can ask the DWP to resume ESa payments. (Be insistent as often ill-informed DWP employees are not aware that this can be requested).

You can then send further evidence diectly to the TS in readiness for your hearing.
This might include further evidence from your GP (very useful if they are supportive, you can see them and show them the ESa descriptors, and their letter relates directly to the appropriate descriptors); evidence from family, carers, friends; your statement outlining to the TS why you should be awarded Esa; your comments on the DWP reasons for not awarding the benefit and the validity of the WCA.
It is best to keep your submissions to the tribunal brief, to the point, and relevant to the ESa activities.
(Think of the panel's reaction to the info you send them).

Some more info here:
http://www.advicenow.org.uk/tags/benefit-appeals
http://www.advicenow.org.uk/guides/how-win-pip-appeal

The How To Win a PIP Appeal guide is really helpful on the appeal process (which is virtually the same process as ESa appeals).

For instance these bits are really helpful when you are preparing for the tribunal -

"For most people, the thing that is of most help is written evidence from their GP or other doctor. If you have a social worker, community psychiatric nurse, occupational therapist, or other professional, evidence from them will be very useful too.

The most useful evidence will explain how your illness or disability affects you, and the help you need (paying particular attention to the descriptors that you meet). This is unusual, so your doctor/social worker etc may not understand that. So give them a copy of the activities / descriptors.......

......You should think about keeping a diary of the help you need each day. It will help the tribunal panel to get a proper understanding of your situation. It is particularly helpful if your illness or disability isn't the same every day. Keep a diary for a month if you can (but a shorter time will also be helpful). It can be brief. Include everything that is connected to the activities’ that entitlement to [ESa] is based on.

If you get help from somebody and find this sort of thing hard, you could ask them to keep a diary of the help they have given you instead (as an alternative to the letter - see above).......

.......f you (or someone who is helping you) are good with writing, you should think about writing a statement for the tribunal. These can be very useful as they set out all your points, which means that you don't have to remember everything to say on the day. They also give the panel time to think about what you’ve said and why you should be getting the benefit before they meet you."

Good Luck

Alice_Holt

Re getting medical evidence from your GP / other health professional.


Could you speak to / see your GP?
Let him/her know what is happening, and ask if (s)he would be able to support your appeal.

If the answer is yes, then you could write a follow-up letter along these lines:

"Dear Dr [XXX],

I am appealing a DWP decision of [date] that found me fit for work.

I will be sending a statement to the Tribunal Service detailing why I believe this decision to end Employment and Support allowance to be wrong, and the difficulties that my anxiety, depression, panic attacks, and IBS would bring to the activities necessary for work.

I understand that it would be helpful if I am able to supply the Tribunal Service with medical evidence. Is it possible that as my GP for over XX years, you could respond to the following:

1) Could you comment if I am unable to reliably engage in social contact due to my difficulty in relating to others or because of experiencing significant distress.

I am of this opinion because:

.................................................. .................................................. .................................................. .................................................. .................................................. .................................................. .................................................. .................................................. ..................................................

[Only include if these if they are appropriate to you] 2) Can you comment if dealing with changes is difficult for me.
3) Could you comment on my ability to reliably initiate or complete at least 2 personal actions.
4) Is my mental health likely to occasion uncontrollable episodes of disinhibited behaviour that would be unreasonable in any workplace.

5) Do you think because of my mental health condition there would be a risk to my health if I was found fit for work.
.................................................. .................................................. .................................................. .................................................. .................................................. ..................................................


GP's Name:

GP's signature:

Surgery:

Date:



If the GP supports you, then this letter would be medical evidence which you could sent to the TS for the next stage of the appeal.
To prepare the letter go through the ESa descriptors and see were you would score the necessary 15 points (see http://www.benefitsandwork.co.uk/forms/forms/formprocessorpro.php ), and ask your GP to comment on the activities that you are unable to do reliably and repeatedly.
Include point 5, as if you can't get to 15 points you can be awarded ESa on substanial risk to your health if found fit for work.

Again, if you can get help from the CAB they can write to get medical evidence. It does help if you update your GP and get his/her support for the appeal.