Applying for ESA for a second time for worsened condition

julie237

Hi
I'd really appreciate any help from anyone on this. I was planning on going to CAB but im not going to have enough time.
I was on the awaiting assesment rate of esa until July this year, when i had an assesment and scored 0 points. My claim was for anxiety & panic attacks, and depression & IBS, the main condition being anxiety.
I took beta blockers before my assesment which i now realise i shouldnt have done, as i must have come accross as being fine, when i was actually terrified. Anyway, i failed the medical and was advised to claim JSA, which i did for a about 8 or 9 weeks until it all became too much for me. I am a single parent with no support, i have no family that can help out, no friends, no social life etc. Since my son started school 5 yrs ago i have dropped him off in a morning and gone straight back to bed until around 2:30pm to pick him up again. I was first diagnosed with severe depression 17 years ago, after a nervous break down. I have had a few jobs since then, but since having my son i havent done much at all. Ive never taken anything for depression as i never really wanted to admit to myself that i was 'ill' but after filling in all these forms and speaking to various drs, it has become blindingly obvious and i wonder why nobody has ever said anything to me about it!
I am now having CBT and have cashed in a prescription of Citalapram.
I couldnt cope with the demands of being on JSA, they were wanting me to attend daily, with proof of 35 hours of job search per week otherwise my money would be stopped.
My work coach advised me to re apply for jsa, and after one session with my counsellor she said she did not think inwould be able to get through a job interview, let alone anything else.
I am currently receiving nothing but child benefit and child tax credit, and housing benefit. I have an esa83 form to send back and i have to say how my depression has worsened. I am going to ask my counsellor for a letter of support, but im really scared that i will end up getting turned down again. I thought i was ill enough last time to warrant ESA, but it seems rather like writing an essay and learning the answers they would give points for. It seems like a ridiculous system i wish they would just look into my medical records instead.
I do want to work and get back to the real world, im actually looking forward to it. Im so fed up of my current situation.
Has anyone got any advice on how i can explain it all?
I hope the fact that im now having counselling and (about to start) taking antidepressants will demonstrate to them that i have got worse
But im just so worried that they will turn me down.
Sorry for the long post! And thanks for any advice x

NeilCr

I think I'd be inclined to suggest that you get help with completing the form - maybe from your local CAB. If, for any reason (and I have no idea how it will go) you are unsuccessful then they will be able to help out through the Mandatory Reconsideration/appeal process.

In addition, they could do a benefit check to ensure that you are getting all you are entitled to. It is possible that you could apply for PIP too

Is there a time limit for getting the Esa83 back? You'll need to mention that if you do contact them

julie237

Thanks NeilCr
Im not sure if there is a time limit, but the longer i leave it, the more time im living on next to nothing and if they decide to not award me the esa, it won't get backdated.
I signed off JSA on 12th oct, so its really worrying me.
Im busy everday this week with counselling appointments and having repairs done at home ( been 2weeks with no working boiler).
I'll try to get to cab on friday .
Thanks again.

Alice_Holt

Couple of things you may want to discuss with the CAB -

Is it too late to appeal the first ESa decision?
Yes, you are past the 1 month deadline for asking for a Mandatory Reconsideration, but if you and the CAB can put together a reasonable case for not appealing earlier it may be possible to make a late MR about the first decision to refuse you ESa.

The advantage is that if the DWP do look again at he first decision, and you can then proceed to a successful Tribunal Service appeal your ESa will be backdated to the date it was closed (less any JSa payments).

If the MR is not accepted (or you can't now ask for a MR) then put in a new claim on the basis of a worsened condition.

However, in my experience the DWP often don't accept that your condition has worsened. So you may need to appeal a DWP decision to decline your second ESa application. You will need to appeal on the grounds that:
1) Your condition has significantly worsened; - Get medical evidence from your counsellor / GP / etc
2) You meet the ESa criteria.

Because this is quite complicated, I think it's really important to get CAB advice from an experienced benefits adviser or a benefits caseworker. They will be able to help you with an appeal if your second ESa application is also refused.

I'm sorry this is not good news for you. You may have to sign back onto JSa to get an income whilst an ESa MR is going through, or request a short-term benefit advance. As NeilCr suggested can you claim PIP?

Some (rather techinical) info here from CPAG: http://www.cpag.org.uk/content/ask-cpag-online-what-can-you-claim-pending-mr-esa-decision

"If you reclaim ESA after being refused or disallowed ESA because you do not have LCW and cannot be treated as not having LCW, you are only entitled to ESA pending a new decision on whether you have LCW if:......

.........you are suffering from a new or significantly worsened disease or disablement since it was decided that you do not have LCW (see below).
In all cases, you must provide a medical certificate with your new claim.

The new rules from 30 March 2015 mean you cannot get ESA pending a decision on whether you have LCW, if a previous decision was that you did not have LCW because you failed to score enough points and could not be treated as having LCW, unless since that decision was made, you are have a new or significantly worsened medical condition.

There is no legal definition of a ‘new’ or ‘significantly worsened’ condition, although case law suggests that a condition has only ‘significantly worsened’ if you are likely to satisfy the work capability assessment (see CIB/1959/1997 and CIB/2198/1997). You should be sent a form ESA83 to complete asking for details of how your medical condition has changed since your previous work capability assessment.

In practice you will need to submit medical evidence which diagnoses a new condition (this could be related to the previous condition e.g. fibromyalgia, previously chronic fatigue), or gives details of how an existing condition has significantly worsened. In some cases, being without money could exacerbate a mental health condition.

The DWP may seek additional evidence from your doctor or advice from Maximus. If the DWP refuses to accept that you are suffering with a new or significantly worsened condition, you will normally get a new decision that you are not entited to ESA because you do not have LCW, which you can only challenge by requesting a MR. If the evidence is unclear, you may be required to submit a new ESA50 questionnaire and attend a Maximus medical examination, pending which you are not entitled to ESA.

It may be possible to request a short-term benefit advance if you have reclaimed ESA on the basis of a new or significantly worsened condition if you are in financial need.

For an Example letter accompanying a reclaim for ESA - see http://www.cpag.org.uk/content/ask-cpag-online-what-can-you-claim-pending-mr-esa-decision


Claiming JSA during an ESA dispute
You can claim jobseeker’s allowance (JSA) while you are disputing an ESA dispute without prejudicing your case that you are entitled to ESA. You must, however, satisfy the jobseeking conditions and need to be aware of the restrictions you can place on your jobseeking activity without risking a disallowance or sanction.

It is important to understand that you cannot claim JSA if you state that you are too sick to work. This can result in a ‘revolving door scenario of being told you cannot claim ESA because you are fit to work and cannot claim JSA because you are unfit to work.

You need to:

insist on your right to make a JSA claim, even though you are disputing an ESA decision and are covered by a current medical certificate, when you make your telephone claim and attend your initial interview at the jobcentre with a ‘work coach';
agree a ‘claimant commitment’ which sets out details of your availability for work and work seeking activity, taking into account realistic and allowable restrictions in the light of your medical condition;
satisfy the jobseeking conditions of being available for work and actively seeking work.
If your claim is refused because of the jobseeking conditions, or you are threatened with a sanction, see Ask CPAG Sanctions.

If you become sick while you are on JSA, you can remain entitled to JSA without having to satisfy the jobseeking conditions for up to 13 weeks. If you are suffering from a new or significantly worsened medical condition, you will need to decide whether to stay on JSA or whether you should instead reclaim ESA which is paid at a higher rate after the assessment period.

If you are entitled to ESA while you are appealing against a LCW decision, you will need to relinquish your JSA claim before your ESA can be restored."