ESA Stopped.

TheDonovanViper

Hi everyone,

I'm just posting to get some help if I am honest as the DWP aren't very empathetic due to my current issues.

Long story short, been on ESA for three years now, went for two medicals in December, scored 6 points and have had my mandatory reconsideration refused.

I have Depression, Anxiety, Psoriasis and a recently diagnosed case of Fibromyalgia.

During the period of time between the medical and the mandatory reconsideration refusal, my Grandmother passed away in my home so I haven't been able to mentally cope with the death of her and therefore have not applied for JSA (as the wonderful lot at the DWP insist I do, hence why I am asking for help).

As I am collating the evidence together to send to the tribunal (with an added sick note) I was wondering where I stand with the weeks from January to the ongoing Tribunal case to heard in terms of money that I haven't claimed as I hear you can ask to be put on the Assessment Rate of ESA whilst your case is ongoing with the Tribunal.

Luckily I live with a very understanding mother who has helped me with this ongoing problem by not asking for rent or anything whilst I go through these troubling times. Cos my Grandmother passed in the front room, I am now even feeling awkward living in my own home, let alone going in the front room on my own.

I am a complete mess with everything that has gone on as these is a mental health relapse, so any help is greatly appreciated.

(I apologise for the long winded paragraphs and any poor grammar or layout, I just need help).

NeilCr

Information here. But, yes, ESA can be reinstated during an appeal

http://www.cpag.org.uk/content/benefit-during-employment-and-support-allowance-dispute


Best to submit the appeal in as soon as possible. You are aware that you have 30 days to get the appeal in from the date of the MR notification aren't you?

Some general info on appealing here

https://www.citizensadvice.org.uk/benefits/benefits-introduction/problems-with-benefits-and-tax-credits/challenging-a-benefit-decision/challenging-a-dwp-benefit-decision-on-or-after-28-october-2013/appealing-against-a-benefit-decision/appealing-against-a-dwp-benefit-decision/

I'm sure someone more knowledgable, like Alice, will be ale to go in to more detail

Good luck

TheDonovanViper

Thanks for the help Neil.

Already been through the Mandatory Reconsideration phase, now I am just collating all of the information together to go to the Tribunal and write that letter.

So no hope on a potential backdated payment since January 14th 2017 up until it is reinstated as discussed or do I have to wait until I go to the Tribunal and potentially win that to get that time period of payment (as already said in first post that I am on nothing, no JSA or anything due to not coping well with the loss of my Grandmother).

Tommo1980

No you won't get the assessment rate backdated.

If you win at appeal you would get payment backdated to your failed WCA.

Tom

NeilCr

TheDonovanViper wrote: »

Thanks for the help Neil.

Already been through the Mandatory Reconsideration phase, now I am just collating all of the information together to go to the Tribunal and write that letter.

So no hope on a potential backdated payment since January 14th 2017 up until it is reinstated as discussed or do I have to wait until I go to the Tribunal and potentially win that to get that time period of payment (as already said in first post that I am on nothing, no JSA or anything due to not coping well with the loss of my Grandmother).

Sorry. My fault. I meant appeal rather than MR. I'll change my post now. Still 30 days though!

As far as I am aware you can't now get the ESA from January. Someone better versed may know different but I suspect that the answer is you could have claimed JSA

TheDonovanViper

Thanks to you both for that information.

I have had conflicting information told to me and it is better to get the advice and knowledge of people who know what they're talking about, so thanks.

Yep, was told to claim JSA and there was no sense of empathy at all. As it won't be worth putting in a claim for anything else now, I shall just wait until I post in my Tribunal paperwork on Monday and get the ball rolling on that one, so it saves any sort of hassle in the future with over payments as I am reading some people are dealing with at the moment.

Thanks.

Alice_Holt

The next stage in the appeal process is to lodge your appeal with the Tribunal Service. It's very rare for a DWP MR decision to overturn the original DWP decision.

The majority of TS appeals are successful.
Once the DWP have received the appeal paperwork, you can ask for your ESA payments to be re-instated pending your hearing (per Neilcr). You will need to supply "fit notes" during this period.

Here is the form to continue your appeal.
http://formfinder.hmctsformfinder.justice.gov.uk/sscs001-eng.pdf
Be mindful of the deadline. You need to attach your MRN.
Opt to attend the hearing, and I suggest not requesting short notice.

You can then follow up with supporting evidence, written statements, etc.

This is a very good guide:
http://www.advicenow.org.uk/guides/how-win-pip-appeal
It's about PIP appeals but the appeal process is virtually identical
Also: https://www.leicester.gov.uk/media/182136/employment-and-support-allowance-appeals-guide.pdf

ESA points system:
http://www.benefitsandwork.co.uk/employment-and-support-allowance/start-the-esa-test

Can you get help with the appeal from your local CAB / advice agency?
https://www.citizensadvice.org.uk/about-us/how-we-provide-advice/advice/

TheDonovanViper

Thanks for all that info Alice, it is greatly appreciated.

In regards to the appeals guide, who can I get to fill those out other than my GP? I am seeing a therapist for the first time on April 5th, would that be suitable?

All the other consultants I see I have already elapsed the time of seeing (Dermatologist, Pain Clinic) or the appointments will be too far away from the appeal time (Urologist, Hearing Therapist).

Do you think the GP (of twenty years) and the therapist of who I will have only seen once will be sufficient enough?

I'm just too overly concerned now about my well being as I have five prescriptions here which I am unable to afford, so the quicker I can get the SSCS1 posted off, the better.

I do have hospital letters from the last time I saw the majority of the consultants in regards to what is going on with me which the DWP have seen but overlooked. Should I add those in as well? Also, my Mum wants to add in a letter of her own discretion, I just need to double and triple check that what I am doing is 100% correct as it has been many years since I last had a tribunal in regards to ESA.

Alice_Holt

In terms of getting medical evidence to support your appeal, a letter from your GP would be helpful.
It really helps if it references the relevant ESA activities and descriptors.


I think it's worth going carefully through the ESA points and seeing where the additional 9 points should be awarded. Then concentrate on getting / compiling the evidence to support these. Would the significant risk exceptions be applicable?
http://www.cpag.org.uk/content/making-exception

You may want to get a copy of the medical assessment (ESA85 from the DWP), as it can be useful in identifying any inconsistencies / errors. Going back to your ESA50 form is also useful. If you identified a difficulty that was dismissed at the assessment - then evidencing those difficulties is helpful for the hearing.
(But you will get both of these reports as part of the DWP evidence bundle).

Keeping a diary / notes is useful, and you can then use this to give the tribunal panel verbal examples and illustrations of your problems with the descriptors at the hearing.

The key is to explain difficulties around those descriptors for which you should have scored the additional points (as this is how the tribunal will come to their decision).

It's a case of stacking up the medical evidence / your written submission / your verbal evidence on the day, so this is cumulatively more persuasive than the (probably flawed assessment) . Remember that if you can't complete the descriptor reliably, safely, repeatedly, and in a reasonable time period - then you should be scored as not able to do it.

This is nicked from Benefits & Work - "Or you may sometimes be able to do an activity and sometimes not, without any way of being able to predict which will be the case. This is less an issue of your condition being variable and more about being unable to rely on your ability to do a specific activity on any given occasion. We would argue that in this case you should count as not being able to do it, at least for the majority of the time, because you can never predict whether you can do it or not."


From sending in the SSCS 1 to the hearing date, an approximate timescale is approaching 3 months (but it does vary between regions and TS workload). So you may have time to wait to get evidence from your therapist after a few more appointments.
It worth sending in any relevant recent medical evidence, just read them through carefully and make sure it supports your case. If the DWP already have any of these reports there is no need to sent them in, as they will be in the DWP evidence bundle.

A letter from your Mum is a good idea - again make sure it relates your condition and difficulties to the ESA descriptors.

TheDonovanViper

Hi again Alice,

I just had to take the whole weekend to take in what was going on, especially with this weekend being Mother's Day and all.

I was wondering (as I cannot find head nor tail of any concrete information on the question) can I just send in the cover letter now explaining that I would like to take it to a Tribunal with not much medical evidence at the moment, but continually post in information up until the Tribunal date is set, or do I have to post everything within the month allocated?

Sorry for all of the questions, I just want to be as prepared as possible when it comes to the day.

All the best.

Alice_Holt

Lodge the appeal with the Tribunal Service with the SSCS1 form I linked to in post 7.

You can then follow up with the additional evidence, a statement, etc

These guides explain the appeal process:
http://www.advicenow.org.uk/guides/how-win-pip-appeal
It's about PIP appeals but the appeal process is virtually identical
Also: https://www.leicester.gov.uk/media/182136/employment-and-support-allowance-appeals-guide.pdf
https://www.citizensadvice.org.uk/benefits/benefits-introduction/problems-with-benefits-and-tax-credits/challenging-a-benefit-decision/challenging-a-dwp-benefit-decision-on-or-after-28-october-2013/appealing-against-a-benefit-decision/appealing-against-a-dwp-benefit-decision/
http://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-appeals