Letter from Health Assessment Advisory Service

AElene

OH has received a letter from the above, along with a DWP leaflet (WCA AL1C)
It sounds like he has to go for a work capability assessment, and I'm assuming it's regarding his ESA claim. It doesn't say specifically, it just says "your benefit claim".


He's had an assessment for P.I.P. already, and we're wondering if this new assessment is going to differ a lot from the P.I.P. one. Does anyone have experience of both, or of the Work Capability Assessment?


I'm reading a lot that if it's mental health problems they don't take them seriously and just refuse the ESA and make them sign on for JSA, which is worrying, given that OH has a serious mental health diagnosis. He's due to see his psychiatrist about a week after the assessment.


Is there anything we need to do to prepare for this assessment? Would be grateful for any advice. Thanks.

poppy12345

AElene wrote: »

OH has received a letter from the above, along with a DWP leaflet (WCA AL1C)
It sounds like he has to go for a work capability assessment, and I'm assuming it's regarding his ESA claim. It doesn't say specifically, it just says "your benefit claim".


He's had an assessment for P.I.P. already, and we're wondering if this new assessment is going to differ a lot from the P.I.P. one. Does anyone have experience of both, or of the Work Capability Assessment?


I'm reading a lot that if it's mental health problems they don't take them seriously and just refuse the ESA and make them sign on for JSA, which is worrying, given that OH has a serious mental health diagnosis. He's due to see his psychiatrist about a week after the assessment.


Is there anything we need to do to prepare for this assessment? Would be grateful for any advice. Thanks.

Yes it's an ESA assessment. They'll assess his capability to be able to do any type of work. ESA and PIP are 2 completely different benefits. ESA is about the work you can do and not the work you can't do.

During the assessment they'll ask him various questions beased on what was put in the ESA50 form, so similar to PIP assessment, but the criteria is different. Did you send in evidence to support the claim? If you didn't then you should take this with you along with a printed list of all his currect medication. Don't just answer the questions with a yes or no, give as much detail as possible. There's plenty of info on the internet about the assessments for ESA. Just remember it's about the work he can do, not what he can't do, a lot of people fail to understand this. Good luck.

Alice_Holt

Some info on WCA:
https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/help-with-your-esa-claim/esa-medical-assessment/
https://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-medicals

epitome

https://www.gov.uk/government/publications/esa214-a-guide-to-employment-and-support-allowance-the-work-capability-assessment

They don't ignore mental health, loads of claimants are passed on mental health. Loads are failed on Mental Health just as

Loads of claimants are passed on physical conditions and loads are failed on physical conditions.

The link above is the ESA214 leaflet, it explains it all, however, it is also a good source for the ESA Descriptors Page 17 / 18 onwards

The ones with points are for the WRAG
The later ones without points are for the Support Group.

It is also important to know what each one means, they are actually self explanatory, but a lot of people don't read them properly.

Alice_Holt

Also it is possible to be awarded ESA if there would be a significant risk to health -
- if found fit for work (reg 29) - WRAG (regardless of whether 15 points are attained).,
- if unable to to participate in Work Related Activities (reg 35) - then the Support Group applies.

More info here:
http://www.cpag.org.uk/content/making-exception
https://www.rethink.org/living-with-mental-illness/money-issues-benefits-employment/work-capability-assessment/what-next

If your OH has a serious mental health diagnosis then it is quite possible this might apply.
It would be worth seeing what medical evidence you have to hand that would show that the JSA / UC claimant commitment would cause his MH to worsen.
It may even be worth seeing if his GP would give you a brief note to this effect, which you could copy and take to the assessment.
This is not covered in the ESA50 questions - so if it applies, raise it at the WCA (with medical evidence if possible).
https://www.benefitsandwork.co.uk/news/2955-regulation-35-2-b-is-now-the-main-route-into-esa-support-group

AElene

Thankyou for your replies. Just a quick question, can we ask for a copy of what the assessor has written about him, and who would we need to ask/what would we need to ask for?

KxMx

Yes. A few days after the medical, ring the DWP and ask for a copy of the report which is called ESA85.

It is not standard practice to send it out after a medical, but claimants are entitled to receive that report upon request.

poppy12345

AElene wrote: »

Thankyou for your replies. Just a quick question, can we ask for a copy of what the assessor has written about him, and who would we need to ask/what would we need to ask for?

Also you may find that they won't send the report out to you until after a decision's been made. This is very often the case with ESA unlike PIP.

epitome

poppy12345 wrote: »

Also you may find that they won't send the report out to you until after a decision's been made. This is very often the case with ESA unlike PIP.

However such a refusal is always going to be an incorrect refusal. And if refused, you should, first ask for the name of the person you are speaking to and what office they are in.....Then ask to speak to a manager and make a formal complaint to that manager over the phone and request a written response to your complaint if they don't change their mind and send you the report there and then.

If they still refuse after you have made a formal complaint. Then end the call, phone back to get someone else who most likely will send you the form,,, and make the same formal complaint with them about the manager you were speaking to earlier for refusing to send the med report. (just incase that previous person does not actually do the complaint).

poppy12345

epitome wrote: »

However such a refusal is always going to be an incorrect refusal. And if refused, you should, first ask for the name of the person you are speaking to and what office they are in.....Then ask to speak to a manager and make a formal complaint to that manager over the phone and request a written response to your complaint if they don't change their mind and send you the report there and then.

If they still refuse after you have made a formal complaint. Then end the call, phone back to get someone else who most likely will send you the form,,, and make the same formal complaint with them about the manager you were speaking to earlier for refusing to send the med report. (just incase that previous person does not actually do the complaint).

Interesting thanks. My question is, why do they mostly refuse people when they ring and ask for the ESA assessment report, saying it can't be sent out until after a decision's been made?

epitome

In my experience, it is "refusal to issue" that is the most unlikely response, i.e. most will have no problem to print/send it as long as it is has been written. They are generally written within 2 days of the WCA appointment.

If I had to put a figure on it I would say less than 10% refuse saying not until after a decision has been made.

As to why it happens:
I can only guess that someone has got a wrong idea into their head and told other's and then it spreads through the office as gospel.

Similar with office gossip. Those ones who do refuse will also put a note on your file to say they refused. When you call again and get a different office.... even if it is weeks/months/year later on a different enquiry, those people are likely to read previous notes and see that note, and then they might think...."oh I didn't know we couldn't send them until after the decision" and then those people will start to refuse aswell...and then tell their colleagues in their office.
Whereas others who read those previous notes would think "stupid idiots don't know what they are doing"...and carry on issuing it to a claimant whenever they ask for it. And hopefully they would also send an error against the person who refused.

There is certainly nothing stopping them from accessing MSRS and printing it. And doing that and sending it to a claimant would have no effect on the decision making process, because the DM just prints it aswell and has the paper-work file and makes the decision independently of whether a call centre has printed a copy and sent it to a claimant.

On a similar topic.....You also get a lot of call centre people refusing to take a Man Recon until the claimant says they have received the WSOR (written Statement of Reasons). This also is completely without foundation, and is wrong. Personally I think this one has more to do with that agent not wanting to send a HOTT, because the DWP has targets for the number of HOTTs that are sent (fewer the better according to managers).

When you say you have now received your WSOR, you also get them refusing to take the Man Recon by phone, telling you to put it in writing....which is also incorrect refusal. And stems from the premis that they don't want to send a HOTT because it goes on their weekly stats....and that some dictated Man Recons could take a very long time to type over the phone.

This is why it is important to make an official complaint over the phone with the person who refused you, and insist on a written response, so that incorrect actions eventually stop happening.