Question after ESA assessment

Clouds88

Hey guys, so as some of you know my husbands claim started July 2019 and he finally this morning had his assessment! Yay.

The nurse who did it was lovely, she said it will take 2-4 weeks sometimes longer to hear back from DWP. My husband also receives pip enhanced living and lower mobility and we requested the assessors report after that. Is there a similar thing we can do with this report? And do you chase the DWP or just wait for them to send letter? (We have had to chase SO much with them I'm dubious about leaving it and not chasing anything).

Also, those in ESA support group do you get any contact from any work coaches just to 'check in' as such. I am not sure how it went to be honest, she said hes clearly not fit for work and that in the future once DWP has decided he will get sent another ESA50 form to fill out which could be as soon as 6 months or as long as 3 years. But she also said dont be alarmed if you get any phone calls from a work coach checking in see how you are going, they might talk about future training you might want to do or volunteering? Does this sound more like work related group? When I looked online it said for work related group he would need to attend interviews ect which he isnt capable of doing.

Thanks in advance x

poppy12345

Yes you can ring DWP to request a copy of the assessment report, the same way you did with PIP. Towards the back of the report there will be recommendations for LCW and LCWRA and this is what you need to look for. LCW is WRAG and LCWRA is Support Group.

Her advice regarding a work coach is not quite correct and this is why you should always take what they tell you with a large pinch of salt. If you're in the Support Group you don't have a work coach, they leave you alone until the next ESA50 form comes through your door and it can be any time from 3 months, not 6 months.

Only those in the WRAG have a work coach.

When she told you "don't worry, he's not fit for work" she should not have said anything to you because it's not her job to do this. The report is written with recommendations only and only a decision maker can decide what that decision will be, although they do mostly go with the report, it has been known for them to go against it.

Waiting times for decisions? there isn't any, it depends on backlog in your area. Some are waiting a couple of weeks, while others wait several or more.

Clouds88

Thank you Poppy. I really believe he should be in the support group so I'll request the report in a week or so the  wait for their decision. 

I will research mandatory reconsideration and appeals in the mean while.

Clouds88

Hey guys just looking for your advice on next moves. Didnt receive the report so rang ESA they said they sent it to UC to make the decision. Seen a letter on my journal which says the decision has been made that he has 'limited capacity for work and work related activity' and that if we are owed any money we will be contacted. That was given to us as a 'UC decision'.

His claim was made in July 2019 but due to failings of ESA and health assessments he only got his assessment in may. So his ESA claim should be reinstated in payments (and I know taken in full from UC) but we should get backdated support group element from October 20192019-July 2020 then full esa payments from july 2020 and going forward until next assessment is this right? 
I know we will also have an overpayment of UC but the fact we are actually entitled to LWRCA and could have been applied as early as october 2019 if they have done the assessment on time my thinking is that the backdated LWRCA should cancel out the overpayment f UC paid to us because of the backdated ESA we should get  does this all make sense?

Spoonie_Turtle

For UC it's from the 4th payment, assuming he notified UC of his health condition right at the start of his claim.  For ESA it's from 13 weeks after.

I believe the LCWRA element is more than the Support Group payment so yes there will still be an overall underpayment that UC owes you.

If you were earning at all during the UC claim then the work allowance should be applied from the start (or to whenever they were notified of his health) which would then be another underpayment too, unless you have children in which case you will have already had the work allowance.

I would suggest making sure you have your original UC statements saved before they overwrite them when recalculating all or most of your payments.  That way you can be sure of what you've already received and that they haven't made any mistakes with the recalculation. 

Clouds88

Thanks Spoonie but from ESA side of things, he should be due the extra?£40 or whatever it is for support group from 13 weeks after claim started for example november 2019 and then they stopped paying us money in July 2020 because they hadn't done the assessment by then. So from July 2020 ESA will then backdate normal weekly payments until this date and then continue them.

For UC side, I'm not sure if we notified them straight away because we already had an ESA claim an they said ESA will tell them and they will backdate LWRCA payments from the date that ESA state he is eligible for support group. So potentially November 2019. I did inform them of his health condition myself ?jan 2020 as I said ESA was taking ages and can they do their assessment but they said best to just wait for ESA. Its bee so long and drawn out. 

I will be so so happy when we eventually get a back payment, I've had to take out payday loans and put money on my credit cards because we are always short. That extra £343 will mean so much! I have the work allowance already as I work currently, they deduct about a grand off our UC each month due to my earnings.

Spoonie_Turtle

Clouds88 said:

Thanks Spoonie but from ESA side of things, he should be due the extra?£40 or whatever it is for support group from 13 weeks after claim started for example november 2019 and then they stopped paying us money in July 2020 because they hadn't done the assessment by then. So from July 2020 ESA will then backdate normal weekly payments until this date and then continue them.

For UC side, I'm not sure if we notified them straight away because we already had an ESA claim an they said ESA will tell them and they will backdate LWRCA payments from the date that ESA state he is eligible for support group. So potentially November 2019. I did inform them of his health condition myself ?jan 2020 as I said ESA was taking ages and can they do their assessment but they said best to just wait for ESA. Its bee so long and drawn out. 

I will be so so happy when we eventually get a back payment, I've had to take out payday loans and put money on my credit cards because we are always short. That extra £343 will mean so much! I have the work allowance already as I work currently, they deduct about a grand off our UC each month due to my earnings.

Okay, for UC I don't know then.  Maybe looking at the journal online will show when they're counting your husband's health condition from - though I'm not sure what exactly it would say.  Were you submitting fit notes for UC and/or ESA at all?

The work allowance is an amount of earnings they ignore before making deductions.  So if you don't have children, you won't have had the work allowance because the only other people who have it are those with LCW/LCWRA.  That should backdate to whatever date they use as the start to calculate the 4th full AP for the LCWRA element.  It's just under £300 if you get help with rent, or about £500 if you don't (exact figures have changed with the tax year, and your claim spans 3 different tax years so far!).

poppy12345

The extra for the ESA will be from week 14 of his claim. He will also receive money from the date it stopped and payments should start back up again but because the WCA was with UC then he may need to contact ESA to tell them about the decision of the recent WCA.

You can check back on his journal whether the condition was reported when you first claimed UC. ESA don't usually tell them anything about a health condition so i'm unsure why you were told  they would inform them. Fit notes should have also been repoted onto his journal.

Regarding the work allowance, unless you have qualifying young children on your maximum UC amount then you won't have had any work allowance previously to the WCA decision.

The work allowance will be either £293 per month if you claim for help with the rent or £512 per month if you don't claim help with the rent. It means you can earn that amount of money each month before the 63% deductions apply. If you didn't have the work allowance then they will owe you money from that too.

It may take a while to calculate the money that's owed because they have to go through your journal and recalculate each month.

It maybe worth taking screenshots of your statements now before the re-calculations are done.

Clouds88

Thank you for your input I appreciate it. I've done a brief time line to make it clearer:

ESA claim submitted 20th July 2019
Telephone interview of ESA50 was 17th May 2021

Decision made by UC (not ESA??) Today 2nd June 2021.
UC elements we get already:
Couple, child element x2, carers element (started Sept 2021 when he was awarded pip) and I get a work allowance of £293 or something like that.

What I do not understand is why ESA sent it over to UC to make a decision on his WCA. ESA person on phone today couldnt tell me this either. They said UC will then notify them of the outcome. I will ring ESA tomorrow to update them and ask about back payment.

UC told me in September 2020 to wait for ESA to do their assessment as I was moaning about the delay on my journal. I have screen shots of my award and a screen shot from october 2019 where they talk about being aware of his health condition that limits his work. We sent docs notes for over a year, I cant remember if we sent them to UC pre covid they went to job center I think.

poppy12345

The WCA process for ESA and UC are exactly the same and when you claim both, you don’t have a WCA for both. Usually one or the other will take the WCA. 

With regards to the money owed I think you need to wait until the calculations are done and then do the calculations to see if they are correct. The 3 month waiting period will apply to UC and the LCWRA will be paid from the 4th month. How long you will have to wait for this, I really have no idea. Hopefully not too long.