ESA Health Assessment

sarahw1976

Hi

I hope you can help?

I received ESA from July 2020 to August 2021. 

In the meantime I was awarded PIP at the higher mobility rate and standard daily living rate. I'm on the transplant list for 2 new organs. 

In June 2021 I received a form from the Health Assessment Advisory Service which was duly completed. My ESA finished on 1st August. 

I've received an appointment on 11th October for a telephone assessment to see if I'm fit for work! 

Does anyone have any experience as to how long it will take for the DWP to make a decision about ongoing ESA as my PIP, quite rightly, goes towards my transport and care at home. 

Thanks in advance 

TELLIT01

Your ESA has stopped without you receiving notification or having an assessment?  That is not what should happen.  Payment should not stop until you have been reassessed.

poppy12345

TELLIT01 said:

Your ESA has stopped without you receiving notification or having an assessment?  That is not what should happen.  Payment should not stop until you have been reassessed.

It sounds like the OP is claiming New style ESA which can't be paid for longer than 1 year unless placed into the Support Group and then it's paid for as long as they remain in that group.

OP there's no timescales for any decision but the guide at the moment is between 2-12 weeks because the backlogs are huge.

Have you used a benefits calculator to check entitlement to Universal Credit? It's means tested so if you live with a partner you claim as a couple. Savings/capital of more than £16,000 will exclude you from claiming. 

If you're placed into the Support Group for ESA and your ESA starts back up again with payments then the ESA is deducted in full from any UC entitlement.

https://www.entitledto.co.uk/benefits-calculator/Intro/Home?cid=1eaf2ecc-79e9-477f-952b-6597811e2e93

sarahw1976

Thank you for your comments. I really do appreciate it. 

We don't qualify for Universal Credit but I'd like to 'pay my way' because I'm finding the whole experience of stopping work and having rely on other people quite traumatic. 

I did receive notification that it was stopping but it just seems like such a long wait. 

I do appreciate the backlogs are huge and I'm grateful not to be having to worry too much about keeping warm and eating properly. 

Thanks again 

Alice_Holt

Here are the descriptors for the ESA support group:

https://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1353-support-group-descriptors

As you have enhanced Mobility for PIP, see if 1 applies.
A difference between PIP & ESA is that the ESA "mobilising" definition includes the use of a manual wheelchair.
Are there any reasons why you would not be able to use a manual wheelchair -  fatigue, upper body weakness,  etc.
If so then fully explain these at the telephone interview.

Another reason for getting into the Support Group is through Reg 35 (risk to health):
https://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1353-support-group-descriptors
https://wcainfo.net/issues/substantial-risk-lcwra

If you feel that your health would be at risk if you had to attend work focused interviews, etc at the jobcentre, then explain why to the assessor.

https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/help-with-your-esa-claim/esa-medical-assessment/


If you are allocated to the ESA support group, then as poppy says your award should continue.

"New Style ESA lasts for 365 days if you’re in the work-related activity group.

There’s no time limit if you’re in the support group."

https://www.gov.uk/guidance/new-style-employment-and-support-allowance

TELLIT01

poppy12345 said:

TELLIT01 said:

Your ESA has stopped without you receiving notification or having an assessment?  That is not what should happen.  Payment should not stop until you have been reassessed.

It sounds like the OP is claiming New style ESA which can't be paid for longer than 1 year unless placed into the Support Group and then it's paid for as long as they remain in that group.

OP there's no timescales for any decision but the guide at the moment is between 2-12 weeks because the backlogs are huge.

Have you used a benefits calculator to check entitlement to Universal Credit? It's means tested so if you live with a partner you claim as a couple. Savings/capital of more than £16,000 will exclude you from claiming. 

If you're placed into the Support Group for ESA and your ESA starts back up again with payments then the ESA is deducted in full from any UC entitlement.

https://www.entitledto.co.uk/benefits-calculator/Intro/Home?cid=1eaf2ecc-79e9-477f-952b-6597811e2e93

Thanks poppy.  I'd missed the fact that it was roughly 12 months.  Nonetheless I would be surprised if the OP doesn't qualify for the Support Group.  The pandemic certainly won't have helped with reviewing the assessment.

sarahw1976

thank you thank out again for your help Poppy and Alice. 

It's tricky navigating this and just want to do my bit for more needy claimants but also get the best for myself, 

this forum is very helpful 

sarahw1976

When I say needy I mean more in need than I am. Sorry for sounding patronising 😱😱

poppy12345

You don't sound patronising at all. You're only claiming what you're entitled to.

sarahw1976

Hi everyone

I completed my assessment this morning over the phone with a lovely nurse. 

She guided me through the questions and I answered honestly (obviously). 

How my condition affected me
Details of an average day
How I look after myself (getting to appointments etc, bathing...) 

She said because I had provided her with a copy of my latest hospital discharge notes she was fully up to date with what's happening. I told her about a few very recent changes which she made a note of. 

The call lasted about 40 minutes and was quite relaxed, informative and supportive. 

The nurse explained that I would expect to hear from DWP in about 2 weeks. 

Thank you again for all of your assistance and reassurance. 

poppy12345

sarahw1976 said:

The nurse explained that I would expect to hear from DWP in about 2 weeks. 

Glad it went ok. Although that timescale is very optimistic and the HCP doesn't know how huge the backlogs are, so i'd extend that to anything from 2 - 12 weeks.