ESA Tribunal

First of all I'd like to introduce myself

My name is HC and I have uncontrolled epilepsy, agoraphobia as well as a few other health issues.

I have been on Severe Disablement Allowance for a number of years but recently been assessed for ESA. I have been placed in the work group.

I have had a Mandatory Reconsideration Notice today with the option to go to tribunal. I would like to do this but wanted to come and chat to others who have been through or are going through the same thing.

I felt that a lot of the questions do not really cover my conditions?

The letter I received today states that I met the conditions for limited capability for work but did not have, nor could I be treated as having limited capability for work related activity.

I have at least 10 to 15 drop down seizures a month.

This is an estimate and could be a higher number due to not always having someone with me and the confusion afterwards. I have partial seizures daily including strong myoclonic jerks and night time seizures. A lot of the time I cannot fully function and am also afraid to go out unless I have someone close with me.

I also have hypermobility syndrome, underactive thyroid and thought now to have sleep paralysis.

I sent photographs of injuries which include a tib and fib break (now have a rod in my leg) and an ankle break due to falling and having seizures, a detailed letter of how I'm affected etc..

I then had what I can only describe as a very degrading call asking all sorts of questions....It seems I have even been penalised for being able to hold a phone to my ear! My GP is at a loss as to how it has got as far as it already has!

I have been put on jobseekers and had a phone interview with a lovely lady at the job centre. She told me to keep appealing and will call back in August.

I was going to go to my local CAB but as I am agoraphobic and can't get out on my own I just can't get there.

My husband only has fridays off and they are not open then.
So this is my story.

What to do next!?

HC wrote: First of all I'd like to introduce myself

My name is HC and I have uncontrolled epilepsy, agoraphobia as well as a few other health issues.

I have been on Severe Disablement Allowance for a number of years but recently been assessed for ESA. I have been placed in the work group.

I have had a Mandatory Reconsideration Notice today with the option to go to tribunal. I would like to do this but wanted to come and chat to others who have been through or are going through the same thing.

I felt that a lot of the questions do not really cover my conditions?

The letter I received today states that I met the conditions for limited capability for work but did not have, nor could I be treated as having limited capability for work related activity.

I have at least 10 to 15 drop down seizures a month.

This is an estimate and could be a higher number due to not always having someone with me and the confusion afterwards. I have partial seizures daily including strong myoclonic jerks and night time seizures. A lot of the time I cannot fully function and am also afraid to go out unless I have someone close with me.

I also have hypermobility syndrome, underactive thyroid and thought now to have sleep paralysis.

I sent photographs of injuries which include a tib and fib break (now have a rod in my leg) and an ankle break due to falling and having seizures, a detailed letter of how I'm affected etc..

I then had what I can only describe as a very degrading call asking all sorts of questions....It seems I have even been penalised for being able to hold a phone to my ear! My GP is at a loss as to how it has got as far as it already has!

I have been put on jobseekers and had a phone interview with a lovely lady at the job centre. She told me to keep appealing and will call back in August.

I was going to go to my local CAB but as I am agoraphobic and can't get out on my own I just can't get there.

My husband only has fridays off and they are not open then.
So this is my story.

What to do next!?

Hi HC,

Welcome to Benefits and Work

Just to make you aware that this is not a chat/discussion forum as such although other members are most welcome to provide feedback.

B&W tends to operate as a Q&A forum where members post queries, and the site Mods try and help as much as they can within the remit of the forum.

It is important that you fully understand that with The ESA WCA it is is not an assessment of your medical conditions, it is an assessment of your "capabilities" and "limitations" as a result of the medical conditions.

Yes, Limited Capability for Work (LCW) means that you are "unfit for work" and as such you are placed into The Work Related Actvity Group. (WRAG)

If in The WRAG, you should be aware of the following :

12 Month Limit for ESA(CB)

Work Focused Interviews

Work Programme

&

Changes to ESA Sanctions

As you have been placed into The WRAG, you must have scored a minimum of 15 points or more cumulitvely across : The WRAG (LCW)Schedule 2 Descriptors

Or, if you could not score 15 points, via : ESA Reg 29 for entry to The WRAG (LCW)

PLUS Post 28/01/13 Amendment of :

(3) Paragraph (2)(b) does not apply where the risk could be reduced by a significant amount by—

(a)reasonable adjustments being made in the claimant’s workplace;

or

(b)the claimant taking medication to manage the claimant’s condition where such medication has been prescribed for the claimant by a registered medical practitioner treating the claimant.”.

From : www.legislation.gov.uk/uksi/2012/3096/regulation/3/made

See also : Qualifying for the WRAG

From our : ESA FAQ’s

To gain access to The Support Group, (SG) not only must you be found to have LCW, you must also be found to have Limited Capability for Work Related Activity. (LCWRA) (Unfit to take part in WRA as well as Work)

The only ways that you can achieve SG entry is by fulilling at least one of : The SG (LCWRA)Schedule 3 Descriptors

Or, if none of those, via : ESA Reg 35 for entry to The SG (LCWRA)

See also : Qualifying for the Support Group

Therefore, if you are to appeal directly to The Tribunal Service (TS) is will be important to show which of The SG Schedule 3 Descriptors you feel that you qualify under, giving reasons. (Any one of them will do)

In addition, if you feel that there will be a sustantial risk to your health or that of another if you continue to be compelled to take part in WRA, you could also cite ESA Reg 35. (2) (a) & (b).

May I suggest that you read through the following :

ESA Claims Guides

Including the "Understanding ESA" and Being Transferred to ESA" guides on the same page.

If you are to appeal consult our : ESA MR/Appeals Guidance.

See also : Disability Rights UK Factsheet - Appeals and Mandatory Reconsiderations.

&

MOJ Video of ESA Appeals Process and Tribunal

You will continue to receive the WRAG rate of ESA whilst appealing, and once your appeal is accepted by The TS, you should not be referred to a Works Programme Provider. (WPP)

Since you have been transferred over to ESA from SDA, you might also find our : IB, IS, SDA, Migration to ESA FAQ’s of interest.

I know there is a lot of information to take in here, but if you Bookmark/Favourite this page in your browser, you can then find it again easily for future reference, and to pose any further queries that you might have.

For clarification, if you have been classed as having LCW, you will be in The WRAG of ESA, and not on Jobseekers. (JSA)

The telephone interview that you had would have been a Work Focused Interview, (WFI) which is classed as Work Related Actvity. (WRA)

You would only have to have claimed JSA if you had received less than the minimum 15 Points for LCW, WRAG. i.e. you were found fit for work.

It seems that they are limiting your WRA requirements to WFI's over the phone at this time.

You might want to request some ESA documentation that may be helpful if you don't already have it.

See : This Post.

bro58

Thank you for your reply and the information you have given.
The problem I have is that I can have all of those problems on a random day which would be at least three times a week and then recovery time. Then it all starts over again with yet another seizure. When I am feeling well or having a good day then some of those things are possible.
I do lose consciousness several times a week, I am totally unaware of what is going on around me etc.. and am often drowsy due to meds etc.. There are many different types of seizure and I have several.
Is the tribunal an independent body? and would it be worth getting all the information I have together again and resending for the Tribunal?
Also should I ask for an oral hearing or a written one?
Sorry for all the questions. This is all new to me.

Thanks Gordon,
I will focus on why I think the decision is wrong. Many things stated in the Mandatory Consideration were not accurate and I can't in fact do many of the things it states I can. Even my GP letter stated this. I will highlight what they have stated and say why it is inaccurate.
The GP letter was apparently read over the phone to someone at Maximus? They then made the decison.
I will focus on the things I can't do and on how my condition affects me and state what parts were inaccurate.
Sorry if I am not being clear on what I am asking/talking about. I am not that great on the best of days and get easily confused etc.. My memory is also not that great.
I will also ask for an oral hearing. I get very confused and upset when talking about my epilepsy in person. I tend not to talk about it as a way of coping but will do this and will have my husband with me for support.

Housecat wrote: Thanks Gordon,
I will focus on why I think the decision is wrong. Many things stated in the Mandatory Consideration were not accurate and I can't in fact do many of the things it states I can. Even my GP letter stated this. I will highlight what they have stated and say why it is inaccurate.
The GP letter was apparently read over the phone to someone at Maximus? They then made the decison.
I will focus on the things I can't do and on how my condition affects me and state what parts were inaccurate.
Sorry if I am not being clear on what I am asking/talking about. I am not that great on the best of days and get easily confused etc.. My memory is also not that great.
I will also ask for an oral hearing. I get very confused and upset when talking about my epilepsy in person. I tend not to talk about it as a way of coping but will do this and will have my husband with me for support.

Don't worry HC,

We understand how confusing and overwhelming all this can be !!

You should also try to identify any of The SG Activities/Descriptors that you feel apply to you.

Quote the actual descriptor/s, then state how and why you feel you qualify under them.

You can then cross reference your reasoning to any medical evidence that you have provided.

You could also cite ESA Reg 35 as a back up, stating how and why you feel that there would be a substantial risk to your health (or any other persons health) if you continued to have to comply with WRA.

bro58