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TRANSFER FROM IB TO ESA AND PIP CLAIM
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9 years 6 months ago #126155 by Gordon
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Replied by Gordon on topic TRANSFER FROM IB TO ESA AND PIP CLAIM
angelcake
There is only one WRAG group, it is the type of ESA that you are receiving that determines whether the 365 day rule applies.
If you are receiving ESA(CB), as you are, then your payments will stop if you remain in the WRAG for a year.
If you are eligible to receive ESA(IR) then as long as you remain eligible for ESA you will continue to receive payments, even if you remain in the WRAG.
If you are not eligible for ESA(IR) then your payments will stop at the end of the 365 days, you have three options.
1. If you health remains the same, you can keep your claim open and you will receive NI Credits which count towards a full State Pension.
2. If your health deteriorates such that you believe you are eligible for the SG, then you can ask to be re-assessed, you can do this at any time up to the end of the 365 days, or after this, but only if you have kept your claim open (see 1). This will be a full re-assessment of your claim (new ESA50 and likely face to face assessment, if you are placed in the SG then your payments should be re-instated from the date you notify the DWP of what is a Change of Circumstances, while you are in the SG your payments will continue without limit.
3. You can make a new claim for ESA(CB). You can only do this if you can pass the Contribution Conditions, as you were previously on IB your previous Contributions will no longer count, so you will have to have built up a new Contribution history by working.
Do you mean that your savings and assets are in excess of the maximum £16,000?
If they are then you can reduce your savings until they are under the limit, providing that any expenditure that you make is considered as reasonable. I can't guide you as to what is reasonable or not, but spending the money on scratch cards would probably be seen as unreasonable, whereas doing essential repairs on the house would not. You also need to careful about reducing any debts that you have as you can be classed as being still in possession of the savings if the expenditure is seen as unnecessary.
You should keep receipts for all purchases.
Gordon
So are all WRAG groups just for 365 days or is it just the contribution one? As I’m in the contribution one are there zero options to take once the 365 days are up??
There is only one WRAG group, it is the type of ESA that you are receiving that determines whether the 365 day rule applies.
If you are receiving ESA(CB), as you are, then your payments will stop if you remain in the WRAG for a year.
If you are eligible to receive ESA(IR) then as long as you remain eligible for ESA you will continue to receive payments, even if you remain in the WRAG.
Does that mean you are cut off completely or can you make a fresh claim? Are there any options?
If you are not eligible for ESA(IR) then your payments will stop at the end of the 365 days, you have three options.
1. If you health remains the same, you can keep your claim open and you will receive NI Credits which count towards a full State Pension.
2. If your health deteriorates such that you believe you are eligible for the SG, then you can ask to be re-assessed, you can do this at any time up to the end of the 365 days, or after this, but only if you have kept your claim open (see 1). This will be a full re-assessment of your claim (new ESA50 and likely face to face assessment, if you are placed in the SG then your payments should be re-instated from the date you notify the DWP of what is a Change of Circumstances, while you are in the SG your payments will continue without limit.
3. You can make a new claim for ESA(CB). You can only do this if you can pass the Contribution Conditions, as you were previously on IB your previous Contributions will no longer count, so you will have to have built up a new Contribution history by working.
I’ve never been in this position before whereby I have gone over the threshold of income does it make a difference in being able to claim if my income goes down below the threshold after the 365 days?
Do you mean that your savings and assets are in excess of the maximum £16,000?
If they are then you can reduce your savings until they are under the limit, providing that any expenditure that you make is considered as reasonable. I can't guide you as to what is reasonable or not, but spending the money on scratch cards would probably be seen as unreasonable, whereas doing essential repairs on the house would not. You also need to careful about reducing any debts that you have as you can be classed as being still in possession of the savings if the expenditure is seen as unnecessary.
You should keep receipts for all purchases.
Gordon
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9 years 6 months ago #126210 by angelcake
Replied by angelcake on topic TRANSFER FROM IB TO ESA AND PIP CLAIM
Hi Gordon,
Thank you for your reply I think I understand more clearly now.
The backdated PIP award lump sum took me over the threshold as I had some severance left. If there had not been a large backdated lump sum of PIP I would be in the WRAG (IR).
Anyway I rang the benefits office today to ask for a mandatory reconsideration. The first person I spoke to just said that I would get a call tomorrow and they would expect me and I would have to explain why the decision is wrong and why I’m unfit for work. Which I was horrified at the thought not being able to state my case effectively due to my health and it is too pressurising and anxiety provoking. Then they would make a mandatory decision from the phone call. I’m trying to get to a hospital appointment tomorrow which is enough pressure as it is coping with this task with health being as it is and I explained that I’m not sure I’d be able to pick up the phone. To which he said I’d would have to ring in if missed the call. I asked him about the docs and statements I need and he said that I’d have to ask tomorrow in the phone call.
I called in again as I was anxious about what was required of me and it was only when I got to the third person phone call then I was informed that she could email the ESA to send the docs out which would take 10 days and that I didn’t need to have the phone call but I would need to put in for a mandatory reconsideration by 30 days. It say’s on my letter from the date of the letter which is 16th Oct but she had a look and said it is 30 days from the 24thOct so the 24th November. The discrepancy in the dates is worrying as I don’t want to miss that deadline but she said she checked and it’s the 24th and not the 16th even though that is the date on my letter. I hope it is the 24th too as by the time I receive the documents I would have practically no time left on the 16th time-frame.
I read through the list of forms needed and she said she could email and ask for the ESA 72, 85, 113 and LT 54 and written statement but she said she could not ask for the others on this list. Can you tell me if I need to do this and how to go about it?
• ESA72 award form (may be available)
• ESA85 medical report (if you had a medical)
• ESA85A medical report (if you did not have a medical)
• ESA113 report from your GP (if one was requested)
• LT54 Decision Makers form (if you were transferred from another benefit or the Decision was the result of a Reconsuderation).
• any medical reports from your GP or Consultants
• any queries, requests for clarification, correspondence, memos, emails or other communications between ATOS health professionals and the decision maker in relation to your claim, or any notes or records of conversations between ATOS and the DWP
• any other evidence considered by the decision maker in reaching their decision
• a copy of any worksheet, score sheet or any similar document which sets out which descriptors, exemptions or exceptional circumstances the decision maker considered.
I’m very confused by the mixed information I’ve received its not clear on the original award form the steps and two of the people on the phone were ill-equipped to explain the process to me. Is this correct that I don’t have to speak to anyone to explain why I think I should be in the support group? I then wait for the forms and statement to arrive and then I apply for a mandatory reconsideration and write my evidence to argue why I think I should be in the support group and this is what needs to be done within the 30days.
I now realise only going through the process that I have potentially put myself under more pressure and anxiety by avoiding contacting the benefits office in the first place because now I cannot do anything until I get the information from them (10 days) and by then there will not be very much time left for me to write my evidence given that my health drastically impairs any activity, I am feeling extremely anxious...
I don’t suppose there is anything I can do now until I receive the information on what they based their decision on can I? I’m really panicking on what time I’ll have left now once the documents have arrived.
Please can you explain if there is anything else I need to do or if anything they have told me is incorrect as I’m not very confident in what I’ve been advised and I’m really confused.
Many thanks
Angelcake
Thank you for your reply I think I understand more clearly now.
The backdated PIP award lump sum took me over the threshold as I had some severance left. If there had not been a large backdated lump sum of PIP I would be in the WRAG (IR).
Anyway I rang the benefits office today to ask for a mandatory reconsideration. The first person I spoke to just said that I would get a call tomorrow and they would expect me and I would have to explain why the decision is wrong and why I’m unfit for work. Which I was horrified at the thought not being able to state my case effectively due to my health and it is too pressurising and anxiety provoking. Then they would make a mandatory decision from the phone call. I’m trying to get to a hospital appointment tomorrow which is enough pressure as it is coping with this task with health being as it is and I explained that I’m not sure I’d be able to pick up the phone. To which he said I’d would have to ring in if missed the call. I asked him about the docs and statements I need and he said that I’d have to ask tomorrow in the phone call.
I called in again as I was anxious about what was required of me and it was only when I got to the third person phone call then I was informed that she could email the ESA to send the docs out which would take 10 days and that I didn’t need to have the phone call but I would need to put in for a mandatory reconsideration by 30 days. It say’s on my letter from the date of the letter which is 16th Oct but she had a look and said it is 30 days from the 24thOct so the 24th November. The discrepancy in the dates is worrying as I don’t want to miss that deadline but she said she checked and it’s the 24th and not the 16th even though that is the date on my letter. I hope it is the 24th too as by the time I receive the documents I would have practically no time left on the 16th time-frame.
I read through the list of forms needed and she said she could email and ask for the ESA 72, 85, 113 and LT 54 and written statement but she said she could not ask for the others on this list. Can you tell me if I need to do this and how to go about it?
• ESA72 award form (may be available)
• ESA85 medical report (if you had a medical)
• ESA85A medical report (if you did not have a medical)
• ESA113 report from your GP (if one was requested)
• LT54 Decision Makers form (if you were transferred from another benefit or the Decision was the result of a Reconsuderation).
• any medical reports from your GP or Consultants
• any queries, requests for clarification, correspondence, memos, emails or other communications between ATOS health professionals and the decision maker in relation to your claim, or any notes or records of conversations between ATOS and the DWP
• any other evidence considered by the decision maker in reaching their decision
• a copy of any worksheet, score sheet or any similar document which sets out which descriptors, exemptions or exceptional circumstances the decision maker considered.
I’m very confused by the mixed information I’ve received its not clear on the original award form the steps and two of the people on the phone were ill-equipped to explain the process to me. Is this correct that I don’t have to speak to anyone to explain why I think I should be in the support group? I then wait for the forms and statement to arrive and then I apply for a mandatory reconsideration and write my evidence to argue why I think I should be in the support group and this is what needs to be done within the 30days.
I now realise only going through the process that I have potentially put myself under more pressure and anxiety by avoiding contacting the benefits office in the first place because now I cannot do anything until I get the information from them (10 days) and by then there will not be very much time left for me to write my evidence given that my health drastically impairs any activity, I am feeling extremely anxious...
I don’t suppose there is anything I can do now until I receive the information on what they based their decision on can I? I’m really panicking on what time I’ll have left now once the documents have arrived.
Please can you explain if there is anything else I need to do or if anything they have told me is incorrect as I’m not very confident in what I’ve been advised and I’m really confused.
Many thanks
Angelcake
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9 years 6 months ago #126213 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic TRANSFER FROM IB TO ESA AND PIP CLAIM
angelcake
Good evening, let me tackle your savings first, if it is only your PIP award that has pushed you over the £16,000 then you may still be eligible for ESA(IR) as back dated payments should be disregarded for at least 52 weeks although you will need the DWP to confirm this and there will be a deduction of £1/week for every £250 of savings in excess of £6000.
As to the MR, it is DWP policy for the Decision Maker to phone the client, you don't have to take the call but it may be to your advantage to do so as we have had members over turn the original Decision when they have talked to the DM and explained their limitations.
If you do decide to take the call, then I would prepare a short checklist of reasons why you believe that you should be in the SG, which you can then refer to during it.
Your requesting an MR is not limited by whether or not you take the call, despite what you have been told I would stick to using the date of the letter, that way there can be no confusion that the MR has been submitted on time.
The list of documents from the FAQ is what might be available, there will be variation from claimant to claimant, you should expect an LT54 and ESA85, if there was an ESA72 then you should have already received it with the Decision letter, the ESA113 will depend on whether they contacted your GP or not.
Not having the documents available now, may be another good reason to take the DM's call, as it will hopefully explain the areas that they feel you did not meet the SG criteria. Your task with the MR is to show that you meet those criteria so it will not completely disadvantage you if the documents do not arrive on time, at this stage your arguing against the assessment report is unlikely to change the DM's mind, unless there are clear discrepancies they will accept it is being accurate, so just go back through the guides and concentrate on showing where you meet the SG criteria and why.
Gordon
Good evening, let me tackle your savings first, if it is only your PIP award that has pushed you over the £16,000 then you may still be eligible for ESA(IR) as back dated payments should be disregarded for at least 52 weeks although you will need the DWP to confirm this and there will be a deduction of £1/week for every £250 of savings in excess of £6000.
As to the MR, it is DWP policy for the Decision Maker to phone the client, you don't have to take the call but it may be to your advantage to do so as we have had members over turn the original Decision when they have talked to the DM and explained their limitations.
If you do decide to take the call, then I would prepare a short checklist of reasons why you believe that you should be in the SG, which you can then refer to during it.
Your requesting an MR is not limited by whether or not you take the call, despite what you have been told I would stick to using the date of the letter, that way there can be no confusion that the MR has been submitted on time.
The list of documents from the FAQ is what might be available, there will be variation from claimant to claimant, you should expect an LT54 and ESA85, if there was an ESA72 then you should have already received it with the Decision letter, the ESA113 will depend on whether they contacted your GP or not.
Not having the documents available now, may be another good reason to take the DM's call, as it will hopefully explain the areas that they feel you did not meet the SG criteria. Your task with the MR is to show that you meet those criteria so it will not completely disadvantage you if the documents do not arrive on time, at this stage your arguing against the assessment report is unlikely to change the DM's mind, unless there are clear discrepancies they will accept it is being accurate, so just go back through the guides and concentrate on showing where you meet the SG criteria and why.
Gordon
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9 years 6 months ago #126291 by angelcake
Replied by angelcake on topic TRANSFER FROM IB TO ESA AND PIP CLAIM
Hello Gordon
Yes it's only my PIP award that has pushed me over the £16,000 - can you tell me how I go about sorting this and shouldn't they have realised this? Thanks for picking up on this!
It's very useful and good to know about the possible advantages talking to the decision maker. Are you saying that it is much easier to clarify by talking to the DM rather than just looking at the docs where you've failed to get in the SG??
They didn't call as the lady I finally spoke to changed it and just requested the docs but it sounds like it would be a good idea to request a phone call like you say, especially with the worry of the documents arriving on time and also I could get the DM to clarify my deadline date.
Would it be the DM who looked at my original claim or could it be anyone?
What I'm concerned about is I would like to speak to them for the reasons you've suggested it would be a good idea but I'm worried that they would make a decision there and then and not leave it open for me? to submit further evidence when I get the docs?
If they're explaining areas where they feel I did not meet the SG criteria I might not be able to argue and express myself effectively against this put on the spot due to the pressure and anxiety. I had these sorts of problems in the assessment and frightened that I would blow my chance and do a bad job of arguing my case.
It's a case of finding out but the reasons why and I'm worried I may not have the opportunity to reflect and explain my case after the phone call if they make a decision there and then if you know what I mean?
I will have to go back through the guides like you say and put in some preparation before I even call to make a request for a phone call.
Do I still need to write a letter as well as back-up to state I want to ask for a MR? Or should I just wait till I'm ready to approach them for a phone call?
Many thanks
Angelcake
Yes it's only my PIP award that has pushed me over the £16,000 - can you tell me how I go about sorting this and shouldn't they have realised this? Thanks for picking up on this!
It's very useful and good to know about the possible advantages talking to the decision maker. Are you saying that it is much easier to clarify by talking to the DM rather than just looking at the docs where you've failed to get in the SG??
They didn't call as the lady I finally spoke to changed it and just requested the docs but it sounds like it would be a good idea to request a phone call like you say, especially with the worry of the documents arriving on time and also I could get the DM to clarify my deadline date.
Would it be the DM who looked at my original claim or could it be anyone?
What I'm concerned about is I would like to speak to them for the reasons you've suggested it would be a good idea but I'm worried that they would make a decision there and then and not leave it open for me? to submit further evidence when I get the docs?
If they're explaining areas where they feel I did not meet the SG criteria I might not be able to argue and express myself effectively against this put on the spot due to the pressure and anxiety. I had these sorts of problems in the assessment and frightened that I would blow my chance and do a bad job of arguing my case.
It's a case of finding out but the reasons why and I'm worried I may not have the opportunity to reflect and explain my case after the phone call if they make a decision there and then if you know what I mean?
I will have to go back through the guides like you say and put in some preparation before I even call to make a request for a phone call.
Do I still need to write a letter as well as back-up to state I want to ask for a MR? Or should I just wait till I'm ready to approach them for a phone call?
Many thanks
Angelcake
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9 years 6 months ago #126294 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic TRANSFER FROM IB TO ESA AND PIP CLAIM
angelcake
With regard to your ESA(IR), I would start by requesting an ESA3 form from the office that deals with your ESA, this captures your financial data, you need to complete it from the date your ESA(CB) stopped and be able to provide the required financial from that date until today, I would include a separate letter that explains that £x was from your PIP award and should therefore be disregarded.
As to the PIP MR, speaking to the DM will allow to understand why they thought that you did not meet the criteria, it also offers you an opportunity to explain why you think that you do, it is possible that the DM has overlooked a specific piece of evidence that could change their mind on the award.
The DM may not be convinced by your arguments but they cannot make a Decision on your MR based on this conversation, if you want to make some sort of submission explaining your thoughts in more detail, then you should tell the DM that you will be submitting more evidence they should then allow you four weeks to do this.
I would still make the request for the MR in writing, the DWP seem to have problems transferring the spoken word into written action, if it is in writing then they can't ignore it.
Gordon
With regard to your ESA(IR), I would start by requesting an ESA3 form from the office that deals with your ESA, this captures your financial data, you need to complete it from the date your ESA(CB) stopped and be able to provide the required financial from that date until today, I would include a separate letter that explains that £x was from your PIP award and should therefore be disregarded.
As to the PIP MR, speaking to the DM will allow to understand why they thought that you did not meet the criteria, it also offers you an opportunity to explain why you think that you do, it is possible that the DM has overlooked a specific piece of evidence that could change their mind on the award.
The DM may not be convinced by your arguments but they cannot make a Decision on your MR based on this conversation, if you want to make some sort of submission explaining your thoughts in more detail, then you should tell the DM that you will be submitting more evidence they should then allow you four weeks to do this.
I would still make the request for the MR in writing, the DWP seem to have problems transferring the spoken word into written action, if it is in writing then they can't ignore it.
Gordon
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9 years 6 months ago #126295 by slugsta
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Replied by slugsta on topic TRANSFER FROM IB TO ESA AND PIP CLAIM
You have talked about the £16000 ceiling, but income-related ESA should also have been reduced proportionally since you went over £6000.
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