Query about claimants stuck in backlog

Though not affected myself something in a conversation on news topics section aroused my curiosity. A member who has been sent for f2f on basis of an esa50 filled in over a year-eighteen months ago is rightly angry at that esa50 being used to decide her claim.
Question is this: given people in this situation will likely have experienced either improvement or deterioration in their conditions over this lengthy period how would Maximus/DWP approach this? Would it be similar to an appeal where the award goes on the situation at time of the original claim being refused? Or would the findings reflect the current situation when the actuall f2f comes up?
What if the claimant was found entitled to wrag for first 12 months of backlogged claim but info since showed sg was more sjitable. Wojld DWP split payments?
I ask as it's a scenario sure to come up and could be the first big headache for the new Maximus regime.Do mods know if there's any precedent remotely like this?

micksville wrote: Though not affected myself something in a conversation on news topics section aroused my curiosity. A member who has been sent for f2f on basis of an esa50 filled in over a year-eighteen months ago is rightly angry at that esa50 being used to decide her claim.
Question is this: given people in this situation will likely have experienced either improvement or deterioration in their conditions over this lengthy period how would Maximus/DWP approach this? Would it be similar to an appeal where the award goes on the situation at time of the original claim being refused? Or would the findings reflect the current situation when the actuall f2f comes up?
What if the claimant was found entitled to wrag for first 12 months of backlogged claim but info since showed sg was more sjitable. Wojld DWP split payments?
I ask as it's a scenario sure to come up and could be the first big headache for the new Maximus regime.Do mods know if there's any precedent remotely like this?

Hi mv,

Under this scenario, the ESA award would exist until a fresh decision was made.

If Maximus/DWP did use an old ESA50 and came to an adverse decision, the claimant could request an MR of that decision, and could argue that the decision is unsafe as the claimant was not allowed to present a current ESA50.

When the WCA is carried out, the claimant should be assessed on how they are at the time of the WCA.

The decision as a result of this should reflect any improvement/deterioration since the claimants last assessment.

"What if the claimant was found entitled to wrag for first 12 months of backlogged claim but info since showed sg was more sjitable. Wojld DWP split payments?"

This can't happen, see my first sentence.

In simple terms, an ESA award will exist until a fresh decision is made as the result of a reassessment (WCA) or the award is superseded under review as a result of a Change in Circumstances (C of C) being reported.

Obviously, if in the interim period between the prior ESA Award and the present one, the claimant's condition improved to such an extent that they no longer qualified for the original award, they should have reported a C of C.

Failure to report a C of C in this case may result in a decision that the claimant had received an overpayment.

This overpayment may then be clawed back, and further action could be taken against the claimant, much the same as not reporting a C of C that affects entitlement with any benefit.

bro58

Just an update re delays and deferrals. I am due my normal re assesment review this June if my 2 year prognosis is anything to go by from 2013. However, having contacted esa over an entirely different matter recently I took the opportunity to ask if I will be receiving esa50 soon and is my expected review still scheduled for June. I was told over the phone that my next review is showing on the screen as June 2017. Granted this was only the call centre and obviously this might come forward depending on Maximus' handling of backlogs. However, this person was clearly reading from their screen and it appears a 2 year deferral has recently been applied to my case...this as when I queried matters last year I was still showing as a review date of June this year.
Yet clearly from other posts by members some are coming up for re assesments....makes me wonder if theyre cherrh picking cases to review, doing it randomly or just doing cases that might have been due to come up for rdview around the time of Atos handover to Maximus?

micksville wrote: Just an update re delays and deferrals. I am due my normal re assesment review this June if my 2 year prognosis is anything to go by from 2013. However, having contacted esa over an entirely different matter recently I took the opportunity to ask if I will be receiving esa50 soon and is my expected review still scheduled for June. I was told over the phone that my next review is showing on the screen as June 2017. Granted this was only the call centre and obviously this might come forward depending on Maximus' handling of backlogs. However, this person was clearly reading from their screen and it appears a 2 year deferral has recently been applied to my case...this as when I queried matters last year I was still showing as a review date of June this year.
Yet clearly from other posts by members some are coming up for re assesments....makes me wonder if theyre cherrh picking cases to review, doing it randomly or just doing cases that might have been due to come up for rdview around the time of Atos handover to Maximus?

Hi mv,

Well you "bit the bullet" and asked "The $64,000 question" !!

At least you have a very good idea of when to expect your next ESA50 now !

As we are always advising, the best way of finding out the recommended date of your next ESA re-assessment is to ring up and ask.

They can access this information on screen after a few security questions.

The ESA Call Responders that are your first point of telephone contact, do not have any executive powers, they alone "cannot" instigate a reassessment of your ESA.

They can however, access your ESA File on-screen.

bro58