Unusual Circumstanced - should I apply for MR?

Hi - I wonder if you could advise on this situation please? The background is as follows:
In May 2015, I became ill and claimed and was awarded the assessment rate of ESA. The claim was late due to hospitalisation and was almost at the 13th week by it was submitted. Due to this, I expected some delay in being sent for a medical, but some time later, with no medical in sight, I contacted the DWP. The first person gave me the number to ring as the 'medical people make their own appointments'. I duly rang the number to be told they had not received a request for a medical, so back to DWP and the second person confirmed it appeared to have been 'missed' and said she would order it again. Another bout of problems meant it was some time before I again rang up chasing the medical. Same thing, given a number to ring the medical people, they had not heard of me, so back to DWP who then said they would put it to a supervisor (or manager) to get it pushed through. Then we hit Christmas and all the delays, and on 5th January, I retired!
They promptly closed the claim! This meant I had had 17 weeks over and above the 13 week assessment phase, when I would have at least been receiving the work related rate if not the support group rate. During this time I had claimed, been assessed and awarded the higher rate Daily Living and Mobility components of PIP, with help from your amazing guides, so there would be a strong chance of the SG rate being awarded.
Even at the WRAG rate, we are looking at a difference of approximately £500 and to lose this due to their inefficiency is really quite galling. I asked for them to look into it and they put it to a manager. Today I have received a 'decision', which true to form, is as clear as mud. Can you help me determine what it means please?

The bottom line is that I have not been awarded either rate. The wording is 'The decision awarding ESA at the assessment rate from 25.05.2015 cannot be superseded' which effectively means I was in the assessment phase for the entire time of the claim due to them messing up.

The reasons are the bit that are totally unclear; the letter states:

See guidance from DMG below:

42355 In cases were an award of ESA ends during the assessment phase, a claimant may request arrears of a component to be paid, even though no determinations about LCW or LCWRA have been made before entitlement ends.

42356 Where

1. a claimant's entitlement to ESA ends, for example because hey have returned to work, after the 13th week of entitlement but before the WCA has been carried out and

2, the claimant asks for arrears of a component to be paid from week 14 the DM should make a decision not to supersede the decision which awarded entitlement, or any later superseding decision, on the grounds that the conditions allowing supersession are not satisfied. See DMG 04019-04020 for guidance on making a decision not to supersede. The decision carries the right of appeal to a FtT1.

So, as I said, as clear as mud. The first bit seems to say I have the right to request arrears to be paid, but the second bit seems to say I cannot. I fail to see how they can say I do not satisfy the conditions to be upgraded from the assessment phase rate when the reason for my not having a medical was due to their repeated errors. They have no medical report to base a decision on and the reason for this is their own failures, not mine.

I understand I need to apply for a Mandatory Reconsideration, but all the advice notes are on applying for this if you have been turned down on health grounds. How do I proceed please?

Thank you in anticipation of your help.

[removed]

Hi Gordon

Thanks for that. I had realised that 42355 was only saying that I may request the additional payment, not that it would be granted. I also thought it was saying that the Decision Maker could only render the decision they did based on the fact that they did not have a medical report, and so had no information to base a decision on, thus the criteria had not been met.

I expect therefore that the tribunal would rule that the DM had acted correctly. My query is, can a tribunal look at the fact that the reason the DM did not have the information is down to DWP and the medical assessors messing up three times and that they had 17 weeks over and above the 13 week assessment phase in which to schedule an assessment? Do they have the power to say the DWP must still arrange an assessment so a decision can be made?

I expect this is perhaps not the case, as if a claim was closed due to the claimant returning to work, they would not be able to be assessed as the illness would have passed. In other cases, the continuing illness would mean the claim was not closed, so it is only in a case such as mine, where the illness continues but I have reached retirement age and ESA must stop, that such a problem arises with the length of time they have taken and the errors they have made over scheduling an assessment.

I expect this means I am going to miss out on this £500+, due to this loophole and that as the DM has acted in accordance with the rules, the tribunal would be unable to rule any other way. I would therefore be wasting my time and causing undue stress for nothing.

I think I must leave this and write it off, but it does make one wonder if the mistakes made in ordering an assessment on three separate occasions, were made deliberately to drag this on past my retirement date, or am I being paranoid?

Thank you anyway, you actually confirmed what I feared, so I will resign myself to losing out on this occasion.