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ESA Recon/appeal
- Starmaster
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7 years 11 months ago #157630 by Starmaster
ESA Recon/appeal was created by Starmaster
Hello,
As with many here,received an unexpected stop to ESA after assessment...I'm using the guides here,which are very good.
Basically my question is about the appeal side.I receive PIP at the standard care rate,following a tribunal last year.
I've been informed that if it does go to appeal,I'd be better off on JSA while waiting,since I'd receive a disability premium,while on the ESA assessment phase,I'd just receive the flat rate.I would appreciate if anyone could let me know if this true.
I'd also like to add that the guides here are very good.I noticed on page 50 of the WCA handbook that the assessor must read through any new medical evidence brought to the assessment,which she didn't-she merely flicked through the evidence and said she'd seen it all before...that,and many other things of course.
Thank you for your help.
As with many here,received an unexpected stop to ESA after assessment...I'm using the guides here,which are very good.
Basically my question is about the appeal side.I receive PIP at the standard care rate,following a tribunal last year.
I've been informed that if it does go to appeal,I'd be better off on JSA while waiting,since I'd receive a disability premium,while on the ESA assessment phase,I'd just receive the flat rate.I would appreciate if anyone could let me know if this true.
I'd also like to add that the guides here are very good.I noticed on page 50 of the WCA handbook that the assessor must read through any new medical evidence brought to the assessment,which she didn't-she merely flicked through the evidence and said she'd seen it all before...that,and many other things of course.
Thank you for your help.
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- Gordon
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7 years 11 months ago - 7 years 11 months ago #157631 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic ESA Recon/appeal
Stuart
You don't say where you are in the process.
During the MR stage the only benefit you are entitled to is JSA. Once your claim has been accepted you can submit a new Fit Note and be excused any Job Search requirement for up to 13 weeks.
Once the MR is completed and if you need to make an appeal, then you can request the DWP switch you onto the ESA Assessment rate until a hearing is held.
There are several Premiums that can be paid if you are receiving a PIP Daily Living award.
The Disability Premium is only payable with JSA, the equivalent under ESA is either the WRAG or the Support Group component which of course requires an award. However, once you have exceed the 13 weeks (above) then you will be required to meet you Job Search agreement, it may be possible to reduce this requirement to a minimum, but you need to decide whether you are able to do this. Your claiming JSA will not count against you in regard to any MR or appeal.
The first stage to challenging a Decision is for you to request a Mandatory Reconsideration, this needs to be done in writing to the DWP, within one month of the Decision, to the office that dealt with your claim, have a look at our ESA Appeal guide for details of the process and template letters that you can use to make the request with.
www.benefitsandwork.co.uk/help-for-claimants/esa1
You should contact the DWP for a copy of the assessment report (ESA85) if you have not already done so, I would phone them but again follow up the request in writing. Once you have the assessment report you will have a better understanding of how the DWP Decision Maker has come to their conclusions and will then be able to argue against them.
Your primary task is to show that you meet the criteria, there are many reasons you may have failed, you need to address each of these but don't get bogged down in criticising the assessment report unless you can clearly show that it is incorrect, it is a lot easier to argue the facts of the situation;
"the assessor recorded that I walked 50m, I did but they have failed to document that I had to stop every 10m for a rest due to breathlessness"
than their opinions
"based on my observations of the claimant walking I believe that they can reliably walk more than 200m.
When you have a better idea of the issues with your claim, come back to the forum and we will do our best to help.
Gordon
You don't say where you are in the process.
During the MR stage the only benefit you are entitled to is JSA. Once your claim has been accepted you can submit a new Fit Note and be excused any Job Search requirement for up to 13 weeks.
Once the MR is completed and if you need to make an appeal, then you can request the DWP switch you onto the ESA Assessment rate until a hearing is held.
There are several Premiums that can be paid if you are receiving a PIP Daily Living award.
The Disability Premium is only payable with JSA, the equivalent under ESA is either the WRAG or the Support Group component which of course requires an award. However, once you have exceed the 13 weeks (above) then you will be required to meet you Job Search agreement, it may be possible to reduce this requirement to a minimum, but you need to decide whether you are able to do this. Your claiming JSA will not count against you in regard to any MR or appeal.
The first stage to challenging a Decision is for you to request a Mandatory Reconsideration, this needs to be done in writing to the DWP, within one month of the Decision, to the office that dealt with your claim, have a look at our ESA Appeal guide for details of the process and template letters that you can use to make the request with.
www.benefitsandwork.co.uk/help-for-claimants/esa1
You should contact the DWP for a copy of the assessment report (ESA85) if you have not already done so, I would phone them but again follow up the request in writing. Once you have the assessment report you will have a better understanding of how the DWP Decision Maker has come to their conclusions and will then be able to argue against them.
Your primary task is to show that you meet the criteria, there are many reasons you may have failed, you need to address each of these but don't get bogged down in criticising the assessment report unless you can clearly show that it is incorrect, it is a lot easier to argue the facts of the situation;
"the assessor recorded that I walked 50m, I did but they have failed to document that I had to stop every 10m for a rest due to breathlessness"
than their opinions
"based on my observations of the claimant walking I believe that they can reliably walk more than 200m.
When you have a better idea of the issues with your claim, come back to the forum and we will do our best to help.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 7 years 11 months ago by Gordon.
The following user(s) said Thank You: Starmaster
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7 years 11 months ago #157653 by Starmaster
Replied by Starmaster on topic ESA Recon/appeal
Thank you for the advice and quick reply Gordon.
I have only received the letter saying the ESA would stop on Friday just gone,so I am at the beginning of the MR stage.I have called them today to ask for a copy of the healthcare professional's report.
I have been reading through the guides,they are extremely helpful.
I will now await the copy of the report.I am hopeful that this will be overturned at the reconsideration stage,I have (I hope)very strong medical evidence,and the assessment seemed to go well.I have the feeling that the DWP decision maker has chosen to stop the ESA as they were unable to contact me,and may have focussed on a narrow part of the assessment.I won't go into details but,as you write,hopefully the assessment report will show any discrepancies.I will follow your advice and wait for the report.
I don't really have a choice as the only income I will have now is PIP of just over £200 per month,so I will have to claim JSA.I would have great difficulty living on assessment phase ESA.I have had a benefits assessment and I think it works out quite similar to the ESA and disabilty premiums award,though I'm not that sure.
I have previously had periods of severe homelessness,etc due to similar issues.Fortunately,I got advice at the time of the PIP award,and have enough put away to pay at least two months rent,if it comes to that.Hopefully the JSA will get sorted out.I shouldn't have a problem receiving a sick note,and there are healthcare professionals who will provide further evidence,if necessary.
I had to go for appeal on my PIP claim,and the DWP's decision was overturned immediately,with the Tribunal stating that due to medical evidence they couldn't understand why the DWP hadn't awarded it initially.I was straight in and out of the Tribunal.As everyone here is probably aware I think the DWP are making negative decisions with the hope that people will be discouraged and not follow them up.
I will await the health report.
Thank you again for your reply.
I have only received the letter saying the ESA would stop on Friday just gone,so I am at the beginning of the MR stage.I have called them today to ask for a copy of the healthcare professional's report.
I have been reading through the guides,they are extremely helpful.
I will now await the copy of the report.I am hopeful that this will be overturned at the reconsideration stage,I have (I hope)very strong medical evidence,and the assessment seemed to go well.I have the feeling that the DWP decision maker has chosen to stop the ESA as they were unable to contact me,and may have focussed on a narrow part of the assessment.I won't go into details but,as you write,hopefully the assessment report will show any discrepancies.I will follow your advice and wait for the report.
I don't really have a choice as the only income I will have now is PIP of just over £200 per month,so I will have to claim JSA.I would have great difficulty living on assessment phase ESA.I have had a benefits assessment and I think it works out quite similar to the ESA and disabilty premiums award,though I'm not that sure.
I have previously had periods of severe homelessness,etc due to similar issues.Fortunately,I got advice at the time of the PIP award,and have enough put away to pay at least two months rent,if it comes to that.Hopefully the JSA will get sorted out.I shouldn't have a problem receiving a sick note,and there are healthcare professionals who will provide further evidence,if necessary.
I had to go for appeal on my PIP claim,and the DWP's decision was overturned immediately,with the Tribunal stating that due to medical evidence they couldn't understand why the DWP hadn't awarded it initially.I was straight in and out of the Tribunal.As everyone here is probably aware I think the DWP are making negative decisions with the hope that people will be discouraged and not follow them up.
I will await the health report.
Thank you again for your reply.
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