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Messy & urgent: Request mandatory recon?

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5 years 1 month ago #227942 by Wiggles
Having finally received what the decision was on my ESA renewal from Sept 2018, despite asking on three separate occasions for the details that they claimed to of sent to me (not even a confirmation of award letter was sent to me), I found out that I wasn’t awarded points for several things I clearly should have including but not limited to bladder/bowel, cognitive problems. All the evidence I submitted to ESA was newer evidence, nothing had changed in terms of my condition (only worsened in a few cases) and yet they decided I didn’t qualify for points. I’m in the Support Group, but this isn’t why I’m concerned, I should have qualified for more points.

In addition, I’m currently under review for PIP. As I know that PIP uses what’s found from ESA, I’m beside myself with concern.

To confuse things further, I only recently found out that I should have automatically qualified for the Disability Premium Income Support, but I wasn’t informed about this and wasn’t even aware it existed. It was by chance I found out about it. I’ve asked for ESA to create a mandatory reconsideration about this, and I’m waiting to hear back.

What should I do? It’s been so long since ESA came to their conclusions (Aug/Sept 2018) I don’t know what I can/should do.

I’m worried, I have no family or support network.

Thanks for all your help.

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5 years 1 month ago #227955 by Gordon
Replied by Gordon on topic Messy & urgent: Request mandatory recon?
D

If you were placed in the Support Group then I would not worry about the missed points, the SG is not points based and you could literally score no points and still be placed in the group.

Also, assessors and Decision Makers are told that they do not need to look further into the claimant's problems if they are satisfied that they already meet at least one of the SG Descriptors.

Gordon

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5 years 1 month ago #227979 by Wiggles
Replied by Wiggles on topic Messy & urgent: Request mandatory recon?
Hi Gordon,

Thanks so much for your very prompt reply.

I do have a few more questions, if you'd be alright with that.

I asked for a mandatory reconsideration of ESA over the phone (stupid, I know, now!) because I should have received Disability Premium Income Support automatically for the length of time I've been on ESA. I just wanted to be considered for it going forward. I'm presuming I've opened myself up to a can of worms by asking for this, should I write and clarify that I'm not asking for a mandatory reconsideration over all of my ESA just the Disability Premium Income Support?

I know that PIP uses the findings from ESA to make their decision, this is what concerns me the most. If I lose my PIP renewal, I'm presuming I would have to ask for a mandatory reconsideration, but if they're basing part of their decisions on ESA is it worth noting their incorrect assessment in writing to ESA?

I've been awarded 3 years of ESA.

Outside these questions I would like to highlight that it's shocking how few points they awarded me in categories I clearly meet the targets. It looks like they ignored all the evidence (Drs reports, tests, letters from Drs) and just awarded me without doing due diligence. I'm equally concerned my lack of request for a mandatory reconsideration may bite me back later. I do wish they'd have bothered!

Thank again, as always.

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5 years 1 month ago #227988 by Gordon
Replied by Gordon on topic Messy & urgent: Request mandatory recon?
D

Are you receiving Income Related ESA or Contribution Based ESA?

If the former then the Enhanced Disability Premium should be added automatically to your ESA payments, the Severe Disability Premium, if you qualify, requires you to contact the DWP as you need to attest that you meet the criteria.

If you are only receiving ESA(CB) then the Premiums are not payable, however, you may be eligible for an ESA(IR) top-up to your current payments but this will require a financial assessment which is done via an ESA3. ESA(IR) is dependant on your household income, your savings and assets, and any hours that your partner works. See

Asset and savings rule for ESA(IR)

24 hour work rule for ESA(IR)

Yes, I would contact the DWP again and qualify the MR subject to your being eligible for an ESA(IR) payment in the first place.

It would actually be unusual for a PIP Decision to take account of your ESA award, it does happen but there is no guarantee that they will look at the ESA paperwork. So unless you know specifically that your ESA report was used I would not make any reference to it in any MR that you might make.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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5 years 1 month ago #228056 by Wiggles
Replied by Wiggles on topic Messy & urgent: Request mandatory recon?
Hi Gordon,

Thanks for the clarification.

I’m on IR ESA and in the support group, I receive PIP currently though that’s being reviewed at the moment. There’s obviously some confusion on my part, but I believe that the conversations I had with the DWP/ESA is what has fuelled it. Also the .gov website seems to be misleading.

When I finally received my decision letter, I checked the .gov website for the severe disability premium and it states that I should receive it automatically. www.gov.uk/disability-premiums-income-support/how-to-claim
I asked the DWP/ESA about this but I was told they don’t know if I should be receiving it, which isn’t what I was told previously. I explained that the .gov website states I should receive it automatically and that I do qualify www.gov.uk/disability-premiums-income-support/eligibility. So, I asked for a MR.

After reading what you’ve written it looks like I’ve made a huge mistake. I don’t understand why the .gov website states it should be automatically added, I don’t understand why the DWP couldn’t simply explain things. I’d never heard of it before. If I’d known it existed, it looks like I could have made a claim for it for the past few years. I really could have used this.

I will write to the DWP/ESA and as that they stop the MR and ask about the severe disability premium again. Do you know what it is that they require from me in order to assess if I qualify? I’d like to have the information to hand so that I can answer everything.

I trust I've been clear. Thank you kindly for your time and assistance.

I feel like such a fool!

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5 years 1 month ago #228062 by Gordon
Replied by Gordon on topic Messy & urgent: Request mandatory recon?
D

First of all, you should stop referring to Income Support in regard to the Premiums, it will just cause confusion this is about the Premiums being added to your ESA.

The Severe Disability Premium is dependant on your receiving a qualifying benefit such as PIP Daily Living (there are others), no one must be receiving Carers Allowance against that award and you must be living alone or considered to be living alone, it is the latter requirement that you need to attest to with the DWP.

You can either request an IS10 form that asks about your living arrangements or fill it in over a phone call. It is possible that the DWP will not require this as they should know your living arrangements from your ESA claim if it is IR.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
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