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ESA - no medical assessment offered

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2 years 11 months ago #258971 by Eloise
ESA - no medical assessment offered was created by Eloise
I should like to ask three questions if I may, as I am thoroughly confused by the ESA process:

1. Is the DWP obliged to offer a medical assessment before discharging a claim?

2. Can a Claimant whose ESA claim is discharged go straight to appeal without first obtaining a mandatory reconsideration?
3. Can a new claim for contributory ESA be submitted after the original 365 day period has ended?

The background to my questions is as follows: I applied for ESA online in April 2020 and was awarded it for 365 days. I gather that this must have been contributory ESA, although this was not clear to me at the time. I suffer from lupus, fibromyalgia and cognitive impairment, (memory and concentration), and have had FIT notes throughout this period and these continue. I have never had a medical assessment, but I was asked to submit an ESA50 questionnaire by the end of March this year. I duly submitted this, having been told by the DWP that, if I submitted it, my ESA payments would continue. However, three weeks after I submitted the questionnaire, my ESA payments stopped. The DWP has provided no explanation for this other than that, in the absence of a medical assessment, there is insufficient evidence that I qualify for the support group. To date, thirteen months after I applied for ESA, no medical assessment has been offered.

Any input would be much appreciated!

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2 years 11 months ago #259190 by Gary
Replied by Gary on topic ESA - no medical assessment offered
Hi Eloise

Your post is impossible to answer in full as we do not have enough information.

1. Is the DWP obliged to offer a medical assessment before discharging a claim? The answer to this question would depend on why they discharged the claim

2. Can a Claimant whose ESA claim is discharged go straight to appeal without first obtaining a mandatory reconsideration? You have to go through a mandatory reconsideration first before you can appeal a decision; www.gov.uk/government/publications/compe...ayments-html-version.

3. Can a new claim for contributory ESA be submitted after the original 365 day period has ended? it would depend if you met the qualifying conditions.

The years used for eligibility are the two complete Tax Years preceding the year of claim.

So for a claim in 2021, the Tax Years that will be used are 2018-19 and 2019-20. The Tax year 2020-21 will not be used and 2021-22 will not be usable until 2023.

You cannot make a new claim for legacy ESA, it will be New Style ESA which is a Contribution Based benefit only.

Gary

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

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2 years 11 months ago #259194 by Eloise
Replied by Eloise on topic ESA - no medical assessment offered
Dear Gary,

Thank you for your reply.

As I am trying to speed things up, I was wondering whether the High Court’s decision in the Connor case that the mandatory reconsideration requirement for ESA claimants was unlawful applies to me, (I read about the decision on this site). I cannot see why it wouldn’t apply to me, but I may have misunderstood the decision.

To clarify the position, the response I received when I asked why my ESA payments had stopped was that a decision maker had looked at my ESA50 questionnaire and decided that I was ineligible. However, as they wanted to make sure that this decision was correct, DWP would be contacting me in the future to arrange an assessment. To date, no assessment has been offered and no letter has been received explaining the decision maker’s findings.

I strongly suspect that my questionnaire was not looked at properly, if, indeed, it was looked at at all, as, if it had been, surely some sort of letter would have been issued referring to it? Instead, a letter was issued stating that, as the 365 days were up, my claim had ended.

In answer to your query, there is no dispute that they received my questionnaire.

Thank you for your time.

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2 years 11 months ago #259221 by Gary
Replied by Gary on topic ESA - no medical assessment offered
Hi Eloise

To speed things up, you may want to contact your MP, if a decision maker has made a decision then they should send you a copy of the decision, if you disagree with the decision then you ask for a MR then appeal.

I am not aware that the Connor case changes the appeal process but will check with back office.

Gary

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: Eloise

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2 years 11 months ago #259225 by ThisGovernmentsGoneToFar
Replied by ThisGovernmentsGoneToFar on topic ESA - no medical assessment offered
This Conner case is regarding income related ESA. What this means is only IR ESA can BYPASS the Mandatory reconsideration process and go straight to the Appeal process.

The High Court has recently ruled that the practice of the DWP suspending payments of Income-related ESA during the mandatory reconsideration stage is unlawful. This means that people will no longer have to wait until appeal stage before getting any benefit or alternatively being forced to claim an alternate benefit during the relevant period.

Read full info here as this explains it in good detail www.wolverhampton.gov.uk/sites/default/f...ation%204.8.2020.pdf

I was formely known as (GoingOffMyHeadWithThisGovernment) Won PIP November 2017 ongoing award HR both. Now kept and got my ESA Support group but took a while.
The following user(s) said Thank You: Gary, Eloise

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2 years 11 months ago #259284 by Gary
Replied by Gary on topic ESA - no medical assessment offered
Hi ThisGovernmentsGoneToFar

Thank you for the link, it is very informative.

Gary

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: ThisGovernmentsGoneToFar

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