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Not sure what to do about ESA result

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12 years 5 months ago #70228 by Benson
Not sure what to do about ESA result was created by Benson
Hi group,

I just paid the sub to this site, which looks great, I have yet to read the documents but have just downloaded them ready to read. In the meantime I wondered if people can advise me on this issue.

I have been on IB for 12 years, then in July I got a letter saying my time is now for changing from IB to ESA. So I filled in the forms, and sent them back. I got a phone call and letter at the end of September saying I was now being put in the Work Related (Income Related) side of ESA. I was expecting a ATOS medical as I have had more of those then I can even count, it became routine.

I personally feel I can't work, so I am concerned about being put in the work group. If possible can I ask some questions below ? Thanks.

1. If I was to ask for the decision to be looked at again, do I risk the chance of losing even the work group ? Or do they just look to see if I can be put in the support group and if not then I stay in the work group ? I am paranoid that I will shoot myself in the foot if I ask them to reassess.

2. If I did ask them to reassess then what do you suggest I do to try and get in the support group ? Is there a guide on here that mentions which descriptors are needed to get in that group so I can see if my symptoms qualify ? If they do, how is the best way to lay out my reply ?

3. Do I risk being sent for yet another ATOS medical if I ask for it to be looked at again ?

4. I am on income based ESA (or I will be by the end of October), if I go to the 6 interviews will I be left alone for 36 months ?

5. If I tell my advisor that I feel I can't work, and give reasons, what do they then do ? I am confused what can possibly be said during an advising interview, especially 6 of them.

Thanks for any help and advice, so much appreciated !!

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  • bro58
12 years 5 months ago #70233 by bro58
Replied by bro58 on topic Re:Not sure what to do about ESA result
Benson wrote:

Hi group,

I just paid the sub to this site, which looks great, I have yet to read the documents but have just downloaded them ready to read. In the meantime I wondered if people can advise me on this issue.

I have been on IB for 12 years, then in July I got a letter saying my time is now for changing from IB to ESA. So I filled in the forms, and sent them back. I got a phone call and letter at the end of September saying I was now being put in the Work Related (Income Related) side of ESA. I was expecting a ATOS medical as I have had more of those then I can even count, it became routine.

I personally feel I can't work, so I am concerned about being put in the work group. If possible can I ask some questions below ? Thanks.

1. If I was to ask for the decision to be looked at again, do I risk the chance of losing even the work group ? Or do they just look to see if I can be put in the support group and if not then I stay in the work group ? I am paranoid that I will shoot myself in the foot if I ask them to reassess.

2. If I did ask them to reassess then what do you suggest I do to try and get in the support group ? Is there a guide on here that mentions which descriptors are needed to get in that group so I can see if my symptoms qualify ? If they do, how is the best way to lay out my reply ?

3. Do I risk being sent for yet another ATOS medical if I ask for it to be looked at again ?

4. I am on income based ESA (or I will be by the end of October), if I go to the 6 interviews will I be left alone for 36 months ?

5. If I tell my advisor that I feel I can't work, and give reasons, what do they then do ? I am confused what can possibly be said during an advising interview, especially 6 of them.

Thanks for any help and advice, so much appreciated !!


Hi B, and welcome.

Many of your questions will be answered if you read the ESA Guides that you say you have downloaded from the MEMBERS ONLY area.

They are excellent, and also go through ESA appeals process.

If after reading the guides you still have any general questions, please come back to the forum, and we will do our best to help.

cheers

bro58

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12 years 5 months ago #70265 by Benson
Replied by Benson on topic Re:Not sure what to do about ESA result
Thanks Bro58. Excellent PDFs, I just gave a few a read.

They did indeed answer the majority of my questions. I couldn't see the answers to all my questions though but that could just be because there is so much to read that I missed it.

I will try and re-write my questions now I have read most of the PDF's.

1. If I asked for a reassessment (which I know the PDFs suggest not to do) then do they literally just re-look at the ESA50 form and whatever new evidence I have sent in ? Or might they call me for a ATOS medical or request more GP info ? The reason I am thinking of doing this rather than appealing is I have appealed before on IB (successful) and it was a long and heavy procedure and given I have a ESA benefit granted (just not Support Group) I am not sure it worth the stress to just change groups. But a reassessment seems simple enough. I am not saying I wouldn't appeal, but I would have to give it a long thought first.

2. If I did the above, does any WFI get put on hold until the decision is made ? Speaking of which, I am going from IB to ESA (IR) at the end of this month, how soon are WFI's interviews usually set for people who are transferred ?

3. The PDF's mention a risk of not getting any benefit at all if asking for a change of decision with WRAG to Support. Do you know the percentage of those who end up with no benefit at all after disagreeing with such a (WRAG to SG) decision ?

4. I like on the PDF's that it mentions the questions on the forms related to passing the support group. If I feel my health relates to one of those, can I directly comment about one of those ? Or are the public not meant to know what gets you in the support group ? Just that on a couple of those I feel I would pass in to the support group but perhaps I wasn't strong enough in explaining this on the ESA50 as I had no idea what had an impact and what didn't. I mostly chose "sometimes" or "other" and explained in the boxes.

Also just to re-mention, I am a 12 year IB claimant who is being moved over to ESA WRAG and has just received a letter to say this after sending in my ESA50 form. I am guessing the decision was made from the form as I didn't go to a medical (although I have been to about 10 in the past with ATOS and whoever came before them).

Once again those PDF's are fantastic and a great read, I wish I had signed up prior to me sending off my ESA50 form.

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12 years 5 months ago #70267 by Gordon
Replied by Gordon on topic Re:Not sure what to do about ESA result
Benson

1. A Reconsideration is done by a different Decision Maker from the one who placed you in the WRAG.

They will use all of the existing evidence and any that you send in as part of the process.

As you did not attend a medical to be placed in the WRAG it is possible that a medical will be required for the Reconsideration, however, other members have been moved to the Support Group without one being done.

If you appeal, then the DWP are obliged to carry out a Reconsideration as part of the process anyway, if you subsequently change your mind, you cancel the appeal at any time without fault.

2. WFIs are not suspended while appealing to the Support Group, but it may be possible to have them deferred, this will depend on your Personal Advisor at JC+.

3. There are no statistics available regarding the loss of ESA when appealing to be placed in the SG from the WRAG. The liklihood is small, especially as you were placed in the WRAG without a medical, but it does exist and we are obliged to make members aware.

4. All of the criteria for the WRAG, SG, and exceptional circumstances are in the public domain, so there is no reason why you cannot reference them directly.

The differences between the WCA and PCA are significant enough to require the ESA50 to be reviewed, but previous IB evidence may still be relevant, removing the need for a medical.

Hope this explains everything.

Gordon

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

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12 years 5 months ago #70272 by Benson
Replied by Benson on topic Re:Not sure what to do about ESA result
Thanks for the advice and help.

So do you have any thoughts on why they put me in to the WRAG without a new ATOS medical ? The last one I had was a few years ago now, although I did have many previous to that, sometimes only a few months apart, which I found odd. When I didn't hear from them in about 2 to 3 years I presumed I was on a "written off" list, but then all of a sudden got this IB to ESA change. Back in the days of the IB forms I ALWAYS had to have a ATOS medical before a decision was made.

I am still stuck on what to do, if I knew I was not likely to be dragged in for another medical or possibly lose even the WRAG ESA then I would be writing my appeal right now. In your expert opinion, does the fact I skipped the ATOS (for now at least) mean they are either just backlogged so planning it later, or that my evidence was good enough ?

I read elsewhere that ATOS are calling ESA WRAG claimants every 3,6,9, or 12 months for a medical. Is that everyone in that group ? Is there any word of people being in the WRAG who have had none or not many WFI's and been totally left alone after that for over a year ?

Sorry if I sound paranoid, or repetitive, or overly worried. This is all part of my health issue, my mental health has gotten worse over the last 12 years and to the point now where I overly worry about anything and everything. So apologies if I get annoying :)

Thanks again for the help and the great documentation in the members area.

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  • pete17971
12 years 5 months ago #70273 by pete17971
Replied by pete17971 on topic Re:Not sure what to do about ESA result
Benson wrote:

Thanks for the advice and help.

So do you have any thoughts on why they put me in to the WRAG without a new ATOS medical ? The last one I had was a few years ago now, although I did have many previous to that, sometimes only a few months apart, which I found odd. When I didn't hear from them in about 2 to 3 years I presumed I was on a "written off" list, but then all of a sudden got this IB to ESA change. Back in the days of the IB forms I ALWAYS had to have a ATOS medical before a decision was made.

I am still stuck on what to do, if I knew I was not likely to be dragged in for another medical or possibly lose even the WRAG ESA then I would be writing my appeal right now. In your expert opinion, does the fact I skipped the ATOS (for now at least) mean they are either just backlogged so planning it later, or that my evidence was good enough ?

I read elsewhere that ATOS are calling ESA WRAG claimants every 3,6,9, or 12 months for a medical. Is that everyone in that group ? Is there any word of people being in the WRAG who have had none or not many WFI's and been totally left alone after that for over a year ?

Sorry if I sound paranoid, or repetitive, or overly worried. This is all part of my health issue, my mental health has gotten worse over the last 12 years and to the point now where I overly worry about anything and everything. So apologies if I get annoying :)

Thanks again for the help and the great documentation in the members area.



Hi,

Whilst we cannot answer individual claim specific queries, in general the government have indicated that ESA claimants will be reviewed more often than under the Incapacity Benefit/Income Support on grounds of disability regime.

Whether that review will include a Work Capability Assessment (WCA - i.e. medical) is anyone's guess.

In general though a WCA maynot be needed if on/with the ESA50 questionnaire one can supply enough evidence for a Decision Maker to award ESA without the need for a medical. Notwithstanding that a WCA medical maybe required at some point.

Currently the migration process from IB/IS to ESA is in full swing. It appears from members of this forum that awards of ESA are being made without a WCA in some cases. Whether this is down to good evidence being sent on/with the EA50 is not known but obviously enough evidence must have been supplied for a Decision Maker to award the benefit. In cases where the Decision Maker cannot make the decision a WCA is still required.

The only thing we can really say is when completing ones ESA50 be sure to send as much evidence as possible to help demonstrate ones incapacity to work based on the descriptors as shown in the guides in the members area. This may help reduce the need for a WCA but unfortunately it is no guarantee however it may help minimise the chances of being called to a WCA medical.

As to wfi's, again as migration from IB/IS to ESA is under way, one cannot really pick up on any long term trends with regards to wfi's. All that really can be said is that if placed in the WRAG, one will have to have the wfi's. Whether in the future that may lead to claimants being 'parked' after their initial wfi's is not possible to say, albeit it seems that is something the government seem to not want to happen under ESA.

Pete

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