ESA Claim rejected.

Hi

Just joined and hoping someone here is able to help us navigate this crazy system.

My wife had claimed Incapacity benefit for over 30 years as she has many illnesses which are degenerative. On the 8/09/12 my wife was denied any form of ESA due to the decision of the ATOS representative awarding my wife 6 points.

An appeal to a decision maker, with a copy of a doctor’s letter stating that my wife was “not fit for any sort of job” again failed to overturn their decision.

On appeal, which was heard on the 2/2/13, the decision was set aside and my wife was awarded 21 points by the tribunal. We were told that the money owed would be backdated to the 8/09/12 within a few days.

My wife then had a letter stating that it could not be backdated as she was out of time. The only reason it was out of time is because of the failure of the ATOS representative to do their job correctly and the length of time we had to wait for the appeal, if my wife had been awarded the 21 points that the judge deemed appropriate when the initial interview took place we would have completed the necessary forms in plenty of time as her contribution based ESA ended on the 6/8/12.

Now after many months of telephone calls and income based application forms we have still not received any money whatsoever, today we have been informed that because I am available for work 50 hours a week she is not eligible for any money even though the self-employment forms I have completed show that over the last 3 years I have made a loss with NO INCOME whatsoever as I am unable to sell my stock.

I have been self-employed for the last 15 years as I am unable to work elsewhere because I am my wife’s carer on a 24/7 basis even though she only receives the lower rate allowance.

I understand that if she was placed in a support group it would not be income based, is that correct and if so how do i go about getting her into this group.

any help would be gratefully appreciated.

Hello and welcome to the site. As you are new you might find this helpful

Welcome to Benefits and Work

I am sorry that you and your wife are going through such a difficult time relating to her claim for ESA.

The criteria for ESa are very different from those relating to IB. It is entirely possible for someone to have been, quite properly, claiming IB but not be entitled to ESA. Nor is the ability to work actually what is considered but the claimant's ability to fulfil very specific criteria. For instance, 'not fit for any sort of job' would entitle the claimant to the WRAG at best. These are the WRAG and Support Group criteria

Qualifying for the WRAG

Qualifying for the Support Group

Your wife should have been paid the ESA assessment rate while awaiting appeal and is now entitled to the difference between that and her previous rate of IB for the 365 days that she was allowed to receive payment.

I am afraid that your wife's entitlement to income-related ESA depends on both your income, savings and the hours you work

24 hour work rule for ESA(IR)

Your wife will now be getting NI credits which will count towards her state pension. She is still counted as being 'on ESA' and will be reassessed periodically. It is possible that she might be placed into the Support Group at one of these reassessments or you can contact DWP yourselves and ask for a 'supersession'/review of her claim if you can show that her condition has worstened appreciably since the first decision such that she now meets Support Group descriptors.

If you have any further questions, please come back and ask them on this thread/topic as it is helpful to keep everything in one place. You will be able to find it easily in future if you mark it as a 'favourite' now

Hi

Thanks for the reply.

She was not paid any money while waiting for the appeal because her contributions period ran out on the 6th September and as she was denied ESA from the 8th. She never received any forms to fill in regarding the means tested or income based ESA at any time. Now it seems that it is neither income based OR means tested as we qualify on both these, but working hours, although i have had no income for years.

Hi B,

MHB is correct, even if your wife has exhausted her 365 days entitlement to CB ESA, (Which she would have been paid as she was previously in receipt of IB) see :

12 Month Limit for ESA(CB)

From our : ESA FAQ’s

&

What will I be paid?

What will I be transferred to?

From our : IB, IS, SDA, Migration to ESA FAQ’s

She would still be entitled to the difference between what she has been receiving at Assessment Rate ESA whilst appealing,(Approx £71) and the same amount that she was receiving before being transferred from IB.

This would be owed from the date of the fit for work decision, until the date that her 365 days entitlement to CB ESA was exhausted.

With regards to IR ESA see also :

Asset rule for ESA(IR)

This : Benefits Calculator may also help.

See below for potential sources of face to face advice :

Where to get advice?

bro58

Brynogwy wrote: Hi

Thanks for the reply.

She was not paid any money while waiting for the appeal because her contributions period ran out on the 6th September and as she was denied ESA from the 8th. She never received any forms to fill in regarding the means tested or income based ESA at any time. Now it seems that it is neither income based OR means tested as we qualify on both these, but working hours, although i have had no income for years.

Hi B,

There seems to be an anomaly here.

Was your wife transferred directly over from IB to ESA, and then received the fit for work decision after a face to face assessment ?

Did your wife submit an appeal within one month of the date of the Decision Notice letter informing her of the fit for work decision ?

Did she also obtain a "fit note" Med 3 from her G.P. to cover her from the date of the fit for work decision, and send it to the DWP ?

If the answer to all three of the above is "Yes" then she should have been paid CB ESA at the assessment rate for 365 days.

bro58

Hi bro58

Was your wife transferred directly over from IB to ESA,
Yes

and then received the fit for work decision after a face to face assessment ?
Yes

Did your wife submit an appeal within one month of the date of the Decision Notice letter informing her of the fit for work decision ?
Yes and found unfit for work at the tribunal and given 21 pts

Did she also obtain a "fit note" Med 3 from her G.P. to cover her from the date of the fit for work decision, and send it to the DWP ?
Sorry don know anything about this