DLA and ESA results query

Hi everyone. May I just start by a saying a massive thank you for the wonderful guides. As a result of these I have been awarded High rate mobility and medium rate care. I was over the moon at the result which I thought excellent as my health has deteriorated this past year. So thank you to everyone for your advice and kind words.
However that had been tainted by what has happened with my ESA award. I requested a supersession and was issued with an ESA50 form from Atos. I believed that this was due to my letter. My husband completed it for me including the same doctors/specialist reports that we sent for DLA. I was hoping to be moved from the Wrag group to the support group as on top of my previous conditions I have now been diagnosed with Cardiac arrest which resulted in my having seven stents as my arteries were so damaged, Fibromyalgia and substantial Degenerative discs verified by MRI scan in January 2013. However after waiting nearly three months I received a letter on Saturday advising that my ESA payment had finished on the 1st May and this has not changed. I rang the DWP to find out what this letter was about and they told me that I was still in the Wrag group and it had not changed inspite of my deteriorating conditions.
My question is this, I am afraid that if I appeal then it might affect my DLA award.However I cannot mobilise more that 20 metres without being in severe pain and I really feel that along with all my other conditions I should be in the support group. I really need your advice please as I am really tired of being treated so shabbily. I cannot understand how I am ill enough to receive nearly the maximum DLA award but not support group. It doesn't make sense.
Best wishes Lizzie

Lizzie23 wrote: Hi everyone. May I just start by a saying a massive thank you for the wonderful guides. As a result of these I have been awarded High rate mobility and medium rate care. I was over the moon at the result which I thought excellent as my health has deteriorated this past year. So thank you to everyone for your advice and kind words.
However that had been tainted by what has happened with my ESA award. I requested a supersession and was issued with an ESA50 form from Atos. I believed that this was due to my letter. My husband completed it for me including the same doctors/specialist reports that we sent for DLA. I was hoping to be moved from the Wrag group to the support group as on top of my previous conditions I have now been diagnosed with Cardiac arrest which resulted in my having seven stents as my arteries were so damaged, Fibromyalgia and substantial Degenerative discs verified by MRI scan in January 2013. However after waiting nearly three months I received a letter on Saturday advising that my ESA payment had finished on the 1st May and this has not changed. I rang the DWP to find out what this letter was about and they told me that I was still in the Wrag group and it had not changed inspite of my deteriorating conditions.
My question is this, I am afraid that if I appeal then it might affect my DLA award.However I cannot mobilise more that 20 metres without being in severe pain and I really feel that along with all my other conditions I should be in the support group. I really need your advice please as I am really tired of being treated so shabbily. I cannot understand how I am ill enough to receive nearly the maximum DLA award but not support group. It doesn't make sense.
Best wishes Lizzie

Hi L23,

I am sorry to hear that your request for a supersession/review to be placed into The SG, due to a deterioration in you health, was unsuccessful.

I understand your comments regarding your DLA award, and not being placed into The SG, however, the qualifying criteria are different.

e.g. The DLA test for mobility is a "Walking" test, the ESA test also takes into account the use of a manual wheelchair unaided, even if you have never used one.

You might wish to request the evidence used by the DM in the supersession/review.

You can now appeal this decision, within one month of the date of the letter, however payment of your CB ESA will not be reinstated unless you can gain access to The SG.

The only way that you can get into The SG is by fulfilling at least one of the descriptors.

SG (LCWRA)Schedule 3 Descriptors

Or

ESA Reg 35 for entry to The SG (LCWRA)

PLUS Post 28/01/13 Amendment of :

(3) In regulation 35(1) (certain claimants to be treated as having limited capability for work-related activity)(6), for sub-paragraph (b) substitute—

“(b)the claimant is-

(i)receiving treatment for cancer by way of chemotherapy or radiotherapy;

(ii)likely to receive such treatment within six months after the date of the determination of capability for work-related activity; or

(iii)recovering from such treatment,

and the Secretary of State is satisfied that the claimant should be treated as having limited capability for work-related activity; or”.

From :

www.legislation.gov.uk/uksi/2012/3096/regulation/4/made

Qualifying for the Support Group

With regards to appealing, you can download The GL24 appeals form from the link on this page :

How to submit an appeal

See also :

How long do I have to appeal?

From our : Appeals FAQ’s

There is also an ESA appeals guide on this page :

ESA Claims Guides

You may also find the following helpful :

Disability Rights UK Factsheet - Appeals and reconsiderations

MOJ Video of ESA Appeals Process and Tribunal

ESA FAQ’s

Please reply to this topic if you have further queries.

bro58

Hi Lizzie
I also have DLA and succesfully appealed to be placed in the support group, you should certainly give it a try

Hi L23,

As it seems that payment of your CB ESA in The WRAG has ceased due to you exhausting your 365 days entitlement.

12 Month Limit for ESA(CB)

Have you been financially assessed using an ESA 3 Form, to see whether you are entitled to IR ESA ?

Sample ESA 3 Form

Asset rule for ESA(IR)

24 hour work rule for ESA(IR)

I have looked back at your previous posts, (as far as I can) and cannot see that this possibility has been mentioned previously.

bro58

Thank you very much for your reply. It is appreciated. We cannot claim any more help as my husband who is 70 has returned to work full time and as a result I have lost my ESA payments due to the 365 day rule. I wondered whether I may still be eligible if he were to reduce his hours to 24? or whether they would also include his pension in their calculations?
In reply to your query regarding my application for the support group, I should have been considered under the descriptors for mobilising as I also suffer with Osteoarthritis and Osteoporosis which has greatly affected my mobility, that is now including the Fibromyalgia and Degenerative dIsc disease but even though I have provided proof it doesn't seem to have been taken into consideration. I am still in the Wrag group. Thank you for your advice to appeal but can you advise whether it will affect my DLA decision? I was awarded both components indefinitely as previously mentioned and cannot afford to risk losing this award as well. Thank you for your patience.

Lizzie23 wrote: Thank you very much for your reply. It is appreciated. We cannot claim any more help as my husband who is 70 has returned to work full time and as a result I have lost my ESA payments due to the 365 day rule. I wondered whether I may still be eligible if he were to reduce his hours to 24? or whether they would also include his pension in their calculations?
In reply to your query regarding my application for the support group, I should have been considered under the descriptors for mobilising as I also suffer with Osteoarthritis and Osteoporosis which has greatly affected my mobility, that is now including the Fibromyalgia and Degenerative dIsc disease but even though I have provided proof it doesn't seem to have been taken into consideration. I am still in the Wrag group. Thank you for your advice to appeal but can you advise whether it will affect my DLA decision? I was awarded both components indefinitely as previously mentioned and cannot afford to risk losing this award as well. Thank you for your patience.

Hi L23,

You would have to be careful with regards to your Hubby cutting his hours in order to gain entitlement to IR ESA, this could be classed as deliberate deprivation of income.

Disregarding that, with respect to household income which would be taken into account when carrying out a financial assessment for IR ESA, his pension would also be counted.

DLA would not be counted as household income for this purpose, though.

You would need advice on this where the adviser would have access to all your personal and financial details.

This : Benefits Calculator may give some indication.

The HR Mobility award should help to prove the walking aspect of the ESA Mobilising SG Descriptor, so you would need to concentrate on showing that you cannot self propel a manual wheelchair unaided, either, for the requisite 50 metres.

This could be covered by sitting limitations, upper body, neck, or cervical spine limitations.

Limitations with respect to transferring from one seated position to another, as at activity 2. of The SG Descriptors could also come into play here, as that would be necessary to get in and out of a wheelchair.

Cardio-Respiratory problems could also preclude the use of a manual wheelchair due to poor function and exertion.

All these things, and more should be taken into account.

Would it be reasonable to expect to to use a manual wheelchair, do you have somewhere to store it, would you have access problems with your home, such as steps.

The best way to approach the "Virtual Manual Wheelchair" scenario is to break down all the individual components of having to use such a wheelchair in note form, and then see how your limitations would preclude your use of one.

Has your G.P. advised against wheelchair use?, this would be another aspect to look at.

It should not have an adverse affect on your DLA, as I have previously stated the Mobilising test for ESA and DLA are different.

It may help to gain an understanding of why you did not qualify for The SG if you request the evidence used by the DM in not changing the WRAG award.

You may well of provided adequate and relevant evidence already, it doesn't mean that you haven't, just because the DM has not changed the award to SG.

In that case it may well suffice to reiterate evidence already provide with a little more detail.

On appeal it will again be reconsidered by a different DM.

Concentrate on the limitations that you suffer as a result of the medical conditions, more so than the conditions themselves.

Then tie these limitation in with the SG Descriptor/s that apply to you.

If you are to appeal, do not miss your one month deadline to do so, even if any documents that you may have requested have not arrived.

You can always refer to them later, when you have them.

bro58