ESA - Help and advice needed.

[antone]

You won't receive the increase unless you win the appeal. If this happens, you'll get an increase in your payments and it will be backdated to day 92 of your claim. Until then, it will continue to be paid at the lower rate.

 

Edit to add: sorry I can't write more, got to rush. Will pop back in later, in the meantime others should be able to help.

[antone]

Sorry I let this drop. I'll do my best to answer your questions - until last Friday, I was an ESA processor (just took a new job back in my own field of IT after 4 years with the civil service) but that doesn't make me an expert in all aspects of the benefit.

 

If your ESA is contribution-based, then your entitlement is based on NI contributions you made when you were working. Income related ESA, ESA(IR), is available to those who haven't made the necessary NI contributions and is means-tested - in other words, they consider the amount of money your household has coming in and compare it with what the government says you need to live on.

 

In deciding entitlement to ESA(IR), a lot of things are considered which are not considered for ESA©.

 

I can't possibly list all the differences here, but the key ones for most people would be:

 

 

• ESA© takes no account of your partner's income
  
• it takes no account of any capital (for example, savings accounts) that you or your partner may have
  
• it carries no automatic entitlement to Local Housing Allowance, Housing Benefit, or Council Tax Benefit, but you may still be entitled to these - contact your local council for advice
  
• if you own your home and need help with mortgage interest payments, the rules get somewhat complex.
  
• premiums, such as those for people on DLA, Carers' Allowance and so on are not paid with ESA©
  

But you can be on both types of the benefit, and this is where it gets hellishly complicated to explain in a message board post. Without having your claim details in front of me, I wouldn't even begin to try to explain this.

[antone]

Regarding your appeal, you will be paid at the lower rate until it is decided. Should you win the appeal, the additional amount you would be entitled to will be backdated to day 92 of your claim.

 

If Belfast BDC has signed for your appeal documents, then your payments should be reinstated at the lower rate (the "assessment phase rate") within a week or two. I understand from your posts that this has already happened, if I'm wrong, call Belfast ASAP and complain.

 

The appeals process itself can take several months to complete, but as long as you continue to provide medical certificates, you should be paid, albeit at the lower rate.

 

In the first place, a decision maker at the DWP will look again at your claim. I wouldn't hold out much hope of them changing the decision (they generally don't) but this stage can't hurt you, even if it isn't all that likely to help.

 

If they decide in your favour, all is well, and your benefit will increase from day 92 of your claim. If, as is more likely, they decide against you, the case is passed to an independent tribunal. This is not part of the DWP, and isn't known for being particularly sympathetic to the DWP either.

 

The Tribunals Service should contact you with a date for a hearing. As I didn't work for them, and have never claimed ESA, I am not well placed to advise here, but I am told that it is a very good idea to attend this hearing in person (although it isn't compulsory) and that it can help to seek free advice about how best to handle the hearing. I'm told that CAB and other welfare rights organisations can provide this.

 

One last point was from your first post, when you said this:

 

I appealed against the decision in February, and it is now coming to the end of my next claim. (13 weeks)

The fact that it is 13 weeks since you appealed doesn't make any difference, your payments will continue at the lower rate until the appeal is decided.

 

Edit to add: If you want to know when your appeal is likely to be heard by the Tribunal, you could contact the Tribunals Service directly. Belfast BDC should be able to give you their number.

[antone]

I withdraw my previous comment re. new thread seeing as you're doing a joint claim.Were you living together then? if so the claim ought to have been a joint claim at the outset and events post 9 April are just a change in your circumstances. Did your partnership only begin immediately following your OH's losing her job?

 

This only applies to the income-related forms of ESA and JSA. From my reading, they both qualify for the contributory forms based on their individual NI contributions, so they would need to claim separately.

[antone]

This all illustrates some of the problems with discussing benefits on message boards - it's not easy to cover all the possibilities and look at all the options. So I'll do my best, but usual disclaimers apply.

 

When you claim JSA, you must claim JSA© (the contribution-based benefit), and you can also claim JSA(IB) (the income related benefit) if you wish. A couple can receive the contributary benefits separately, but the income-based benefits are calculated jointly. So although you made joint claims for both ESA and JSA (did you?), it sounds as if you've each been awarded contribution-based benefits in your own right.

 

If this is indeed the case, it does mean you'll likely get more money between you than you would on the income-related benefits. But as your GF has noticed, there is one thing about JSA© which does not apply to ESA© - your contributions "exhaust" 6 months after the date you're first paid the benefit.

 

This applies to everyone. JSA© considers only recent contributions. For a claim made in April 2010, they'll look at the tax years 2007/2008 and 2008/2009. Other contributions are important for your state retirement pension but won't be considered for JSA.

 

Once the contributions exhaust in October, your GF would need to claim JSA(IB). In this case, your ESA© would count as income and be taken into account when assessing her entitlement. Confused yet? As a sample calculation, something like this would work:

 

a) JSA(IB) Entitlement for a couple, both under retirement age and over 25: about £102 per week

b) ESA© Entitlement for single person over 25: about £65

Total payable to her is a-b so about £37. You still get your ESA©.

 

As to the amount she received, the £37 sounds about right, as it's only meant to cover a couple of days. JSA is paid fortnightly in arrears, and the payday is worked out based on the last 2 digits of a claimant's NI number. So because it's the start of her claim, there were probably only three payable days before payday. Her next payment will be the full amount, around £130 for the fortnight.

 

Not paying for the first three days of a claim - this is normal, happens on most new claims (unless they "link" to older claims and we really don't want to go into that) and I've never been given a satisfying explanation as to why it is the case.

 

Finally, have you looked into Council Tax Benefit? Also Housing Benefit/Local Housing Allowance if you pay rent to a landlord. These are administered by your local council, so it may be an idea to contact them.

[antone]

Thanks Antone, I would like to apologise for trying to advise on a topic where I was "out of my depth" and thankfully your advice has saved the day.

Just want to mention that happy's OH's JSA CB is subject to the 108 day rule when things become "Income Based", this rule does not apply to ESA.

 

Hell, I had to add disclaimers to my post - it's not at all certain I've read every aspect of the situation correctly. None of this is easy to advise on at the best of times.

 

And yes, ESA© does not exhaust. I think the logic is that it is harder for an ill person to work and pay NI conts.

[antone]

 

I also mentioned about my appeal, and when i go back to work after my operation, whether the appeal would continue, and they stated that once i went back to work the appeal would cease.????

 

Is this correct, if the appeal has not been heard or completed when i go back to work then i wont get any of the monies backdated??????.

 

 

This is not the case - you have been advised badly.

 

You are asserting a period of LCW (Limited Capability for Work) from the start of your ESA claim to the point where you either return to work or cease claiming ESA for some other reason, for example by claiming JSA instead.

 

You have provided supporting evidence in the form of medical certificates and other documents from the doctors involved in your care. Your appeal will not cease simply because you return to work. That will only affect your entitlement to ESA after that point. The fact that the Tribunals Service is currently swamped with ESA appeals and is taking ages to process them is neither here nor there.

 

Edit to add: Didn't perhaps make clear, but you should indeed be entitled to backdated payments, even if you've returned to work, for the period you're appealing.

[antone]

This morning i sent reply to cbbc saying well done and congrats on Appeal..

 

also mentioned i had Concerns about Thread 6

IT was Explained that only Evidence up untill Medical in September could

be taken into Consideration.? Unjust Unfair and WRONG... IMO

 

Basically, when you appeal you are saying that you believe the decision was wrong at the time it was made. Therefore, you can only question the information used to make the decision in the first place. Decision Makers can't be expected to see into the future, so medical evidence from, say, March 2010 can't be used to prove that the DM made a mistake in September 2009.

 

If a customer's condition has become worse since the decision was made, the correct procedure would be to make a fresh claim based on that fact.

[antone]

antone beat me too it :grin:

 

Heh, and with a name like speedfreek, too

 

Although I've read post on forums where they say new evidence has been accepted. I'm sceptical as it may just be this new evidence is really clarification of other items given to the DM at the time.

 

[bolding mine] This. It's the difference between saying "this report from my doctor shows that I am in poorer health now than I was when the decision was made" and saying "this document demonstrates a material fact that the DM did not properly take into account at the time". The first case can't be considered by the Tribunal, the second can.

[antone]

You can indeed submit further evidence, and it's a good idea to do just that. But the evidence must relate to the period covered by the decision you're appealing.

[antone]

For give my ignorance,but dont the tribunial(when you finally get it)

take into account where you Live? Journey/travel etc

 

can some one Please "clarify"

 

Thanks

 

Yes, they should. It is possible to contact the Tribunals Service and ask about this sort of thing. To get the phone number, call the DWP office that paid/pays your benefit. The Tribunals Service is not part of the DWP.

[antone]

Thank you very much again antone Appreciated

 

just one more query? Re- Reconsideration,revision or superseding

of a decision(this a copy from job centre plus),from mountain of

papers recieved few days ago.

 

I personally have never asked/applied for this,but according to

papers, it states i Applied on 11feb,reconsideration 30march,

Notified to customer on30march on form/ietter DR1.(I was not

Notified,untii few days ago)

 

meant to put (30-march date in earlier,unsure/scared),but as is

say first time i have seen,(we are in May now?)

 

Is this Normal ,thanks again antone,anybody else,advice/help

" Appreciated "

 

Keep asking" Questions"

 

 

,

 

When you appeal against a decision, the first thing that happens is that your request is referred back to the Decision Makers at the DWP. A DM will look at your case, and see if the decision you are appealing is so obviously wrong that it can be changed without the need for a full appeals tribunal. Appeals are expensive and a hassle, so if it's simply a case of the DM who decided against you having a bad day then it would be easiest for all concerned if one could be avoided.

 

This is a "reconsideration", or a request for supercession of a decision, and it would seem that this is what your papers are referring to. Since you've appealed, a reconsideration will have been done.

 

It can only work in your favour, really. If the reconsideration decision is adverse to you, then it goes on to the tribunal.

[antone]

On the letter recieved it suggest that i will have my appeal at

Bexleyheath south london(not far from where i live) Good.ok

 

so why does it state the office dealing with my appeal is

 

1 address SM1 1DA,but the prepaid response letter ,

states 2 address SM1 1BD?(place got to send it back to?)

 

This also got me thinking...(when i got my "bundle"of paperwork recently) it came from Belfast bdc job centre plus,plaza building 31-41

chichester street BT1 4JD (according to letter)

But, the "Envelope", the "bundle"of paper work

ADDRESS was DWP

PO BOX 585 BELFAST BT1 1DW?

 

Why different addresses,and why different post code to where you send,

all IMPORTANT tribunal info/medical evidence....

 

The incoming mail addresses for government offices are often not the same as the physical street address of the building. Most mail is opened at secure facilities operated by Royal Mail. This certainly applies to DWP. Also, the address you see on the back of DWP envelopes is basically a "dead letter office" in Belfast. As far as I know, it's the same on most DWP letters from anywhere in the UK.

 

I'm not sure about the Tribunals Service, which isn't part of the DWP, but they probably have central mail handling arrangements of their own, and the address that receives mail isn't necessarily the address where appeals are actually heard.

[antone]

All the best with your medical procedure.

 

Here's one thing I learned from my time as an ESA processor: a lot of people seem to assume there is some sort of organised assault on benefit claimants, and that the staff of the various government departments involved are actively trying to deny claims. This is absolutely not the case: it makes no difference to the processor whether or not a benefit is paid.

 

So the address issue, well, I respectfully advise that you don't get too hung up about this. It's procedural and logistical, not an intentional plan to lose your mail.

[antone]

The processes for the WCA are totally separate from those for the work focused interviews. They aren't connected with each other so yes, it's perfectly normal for people to be asked to attend WFIs before they've had their WCA.

 

I'm afraid I don't really understand what you're asking in the rest of your latest post. Could you rephrase or clarify?

[antone]

hellow:-)

 

operation has been done(hooray)

it all went well,i feel it has been a success,"looking good for future":-)

continuous pain in leg seems to be gone. "heaven"

 

i have been signed off sick (unfit note) for another 6 weeks so that i can rest and recover on the advice(letter)from the consultant(nero-surgeon).,

and then go back to work after this period.

 

can anyone advise/help if my appeal is NOT heard in this time frame.,

if i am well and able to go back to work,what happens with the appeal:rolleyes:

 

1-will it just be forgotten about?(because i am all better)

2-because i am better(no more unfit sick notes issued)

 

"what happens next" cheers happyhamr:)

 

Glad to hear you seem to be getting better. If, six weeks down the line, you and your doctors decide you are fit for work, you would of course need to stop claiming ESA from that point onwards. But your appeal relates to a period in the past when you are asserting that you were not fit for work.

 

So, your appeal will continue unless you withdraw it in writing, and if the Tribunal decides that you did indeed have limited capability for work and should have been paid more money then arrears would be paid to you for that past period.

[antone]

This is a system-generated letter which gets issued when the processor runs through your claim to make some minor change. Operators can and should inhibit the sending of these letters when they're not necessary, but sending them by accident is a fairly easy mistake to make.

 

A "minor change" could be something as small as the processor updating your claim with a new medical certificate, for example. Or sometimes a computer glitch stops payment, and operator intervention is needed to get it started again.

 

The wording of the letter is standardised, and they all have the "How to Appeal" section in them, no matter what else they say. I'd be 90% sure you could ignore this letter, but it would be worth calling your BDC to ask if there's anything you need to know about.

[antone]

It's definitely a system-generated letter. No doubt about that at all. Now the system is not particularly intelligent about the letters, as you'll have noticed. It doesn't know what to do about the post-assessment-phase bit of your claim. Why? I don't know, but I suspect that it wasn't written with the assumption that vast numbers of people would appeal decisions.

 

So it can see that you're past the assessment phase, and you should be receiving a higher rate of benefit (or none at all). But it can't specify what the actual rate should be, because the appeal hasn't been decided yet. In effect, you're being paid an "interim" rate of ESA until your appeal result is handed down, and no-one has coded the computer to be able to explain this properly. Which is, sadly, about par for the course.

 

Anne Hannah exists, yes. At least, I presume she does: the names on the letters from the BDCs I've worked in have been real people.

 

For some reason that isn't clear to me, the centre manager's name is always put at the end of the letters. But you won't get put through directly to her and indeed, you wouldn't want to be - not at first, in any case. You might end up speaking to her if you make a noisy enough complaint, I suppose, but BDC managers are not usually experienced in dealing with the nuts and bolts aspects of claims.

[antone]

hellow:)

 

when i originally put my claim in for ESA in November2009 i got the 12 page letter back with regard to all the information i submitted.(telephone claim)

 

on page 6 of 12 it states;

 

claim sub- type ESA©

 

From this i cameto the conclusion that i would be on ESA contribution based. (would i be correct in this)(been self employed since 2002)

 

antone if you are about , can you confirm this:)

 

thanks happyhamr:)

 

I can't 100% confirm what type of ESA you get, but if you were paying NI contributions in tax years 2007/2008, 2006/2007 and 2005/2006 then it does seem likely you would qualify for ESA© - the contribution based benefit.

 

The self-employment issue does make it a little more complicated, and I was never a New Claims processor - they're the people who usually deal with such things. But in many circumstances, NI conts you make while self-employed will count towards ESA©.

 

So I'd say it's likely you get ESA©, but I can't be certain.