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Appeals against ESA & wrong information advice needed please!


gazmix
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Hi all

 

I wonder if you can help at this stressfull time!

My partner has had her ESA medical & has been paid housing benefit, council tax benefit & ESA up until now!

Her 1st medical cerificate ran out on Oct 11th & we sent another out to get there before this date!

Because we didn't have an envelope with the Freepost address on, we called DWP & they said it was ok to write the envelope, starting Freepost & then the long code, then the address!

This was sent & now they say they haven't received it & we shouldn't have sent a written envelope!! buit we were told it was ok to send a written envelope as they aren't usually sent out & its only a courtesy gesture if they are!!, as its the customer that has to keep a record of when the medical certificate runs out!

This apparent negligence on their part has delayed the medical certificate arriving & now we are behind!

 

Now, we have been told that the medical examination has shown that my partner has only been allowed 6 points & therefore isn't ill!!!! She has very strong emotional issues that is dealing with now, very depressed & clearly ill, so how can they say this!! I mean she never goes out unless with me!!

They say different things each time we call, like 1 person said that if i get the medical certificate too them asap, we can continue getting paid & that the Medical examination is a seperate part from that, someone else said that the Examiner overuled the GP that gave us the DR's note!

 

They tell us that once we appeal, & they get the appeal, we will still receive benefit until the appeal has been decided!! Could someone say if this is true as i'm bound to get a different answer if i call again! Nobody seems to know whats what & give consistent advice!!

 

Any help much appreciated!!

 

Gaz

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Hello Gaz. I think the 'assessment rate' should be paid until your appeal or tribunal is decided. I have a sticky in the yellow section above the Benefits threads, and there are quite a few threads with the same questions that you could have a browse through.

 

My best, HB

Illegitimi non carborundum

 

 

 

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Thanks honeybee

I will have a proper look through your sticky above! & at other threads, its just so annoying that we are powerless when most of the time its their neglegance & we have to pay for it!!

 

I'm just worried that because we have bills due on Monday, direct debits etc that i thought eventually we'd sorted, now we seem to be back at sq1! The prospect of losing our flat is destroying my partner!!

 

Do you think we will carry on getting housing benefit that we were getting prior to this decision, along with the assessment rate?

It is due on the 1st of each month!!

 

Many Thanks

 

Gaz

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Yes - if your income remains the same so will your housing benefit. However, HB and CTB may temporarily be placed on suspension (not terminated, just payments suspended) if DWP have informed them that ESA is no longer in payment.

 

This is something that councils do once they receive information that someone is no longer getting benefit that passports to HB/CTB. If that happens, advise that you have appealed against the decision for the ESA and ask them to reinstate your housing benefit/council tax benefit.

 

When you submit the appeal, you need to continue to provide the GP certs until the outcome of the appeal. As the last GP cert is missing, you will need to submit another one which covers the period commencing from the end date of the last one with your appeal to get the assessment rate reinstated without a break in payments.

My advice is based on my opinion, my experience and my education. I do not profess to be an expert in any given field. If requested, I will provide a link where possible to relevant legislation or guidance, so that advice provided can be confirmed and I do encourage others to follow those links for their own peace of mind. Sometimes my advice is not what people necesserily want to hear, but I will advise on facts as I know them - although it may not be what a person wants to hear it helps to know where you stand. Advice on the internet should never be a substitute for advice from your own legal professional with full knowledge of your individual case.

 

 

Please do not seek, offer or produce advice on a consumer issue via private message; it is against

forum rules to advise via private message, therefore pm's requesting private advice will not receive a response.

(exceptions for prior authorisation)

 

 

 

 

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I think you may be confused (or being thrown a red herring) on the addressing and sending. As writing the correct address on an envelope (and unless it's freepost) paying postage costs is the correct & established way to use the English postal service and has been since it was invented! I believe only letters to Santa Cluas have a special exemption from this rule.

 

I always send mine hand addressed to their freepost address.

 

Bit of advice on this which may work on the Fit note problem (get this sorted A.S.A.P. to get your payments reinstated)

 

You need to find out if the BDC (Benefit Delivery Centre) will accept a faxed copy of the note? Some do and some don't you'll have to ask. If they do then if your doctors willing they can fax over a copy of the note (has to be faxed from the surgeries fax machine) which will be accepted and you can follow it up with a hard copy as soon as you can.

 

Remember always call the BDC to get confirmation of receipt once sent (with letters give it 7-10 days).

 

Something to remember here is that when sending Fit/Sick note always include a covering sheet with which benefit the note is for. DWP post is received and opened at a central sorting office before being resent internally by their own internal mail system to the correct office. I've seen it posted up on a number of benefit forums that this helps.

 

Also the consensus on here was do not send it recorded/signed for as it will just delay it's receipt by the DWP. If you can get to a Post Office ask for a proof of posting slip, they are free, time/date stamped and show the address sent to.

 

Yes - if your income remains the same so will your housing benefit. However, HB and CTB may temporarily be placed on suspension (not terminated, just payments suspended) if DWP have informed them that ESA is no longer in payment.

 

This is something that councils do once they receive information that someone is no longer getting benefit that passports to HB/CTB. If that happens, advise that you have appealed against the decision for the ESA and ask them to reinstate your housing benefit/council tax benefit.

 

When you submit the appeal, you need to continue to provide the GP certs until the outcome of the appeal. As the last GP cert is missing, you will need to submit another one which covers the period commencing from the end date of the last one with your appeal to get the assessment rate reinstated without a break in payments.

 

Almost but you've missed out a step.

 

There will usually be a few weeks (more like a month) delay between receiving the decision, sending in the appeal and receiving notification that the appeal has been accepted. During this period to continue receiving LHA/HB/CT payments you will have to fill in a change of circumstances form and provide evidence of your income/savings etc.

As Erika said although ESA grants you LHA/HB/CT it is based on your income. If ESA is stopped you have to provide proof of you current income (even if it's nothing) to your Council to prove you are still eligible under the low income rules or payments will be suspended until you do.

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Hi

We have n appointment with gp on Monday, then we hope to call DWP to get the appointment at the job centre where we will take the 'Fit Note', & also handing in the appeal form!!

I'm hoping i can hand in the fit/sick note there to get it faxed or sent asap!

I hope we get this Monday as it will be hard to fill in the appeal form.

If i hadn't called them about the fit note issue, i wouldn't know anything about the decision! The said they would send out an appeal form which arrived today & has come before the letter about the decision!

 

I hope the letter has a broken down explanation of why my partner has only 6 points as when i looked on the link in Honeybee's sticky to the pdf about points etc, i am absolutely dumbfounded at the results of only 6 points!

From questions 21 onwards about mental health, i amounted more than 30 points at least & recall all the questions at the medical answered that way, so i can't for the life of me understand a score of 6!.

It;'s maddening, outrageous & unbelievable the score of 6! as the qustions asked warranted more points by the answers gave according to the points in the pdf link!

 

 

Regards

 

Gaz

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Ok, so tomorrow is the day i take my partner to the GP to get a medical certificate, to then call the DWP to get an appointment at the benefit office to hand in the appeal form.

I'm wondering from anyone if this is how it works! I've seen the link in honeybee's sticky that shows the points awarded & can't believe my partner has only 6 points! I've also seen on some threads that people aren't surprised that they fail the medical, especially when it comes to mental illness.

Does the written explanation come with a detailed breakdown of points scored & where points haven't been awarded!

 

Also, is it true that if on DLA, a medical for ESA wouldn't have been necessary?

 

Help appreciated ahead of tomorrow!

 

Regards

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Hi all talking about E,S,A Appeals My benefit was stopped after i went for Atos medical work assessment,in there final report,they said i was capable of going back to work on the short term, I didn't agree with this so i decided to appeal against there decision, which my benefit has resumed, I then explained all this to my GP, He told me that i wouldn't be able to continue to go back to work, So he has given me a letter explaining all this, Which i have now sent it to DWP, They have since sent me letter to say i have to go to a pathways to work interview, This tells me that they have disregarded my Doctors letter, My Question is can they overide your own doctors advice, I have been suffering from blood pressure problems for about 7years now,last Dec I was taken ill and my blood pressure was so high i nearly took a stroke,it has taken my doctor over 10months to get this under control, I have since lost my job due to this condition,My GP has explained i go back to work i will be back in the same positon as before and might not be so lucky next time, Is there anybody out there with the same problem as me, Please feel free to get back to me it would much be appreciated.

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They must not take mental health problems seriously. I am claiming on mental health grounds, and my assessment was maybe 20 minutes. There must be thousands of cases like your partners. This is my second time through the process, first time I won on appeal. Tribunal's are more sympathetic. Take some heart from the appeal success rate (around 40% I think), which might not seem that high, but it is and indicates some serious problems with their assessments.

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Re the sending of fit for work notes. I would advise the following:

1. Ring ATOS and ask for fax and fax confirmation number

2. Fax both sides then ring confirmation number to check

BEFORE posting via recorded delivery

Far too many people are enduring "lost note syndrome"!

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Re the sending of fit for work notes. I would advise the following:

1. Ring ATOS and ask for fax and fax confirmation number

2. Fax both sides then ring confirmation number to check

BEFORE posting via recorded delivery

Far too many people are enduring "lost note syndrome"!

 

Do you mean the DWP?

 

As for sending Recorded Signed for, there was a thread on here about this and we all agreed it's pointless.

 

All though the case regarding unfair mail sending terms was won v's the DVLA (i.e. a judge ruled that you can not be expected to follow rules for post that is above and beyond their own rules) the DWP still insist that an item has not been received until it gets to the correct department. All mail to the DWP is sent to (& opened) at central mail depots then forwarded via their internal mail system to the correct departments. So even though it has been signed for it has still in their eyes not been received.

 

Highly unfair (and I'm 99.9% certain illegal) but as it stands unless somebody challenges it (the DVLA case took over a year) in court thems the apples we have to go through hoops for.

 

It also for some unknown reason delays it?

 

As I said earlier there is no guarantee it will not get lost what ever you do. The only things you can do is copy/scan everything you send, include a cover sheet (or write on it) which department it's for and call 7 days after sending to check receipt. If you can get to a Post Office then a free Proof of Posting certificate provides exactly the same level of protection and doesn't delay it.

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Hi

My partner opened her heart about a rape issue in her past, her family upbringing that was bad, bereavement & that she's addressing issues now!! These things are heavy & can't be seen!!, how the heck can someone think about work & deal with all the benefits malarky when dealing with this stuff!!

The guy was just ticking boxes, he seemed to empathize, but now after the 6 point score that is a disgrace after all the questions he asked we told the truth & got no score for!

It seemed that the process doesn't consider an individual, justticks boxes & its terrible!

 

Can anyone say how long it takes to re-install assessment payments as we've now sent the appeal?

I'm so stressed as bills go out on the 1st of the month & there is nothing in the bank! I can't get a desperation loan as hey are just for food!

 

Help appreciated anyone!!

 

 

Gaz

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Hello

 

This might be of interest. It is taken from an internal website from a Local Medical Committee that represents GP's in the South of England:

This was information received from an LMC secretary in England who provides useful information

"I sit on Employment and Support Allowance appeals.

 

The criteria for ESA are VERY much stricter than for Incapacity Benefit, which it replaces.
Although the Department for Work and Pensions talks about the test defining the claimants ability to work, it does no such thing.
You have to pass the test ((score 15 points) to claim the benefit. If you don't you have to claim Job Seekers Allowance.
This does not neccessarily mean that you are fit for work or employable.

 

It is likely that nearly all applicants will appeal as you continue to get ESA until your appeal is determined.

 

If the appeal panel hears a case and thinks it would be helped by further medical evidence it can adjourn the case and ask for a GP report or for a copy of the records. The Tribunals Service will pay for these, not a very high rate but better than nothing. The practice does not, therefore, disadvantage a patient if it declines to do a report for at the patient's request before the appeal
."

 

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i was awarded another 6 points that takes me up to 18 thank goodness!!!! someone has said that this may not be the end of it though but that the DWP could appeal against the decision : ( i do hope not . I thought that would be it all done and dusted not sure what happens now though i gather i do not have to keep getting sick notes and that i will get a little more money each week which will be all good : )

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Hi HoneyBee

 

The score of 6 points we had was a disgrace! We, including the GP unbiasedly scored 99! considering the answers we gave to the medical assessor!

 

We made an appointment to take the Dr's note to the local jobcentre & also the appeal which was wrote & also a headed letter from the GP totally disagreeing with the decision!

The 2 were sent through their internal post system!

 

This was last Tuesday!, now we are awaiting reinstatement of assessment rate ESA!

 

Can you tell me if this will be back dated to when ESA was stopped after the medical?

 

Also, am worried about housing benefit!! It went in last time but as they are different, i wonder if it will go in the bank as normal!

 

Just to note!, the medical assessor was so wrong & i've read & downloaded HoneyBee's link in the sticky to show the points scoring system & its a disgrace! Apparently they have just 3 days training! As i say, me & the GP, scored 99 points!

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Hello again gazmix. I'm afraid I don't know the answer to your question on the ins and outs of ESA reinstatement, but someone here should.

 

I understand exactly the position Atos have put you in and it's not fair. I'm only an ex-appellant myself not an expert, so I can't help at the moment, sorry. I wish you every success with this though.

 

HB x

  • Confused 1

Illegitimi non carborundum

 

 

 

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OK I know its too late but for anyone reading this NEVER send via post additional without doubling up. By that I mean faxing. I would always advise people to get ATOS/DWP fax and confirmation number. You fax any additional information and then telephone to verify they have actually received it. Far too many people are suffering from lost notes syndrone when dealing with ATOS and DWP. The blame always falls on the patient.

They tell us that once we appeal, & they get the appeal, we will still receive benefit until the appeal has been decided!!
That appear to be correct. If you claim ESA and are turned down, you can continue to claim it at the assessment rate until your appeal is heard.
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The ESA will be paid from the time your money was stopped. Housing Benefit should be all right but I would definitely contact them to tell them what is going on.

 

dj

Benefits rules are complex, and although I do try to inform and support people, I may get it wrong because the rules apply to individual claimants and their particular circumstances.

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It's certainly worth a try but I did some of those things and the assessor simply lied in her report. The whole process is based on lies.

 

dj

Benefits rules are complex, and although I do try to inform and support people, I may get it wrong because the rules apply to individual claimants and their particular circumstances.

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