Help needed for claiming ESA

[mackerel]

Hello

 

I am writing this on behalf of my partner, who has mental health problems (bipolar depression, anxiety/panic attacks, ocd and agoraphobia). She currently claims DLA at the middle tier for care, and lower tier for mobility. Her condition is such that DLA will not be reviewed for another 5 years, as she has a long case history with CMHT's and secondary care facilities. She also had a fresh psychiatric evaluation just two weeks ago, as we moved recently and she had to be placed back into the mental health welfare system in a different county.

 

I am her full-time carer and claim carers allowance. We were previously in receipt of income support as a joint claim, and a couple of months ago received a letter in the post saying they would change her benefit to ESA, and she would need to attend a medical. This was expected, but the medical was a complete farce. Considering my partner suffers from panic and agoraphobia, it was incredibly hard for her to attend the interview, and the build up a few days before was dreadful.

 

On the day of the interview, we arrived 15 minutes before the interview as instructed, which was supposed to begin at 4pm. We were told that she might not be seen today, as there was a delay and if the current interviews were not finished by 4:15pm we would have to reschedule, as the dwp is strict about people being out of their building at 5pm, and the interview takes a minimum of 45 minutes.

 

So we waited until 4:30pm, all the time my partners anxiety increasing to unbearable levels; she hasn't been in a building like this in the middle of town for years. They tell us to go home and they'll get in touch soon with a date for an appointment earlier in the afternoon. Obviously my partner flipped, after going through all that to be sent home without even being seen.

 

Anyway, that was about 5 weeks ago. We hadn't received any letter from them with a new date, but this morning get a letter saying she has been placed in the work-related group!!! They haven't even assessed her properly!!! Let alone the fact that she is compleltely incapable of holding down a job (no reliability due to depression and agoraphobia) or being around strangers without getting violent (due to her anxiety).

 

Obviously i need to appeal, but i'm wondering about the best way of doing this? I can go to the CAB first thing on Monday morning, but is there a specific type of cab-advisor i need to ask for, or book an appointment with? Any other pointers would be greatly appreciated.

[Nystagmite]

You need to ask for someone who specialises in benefits.

[MIKEY DABODEE]

Has your claim to Income Support closed now ?

[mackerel]

Hi, thanks for letting me know who to ask for. As for the income support being closed - i'm not sure is the answer. We were on income support, but with the letter this morning saying that my partner is now in the work-related ESA, i'm assuming it is closed, since this morning? Or does the income support stay in place until the time to appeal is over?

[MIKEY DABODEE]

No, if your partner has gone over from IB to ESA and in the work related ESA group then her I.S will have closed.

 

But as a couple you have another option, you say you are in receipt of Carers Allowance for her, you can now claim I.S now in your name, and have your girlfriend on your claim as the partner,

 

This way she will not have to go for the ESA medicals

but of course if she is ESA Income Based then she would have to close the claim

Edited March 16, 2012 by MIKEY DABODEE

[mackerel]

Interesting, but a few things - she was on income support, not incapactiy benefit. And the fact that she has been placed in the work-related group is ridiculous, i think.

 

But if i then claimed income support in my name (which i'm assuming would be esa as a new claim) wouldn't i then be placed in the work-related group, with me having to attend the interviews (i have no problem with this, except the fact i would not be looking for work at the moment due to being a full-time carer).

[Nystagmite]

IS doesn't have those groups. As a carer, I think there are rules regarding work related interviews.

[MIKEY DABODEE]

Ok, she would have been on IB/IS... she would have been claiming I.S on the grounds of her IB.

I know she would have been on IB as all IB customers are going over to ESA, hence her transistion to ESA, IB has ceased for her and along with it her entitlement to I.S.

 

If you claimed I.S as a carers it is NOTHING to do with ESA

your benefit would be Income Support on the grounds of a carers, you have CA so you HAVE the condition of entitlement , it really would be a simple claim. You would not be expected to look for work as you are full time carer.

 

You would claim I.S for her and she would close her claim to ESA

 

CAB would confirm all of this for you if you consulted them

 

I know because I process I.S

Edited March 16, 2012 by MIKEY DABODEE

[feelingsad]

Mackeral if you want to complain to ATOS about their abysmal system their email address is [email protected]

 

I had a similar situation with my first appointment, running hugely late and my anxiety got to panic/distress levels so I ran out and cried outside and they said they would send me a new appointment. I emailed them and said due to anxiety I would not be able to wait any length of time as my anxiety increases the longer I wait until I panic and am unable to cope and suggested I have a 9am appointment as there would be no backlog. That's what they gave me within a week by emailing that address above as well as an apology for the previous wait.

 

But I think Mikey's suggestion above sounds ideal and the easiest solution for sure.

[mackerel]

thanks for explaining further mikey, what you're suggesting sounds ideal. I'm just getting confused how i can apply for income support for the both of us, when income support is being replaced with ESA- eventually, wouldn't be back in the same scenario, with them wanting to stop the income support and put us on ESA? Sorry if i'm being dim, but for obvious reasons i need to have a clear understanding of how these things work, and they don't make it easy!

 

For instance, quoted from http://www.nhs.uk/CarersDirect/moneyandlegal/otherbenefits/Pages/IncomeSupport.aspx

The person you're looking after can claim Income Support if they're on Statutory Sick Pay and their income is too low. Otherwise, if the person you're looking after needs to claim benefits because they're unable to work due to illness or disability, they must claim Employment and Support Allowance (ESA). They can no longer make a new claim for Incapacity Benefit or Income Support due to being unable to work as a result of illness or disability from October 27 2008.

 

If we did proceed with the joint income support in my name route, would my partner be required to attend the work focused interviews? It's fairly unlikely she'd be able to attend them.

 

Feelingsad - at least they sent you another appointment, instead of assuming your fit to work without even assessing you! Thanks for the customer complaints link, i can feel an angry email brewing...

Edited March 17, 2012 by mackerel

[MIKEY DABODEE]

hi Mackerel

ESA is not replacing IS

ESA replaced IB

Universal Credit eventually will replace ESA, IS JSA

but NOT Carers Allowance.... Been told this by a regional trainer of the benefit

 

Ok you have the grounds as I have already explained,

you would get Couple Rate, Couple Disability Premium and Carers Premium but then take away your CA

 

You seem to be having a lot of hastle off ESA and stress

 

there are WFI to attend but these are just informal chats that are a lot easier I would imagine then the medicals and WFIs that come along with ESA

I.S WFIs just advise the customer to what help is available its up to you whether or not you take whats on offer...

 

DLA is ending in a few years but being replaced and if she is still entitled then you should should get carers for her

[mackerel]

ok, i think i'm getting the picture. So because i am claiming carers allowance, i can apply for income support in my name, as a joint claim to include my partner. This would mean that she would not need to go on ESA, but then i would lose carers allowance - i'm assuming that's the payment and not the eligibility - but get income support with couple rate, couple disability premium and carers premium. Would i be worse off financially by not having carers allowance?

 

But then i'd be able to claim carers allowance again in a few years time when DLA is replaced, is that right?

[MIKEY DABODEE]

so sorry its complicated

 

You would keep the Carers Allowance but its classed as an Income for Income Support

and they would take it into account

 

quick calculation am pressuming you are over 25

 

you would get as a couple £122.40 I.S and then your top up of CA £55.55

making it £178.05 in total plus your DLA

dont know how much you are on ESA but maybe IS would be more

Edited March 17, 2012 by MIKEY DABODEE

[mackerel]

It's not your fault your it's complicated, although sometimes i feel it may have been designed that way on purpose.

 

Yes, we are both over 25. I think at the moment, as we are on joint income support under my partners name we get £120 odd per week just for IS, then carers allowance seperately of £56 per week - so what you are proposing would mean we get slightly more, which is always welcome, with the advantage of not having any of this hassle, although i need to compare it to the ESA support group rate, which is what my partner should be placed into.

 

The letter we got said that being placed in the work-related group for ESA, would be £112.30 per week. I would be happy to pm you the page of how they worked this out, if it makes it easier to understand my circumstances.

 

Will definitely print this thread and take it with me to the CAB on monday.

Edited March 17, 2012 by mackerel

[Nystagmite]

Mikey - does your calculation include the carers premium of around £31?

[mackerel]

I may as well post it here as there is nothing personal in it and all the rates are available on the internet. This is from the letter we received yesterday.

 

The Employment and Support Allowance Award

Living expenses for you and your partner: £105.95

Extra money because your partner is a carer: £31.00

 

Limited Capability for Word Addition

Extra Money because you are in the work-related activity group: £26.75

Which gives you a total income-related amount: £163.70

 

Income and Benefits

DLA - MOBIL COMP for you is not counted as income towards Employment and Support Allowance

DLA - CARE COMP for you is not counted as income towards Employment and Support Allowance

Carer's Allowance for your partner: £55.55

Your total income: £55.55

Your income-related amount is £163.70 less total income of £55.55

So your income related entitlement is £122.50

 

Top-up Payment

Included in your Employment and Support Allowance entitlement is a top-up payment which ensures you won't see a reduction in the level of your benefit entitlement as a result of the change to Employment and Support Allowance: £14.35

Your total income-related benefit entitlement is: £122.50

 

Deductions taken from your Employment and Support Allowance

£10.20 for an overpayment

Your total deductions are £10.20

 

So the amount you are going to get each week is: £112.30

Edited March 17, 2012 by mackerel

[poollie1]

Hi, thanks for letting me know who to ask for. As for the income support being closed - i'm not sure is the answer. We were on income support, but with the letter this morning saying that my partner is now in the work-related ESA, i'm assuming it is closed, since this morning? Or does the income support stay in place until the time to appeal is over?

 

On your partners decision letter placing her into the WRAG group it should give a date when ESA will start, until that date you will still receive IS.

[poollie1]

Hello

 

I am writing this on behalf of my partner, who has mental health problems (bipolar depression, anxiety/panic attacks, ocd and agoraphobia). She currently claims DLA at the middle tier for care, and lower tier for mobility. Her condition is such that DLA will not be reviewed for another 5 years, as she has a long case history with CMHT's and secondary care facilities. She also had a fresh psychiatric evaluation just two weeks ago, as we moved recently and she had to be placed back into the mental health welfare system in a different county.

 

I am her full-time carer and claim carers allowance. We were previously in receipt of income support as a joint claim, and a couple of months ago received a letter in the post saying they would change her benefit to ESA, and she would need to attend a medical. This was expected, but the medical was a complete farce. Considering my partner suffers from panic and agoraphobia, it was incredibly hard for her to attend the interview, and the build up a few days before was dreadful.

 

On the day of the interview, we arrived 15 minutes before the interview as instructed, which was supposed to begin at 4pm. We were told that she might not be seen today, as there was a delay and if the current interviews were not finished by 4:15pm we would have to reschedule, as the dwp is strict about people being out of their building at 5pm, and the interview takes a minimum of 45 minutes.

 

So we waited until 4:30pm, all the time my partners anxiety increasing to unbearable levels; she hasn't been in a building like this in the middle of town for years. They tell us to go home and they'll get in touch soon with a date for an appointment earlier in the afternoon. Obviously my partner flipped, after going through all that to be sent home without even being seen.

 

Anyway, that was about 5 weeks ago. We hadn't received any letter from them with a new date, but this morning get a letter saying she has been placed in the work-related group!!! They haven't even assessed her properly!!! Let alone the fact that she is compleltely incapable of holding down a job (no reliability due to depression and agoraphobia) or being around strangers without getting violent (due to her anxiety).

 

Obviously i need to appeal, but i'm wondering about the best way of doing this? I can go to the CAB first thing on Monday morning, but is there a specific type of cab-advisor i need to ask for, or book an appointment with? Any other pointers would be greatly appreciated.

 

Phone DWP and inform them you wish to appeal the decision, they will send you GL24 form to fill in, you have to do this within 1 month of receiving the original decision letter, so dont delay get your appeal in, any evidence you have can be submitted at a later date, you can also cancel your appeal at anytime if you change your mind. As part of the appeals process your partners claim will be looked at again by a different decision maker to see if the decision can be changed. If they cant change the decision your appeal papers will be sent to the Tribunal. Please bear in mind when your claim is looked at again the decision can remain the same in which case your papers will be sent to Tribunal, or be changed in your favour to place your partner into the Support Group, or the new decision maker may decide your partner does not qualify for ESA at all.

Edited March 17, 2012 by antone
Fixed quote tag

[poollie1]

Interesting, but a few things - she was on income support, not incapactiy benefit. And the fact that she has been placed in the work-related group is ridiculous, i think.

 

But if i then claimed income support in my name (which i'm assuming would be esa as a new claim) wouldn't i then be placed in the work-related group, with me having to attend the interviews (i have no problem with this, except the fact i would not be looking for work at the moment due to being a full-time carer).

 

Carers dont have to attend work related interviews, but yes your right, you would have to claim ESA on the grounds of your ill health, Your partner was claiming IS on the grounds of Incapacity, this is in the process of being phased out hence changing to ESA, you should be able to claim IS as you are a carer, this will also be changing soon to the Universal Benefit.

Edited March 17, 2012 by poollie1

[MIKEY DABODEE]

my calculation for IS did include the carers premium

so looks like you would be on roughly the same

£105.95

CP £31.00

DP £41.10

£178.05 less CA £55.55 its an income

leaves 122.50 IS was 10p out....

plus your CA and DLA

 

 

so the decision is up to you, and with regards to WFIs then yes both would need to attend on I.S but the advisor offers advice only...

Edited March 17, 2012 by MIKEY DABODEE

[mackerel]

Well i went to the CAB on Monday, they took some details and made an appointment for me with their benefits guy the next day.

 

We went through a lot of things, but a couple stuck out. First of all, he was really concerned that my partner had been placed in the work-related group without even being assessed. He said they only do that if you fail to turn up for an interview, and that got me fuming thinking that not only did they mess us about on the day, but would they turned round to the dwp and said we didn't even attend? If they do, how can we prove that we did attend but were sent home?

 

As for the joint income support aspect, he wasn't too keen on the idea. He had to get some mammoth text book to support what he was saying, but basically it came down to something like being on DLA does not mean that my partner is not qualified for full-time work, as people can work full-time and claim DLA. He thought it would be too easy for everyone who is on ESA and has a partner as a carer to opt out of the system by just hopping on to their partners income support, which would be a big hole in the system and would lose out of the system a large amount of people that ESA was designed for.

 

He specifically photocoped a section of the book:

You or your partner can be treated as being in full-time paid work, even if you are not, if:

 

• for IS, JSA, HB and CTB, you or your partner (or, for ESA, your partner) are away from full-time paid work without "good cause". What constitutes "good cause" for these purposes is not defined in the rules but all of your circumstances shold be taken into account.
  

Basically he was saying that without going on ESA, it would look like my partner is simply choosing not to work, and under those circumstances the dwp would not be likely to support the joint claim.

 

I'd love some feedback on this. I can see where he is coming from, but later i was mulling it over an thought that being eligible for ESA, as satisfied by Appendix 1 of the descriptors, would be "good cause"? Surely if she is eligible for esa, then she should eligible not to work? Or could that only be decided if she is placed in the support group?

 

Either way, i need to phone the dwp and see why they decided she was put into the work-related group without an assessment. I'll post back after i've phoned them.

[Nystagmite]

First of all, he was really concerned that my partner had been placed in the work-related group without even being assessed. He said they only do that if you fail to turn up for an interview,

 

This is wrong. Some people fill their ESA50 in such a way that DWP believe they have enough information to decide what group someone goes in.

[mackerel]

Finally got through to the dwp, and asked why she was placed in the work related activity group without being assessed. They said that they have no medical assessment on file, and that the decision had been made regardless, without seeing her. Well that makes going to the assessment worth the effort for everyone doesn't it?

 

Got a GL24 being sent to me, starting the appeal process.

[Nystagmite]

Sometimes, if the ESA50 contains enough information, a decision can be made that way. I have heard of it happening a few times.

[count orlok]

A descision was made in my case to be put in the support group on what was written in my ESA50, the only medical evidence I included was a photocopy of my prescription.