Missed ATOS medical.

[ErikaPNP]

He can do all three.

 

The problem is that during an appeal, he won't be entitled to receive any money pending the decision - this is only for people who have attended an assessment and not been granted sufficient points. If he plans to appeal, he needs to do this straight away as he only has one month from the date of the decision to do so. Calling back in two weeks to see if they will reconsider? - that's very bad advice given by the contact centre, unless of course he had already requested a reconsideration and they are giving that as a timescale to call back for an update.

 

A new claim will not secure payment until after a successful assessment, if the last decision was made in the last 6 months - unless there is a significant deterioration of the condition or he is claiming on a new condition.

 

He can apply for a Crisis loan however they will not be able to pay him for an indefinate period and there will come a point where they will refuse to pay any more.

 

He can phone ESA again and request a call back from the ESA department itself. When you call that number you are getting through to a contact centre anywhere in the country, not the actual department that processes benefit. The contact centre have basic access to computerised records for general enquiries only, they have no access to his paper file and are unable to trace physical paperwork. If ESA are able to locate his letter they can then decide whether they will perform a reconsideration based on that or not.

 

However the issue that I forsee is that they may decline to revise the decision in his favour by stating that they do not schedule appointments (ATOS does this and this is stated in letters he should have been sent previously). Their argument will be that he knew an appointment letter had been sent to him and that he did not do enough to ensure that he attended. Not saying it's right but I have seen that argument used before.

 

There is another option. That is submitting an appeal and claiming JSA on a restricted jobsearch in the interim period. I do not like to advise people to do this but it may be his only alternative. It is a last resort though.

 

I'm sorry that I cannot be more helpful.

[ErikaPNP]

Sorry to quibble here but I thought that it was no payment until a WCA has been undertaken and a decision made?

 

That's exactly what it means. A successful (decision favourable) assessment (WCA). Don't apologise, by the way - the bonus of an open forum is for debate and qualification of advice.

 

New decision/claim over rules the fail to attend and hence ESA is payable again win or lose?

 

No. The decision of a 'fail to attend without good cause' is always treated as not having limited capability for work. Any decision of not having limited capability for work means that any repeat claim for ESA within the next 6 months will not be paid until an assessment has been carried out and a decision made, unless the person is claiming for a new condition or a significant deterioration of the existing one.

 

Worried's thread does not talk about fast tracking claims rather than waiting the 13 weeks. That thread relates to payment of the increased rate (WRAG or Support group) elements after the 13 week assessment phase when no assessment has been performed within the 13 week period.

[ErikaPNP]

 

BTW whats he supposed to appeal? because he has contacted ESA today and they have given him the number for ATOS, so if he calls them and they refuse to give him another appointment can he appeal that decision? (sorry to sound dim!)

 

 

He is appealing the decision to stop his ESA.

 

Assuming that his ESA claim has been terminated, which appears to be the case.

 

Note: It will have been terminated if the letter he got from DWP states something along the lines of

 

"We cannot pay you ESA from X date. This is because....."

 

And it will go on to say something to the effect of that they have decided that he does not have limited capability for work because he did not attend the assessment on x date at x place.

 

If the letter simply asks him to make another appointment then his claim has not stopped. But I have never known them to stop someone's benefit and ask them to make another appointment if they have not attended the arranged one.

 

If his ESA claim has been stopped, ATOS will not be able to arrange another appointment, because the claim no longer exists. He cannot appeal a decision not to give him another appointment because that is not a decision on his claim. It is only decisions on his claim made by DWP which can be appealed.

 

Unless you can scan and post the letter here (personal details removed) or write it out (word for word, personal details removed) it is a bit difficult to gauge whether or not his claim has been stopped. We can only draw inferences based on what you have posted, what the law is and what they (DWP) normally do.

 

Also can I just clarify, if he is able to make a new claim he wont receive any money until he has had another assessment?

 

That's right, if the claim is made within 6 months of this one ending - unless his condition has significantly deteriorated or he is claiming with a different condition than he was before, in which case he would be paid.

 

If he resorts to claiming JSA, pending the appeal outcome, JSA would go into payment.

[ErikaPNP]

I have just read worried's thread, he had a much better cause for missing his appointment and still had to jump through hoops to get the decision overturned!

 

Have just asked my brother to have a look at his paperwork (he is staying with me for a couple of nights) he hasn't actually had a letter to say his payments have been stopped, but they have. He has one that says please explain why you missed your medical and a form to fill in.

 

I am just wondering if its worth going though all this, he is stressed and anxious as it is, which is really not helping his depression, and wondering if I should just tell him to make a new claim and wait for a new appointment????

 

P.s. special thanks to Erika for taking the time to write such lengthy replies, it really is appreciated.

 

This changes everything. Do not appeal, there's nothing yo appeal against yet. Complete the form explaining why and send it off. If they then come back and stop his ESA, that's when you appeal.