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Esa Support Group Entitlement???? Confused.....


bladerunner22
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Hi, I am new to the forum and desperate for some advice or views. I was migrated from IB to Esa Contribution based last October 2011 and placed in the Wrag Group, my payments have just recently been stopped because of the 365 day rule, I do not meet the criteria for Income based Esa.

 

. I asked for a reconsideration on the decision as I felt I qualified for the Support Group. The decision was to remain the same, Wrag group. I then appealed the reconsidered decision in May of 2012, as part of the appeal they firstly reconcidered the decision again to no satisfaction, still to remain in the Wrag Group and appeal papers sent to Tribunal.

 

I have just recently one year on from the original decision received appeal pack from Dwp which has also been sent to the Tribunal. Amongst other things there is guidance notes to help the Tribunal with its decision. One of the guidance notes states:-

 

A claimant has Limited Capability for Work Relatied Activity ( Support Group) if they satisfy at least one of the Support Group Descriptors. A discriptor is satisfied if it applies for the majority of the time ( Majority is the key word) or, as the case maybe, for the majority of the occasions on which the claimant undertakes or attempts to undertake the activity described by that descriptor.

 

The reference:- The Employment and Support Allowance regulations 2008 34 (1), (2).

 

When I received my Esa85 medical report from Atos one of the descriptors I satisfied was, Engagement in social contact with someone unfamiliar to the claimant is not possible for the majority ( again key word Majority) of the time due to difficulty relating to others or significant distress experienced by the claimant.

 

My questions are, do I satisfy this descriptor in your opinion taking into consideration the wording of the Esa regulation 2008, should I have been placed in the Support Group? if I should have been in Support Group what is my next step as the Support Group does not apply to the 365 day rule and my payments have already stopped.

 

I have telephoned Dwp to discuss this several times and request a call back but no one has bothered to phone me back, I have just recently emailed my MP to ask for his help. Advice or your views would be much appreciated.

Edited by bladerunner22
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thanks estellyn for your input, yes I know the support group descriptors, looking at my esa85 report I satisfy one of those said descriptors according to the Employment and Support Allowance Regulations 2008 34 (1), (2). if you read this you will find that Majority of the time is the keywords, I have it in black and white from Atos I satisfy a support group descriptor for the Majority of the time, so again my questions are:- what do I do next as I was placed into the wrag group? in your opinion should I have been placed into the support group, if you read my original post again you will see I satisfy a support group descriptor as explained by Atos in my medical report.

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thanks estellyn for your input, yes I know the support group descriptors, looking at my esa85 report I satisfy one of those said descriptors according to the Employment and Support Allowance Regulations 2008 34 (1), (2). if you read this you will find that Majority of the time is the keywords, I have it in black and white from Atos I satisfy a support group descriptor for the Majority of the time, so again my questions are:- what do I do next as I was placed into the wrag group? in your opinion should I have been placed into the support group, if you read my original post again you will see I satisfy a support group descriptor as explained by Atos in my medical report.

 

the descriptor you quoted in your post is the 6 point descriptor, whereas the support group descriptor is the same as the 15 point descriptor. The key isn't the word majority, but the type of interaction that can be undertaken - the descriptor is

Engagement in social contact is always precluded due to difficulty relating to

others or significant distress experienced by the individual.

 

which as you can see is different from the one you quoted. If you could prove that you met the above descriptor, then you may win an appeal to be in the support group.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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the descriptor you quoted in your post is the 6 point descriptor, whereas the support group descriptor is the same as the 15 point descriptor. The key isn't the word majority, but the type of interaction that can be undertaken - the descriptor is

 

which as you can see is different from the one you quoted. If you could prove that you met the above descriptor, then you may win an appeal to be in the support group.

Thanks for that estellyn, yes I am aware of all that and I am appealing on those very grounds you state, so the Esa Regulations 2008 34 (1), (2) are not worth the paper they are written on, as they state a LCWRA which is Support Group, a claimant has to satisfiy a prescribed descriptor for the Majority of the time, or for the Majority of time the claimant trys to undertake the task, not in those words I quote, but the meaning is the same.

Edited by bladerunner22
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Thanks for that estellyn, yes I am aware of all that and I am appealing on those very grounds you state, so the Esa Regulations 2008 34 (1), (2) are not worth the paper they are written on, as they state a LCWRA which is Support Group, a claimant has to satisfiy a prescribed descriptor for the Majority of the time, or for the Majority of time the claimant trys to undertake the task, not in those words I quote, but the meaning is the same.

 

They're talking about a prescribed SUPPORT GROUP descriptor. The support group descriptor says 'always precluded', but it is accepted that this needs to be the majority of the time, and that sociallising with family a few times a year, does not constitute failing to meet the descriptor.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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Right let me see if I got this right then, if I always walk out the room to avoid family when they come to visit, because that is what I do to avoid becoming distressed, never leave the house to meet family or friends, that is precluded, and this has to happen for the Majority of the time, is that right ??? so on a good day if I was to spend an hour with one of my grandchildren say twice a year I would still satisfy that descriptor????

Edited by bladerunner22
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Right let me see if I got this right then, if I always walk out the room to avoid family when they come to visit because that is what I do to avoid becoming distressed, never leave the house to meet family or friends, that is precluded, is that right????

 

Yes, so you can argue that the wrong descriptor was used, as your problem is not just with unfamiliar people, but with everyone.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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Right ok...Thanks. Would I still satisfy the descriptor if say on a good day I was able to spend an hour with someone familiar or unfamiliar say twice a year????? such as the HCP from Atos, as that is DWP argument.

 

Yes, this is where the word 'majority' comes in. Also I would argue that the Atos assessment is not 'social contact', but required professional contact, like that required when speaking to a doctor or a policeman. Attendance is mandatory - I expect that you were quite distressed by having to be there. You need to empasise in your written statement the preparation you had to do and stress you suffered in order to attend the assessment, and the after effects of having to go - and this is not repeatable for you.

 

My husband has mental health problems and is a mess for days before a doctor's appt and then sleeps for a day after due to the stress - just due to a short doctor appt, so I do understand how it can be.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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I appreciate the very good advice thankyou. I have stated on my Tribunal papers that I will be attending, but dont really know wether I will be able to attend on the day, suppose I will have at least 6/9 months to prepare though, which in itself is starting to panic me.I dont know wether it is worth all the stress now my payments have stopped. Just one other question what will happen if I do sucessfully win at Tribunal, will my payments resume automatically?? as if I was put into support group it would be for the 365 day period I was in wrag group.....

Edited by bladerunner22
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I appreciate the very good advice thankyou. I have stated on my Tribunal papers that I will be attending, but dont really know wether I will be able to attend on the day, suppose I will have at least 6/9 months to prepare though, which in itself is starting to panic me.I dont know wether it is worth all the stress now my payments have stopped. Just one other question what will happen if I do sucessfully win at Tribunal, will my payments resume automatically?? as if I was put into support group it would be for the 365 day period I was in wrag group.....

 

Resume and be backdated if you win.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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I have never had to send fit notes in, I was on IB and migrated over to Esa and placed into the Wrag group in October 2011, it has taken all this time for me to receive the appeal pack from Dwp, 13 months in fact. I was receiving more than the Support Group payments anyway as they kept my payments the same as when I was receiving IB, so doubt there will be any back payments to come my way, as I said before my payments have now stopped because of the 365 day rule and therefore not classed anymore as receiving benefits. What I really am confused about is, if I win appeal to be placed in Support Group, does that mean those 365 days dont count in Wrag Group and my payments will resume, or will my payments not resume, will I have to make a new claim. Because of the delay in sending my papers to the Tribunal, payments having stopped, not classed as being on Esa anymore etc this is what is confusing as to what will happen if I was to win. Oh just thought of something... would I be entitled to assessment rate whilst awaiting appeal?? even though I have already had 365 days.

Edited by bladerunner22
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I have never had to send fit notes in, I was on IB and migrated over to Esa and placed into the Wrag group in October 2011, it has taken all this time for me to receive the appeal pack from Dwp, 13 months in fact. I was receiving more than the Support Group payments anyway as they kept my payments the same as when I was receiving IB, so doubt there will be any back payments to come my way, as I said before my payments have now stopped because of the 365 day rule and therefore not classed anymore as receiving benefits. What I really am confused about is, if I win appeal to be placed in Support Group, does that mean those 365 days dont count in Wrag Group and my payments will resume, or will my payments not resume, will I have to make a new claim. Because of the delay in sending my papers to the Tribunal, payments having stopped, not classed as being on Esa anymore etc this is what is confusing as to what will happen if I was to win. Oh just thought of something... would I be entitled to assessment rate whilst awaiting appeal?? even though I have already had 365 days.

 

No assessment rate while appealling, but if you win, the support group payments will be backdated.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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No assessment rate while appealling, but if you win, the support group payments will be backdated.

There wont be any backdated payments, I have been receiving more than the Support Group payment anyway. or have I?? I have been receiving £232 every 2 weeks. Or do you mean if I win, Support Group payments will be backdated to when my CB Wrag payments stopped.

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Yes I know there"s no 365 day rule in Support Group, therefore if I win my appeal to be placed in the Support Group from October 2011 will my payments resume again??? as they have now stopped because of my Wrag (CB)status and the 365 day rule, DWP has only just sent my appeal to Tribunal, this may take up to another year to be heard.

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There wont be any backdated payments, I have been receiving more than the Support Group payment anyway. or have I?? I have been receiving £232 every 2 weeks. Or do you mean if I win, Support Group payments will be backdated to when my CB Wrag payments stopped.

 

If you have transitional protection on your Incap payments (not everyone's incap payments are more than WRAG or Support Group), then you won't get any more for the period you received WRAG payments, but your payments will resume from when your 365 day limit ended.

We hang the petty thieves and appoint the great ones to public office ~ Aesop

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If you have transitional protection on your Incap payments (not everyone's incap payments are more than WRAG or Support Group), then you won't get any more for the period you received WRAG payments, but your payments will resume from when your 365 day limit ended.

 

So if I win they will owe payments from when the Tribunal is heard back to when my wrag payments stopped, is that correct? also just one more question, If my health was to improve in the future and placed back into the Wrag group will I be entitled again for 365 days??.

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