New ESA Claim

[worried33]

estellyn are those the changes in a bbc news article? where they still let you claim but will no longer get any money whilst awaiting assessment?

 

so basically making the reclaim rule that used to just apply to those reclaiming after not attending a WCA now affect anyone reclaiming?

[mazoo]

Estellyn,

 

What changes are you referring to in April?

[estellyn]

What worried33 said. at the moment, following a failed esa appeal a person can reclaim as long as at least 6 months have passed from the original DWP decision. The change that is being brought in is that you can still apply, but unless your condition is significantly worse, or a different condition from the prior claim, then no esa will be paid while waiting assessment.

[mazoo]

I was unaware there was a change coming in. Can you point me to a link for it?

[estellyn]

http://www.welfareweekly.com/dwp-gets-tough-sickness-benefit-claimants/

 

still 'intended' at the moment.

[mazoo]

Working as a WRO I'm all too aware of the rubbish DWP are dreaming up, but unless they do actually implement the change you describe I will keep advising clients as I have done for some while. I stillthink the best bet would be to get your local CAB to make the app.

[estellyn]

Working as a WRO I'm all too aware of the rubbish DWP are dreaming up, but unless they do actually implement the change you describe I will keep advising clients as I have done for some while. I stillthink the best bet would be to get your local CAB to make the app.

 

Well the situation depends on who is erroneously telling him that the 6 month rule applies from the appeal rather than the original decision. If it is a phone monkey on the helpline, then it doesn't matter, as they are poorly trained and don't properly understand benefit rules. If it is someone on the application line, then he just needs to be firm, insist they take his application and let the decision maker decide. If he doesn't succeed in getting the adviser on the application line to take the application (they have a duty to take the application unless the claim is still open) then yes, he will need to get some advocacy.

 

Yes, until the intended changes are made law, the current regs remain - unfortunately it's things like publicised 'intended' changes that confuse DWP workers.

[pcombo]

I made a new claim for ESA on 12th of February.

 

I got a sick note from my doctor today from 19th until 13 weeks. For chronic anxiety, depression and asthma.

 

I failed my medical and tribunal last year, My original medical was 9th of July 2014 and decision 23rd July. My tribunal was 26 november 2014.

 

I now spoke with ESA today about an advance payment as they basically left me high and dry without a penny and they said my claim would need to go to a decision maker because it's within 6 month of having same illness. But Citizens advice and my representative at my tribunal are adamant that the 6 month is from the medical decision. I keep telling esa and they just say we pay the benefits and we know better basically.

 

What do i do . I am so stressed out with everything that is going on.

[Stigman]

Original thread for reference...

 

http://www.consumeractiongroup.co.uk/forum/showthread.php?437409-Appeal-was-refused!!

 

Stigman

[pcombo]

I applied for a budgeting loan on my old esa claim and was accepted before they closed that claim and they awarded me £190 today and told me ill get the money in 3 days, So hopefully that will tide me over until my ESA is fixed properly.

 

A bit of a relief for the time being, Been a horrible 2 months so far.

[estellyn]

The decision maker is probably just going to award the claim. If they don't then insist on a written decision that you can challenge.

[Lapsed Workaholic]

I admire your optimism Estellyn.

Here is what Pcombo has managed to do for himself in the last 7 days.

Called DWP/ESA on 12 Feb and made a new claim for ESA same day.

Phoned ESA again on 16 Feb. Discussed eligibility for making a new claim.

Spoke to ESA again today, 19 Feb. Discussed status of claim. Told it was sent to Decision Maker.

In the meantime managed to negotiate a loan and obtained a sick note for 13 weeks.

Now I don't regard myself as non-compos mentis (no second opinions please) but I would be hard put to to sort all that out in a week.

The other point I don't quite get is what evidence was sent to the DM to determine or to support his claim for ESA if he didn't get his note from doctor until today. Bear in mind also that the DM will have all the evidence from his previous epic struggle.

Goes without saying I wish him all the best but I can't help wondering if he is not repeating the mistakes of his previous encounters and leaving himself wide open to similar charges of not being as poorly as he thinks he is, or would have people believe he is.

[antone]

At this stage, the DM is not being asked to make a Work Capability decision, only a decision as to whether or not 6 months have elapsed since the 23rd July.

[pcombo]

 

I can't help wondering if he is not repeating the mistakes of his previous encounters and leaving himself wide open to similar charges of not being as poorly as he thinks he is, or would have people believe he is.

 

Just curious what you mean by this what mistakes??? and what do you mean at the end like I have money or something and im making out im without a penny??, Lucky i stay with my parents and im not living alone.

[estellyn]

I admire your optimism Estellyn.

Here is what Pcombo has managed to do for himself in the last 7 days.

Called DWP/ESA on 12 Feb and made a new claim for ESA same day.

Phoned ESA again on 16 Feb. Discussed eligibility for making a new claim.

Spoke to ESA again today, 19 Feb. Discussed status of claim. Told it was sent to Decision Maker.

In the meantime managed to negotiate a loan and obtained a sick note for 13 weeks.

Now I don't regard myself as non-compos mentis (no second opinions please) but I would be hard put to to sort all that out in a week.

The other point I don't quite get is what evidence was sent to the DM to determine or to support his claim for ESA if he didn't get his note from doctor until today. Bear in mind also that the DM will have all the evidence from his previous epic struggle.

Goes without saying I wish him all the best but I can't help wondering if he is not repeating the mistakes of his previous encounters and leaving himself wide open to similar charges of not being as poorly as he thinks he is, or would have people believe he is.

 

You need to remember that the people he is speaking to on the helpline have a poor understanding of ESA regs. The decision maker, however does understand, and should make the right decision. There was no need really to call about eligibility a few days after making the claim - except to worry himself by getting incorrect information from the helpline. I know it's difficult not to 'worry in advance' but it doesn't help anything. He knows nothing until the decision maker makes a decision on his claim - something that can take 2 - 4 weeks or more on a standard uncomplicated claim such as his. As long as a med cert is provided along with the new claim, I don't see an issue yet.

[Lapsed Workaholic]

By 'mistakes' I meant that mistakes appear to have been made in ignoring the evidence that you said your doctors etc provided. The Tribunal is obliged to take into account any evidence provided by your doctors. You say that was not done, that was a mistake on somebody's part.

You say nobody of the people advising you advised you about your right to demand a full explanation, that was another mistake on somebody's part.

You can't now deny that mistakes have been made when you spent the past 9 months since last May insisting on it.

 

By 'poorly' I meant ill. A common enough term in Yorkshire where I've lived for many years. I forgot that in Scotland 'poorly' may mean something else.

 

I made no comments insinuating that you have money or that you were making out without a penny.

 

Luckily, as you say, you stay with your parents and you are not living alone. A minor point that I don't believe you mentioned over 9 months.

Several times over the months you stated that you could not cope in social situations.

 

On 30 November 2014 you wrote in a post that you don't or can't speak to people. You said;

 

"It's December almost I'm stuck with no money, no benefit".

 

I would regard that as an assertion of being 'poorly' as you would use the word.

 

You also said;

 

"My entire life is upside down with NO SUPPORT from anyone".

 

Not quite the 'lucky' situation that you now claim to enjoy. Maybe you could clarify what version you would have people accept or believe, or perhaps this is all another 'mistake'

[Stigman]

Pcombo - Have you ever wrote to the Tribunal Court and asked for copies of both the Judges Notes and Statements of Reasons?

 

This may shed more light on why they refused you.

 

Stigman

Edited February 19, 2015 by Stigman
Did not put a capital C in Court

[pcombo]

Pcombo - Have you ever wrote to the Tribunal Court and asked for copies of both the Judges Notes and Statements of Reasons?

 

This may shed more light on why they refused you.

 

Stigman

 

Yeah, I've got the statement here and it annoyed me more to be honest. It basically said I exaggerated my disability with self interest on securing benefits, Which is a complete lie and nonsense and annoyed me.

[pcombo]

I made an application for a short term benefit advance today via ESA. Now there is more dates to the confusion.

 

The decision maker said refused to give me the advance payment because 6 month apparently hasn't passed from the date hes saying 15th august until 15 february, I made my claim on the 12 th february for esa under same illness. But the first 7 days of ESA are self certified and you dont get paid for that only when you get a sick line from the 7th/8th day in my case the 19th of february. So surly by that logic that's been 6 month past. Even though citizens advice told me it's 6 month from the original decision on esa which happened on 23rd of july.

 

I got a scottish *funny enough im scottish * advisor to send an email with all my queries to decision makers to actually give me a call and discuss it. I finally got someone who helped me and went out there way to try there best than just fobb me off by saying "well we pay your benefit we basically know better, bye".

[estellyn]

The decision date that counts is the one on the letter telling you you've been refused esa following your ATOS assessment.

 

Where is the DM getting the august date from ?

[pcombo]

The decision date that counts is the one on the letter telling you you've been refused esa following your ATOS assessment.

 

Where is the DM getting the august date from ?

 

Yeah, thats when i got my mandatory reconsideration decision, Which states the disallowance of ESA from the 23rd of july. And the letter for that was dated the 20th but apparently the decision was made on the 15th of august.

 

There really annoying me and playing with all these dates... Due to make a complaint.

[antone]

Yeah, thats when i got my mandatory reconsideration decision, Which states the disallowance of ESA from the 23rd of july. And the letter for that was dated the 20th but apparently the decision was made on the 15th of august.

 

 

Wait, what? I must be misreading here - the DWP is telling you that the decision to stop your ESA was made three weeks after the letter informing you of that decision was sent?

 

Or is the DM arguing that the relevant date is that of the Mandatory Reconsideration? If so, he's wrong.

[Nystagmite]

Does anyone have a link to the rules regarding the 6 month rule? Just thinking it's worth the OP printing it off and sending it to the DWP.

[Lapsed Workaholic]

EMPLOYMENT AND SUPPORT ALLOWANCE REGULATIONS 2013

Section 27(4)

 

(4) A claimant is to be treated as not having limited capability for work where–

 

(a) it has previously been determined, within the six months preceding the date of claim for employment and support allowance, on the basis of an assessment under Part 5 of the Universal Credit Regulations 2013, that the claimant does not have limited capability for work; and

 

(b) it appears to the Secretary of State that-–

 

(i) the determination was not based on ignorance of, or mistake as to, a material fact; and

(ii) there has been no relevant change of circumstances in relation to the claimant’s physical or mental condition since the determination.

This would suggest that a claimant may be treated as having limited capability for work 6 months after the date of the last assessment. In which case then said claimant would be entitled to claim ESA from that date.

 

[pcombo]

So i spoke with a decision maker today and he explained to me the 15th of august date. So in august while waiting for my mandatory reconsideration i was told i could make a new claim of esa for a different condition, so i thought after looking at my sick note that it only had 2 illnesses stress and anxiety, But i told atos i suffer from asthma as well. So i got a sick line with asthma only and made a new claim for asthma which apparently got disallowed on the 15th of august with NO payment ever giving to me. So i began to get payments from my local council like a emergency fund which has nothing to do with DWP and i didn't start getting esa until september until they got my appeal notice.

 

So they refused to give me an advance payment and no doubt will disallow my new claim based on a claim from the 15th of august which got disallowed and i didn't even get assessed on. How can they do this, this isn't right that they are using a newer claim to refuse me.