LCWRA awarded but not backdated?? **APPEAL WON**

[stuggling]

My partner was rushed in to hospital April this  year server acute pancreatitis with a blood clot in spleen,  part of pancreas is now dead so on more tablets (22 a day and 2 injections for clot). 3 weeks in hospital and returned too work in June (we needed the money my wages just don't cover it)

 

A sick note was given to UC in June showing hospital etc and they were told in April about them being in hospital as well. 

 

Had the call for the health questionnaire on 31st October got awarded LCWRA  but payment if any won't start till next march I asked why not back dated and they dint give a reason? 

 

Any helpv

[unclebulgaria67]

Under UC health journey starts from when first fit note provided, but the journey only continues, if further fit notes are provided up to the date of the work capability assessment.

 

From what you say, a fit note was provided (reported to UC) at the beginning, but then no further fit notes were provided. Therefore following the work capability assessment, the Decision Maker has only awarded it from date of the assessment. There is then a 3 whole monthly assessment period wait until the LCWRA amount starts being paid. This could mean the LCWRA amount is not received until an assessment period is calculated covering a period in February/March 2023.

 

If you have other fit notes for the period April 2022 to 31st October, but did not report these on UC claim due to issues you had during this time, contact UC or Job Centre to ask to raise a Mandatory Reconsideration appeal that the LCWRA award date should be from an earlier date. Provide the fit notes as part of the appeal evidence.

[stuggling]

Thank.you, we only submitted one as it covered all of April and May,  as they returned to work June, but the health issues have been ongoing for years and always reported in past and never had the health questions before.

 

I doubt we would get any extra payments anyhow with us both working full time 

[unclebulgaria67]

LCWRA is awarded to reflect health condition( s) which might affect capability to work. Does not mean that they cannot work at all.  And following the award, the LCWRA amount is added to UC statements after 3 months. The LCRWA award also allows a work allowance to be included on the claim, which you would not have unless you have children on the claim.

 

So the work capability process was not followed by the claimants in this case and the Decision Maker has awarded the LCRWA from the only date they could have noted, which is the date of assessment.

 

The WCA process including fit note requirement would have been explained. In your journal there should be a letter which is a UC35 which explains what was required.

 

 

[stuggling]

We did everything asked, did the questionnaire sent out provided all evidence in June, he was signed off 4th April till 30th June, did not get an assessment till October 31st. 

 

All the letter we got was a UCD35 and states the basic aboyf fit notes and the questionnaire and assessment. 

 

 

[unclebulgaria67]

If you did everything that was asked, go back and ask for mandatory reconsideration appeal and let UC explain how they arrived at the decision I.e, the award date for the LCWRA.

 

Following the expiry of the fit note on 30th June, there should be journal messages about the fit note expiring.  Can you see these ?

[stuggling]

Yes just that the note expires soon and we explained that he had returned to work but still had underline health issues nothing else was said 

[unclebulgaria67]

Submit a mandatory reconsideration appeal, but it would help support the appeal, if a fit note was obtained and reported covering the period 30th June until the date the LCWRA was awarded from.

 

It should have been explained that fit notes were required until the work capability assessment had been completed. Why you do not appear to know this, is difficult to understand, as from what I have seen from this process, it is explained many times about how important it is that fit notes are provided until the assessment process has been completed.

[stuggling]

This is the letter we got, the Dr would not supply any more sick notes as he had returned to work, and with being a life long condition they said they couldn't longer do this. 

 

We explained this to UC and nothing else was said 

ucd.pdf

[unclebulgaria67]

If you want the LCWRA decision from the date you submitted your first fit note, you will need to submit a mandatory reconsideration. Point out that the health condition Is life long and that the DWP is supportive of disabled people being in work if they can, therefore you are surprised that the Decision Maker has penalised a disabled person who has found a job they can do, by not adding the LCWRA decision from the date the health condition was notified to UC and health journey started.  The Doctor could no longer provide a fit note when returning to work, but the assessment report provided to the Decision Maker should have detailed the health condition and that it was a life long condition.  The medical professional completing the Work Capability assessment would have been aware of the return to employment, when they made their recommendations in a report to DWP Decision Makers.

[stuggling]

we had the decision today and it says been moved to LWA thos aware is not subject to the higher payable element of universal credit.

I'm guessing now he entitled to no extra support as we got ot backdated to may last year. 

I will appeal if so as only may wage to live on and paying his medication at time was alot. And other medical supplies which are still costing us alot. 

[stuggling]

So we did an appeal and attended the tribunal, this is outcome 

1. The appeal is allowed.
 2. The decision made by the Secretary of State on 02/11/2022 is set aside.

3 is to be treated as having limited capability for work-related activity. The mátter is now remitted to the Secretary of State to make a final decision upon entitlement to Universal Credit (UC)
 4. The Secretary of State has accepted that has limited capability for work. This was not in issue.
 5. No activity or descriptor from Schedule 7 of the UC Regulations 2013 was satisfied but Schedule 9, paragraph 4 of the UC Regulations applied.
 6. The tribunal applied Schedule 9, paragraph 4 because there would be a substantial risk to the mental or physical health of any person if the appellant were found not to have limited capability for work-related activity.
 7. By reason of physical and mental problems the appellant was significantly functionally impaired following a serious physical illness in April 2022 and required a reasonable recuperation period to avoid the risk of deterioration and relapse at the date of decision.
 8. This has been an oral (face to face) hearing. the appellant attended the hearing today and the Tribunal considered the appeal bundle to page 125. First Tier Agency representative did not attend.
 9. Any recommendation given below does not form part of the Tribunal's decision and is not binding on the Secretary of State. The Tribunal recommends that the Department reassesses within 3 months from today's date.

 

 

We appealed as was told got lwrca but then taken down to lcw, when we got to tribunal they asked why appealing as it had been backdated to April but we explained was told would be some form of payment made to my partner to help, they said that there may be no payment but we did the hearing and this is the outcome .

 

My partner was very ill April last year and was unable to work for 3 months, he had to return to work against drs orders due to financial issues . We are not sure what the above means, any help would be appreciated. 

 

Many thanks (the text is edited to remove names) 

[dx100uk]

threads merged 

title updated

[unclebulgaria67]

Has the tribunal told DWP to apply LCWRA to the claim ?

If yes, then send copy of the tribunal decision to Universal Credit, just to make sure that the tribunal decision is applied.

[stuggling]

OK thank you, they said should get straight away 

[stuggling]

I spoke to Universal Credit they have nothing yet from them.which I understand, and they don't think we are owed anything as we both work.full time (against drs orders he had to as universal were going to sanction it, if didn't do interviews etc even though had sick note)

 

but also told.if are they sort out payment, but I questioned this as last time they were due to pay me 80 in arrears and they paid ex landlord instead as he didn't get full rent from them even though we paid it and ex landlord won't give that money back to us claims he never got it, we questioned if this would happen again and they could not answer us 

[unclebulgaria67]

When they add LCWRA, the earnings deductions may still mean zero entitlement to UC. But if the earnings did reduce for whatever reason, at least the LCWRA might mean you get some UC amounts.

Also with LCWRA the person with this award would be placed in no work related requirements, so if they did stop working, then UC could not apply any sanction due to leaving employment voluntarily.