ESA review

poppy123456

Danny123 said:

Yeah that's right .... had cbesa with income related top up , nor sure what the top up comes under but don't think it was sdp .... think the top up was enhanced premium  maybe ? They were the ones who moved me over anyway so must be right , took me a while to work it out because once I got my back payment I thought they moved me over to fully income related from cbesa but when they moved me to uc they said I was on cbesa , that when I realised that when I got the back payment they kept me on cbesa but gave me a top up aswell , csn be very confusing for people I'm sure , it was for me 🤯

No one is automatically moved onto UC you will have needed to claim this yourself. When an ESA claim is a mixture of both CB and IR then it's usually known as Income Related.

For SDP entitlement in legacy benefits you will have needed to be claiming either daily living PIP, DLA mid/high rate care or be registered blind. You will have also needed to be living alone or treated as living alone.

sh88

Hi, I just wanted to give a little update on my own circumstances. I called the other day as my review is due next month and I’ve still not had my form to fill for reassessment, to be told my review has been moved to august 2025. 

So just for anyone who’s unsure, please don’t be put off calling to ask the question. When I asked why this was, if they’d made a new decision based on paper etc and the lady was very nice and said it’s basically because they are backlogged from during Covid. Hope this helps - I’m majorly anxious and was getting myself so stressed so just decided to call to find out. Now I do know this is just an estimate date 

apple85

What’s the latest on ‘old style’ (pre uc) ESA reassessments? 

It sounds like reviews may of restarted?

However are the ‘floodgates’ fully open? Or are only a certain criteria (only the wrag or support group claimants for example) being done or is it a total lottery (could get the dreaded reassessment tomorrow or in 2 years type thing?)

poppy123456

apple85 said:

What’s the latest on ‘old style’ (pre uc) ESA reassessments? 

It sounds like reviews may of restarted?

However are the ‘floodgates’ fully open? Or are only a certain criteria (only the wrag or support group claimants for example) being done or is it a total lottery (could get the dreaded reassessment tomorrow or in 2 years type thing?)

For those claiming Income Related they are still suspended, with the exception of those that haven’t had a review for many many years.. 8+ years. 

kuju2

Hi I received an ESA50 form at the end of June this year. I am currently getting income based ESA and I am in the support group. I applied for PIP at the start of June, would this have triggered me getting the ESA50 form? I see that Poppy, who I believe to be very knowledgeable, is saying that Support Group assessments are still suspended. I hadn't had a review since 2012, could this be why I've received the ESA50? I just think it's unfair if I received it because I applied for PIP.

poppy123456

@kuju2 it wouldn’t have been because of your PIP claim. 

Reviews for most people are still suspended, with the exception of those that haven’t had a review for a considerable length of time, likely 8+ years.  

11 years without a review is an extremely long time so you were definitely due one. This would be why you were contacted. 

Adrian_Scope

Hello @kuju2 and welcome to the community.  
Claiming PIP shouldn't have trigged a review for your ESA as they are different benefits. We have been hearing from a few members who have also been claiming ESA for sometime and starting to receive review forms so it could just be coincidental. 
I hope your review and claim for PIP both go well. Please let us know if we can help at all.

hughie1

poppy123456 said:

apple85 said:

What’s the latest on ‘old style’ (pre uc) ESA reassessments? 

It sounds like reviews may of restarted?

However are the ‘floodgates’ fully open? Or are only a certain criteria (only the wrag or support group claimants for example) being done or is it a total lottery (could get the dreaded reassessment tomorrow or in 2 years type thing?)

For those claiming Income Related they are still suspended, with the exception of those that haven’t had a review for many many years.. 8+ years. 

Poppy, why is it I recently sent off my esa50 for reassessment then, if they're suspended?

My last review was July 2016. Disallowed. Then overturned by tribunal November 2017. 

kami84

Hey people. I have an upcoming PIP review. I realised that in a question about spending money I answered it wrongly on the form. I actually have problems with simple financial decisions. And I answered it that I have problem with complex decision, what should I do and how to explain it during the assesment? 

chiarieds

Hi @kami84 - I'm sure others will have made some small error with their PIP review form which I'd simply explain in your upcoming review. Then try to give a couple of recent examples as to the difficulty you have with simple budgeting decisions such as where were you, what happened, was anyone with you, do you need support from someone else to supervise or prompt you, why do you need this help (even if you don't receive it) or can you not manage even if someone tries to help?

poppy123456

hughie1 said:

poppy123456 said:

apple85 said:

What’s the latest on ‘old style’ (pre uc) ESA reassessments? 

It sounds like reviews may of restarted?

However are the ‘floodgates’ fully open? Or are only a certain criteria (only the wrag or support group claimants for example) being done or is it a total lottery (could get the dreaded reassessment tomorrow or in 2 years type thing?)

For those claiming Income Related they are still suspended, with the exception of those that haven’t had a review for many many years.. 8+ years. 

Poppy, why is it I recently sent off my esa50 for reassessment then, if they're suspended?

My last review was July 2016. Disallowed. Then overturned by tribunal November 2017. 

They weren't suspended for everyone. If your last review was 2016 then that will be 7 years ago, so quite sometime since you had a review.

WhatThe

Hughie, have you asked DWP why?

You do not need to be reassessed unless DWP has evidence that you no longer meet the qualifying criteria. Do they? Of course not. The determination reached at Tribunal stands until a fresh determination is made and since DWP failed to follow the correct procedures in 2016, why would they now? 
 
When there is good reason to believe that a claimant no longer has the condition that resulted in the decision for having LCW or LCWRA in ESA, they can be referred to CHDA for a WCA. The claimant will retain the decision they have LCW or LCWRA until a review WCA has taken place and a further decision is made.

WhatThe

Hi Hughie,

ESA reviews are only suspended for Income-Related ESA with/without an HB claim (and no other benefits) as far as I know.

But a new assessment in your case needs to be justified - by DWP, like tomorrow. 
When was the WCA referral made, which team made the referral and under which grounds/rules/regulations?

To halt the WCA process, you may withdraw consent for your GP to provide new information to the Assessment Provider via the ESA50 or your GP will be instructed not to issue any more 'fit notes' for you - research this 

tbc

poppy123456

WhatThe said:

But a new assessment in your case needs to be justified - by DWP, like tomorrow. 
When was the WCA referral made, which team made the referral and under which grounds/rules/regulations?

You keep saying this but why do you think that DWP need to justify a review?

WhatThe said:

To halt the WCA process, you may withdraw consent for your GP to provide new information to the Assessment Provider via the ESA50 or your GP will be instructed not to issue any more 'fit notes' for you - research this 

That won't halt a WCA. It will continue even if a claimant withdraws consent. They very rarely contact anyone anyway.

At this stage because there's already a Support Group award in place then no fit notes are needed. Therefore the advice about fit notes is incorrect. GP's have been known to be contacted after the first work capability assessment to advise no further fit notes are needed. In this case it's not a first WCA.

I'm posting the same link i posted on another thread that you've commented on recently. https://researchbriefings.files.parliament.uk/documents/CBP-7820/CBP-7820.pdf Although the severe conditions group was announced 1st Octber 2016. 

Changes didn't take place until 29th September 2017 and claimants would need to go through a work capability assessment from this date to be placed into this group. Those that had an assessment before that date would not be placed into this group.

WhatThe

For Hughie, 

Reg 29 provisions no longer exist in new assessments which is why I'm concerned about you inadvertently starting a new claim for ESA which in reality would be a new claim to UC.. This is the direction of travel.

What did your 2018 Decision Notice state about regs 29/35 and why they (should have been) applied from 2016?

Perhaps the Tribunal was misled by DWP's appeal response and responded in kind. Perhaps DWP failed to reinstate your existing award or upload the correct decision effective date.      

Ask DWP which decision date was revised to trigger the WCA and why

WhatThe

We could message if you'd prefer

chiarieds

Perhaps also showing DWP guidance  for CHDC assessors will also confirm that changes to include the subgroup of 'severe conditions' didn't come into place until Sept 2017, altho, as has been previously mentioned, this was announced in Oct 2016. Please see:

https://www.rightsnet.org.uk/pdfs/WCA Severe Conditions Guidance.pdf  & under Appendix A:

'There will be a small number of those for whom their health condition or disability is such that there can be no realistic expectation that they would move towards work or take part in work-related activity at any point in the future.
To that end, in October 2016, the Secretary of State announced that the Department would stop reassessments for claimants in the ESA Support Group/UC LCWRA Group (those with Limited Capability for Work-Related Activity) with the most severe and lifelong health conditions or disabilities for whom reassessments are likely to provide no further new information'

You quote from here @WhatThe : https://data.parliament.uk/DepositedPapers/Files/DEP2022-0452/169-Work_Capability_Assessments_V17.0.pdf  at the top of p3

'When there is good reason to believe that a claimant no longer has the condition that resulted in the decision for having LCW or LCWRA in ESA, they can be referred to CHDA for a WCA......'   Please note the emboldened words. However you misinterpret this as  'You do not need to be reassessed unless DWP has evidence that you no longer meet the qualifying criteria.'

poppy123456

WhatThe said:

For Hughie, 

Reg 29 provisions no longer exist in new assessments which is why I'm concerned about you inadvertently starting a new claim for ESA which in reality would be a new claim to UC.. This is the direction of travel.

Your advice is very misleading. Hughie isn't starting a new claim, it's a review of an existing claim. It does not mean a new claim for UC at all.

Reg 29 does still exist. https://wcainfo.net/issues/substantial-risk-lcw

What doesn't exist is the extra money paid to those in the WRAG or LCW for claims started after April 2017. It still applies to those that started their ESA claim prior to the changes. Which applies to Hughie.

I've flagged your comments to a member of the scope team for misleading information.

poppy123456

chiarieds said:

You quote from here @WhatThe : https://data.parliament.uk/DepositedPapers/Files/DEP2022-0452/169-Work_Capability_Assessments_V17.0.pdf  at the top of p3

Thanks chiarieds, I also quote from that link the following..which confirms the advice i gave in an earlier comment.

The claimant is given the choice to give or to not give their consent.
If the claimant does not give consent, the WCA action continues. This means the WCA decision can only be based on the information provided.

Totally different to the advice given here.

WhatThe said:

To halt the WCA process, you may withdraw consent for your GP to provide new information to the Assessment Provider via the ESA50 or your GP will be instructed not to issue any more 'fit notes' for you - research this 

chiarieds

WhatThe said:

We could message if you'd prefer

I think it's best that everyone should rather post on the forum as misleading info can unfortunately be given, which may not then be corrected.

As poppy correctly says, hughie1 is expecting a review, so your comments are unfortunately downright confusing.