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Claiming after an operation

ivy1985

my partner recently had an operation on his hand (new thumb joint) it’s his dominant hand and is self employed, so can’t work literally can’t do his own zip up atm. Surgeon has said not to work for 3 months as to not dislodge the joint or damage it as they cannot redo the operation.

We already claim uc and before Christmas they decided he was capable of working even though dr signed him off until his operation up until a few weeks before he was still working, but now he has had operation 2 weeks ago they still insist he is able to work! they will not pay towards our childcare as he put through zero this month, and won’t except the drs sick note or surgeon letter as there work capability before his operation decided he could do some kind of work.

We are not trying to claim long term benefits just help for the few months he is unable to work.
has anyone else come across these issues?

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ivy1985

We was also told because he is not working we can’t claim for the childcare even though I work and my partner would be expected to look after her! Even though he’s in cast and can’t look after himself let alone change a baby’s bottom!
if I take my baby out of childcare I won’t get her a place again in time for my partner to be able to work so he will end up being out of work for longer as childcare spaces are like gold dust now

Kimi87

What was the work capability decision- was this through the WCA process where you fill out a UC50 & have an assessment?

ivy1985

yes took a year for them to finally do it after filling out forms in November 2023!
they deemed him fit to work full time while recognizing he has a health condition but now he has had an operation and currently can’t work they are saying his wca said he can so he has to basically

ivy1985

he didn’t have a face to face appointment just telephone consultation and they looked through his dr files ect

Kimi87

You can appeal the decision, but it won't help financially in the short term

https://www.citizensadvice.org.uk/benefits/benefits-introduction/problems-with-benefits-and-tax-credits/challenging-benefit-decisions/challenging-a-decision-by-the-dwp-or-hmrc/appealing-against-a-benefit-decision/

poppy123456

You will not be entitled to claim for child care costs because for this you either both need to be working or starting working within the next month. Or one of you has a health condition that limits your capability to work and you've had an assessment and been found to have either LCW or LCWRA. As your partner was found fit for work then you're not entitled. See link. https://www.gov.uk/guidance/universal-credit-childcare-costs

Your partner can challenge the decision of the work capability assessment by requesting the Mandatory Reconsideration. (MR) If you're outside of the 1 month timescale from the date the decision was made you must give a reason why you didn't request it within the first month.

The only issue I see here is if this isn't long term then he may still not qualify for either LCW or LCWRA. You can see the descriptors for both here.

https://www.benefitsandwork.co.uk/universal-credit-uc/uc-faq/limited-capability-for-work at least 15 points are needed for this.

LCWRA here. At least one of these needs to apply the majority of the time.

https://www.benefitsandwork.co.uk/universal-credit-uc/uc-faq/limited-capability-for-work-related-activity

No further fit notes will be accepted unless it's for a significant worsening of an existing condition or a completely new condition. Therefore, even if he reports a worsening of condition, it's not going to help going forward due to be found fit for for work and it will take at least 6 months, maybe longer for a decision to be made on a new WCA.

I'm sorry there's no easier answer here.

poppy123456

https://forum.scope.org.uk/discussion/comment/984026#Comment_984026

Did he actually send evidence to support his claim? They very rarely contact anyone for any evidence and looking through his medical files isn't something they would do. It's the claimants responsibility to provide evidence to support their claim.

ivy1985

unfortunately it has gone past his 30 days of appeal, he didn’t get decision until the day before they closed for Xmas then was in hospital beginning of the new year, plus we was told by an advisor on the phone the day after his decision he would be able to get help after his operation as his situation would have changed but that doesn’t seam to be the case now

Kimi87

You can appeal the decision up to 13 months later.

It's just that after 30 days a reason has to be given as to why it wasn't done within those 30 days.

poppy123456

He's been found fit for work so there would be no further support, I'm sorry you were given misleading advice. If it was the UC helpline then I'm not surprised. They are not benefits advisors, they are just call centre staff.

ivy1985

https://forum.scope.org.uk/discussion/comment/984034#Comment_984034

he didn’t send anything other than the form, they didn’t ask for anything other than requesting his dr files from his dr which stated his health condition in depth, and someone called to ask questions that took us a year to get to that point! they acknowledged he has a debilitating health condition, where the muscle around his joints deteriorate, he will eventually need further operations on other joints that are nearly non existent, the operation he had is a fairly new procedure and he is the youngest person to have it done, only performed on people over 60 with arthritis usually!
I totally get we both need to work to claim childcare and we have always both worked, it’s not like he’s decided to quit a job and not work he physically can’t use his hand atm and it being his dominant hand makes it a little harder to do his job

poppy123456

They don't specifically ask you to send it, there will have been information in the form he received to advise what evidence he could have sent with the form. If they contact a GP then it will be to send them a short tick box form to fill in and return. They almost never request medical files and that's for certain.

I realise he hasn't quit his job, I'm just advising you of the criteria to claim for child care. His only option here in my opinion is to challenge the decision by requesting the MR as I advised. Although he should really look at the descriptors for both groups before he does this to see if he could qualify for either LCW or LCWRA because it's a very long drawn out process.

I'm sorry there's no easy solution here.

ivy1985

basically we can’t get help with childcare because he put through zero earnings because he had an operation so physically not able to, so if he was to put through say £10 earnings would we then be entitled to claim childcare?

ivy1985

https://forum.scope.org.uk/discussion/comment/984058#Comment_984058

we didn’t decide what he applied for in the first instance, that’s what form they sent him he just told them his health condition and added the drs note which they never asked for proof of, the guy who phoned to do his consultation down the phone 100% had his dr files on his health conditions they read out parts of it to him on the phone while asking questions literally down to every single joint he has had issues with since his late teens we only put on the form about his hand as that is the worst at this current time and the one he was waiting for an operation on.

poppy123456

For child care you must both be in paid work. I'm not going to advise that he put down earnings of £10 if he isn't working because that would be wrong. Please see the link I provided above.

If you report a health condition and provide a fit note, you will be referred for a work capability assessment, if your earnings are less than 16 x NMW/week. (this doesn't apply if you claim PIP/ADP or DLA) So this would be why he was referred. The form he was sent was the UC50 form and yes, usually they ask you to provide details of the fit note and hold onto it just incase they ask to see it.

I don't know what else to advise other than to challenge the decision if he thinks he qualifies for one of the groups. Unfortunately, there's no easy solution here.

Do you have any family or friends that could possibly help with childcare while you work?

ivy1985

https://forum.scope.org.uk/discussion/comment/984076#Comment_984076

unfortunately neither of us have family that live close, and if I took her out we would loose our place and would still have to pay for the next month as you have to give notice so still wouldn’t benefit us then we screw ourselves over when he can return to work we won’t have childcare, childcare places are like gold dust where we live.

poppy123456

There's no easy solution here. As a last resort thought because your partner is self employed, does he have any work that he hasn't been paid for? I'm sure not all self employed people are paid on time. I don't mean putting £10 down as a figure because I personally don't think he should go down that route. Honesty is always the best policy.

Other than that I'm afraid I have no further advice, other than challenge the decision if he thinks that LCW or LCWRA should apply. If neither of them do then challenging the decision will be wasting his time.