Employment and Support Allowance (ESA)
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Mandatory Reconsideration

SmedleySmedley Member Posts: 60 Courageous
Hello all, 
I have been in receipt of ESA support group for about 2yrs.
I have Bipolar 1 disorder.
Recently I received an appointment for a WCA, however I have Osteo Arhritis very badly in my knees, particularly  the R one.
which has deteriorated so much that I am housebound due to very restricted & painful mobility.
I was on DLA, when that changed to PIP I lost my enhanced rate personal care, but awarded enhanced rate for mobility.
I had previously been awarded enhanced rate for personal care under DLA.
Anyway, to get back to this WCA, I rang them when I got the letter telling them that I could not attend due to being housebound, and having no one to accompany/take me there.
I requested a home visit and they said that couldn't be guaranteed.
Then I received a letter telling me that my reason was not good enough and they stopped my benefit forthwith, declaring me fit for work & enclosing my P45.

I have submitted a mandatory reconsideration which my doctor is going to support, however meanwhile I am left with £58 per week.

My question is, if the mandatory reconsideration goes in my favour will my ESA contribution based support group benefit be reinstated as you were so to speak. ?

Thank you so much for any advice.




Replies

  • Liam_AlumniLiam_Alumni Scope alumni Posts: 1,113 Pioneering
    Hi @Smedlety,

    If the DWP changes its decision following the mandatory reconsideration, then you are entitled to backdated payments up to when the original decision was made.

    Citizens Advice has lots of handy information about mandatory reconsiderations for ESA on their website, which may be of interest to you.

    I hope this helps!
    Liam
  • SmedleySmedley Member Posts: 60 Courageous
    Thank you so much Liam Xxx
  • Liam_AlumniLiam_Alumni Scope alumni Posts: 1,113 Pioneering
    No problem at all. You're very welcome! :) 
    Liam
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    In this case this is not true because you were found fit for work for not attending the assessment. At the MR stage if DWP accept your reasons for not attending then you will still need to attend an assessment and wait for the decision, if you're placed into one of the groups then your money will start back up and you'll be paid all the backpay. You will not be paid any money even if the MR decision goes in your favour. It's a different process for those who were found fit for work for failing to attend. Good luck.
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • SmedleySmedley Member Posts: 60 Courageous
    I'm confused now ! 
    My doc has supplied a letter backing my reasons for not attending WCA
    IE  Bipolar Disorder & Extreme Anxiety facing any change
    Severe Osteo Arthritis in my knees restricting me to my home, in other words housebound.

    That letter is being sent recorded delivery, & the mandatory reconsideration decision makers are aware that this is on it's way.
    If this is also rejected then I have to Appeal the decision Regarding my reasons NOT TO ATTEND THE WCA

    In other words REQUIRING A HOME ASSESSMENT

    Am I right ? 
  • SmedleySmedley Member Posts: 60 Courageous
    Meanwhile I have to make a claim for new style ESA & have a HOME ASSESSMENT for that.
    If the DECISION MAKERS accept my reasons for not attending the WCA then my benefit will be restored & backdated to when my benefits where stopped 27/8/20
    Whether I remain in the support group or put in the work related group.

    Is this correct ? 
  • Liam_AlumniLiam_Alumni Scope alumni Posts: 1,113 Pioneering
    Hi @Smedley,

    Sorry for the confusion! @BenefitsTrainingCo, are you able to advise, please? :)
    Liam
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    That's correct yes, the reason for your MR is because they found you fit for work for failing to attend. If the DWP don't accept your reasons then it's Tribunal for the same reasons.

    If after the MR the DWP accept your reasons for failing to attend then you'll have to wait until you've had your face 2 face assessment and a decision is made. Your money will not be paid before the assessment takes place. If they don't accept your reasons then it's Tribunal and you can't go back onto assessment rate while waiting for the Tribunal.

    New style Contributions based ESA is for those in a full universal credit area that have paid enough National Insurance contributions in the previous 2 tax years from working, as you've been claiming ESA then you won't be able to claim contribution based ESA.

    If your area is a full UC area then it's this you'll have to claim and not ESA. If your area isn't a full UC area then the only way you'll be able to re-claim ESA again is for a new condition or a worsening of an existing condition and then there's no guarantee that you'll be paid. When a claimant has been found fit for work for failing to attend the rules are completely different to being found fit for work after a face 2 face assessment. 
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • SmedleySmedley Member Posts: 60 Courageous
    But I was on Contributory ESA support group.
    As they have closed that claim for not attending WCA, and if the mandatory reconsideration finds my reasons acceptable then they will back date benefit from the date it was stopped.
    Are you telling me that I can no longer claim new style ESA contribution based if an assessment find me unfit for work and places me in the support group. ?

    In other words even if I am deemed unfit to work & put in support group I have totally lost my contributed status even if the mandatory reconsideration finds my reasons acceptable ?

    Sorry but I'm just getting more & more confused !!

  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    You are confusing New style contribution based ESA with the old style ESA and it's different. You won't be able to start a new claim for New style contribution based ESA because you haven't worked and paid NI contributions in the previous 2 tax years. If this MR goes in your favour and DWP accept your reasons for failing to attend, once you have your face 2 face assessment, if you're placed back into the support group then your money will be back dated to the date it stopped. 

    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • SmedleySmedley Member Posts: 60 Courageous
    Thank you, if I am placed back into support group then and my benefit back dated to the date it was stopped, will I still be on old style ESA.
    In other words will my stopped old style ESA be reinstated or will I not be entitled any longer to old style ESA ?
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    Yes your old style ESA will be reinstated as it was previously if after the assessment you're placed back into the support group. First though the DWP have to accept your reasons for failing to attend. 
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • SmedleySmedley Member Posts: 60 Courageous
    Thanks so much ! You have been an enormous help in clearing up my confusions and everyone else who has posted in reply to my endless queries. !

    I am so grateful 😀😘
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    Always happy to help! Good luck! xx
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • BenefitsTrainingCoBenefitsTrainingCo Member Posts: 2,692 Pioneering
    Smedley,

    If the MR is successful and they reverse the decision, then they are no longer saying that you are 'treated as' capable of work. You WILL then get your back pay, as the decision simply goes back to what it was before (ie you are someone getting ESA support group). However, Poppy is correct that you still need to be reassessed.

    Just to put this in context - if this was your first assessment, a revised decision would simply be putting things back to how they were before - someone treated as having limited capability for work whilst submitting sick notes. But you were ALREADY in the support group, so a revised decision puts you back into it, or in other words, it undoes the decision that you have capability for work, & it undoes the termination of your award. Although you do still need to have an assessment, you would get your ESA in the meantime, because there wouldn't be a decision saying you have capability for work.

    Regardless of whether you're in a UC full service area or not, because you've been on ESA for 2 years it's unlikely that you would be able to make a new claim for contributory ESA (whether old style or new style). In either case you'd have to have a gap of 12 weeks after your ESA finished if you were going to use different tax years to last time. So I don't think this can work.

    I'm hopeful that in this case, with your MR request and your doctor's supporting letter, you might actually get the decision changed quickly, and then be back on track to arrange the home visit. As regards your PIP by the way, you don't say if you are getting anything for daily living? Do you think you should be? I know it's risky to ask them to look at it again but just noticed that you may not be getting the right rate there.

    Will
    The Benefits Training Co:
    Paul Bradley
    Michael Chambers
    Will Hadwen
    Sarah Hayle
    Maria Solomon
    David Stickland
  • SmedleySmedley Member Posts: 60 Courageous
    Thanks so much for your reply Will.

    I was on DLA High rate Personal Care & Low rate Mobility

    I had a home assessment by PIP when it replaced DLA

    I lost the high rate Personal Care and receive High rate Mobility.

    I didn't think to question it until I got in touch with The Disabled Advice Bureau locally re my ESA who want to have a look at my PIP claim to see if they can put in a late appeal/reconsideration for me.

    I am to contact them on receipt of the outcome of my ESA WCA MANDATORY RECONSIDERATION, and they will come and visit me at home to either

    Help with an ESA Appeal should I fail mandatory reconsideration 

    Look at PIP award and see if they can help me in any way there.

    Thank you, I hope that makes sense !!! 
  • BenefitsTrainingCoBenefitsTrainingCo Member Posts: 2,692 Pioneering
    PS Smedley, I'd also be wary of making a claim for new style contributory ESA.

    Without knowing more about your situation, it's difficult to advise, but I'd suggest that there is no advantage to claiming new style ESA as it seems very unlikely you could get it anyway. If your MR is successful you should go back on old style ESA. If you claim new style ESA you risk putting yourself into the new system, with no going back.

    Will
    The Benefits Training Co:
    Paul Bradley
    Michael Chambers
    Will Hadwen
    Sarah Hayle
    Maria Solomon
    David Stickland
  • SmedleySmedley Member Posts: 60 Courageous
    No, I am not going to put in a claim for New Style ESA and will not be talked into it by anybody.

    Thanks. 

    My Old Style ESA based on my Insurance contributions which disregards savings is what I want reinstated hopefully after a home assessment to remain in support group.

    Am I right ? 
  • BenefitsTrainingCoBenefitsTrainingCo Member Posts: 2,692 Pioneering
    Smedley,

    Yes, that is absolutely right. It's good to know you are going to get help with the PIP award too. 
    I'm hopeful for your MR; do let us know how you get on.

    Will
    The Benefits Training Co:
    Paul Bradley
    Michael Chambers
    Will Hadwen
    Sarah Hayle
    Maria Solomon
    David Stickland
  • SmedleySmedley Member Posts: 60 Courageous
    Thank you so much Will. 

    Yep, I will definitely keep you posted.

    Kind Regards, and Thanks, all of you Xxx 
  • sam12sam12 Posts: 1,338 Member
    Ring fightback4justicelawyers they help u win pip etc they against dwp am with them I lost my premiums. Esa money inpossible to live on dwp don't care u get number on Facebook try them am glad am with them 
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    sam12 said:
    Ring fightback4justicelawyers they help u win pip etc they against dwp am with them I lost my premiums. Esa money inpossible to live on dwp don't care u get number on Facebook try them am glad am with them 
    There's no need to ring them because Smedley's husband's MR decision went in his favour. 
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • SmedleySmedley Member Posts: 60 Courageous
    Poppy123456,
    I haven't got a husband !!! Lol
    I am waiting a decision re the mandatory reconsideration for ESA WCA unable to attend. Reasons rejected.
    Also, I'm  'she' lol
    Must be either a Monday morning or Friday night ! Jk 😜😀



  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    Smedley said:
    Poppy123456,
    I haven't got a husband !!! Lol
    I am waiting a decision re the mandatory reconsideration for ESA WCA unable to attend. Reasons rejected.
    Also, I'm  'she' lol
    Must be either a Monday morning or Friday night ! Jk 😜😀



    Oops sorry, of course I remember you now LOL I must have been thinking of someone else :D
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • SmedleySmedley Member Posts: 60 Courageous
    Tis Ok lol 😜😘
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