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Esa appeal failing to attend

dave2611

Hi all. I was hoping someone could help me as I'm beginning to get confused with my esa appeal.

My esa was stopped two months ago after failing to attend two medicals due to recently moving house and poor organisation skills.

My mandatory reconsideration was refused and now I have just lodged an appeal. I just recieved a text from the Dwp stating that they have been contacted by the tribunal service and that they have 28 days to respond.

The dwp state that I haven't given good cause for not attending my medicals.

Does anyone know if the dwp are likely to pursue the case and continue to take it to tribunal for failing to attend my medical? And can I get my benefits re instated whilst I'm awaiting my appeal outcome?

Thank you

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brendarogers

Not sure if this helps.. could you write a letter detailing the health conditions in question and its affects on your poor organisational/daily functioning skills resulting in missed appointments. Take it too your GP and ask them to write a letter FAO the DWP stating all that is said in your letter but signed and dated by the the GP. To be submitted in your appeal. This helps the GP with their very limited time in creating the letter yourself.

Yes your ESA should be reinstated during appeal until a final decision is made.

I hope this helps you my friend x

thespiceman

Hello @dave2611 Pleased to met you welcome.

Thank you for joining and sharing. Would it be possible for you to speak to CAB about you ESA enquiry.

They have a lot of knowledge on benefits and it is very confusing, complex. I want you to get the right information and advice you have come to the right place.

I know there are members of our team or members of our community who may be able to help and advise you.

I am unsure of an answer to your question.

We are a supportive community.

Please take care

@thespiceman

dave2611

Hi brenda thanks for your helpful information.
I have already sent off my appeal forms and I think my appeal has been accepted as I have just recieved a text off the dwp stating they have been contacted by the tribunal service.

I have read on the Internet that appeal rate esa is not payable for those who didn't attend there medical??

Also my doctor not very helpful refused to write letter but gave me an indefinite sick note?

I also receive pip enhanced for daily living?

Do u think the dwp will continue with tribunal or will they set it aside an give me another chance at a medical?
Thanks in advance

dave2611

Hi spiceman. Thank you for welcoming me. I'm trying a few organisations regarding advice on this matter as I'm getting told different information by different organisations. Thank u

brendarogers

dave2611

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What counts as 'good cause' to miss a medical?

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TOPIC: What counts as 'good cause' to miss a medical?

What counts as 'good cause' to miss a medical?#81592

MammaT
Offline
Posts: 38

I got a letter yesterday asking for my reasons why I'd missed an ESA medical on 6th Dec. I've had no medical questionnaire form (ESA50?) and no appointment letter. I've filled the form in and returned it but it strikes me that they could refuse to accept this as 'good cause'.
I had no way of knowing a medical was due as nobody knows they want you until they send a questionnaire for you do they? They've suspended my benefit and I fear the worst.
I can't believe it took 9 wks for them to send me this letter asking for my reasons. It doesn't add up to me but how can I prove that???
Has anyone else missed a medical and,if so, how long was it before they sent you a letter asking why?
Thank you all.

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Re:What counts as 'good cause' to miss a medical?#81595

Gordon
Online
Posts: 39496

Mamma

There's not much time before the forum closes for the day so I'll try and cover off as much as I can.

There are very limited circumstances where a Decision can be made on your claim without the issuing of an ESA50 and these all remove the need for a medical, so this has not happened.

So an ESA50 should have been issued if a re-assessment was required.

There are circumstances where a medical can still go ahead, even if an ESA50 has not been returned. It is standard practice, although not specifically required, that in these circumstances the DWP should contact your GP with an ESA113 to request details of your condition, so it would be worth speaking to your doctor to see whether this has happened.

The DWP have a policy of assuming that post is always delivered, so it would be worth checking with the Royal Mail to see if there have been any local postal problems that could have affected the delivery of both the ESA50 and any request to attend a medical.

I am assuming that you have confirmed that the address information that the DWP have for you is correct, if not you should do so.

It is not unusual for ATOS to contact you by phone in order to arrange the medical, do you know if you have missed any such calls?

Beyond the above, there is not much more you can do until a Decision has been made on whether you had Good Cause to miss the medical.

Let us know how you get on and good luck.

Gordon

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Nothing on this board constitutes legal advice - always consult a professional about specific problems

Re:What counts as 'good cause' to miss a medical?#81597

Derek4
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Posts: 2610

Hi MammaT

The most bizarre aspect of your situation, as well as the 9 weeks it's taken them to realise that you didn't attend the medical, is that no ESA50 has been received but they are not suspending your benefit for failing to send the questionnaire on time. In most circumstances benefit would stop when the claimant fails to meet the ESA50 deadline and a face-to-face assessment would not be arranged.

I trust you explained why you had good cause for not attending and hopefully it will be accepted, but if it's not the decision is appealable.

Good luck

Derek

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Re:What counts as 'good cause' to miss a medical?#81600

MammaT
Offline
Posts: 38

Hello and thank you Gordon and Derek for your very useful replies.

I do not answer the phone at all and this has been explained on both the previous ESA50's I've completed and I've had letters arranging medicals before.

My doctor has been contacted on my behalf and there was a form sent to her in November.

The sorting office has been contacted previously as there is another similarly named road in our area and we often get post for the corresponding number there, as do our neighbours. They said it could happen, especially with Christmas temp workers in. Not satisfactory and they need to be chased up on that but it's hard to know you've had post go missing if you don't know a letter is on the way.

I've explained all the above to DWP so it's a waiting game now. My worry is they won't accept the reasons and, although I know I can appeal, I can't claim payment at assessment rate whilst waiting as that's only if you've had the medical and are appealing that decision.

That will leave me in a complete hole with no money coming in, waiting for an appeal and for 6 months to pass before I can claim again.

Believe it or not I'm trying to remain upbeat as I can't actually do anything right now.

Thank you both again.

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Re:What counts as 'good cause' to miss a medical?#81601

MammaT Offline Posts: 38	Actually, can I also just ask what the circumstances are where they send the doctor a form but not you?
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Re:What counts as 'good cause' to miss a medical?#81604

Gordon
Online
Posts: 39496

MammaT wrote:

Actually, can I also just ask what the circumstances are where they send the doctor a form but not you?

Where a claimant has declared either in their ESA application that they have mental health issues, ATOS have instructions to consider proceeding to a medical even if an ESA50 is not returned.

In these circumstances they should contact the GP, to confirm the diagnosis and to find out whether there is a risk to their own staff or the claimant were they to attend a medical.

Hope this explains it.

Gordon

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What counts as 'good cause' to miss a medical?

brendarogers

Found the above site for you dave2611 notice it's indication towards the GP. All the best

dave2611

Thank you so much brenda. Take care

poppy123456

Hi,

It's standard procedure for DWP to respond that way because they obviously don't think you have good cause for not attending a face to face assessment. You have to send your evidence with the reasons why you didn't attend the face to face assessment. The Tribunal is because you didn't attend your assessment. As the MR decision remained the same then the Tribunal will most likely continue. It can take several months for a hearing date.

Unfortunately because you were found fit for work for failing to attend an assessment then your ESA will not be paid whilst waiting for a decision.

This was copied and pasted from this link...see paragraph 3.

http://www.cpag.org.uk/http:/%2Fwww.cpag.org.uk/content/ask-cpag-online-esa-problem-areas-claims-and-payments-have-you-failed-attend-medical-examina

If you fail to attend or submit to a medical examination without good cause, you are treated as not having LWC and cannot get ESA.

dave2611

Hi poppy that's what I thought. I have just rang up esa and the woman on the phone said they have been contacted by the tribunal service and to wait a few days and I will be paid appeal rate. Maybe when someone else looks at it and sees I didn't attend the medical that might change. Just a waiting game now. Fingers crossed.

poppy123456

dave2611 said:

wait a few days and I will be paid appeal rate.

As you were found fit for work for failing to attend an assessment you will not be paid assessment rate for ESA while you wait for the Tribunal decision. This means you won't be paid any ESA at all while you wait for the Tribunal decision.

dave2611

HI poppy thanks yes they have just confirmed I won't be getting paid appeal rate due to failing to attend and my option is now to claim uc. Do you have any advice on claiming uc? Will I lose my premiums I got on esa as I recieve pip high daily living component. I've never had a wca done before in the past on esa do I attend a separate assessment if i apply for uc. Any advice would be much appreciated. Thanks in advance.

poppy123456

Yes, it's as i expected. If you claim UC then you won't be able to go back onto ESA if you win your Tribunal, you'll stay on UC. Any premiums you were claiming on ESA won't be paid on UC so if you were claiming the SDP and EDP then none of them will be paid.

Claiming UC with a fit note isn't as straight forward as ESA is and you'll still most likely have to do some job searches because of the UC claimant commitment. Claiming PIP doesn't automatically excuse you from this. Mostly it's up to the work coach how many hours of job searches you need to do each week to receive your money. If you don't do the job searches then you'll be sanctioned.

UC is paid monthly and if you're claiming housing benefit then this will be transferred to UC. If you claim UC then your housing benefit till be paid for 2 extra weeks and then transfer to UC. There's approximately a 5 week wait to start to receive your money with UC and then after that you'll have it monthly.

As you will be claiming for the LCW under UC then yes there will be a face to face assessment, like there is with ESA and the process is similar. The form they send you will be the UC50 rather than ESA50 and evidence will be needed to support your claim. If your placed into LCWRA group then you'll be paid the extra money for this group. If placed into LCW then there is no extra money.

PIP isn't part of UC and you'll keep that. Council tax reduction needs to be claimed separately as it's also not part of UC.

dave2611

Thanks poppy much appreciated.

dave2611

@poppy123456 hi poppy I was wondering if u could tell me if my uc claim would be backdated from September 11th 2018 when my esa was stopped. My esa is currently going to tribunal for failing to attend medical without good cause. I recieved a text off dwp on the 31st of October stating that they had 28 days to reply to the tribunal and as of yet I've recieved no letters. If I was to make a claim for uc now would they backdate my money from the date esa was stopped. Thanks in advance

poppy123456

UC can only be backdated for 1 month and only in certain circumstances. For this you have to have very good reason why you didn't claim it before.

https://www.whatdotheyknow.com/request/317043/response/783603/attach/5/617 Universal Credit Backdating policy.pdf

worried33

Regarding UC I think you need to get personal advice from someone who can look at your circumstances.

I used to think UC is just bad news all over as there is no disability premiums, but the rates for UC for those with limited capability of work related activity are significantly higher than ESA rates, and are higher than combined IR ESA + EDP. So for those on EDP (but not SDP) moving to UC is ok in some circumstances financially. Poppy is correct that it is a one way trip, once you make the claim for UC, you will not be able to go back on ESA, even if you win the tribunal case. UC however replaces all means tested benefits, so it would also replace housing benefit. This is why I suggest you get personalised advise before deciding if you open a UC claim.

You will not be able to get ESA appeal rate whilst appealing a fail to attend decision.