Employment and Support Allowance (ESA)
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I'm new to the site, sorry if this has been answered before or posted in the wrong place!

Hi -

I was placed in the WRAG of ESA back in December 2017 when I made my claim.  I appealed this via the MR initially and DWP (of course!) didn't change their minds and said I should remain in the WRAG.  I then appealed via the Tribunal Service.  After 50 weeks (!!!!!) I finally got a hearing date.  I had the hearing via 'paper' only.  I claim ESA because I have Bipolar Disorder, depression and anxiety.  I leave the house only for ESSENTIAL medical appointments, which I often have to cancel at the last minute and re-book as my anxiety gets too much and I'm unable to make the appointment.  I didn't make a dental appointment for 2 years as I didn't deem it as essential... it is only really GP and hospital appts I attend, with my mental health workers making home visits and my counselling done via phone.  This is why I don't/can't work, why I can't attend any of the Work Coach appointments DWP wanted me to attend at the local Job Centre, and why I "chose" not to be present at the tribunal.
I have had the decision from the tribunal service which has, thankfully, gone in my favour.  However, I would just like some information and advice about what happens next.

My decision notice states the following:
1. The appeal is allowed
2. The decision made by the Secretary of State on 07/04/2018 is set aside.
3. Miss X is entitled to ESA with the support group component.
4. In applying the Work Capability Assessment 15 points were scored from the activities and descriptors in Schedule 2 of the ESA regulations 2008 made up as follows:

15. Getting about - (b) is unable to get to a specified place the claimant is familiar, without being accompanied by another person - 9pts
16. Coping with social engagement due to cognitive impairment or mental disorder - (c) engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to difficulty relating to other or significant distress experienced by the individual - 6pts

Could you please explain to me what is meant in point 2... the date of my claim was December 2017 so what is the date they mention, the 7th April 2018? Could this be the date DWP initially put me into WRAG even though my paperwork was sent in December?
Could you also please explain about point 4? Does that mean the tribunal awarded me those points (9 and 6, respectively) when DWP didn't?

Going on the decision notice says:
5. No descriptor from Schedule 3 of the ESA Regulations 2008 was satisfied but Regulation 35 was applied. By reason of anxiety and depression, Miss X is significantly limited. As a result, the above Schedule 2 descriptors are satisfied. Nevertheless she does not satisfy and Schedule 3 descriptors. However, if she were found capable of work related activities, this would result in substantial risk of deterioration in her mental health. In reaching its decision the Tribunal placed particular reliance upon evidence of her mental health worker.

I have no idea what any of that means really! If you could explain, I would be very grateful.  I'd like to add that I made my claim, MR and appeal alone without advice or assistance and it is only now I have my outcome that I'm looking for more information.  Waiting for the outcome of the appeal was very stressful and made my mental health considerably worse. However, now I have the outcome I am even worse! I briefly felt relieved, however I am just expecting DWP to appeal it and make this process longer and even worse!

To finish, the decision notice states:
Any recommendation given below does not form part of the Tribunal's decision as is not binding on the Secretary of State.
The tribunal recommends that the DWP does not reassess Miss X within 24 months from today's date (31/05/2019).


I understand that, but wonder whether DWP usually take these recommendations on board or if I'm likely to be going through this whole process again in a few months time?

In terms of backdated benefit... I receive £73.10 per week, paid fortnightly.  I see on the DWP website that those in the support group are awarded £111.65 per week.  I also see that they can be awarded an additional £16.18 or £24.10.  I wondered how I know whether I am entitled to those additional payments?  Also, how long does it take for back payments to be received by the claimant and how long does it take for DWP to place me into the Support Group so that I receive the correct benefit payments going forward?

I realise this is a very long post and thank you for sticking with it! My anxiety is spiralling at the moment so any advice and/or information would be greatly received.

Many thanks!

Replies

  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    Hi,


    Set aside means the decision made by DWP on 7/4/18 has been dismissed, they didn't agree with their decision. You claimed in December 2017 but the decision of that assessment wasn't made until this date.

    Schedule 2 of the ESA regulations 2008 is WRAG and you scored 15 points.

    However they also looked at Support Group and decided that you didn't qualify for that through any of the descriptors. You qualified for this group through regulation 35 which is substantial risk to yourself and others around you if you were  found capability of work related activity. This means that if you were kept in the WRAG then because of your mental health then you could be a risk to yourself and others around you. More on this explained here. http://www.cpag.org.uk/content/making-exception

    As you're claiming Income Related ESA for a single person then your weekly money will be £128.45 from 8th April 2019, slightly less before this date because of the yearly increase. This is made up of the following.... £111.65 for being in the Support Group plus £16.80 per week because you claim Income Related ESA and you're automatically paid the Enhanced disability premium.

    This money is backdated to the 14th week of your claim. So, count 14 weeks from when you first applied for ESA and that's when they will owed you money from.

    Backdated money can take 8 weeks, along with DWP placing you into the correct group. Hope this helps.

    Oh and great news on winning with a paper based decision, very rare that!
    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.
  • Kyah_RidgebackKyah_Ridgeback Member Posts: 10 Listener
    Thank you so much for your reply! That makes a lot more sense now! Do you whether DWP are likely to listen to the recommendation not to reassess for 2 years? And whether they're likely to appeal the tribunal? 
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    You're welcome. They can't appeal unless an error in law is found. To find this they have 1 month from the date of the decision to request the statement of reasons and record of proceedings. There's no timescales how long it will take to receive this if they request it. They sometimes request it but if they do they will contact you. It's rare for them to appeal it.

    The time they give you is just a recommendation. You can be re-assessed anytime from 3 months, even with that 2 year recommendation.

    All you can do for now i'm afraid is wait until you hear from DWP.
    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.
  • Kyah_RidgebackKyah_Ridgeback Member Posts: 10 Listener
    Fingers crossed 🤞🏼 they don't decide to reassess me soon. Really don't know if I could deal with all this again!! It's been really tough, as money has been so bad. £73.10 is not enough to live on a week! Not even close.
    Thank you for getting back to me 
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