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UC WCA and appeal complaint

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tifo
tifo Community member Posts: 76 Connected
edited June 2022 in Universal Credit (UC)
I came to UC in February 2019 as I was not able to work because of eye conditions from October 2018. I was advised (wrongly) that I could not stay on Working Tax Credits as i'm not 'working'.

I also suffer from chronic recurrent gout.

My eye conditions gave me severe pain and migraines for over a year, then they started getting better but have not gone away to date. My gout gives me severe to moderate pain for many months in the year. My eye conditions give me moderate pain throughout the year. Both are present for more than 50% of the year each hence in the majority. Both eye and gout are variable and fluctuate and flare without warning.

My claim started in March 2019. I was telephone assessed in May 2020 but they couldn't decide LCW/LCWRA and said i'd have to wait for a face to face assessment. In August 2021 I made a complaint to the centre and they again sent me a telephone appointment for September 2021. I got 0 points. The decisions echoed this.

I appealed and had the tribunal hearing a few weeks ago. They gave me LCW. I still feel I should have got LCWRA.UC 

I want to raise a complaint about the delay in my assessment. The delay cost me LCWRA as my conditions were much worse in March 2019 than they were in September 2021 or this month.

Initially I was under the misguided impression that the assessor and DWP decision makers would assess me from the start of my claim and give LCWRA or at least LCWRA for some of the time and LCW later. This would've made up for the delay and is fair. The fact that DWP can take as long as they want then assess how you are on the day is a bit unfair, especially for claimants whose conditions get better. I know this may be in the legislation but that doesn't mean DWP should get away with taking so long which changes the decision to the detriment of the claimant.

My complaint isn't about the decision, it's about the delay and the affect this had on the assessment.

I'll look at the decision later.
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Comments

  • Biblioklept
    Biblioklept Community member Posts: 4,948 Disability Gamechanger
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    Have you made a complaint to them? 
  • tifo
    tifo Community member Posts: 76 Connected
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    No, i'm going to do it  ....
  • tifo
    tifo Community member Posts: 76 Connected
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    Sue_Scope said:

    It you feel that the first tier tribunal did not take into account your health  conditions prior to the health assessment you may possibly have grounds to request leave to appeal to the Upper Tribunal.

    Unless you have a decision that you had an entitlement to LCWRA at some point I don't think you can argue that you have lost that entitlement.   

    You may still have grounds to make a complaint for the way the DWP handled your claim and, in particular, the delay in getting the assessment.   
    I'm told by forum members, DWP and the tribunal that the assessment is only about how you are on the day of the assessment. There is slight variance for variable and fluctuating conditions, like mine, but there appears to be no remedy in law for DWP taking a particular amount of time to assess a claimant. There is nothing to say they should carry out the assessment in, say, 4 months, though any payments start 4 months from the claim date.

    This seems to be very unfair against claimants, like myself, who might get better. I would think a person makes a claim for how they are when they make it, not how they'll be when they're assessed.

    If they looked at my claim from when I made it i'd get LCWRA in 2019. But the DWP and tribunal don't do this for any claimant.
  • Biblioklept
    Biblioklept Community member Posts: 4,948 Disability Gamechanger
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    I hope it goes well and good luck @tifo
  • calcotti
    calcotti Community member Posts: 10,010 Disability Gamechanger
    edited June 2022
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    Sue_Scope said:
    I'm trying to think what remedies you may have and I'm tagging  @calcotti
    Please do not tag me. If I have something to say I'll say it.
    Tifo's situation has been discussed at length elsewhere.
    Information I post is for England unless otherwise stated. Rules may be different in other parts of UK.
  • Sue_Alumni
    Sue_Alumni Scope alumni Posts: 485 Pioneering
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    Apologies
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  • Biblioklept
    Biblioklept Community member Posts: 4,948 Disability Gamechanger
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    calcotti said:
    Sue_Scope said:
    I'm trying to think what remedies you may have and I'm tagging  @calcotti
    Please do not tag me. If I have something to say I'll say it.
    Tifo's situation has been discussed at length elsewhere.
    Sorry calcotti I know I've tagged you and poppy123456 in stuff as well it is standard on most forums I use so I didn't realise people don't do it on here and I won't in future I'm so sorry if I upset you too 
  • calcotti
    calcotti Community member Posts: 10,010 Disability Gamechanger
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    Biblioklept said: Sorry calcotti I know I've tagged you and poppy123456 in stuff as well it is standard on most forums I use so I didn't realise people don't do it on here and I won't in future
    No upset caused. I just prefer not to be tagged - partly because it then appears rude or dismissive if I don't reply. I prefer to reply when I feel like doing so on.
    Information I post is for England unless otherwise stated. Rules may be different in other parts of UK.
  • Biblioklept
    Biblioklept Community member Posts: 4,948 Disability Gamechanger
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    Okay I understand and sorry again I will try and remember I never thought of it like that. It's made me conscious of how much I tag people so I'm going to really try and stop
  • poppy123456
    poppy123456 Community member Posts: 56,976 Disability Gamechanger
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    I'm the same as calcotti here and would also prefer not to be tagged. For me it's because i always forget to look at my notifications so if i don't look then it's possible i could miss that comment, it's happened to me so many times and i feel so bad for not replying.
    I would appreciate it if members wouldn't tag me please. I have all notifcations turned off and wouldn't want a member thinking i'm being rude by not replying.
    If i see a question that i know the answer to i will try my best to help.
  • calcotti
    calcotti Community member Posts: 10,010 Disability Gamechanger
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    poppy123456 said:.. i always forget to look at my notifications ..
    I don’t get any notifications because I’ve never turned any on!
    Information I post is for England unless otherwise stated. Rules may be different in other parts of UK.
  • poppy123456
    poppy123456 Community member Posts: 56,976 Disability Gamechanger
    edited June 2022
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    calcotti said:
    poppy123456 said:.. i always forget to look at my notifications ..
    I don’t get any notifications because I’ve never turned any on!

    Me either but oddly i get them if someone tags me. Edit this... just looked and for some reason it was ticked, so i've now unticked it.
    I would appreciate it if members wouldn't tag me please. I have all notifcations turned off and wouldn't want a member thinking i'm being rude by not replying.
    If i see a question that i know the answer to i will try my best to help.
  • tifo
    tifo Community member Posts: 76 Connected
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    In my last hospital visit in May I was told that i've a cortical cataract developing in my right eye. As i'd driven there the clinician didn't dilate the pupil to see inside. The left eye is the one with the inflammation and gives me problems, i've no vision in that. They tend to leave it alone and let it progress as it will.

    I've had my 6 month hospital appointment recently and this time clinician told me I should be careful about direct sunlight, wear sunglasses etc as radiation can accelerate the cataract. My left eye still tears a lot, is occasionally dry and stings. She prescribed different drops to what i've had before.

    I mentioned my LCW/LCWRA claim and how i'd want info from the hospital for the period 2018-2021, esp 2019, as that is when my inflammation in the left affected eye was at its highest and giving me severe problems. She said any representative for my claim would have to ask. We discussed how I can't do my usual work and she said I should also keep away from computer screens for long sessions as the radiation and light can also accelerate the cataract. She said she understand that I can't do certain type of jobs due to monocular vision and reduced depth perception. Also that when the time comes a specialist surgeon will need to operate on me because of monocular vision. Hopefully not for many years yet but the vision will get worse.

    The cataract is a new condition, which will affect me in times to come and worries me a lot because it's the only eye I see from. The LCWRA claim is prior to this and so the tribunal will probably not take it into consideration. Any advice on how I should proceed with this as it affects me and I will have to make changes. On the advice of the clinician I shouldn't sit in front of a screen for too long which means I can't do my usual job and many other jobs. My skills and jobs are office based and I know someone and UC will say "just get a factory job then".
  • poppy123456
    poppy123456 Community member Posts: 56,976 Disability Gamechanger
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    The same advice really as your PIP thread. No, the Tribunal won't take into consideration a new or worsening of condition.
    You can report a change of circumstances for a new or worsening of condition and the process will start all over again. Reporting the change may also prompt another fit note to be sent.
    The WCA is not about the work you did or that you can no longer do that type of work, it's about any work that you're able to do.
    I would appreciate it if members wouldn't tag me please. I have all notifcations turned off and wouldn't want a member thinking i'm being rude by not replying.
    If i see a question that i know the answer to i will try my best to help.
  • tifo
    tifo Community member Posts: 76 Connected
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    Had a chat with the welfare advisors today and they say I have no grounds for appeal to the upper tribunal but that if there is a change of circumstances, for example I now suffer from a cataract, I should make a new claim. I was told the current LCW claim will continue until a new decision is made. So is there any point is making a new claim now if i've to start giving fit notes in again, I might as well wait till the current LCW period is near to expiring?

    They said it's lack of medical evidence from the GP and hospital which cost me the claim and that they tend not to believe what the claimant says unless there's medical evidence. I think there was enough evidence I gave but from a GP or hospital carries more weight.

    I'm told there is nothing I can do about the long delay in assessing me from when I was very ill, the DWP get away with this even though nearly 3 years is a long time.
  • poppy123456
    poppy123456 Community member Posts: 56,976 Disability Gamechanger
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    You can't start a new claim because you're already claiming UC with LCW. As i advised here.

    You can report a change of circumstances for a new or worsening of condition and the process will start all over again. Reporting the change may also prompt another fit note to be sent.

    Your LCW award has no end date and the reviews are still suspended so there won't be another review anytime soon.
    tifo said:

    The cataract is a new condition, which will affect me in times to come
    I don't understand this, you can't claim for something that will affect you in the future.

    I would appreciate it if members wouldn't tag me please. I have all notifcations turned off and wouldn't want a member thinking i'm being rude by not replying.
    If i see a question that i know the answer to i will try my best to help.
  • tifo
    tifo Community member Posts: 76 Connected
    edited November 2022
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    You can't start a new claim because you're already claiming UC with LCW.

    I don't understand this, you can't claim for something that will affect you in the future.

    I understood that if I have a new condition then this has to be in a new claim because the old claim and tribunal did not look at this. It may mean a different decision. So the cataract is a new condition which i've been informed about this year and wasn't in my claim.


    You can report a change of circumstances for a new or worsening of condition and the process will start all over again.

    This what i meant, isn't that a new claim "process will start all over again". I'm told LCW will continue until another decision is made.


  • poppy123456
    poppy123456 Community member Posts: 56,976 Disability Gamechanger
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    No, it's not a new claim as such because you're already claiming UC with LCW. I still don't understand this part.
    tifo said:

    The cataract is a new condition, which will affect me in times to come

     I'm told LCW will continue until another decision is made.

    Correct.
    I would appreciate it if members wouldn't tag me please. I have all notifcations turned off and wouldn't want a member thinking i'm being rude by not replying.
    If i see a question that i know the answer to i will try my best to help.
  • tifo
    tifo Community member Posts: 76 Connected
    edited November 2022
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    I still don't understand this part.
    tifo said:

    The cataract is a new condition, which will affect me in times to come
    I thought they look at my ability to do future work. That's the whole point of LCW(RA) as it's given for a future period. So I have a condition which affects me now and will continue to affect me in the future.

    The hospital clinician said I shouldn't use a computer screen, not never but not as much, and my work or any other (office) work I would normally do involves computer screens. She also said I couldn't do work such as my fork lift driver because of distance perception.

    I know the DWP look at work and not just my work but if i'm an office worker with skills to match they can't ask me to become a builder, can they? Even then, would it be safe for me to use dangerous tools when I can't see or move properly. Not always but when which is a lot of the time. (This is just an example).
  • tifo
    tifo Community member Posts: 76 Connected
    edited November 2022
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    No, it's not a new claim as such because you're already claiming UC with LCW.
    So, what would happen is that, if I submit a new condition, they will assess me from that date. Until a new decision is made LCW will continue. At a new decision they can leave it at LCW, change it to LCWRA (for example) or take me off LCW. Is this correct?

    How would they take me off LCW for a new condition when i'm on it for existing conditions, until September 2023 (the tribunal said June 2023)? For example, if they decide to take me off LCW.
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