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Decision maker timescale

milky9306

Hi everyone,

Just looking at some advice. After nearly a 3 year battle with Universal Credit i got accepted for LCWRA back in June. Recieved my underpayment. But from looking back on my journal i calculated i should have recieved alot more. I've wrote in my journal several times with dates and messages i sent regarding fit notes and me repeatedly asking when i was going to get asessed. It was a mistake on my work coach it turned out to be.

The matter has been put forward to a descion maker to look into. It's now been nearly 3 months. I've asked for an update and even the worker who got back to me said i should of recieved an update by now. And that he was going to ask personaly for an update. This was 2 weeks ago. Still nothing.

Has anyone dealt with this before. And knows the process how long it takes and what they do to come to a descion?

Really relying on the money i'm sure i'm owed as currently sofa surfing with really bad health and need the money to rent my own place. Council won't help.

Thank you.

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Comments

Ross_Alumni

Hello there @milky9306

Thanks for posting, and sorry to read of the long wait you are enduring at the moment.

I am not sure how long that sort of decision usually takes, but it's clear that it has taken longer than it ought to have. Have you considered getting back in touch again to ask for a progress update given that it has been two weeks since you last asked? Worth noting that we are coming off a bank holiday, which may well cause a backlog into the following week as people catch up.

poppy123456

I'm not clear exactly why you've requested the MR because in your other thread your fit notes weren't continuous until June 2021. The LCWRA element was then payable from October 2021. Thread here. https://forum.scope.org.uk/discussion/92254/lcwra-underpayment/p2 Part of the rules are that you send in fit notes without any gaps until the decision is made on your WCA. DWP are correct in only paying you from October 2021.

Timescales for MR decisions are 2-12 weeeks, sometimes longer.

milky9306

Hi @Ross_Scope

Thank you for the fast reply.

I guess that's the only option i really have right now. I wish i could just contact them direct or talk over the phone. Or at least some sort of an update.

I really don't want to get my hopes up either. But i'm almost certain it should go in my favour. Not really sure how the whole situation works.

Thank you.

milky9306

Hi @poppy123456

It's been shown since then my work coach made a mistake. I had 3 months of fit notes for back in the end of 2020, where then he should have activated flagged me as going for a WCA but he didn't it wasn't until June he admited to the mistake and said he should have activated in manualy on the system as he thought it was done automaticly.

I'm unsure what your MR means? And it does state online under certain circumstances they can waiver the 3 month rule of fit notes.

poppy123456

milky9306 said:

Hi @poppy123456

It's been shown since then my work coach made a mistake. I had 3 months of fit notes for back in the end of 2020, where then he should have activated flagged me as going for a WCA but he didn't it wasn't until June he admited to the mistake and said he should have activated in manualy on the system as he thought it was done automaticly.

I'm unsure what your MR means?

MR is Mandatory Reconsideration, which is where a decision maker looks at your claim again and makes another decision (in your case) on when your LCWRA starts from.

In your previous thread you said your fit notes were continuous from June 2021 which is when they applied the LCWRA from. For the decision to apply earlier than this you would have needed to send in fit notes without gaps right up until the decision was made.

milky9306 said:

it does state online under certain circumstances they can waiver the 3 month rule of fit notes.

No idea what you mean by this. Fit notes have to be sent without gaps until the decision was made on your work capability assessment.

The full 3 month assessment period waiting time applies to everyone, unless you're claiming with a DS1500 form if life expectancy is 6 months or less.

milky9306

Sorry i'm really not good with all this.

My current underpayment was paid from Nov 21 there is journal notes back and fourth as far back as Dec 2020. They seemed to have paid it back when there was a consistent 3 month period. But there has been a consecutive period of fit notes back in 2020. All the dates etc just confuse me as my journal is all over the place. I'll grab some screenshots so you can see what i mean as i struggle to explain myself fully sorry.

poppy123456

You gave all the information on your other thread, including screenshots. You said your continuous fit notes were from June 2021. It's not just 3 months continuous fit notes you need to send, you need to continue to send them until the decision is made, regardless of how long that takes. If there's gaps in those fit notes then it affects when the LCWRA is payable from.

milky9306

poppy123456

That's the same screenshot you posted in your other thread. It says your fit notes were continous from 14/06/2021. So first payment of LCWRA would be from October, which is correct. The gap in your fit notes affected when your LCWRA was payable from.

milky9306

I personaly think the mistakes on there part. If i would have actually been asessed back in 17th Dec 2020 i wouldn't of had to send in anymore fit notes. The mistake was there part if it was due to covid or whatever the reason. I was meant to get assesed and i wasn't either way there in the wrong for that. I'll just await the reply from the DM i feel i have a case with them

poppy123456

The time it took really doesn't have anything to do with it. The rules are you must continue to send fit notes without any gaps until the decision is made on your claim.

milky9306

No your wrong. It isn't about making a decision on a claim. It's about when they finaly activate the WCA to then send the forms out and have the face to face meeting to THEN make a decision weather your fit or unfit for work and are entitled to an extra payment. Time matters the most when your ill and time in months lost out on extra money that should of been paid when i was off ill.

poppy123456

I’m sorry but as much as I’d like to say you’re correct here but you’re not. Fit notes must be sent without any gaps until the decision has been made as has been advised.

maddanj

Hi @milky9306

I'm interested to know what the decision for back payment was as I have a similar situation.

thanks

milky9306

Hi @maddanj as soon as i hear back i'll let you know. I know i have a case. My situation isn't a reassesment my original assesment should of been back in December 2020. Were they made a mistake and never assesed me even though they wrote in the journal they was going to assess me. I'll fight it. I have medical notes as far back as then. What's your situation if you don't mind me.asking?

poppy123456

milky9306 said:

Hi @maddanj as soon as i hear back i'll let you know. I know i have a case. My situation isn't a reassesment my original assesment should of been back in December 2020. Were they made a mistake and never assesed me even though they wrote in the journal they was going to assess me. I'll fight it. I have medical notes as far back as then. What's your situation if you don't mind me.asking?

Yet your fit notes weren't continuous, there was a gap which explains why you weren't paid as much as you thought you would be. The rules are there must be no gaps.

maddanj

Hi @milky9306

thanks. likewise. Do try the CAB as I've just had a call from a really helpful advisor who has fully understood the situation of my arrears being duplicated and determining that ESA takes precedence over UC as this was my initial health claim prior to applying for UC for the housing element. She has proposed an approach and is running it by the CAB Specialist Advice team to check case law.

Like you, I never had the initial assessment as despite ESA sending the ESA50 and it being recieved by HAAS, they never made the referal on the system so HAAS never invited me for assessment.

The fit notes for UC can be proven in my journal entries plus my letters sent to JC+ with the fit note dates as the UC system did not send me a To Do task to submit a fit note for those periods and nor did the Work coaches who didnt know what to do with them as the JC's were closed.

UC are confused because the JC Disability Officer investigated my case in in June and expedited the assessment by giving me a UC50 to complete instead of another ESA50 to enable the WCA. She told me that my history of fit notes were complete to be able to recieve full arrears back to wk 13 of my claim.

fingers crossed!

milky9306

@maddanj

Please don't let others disregard your claims. You know what you've had to go through and deal with. Fight for your right if you believe you have a case fight for it. CAB are brilliant and will back you all the way. Just take screenshots of any important dates for future reference.

It gets abit overwhelming but don't take no for an anwser.

Alot of mistakes happened during lockdown and they stopped face2face appointments etc. A fair amount of stuff has slipped through the net and they're now playing catch up.

I hope you recieve the best outcome.