ESA Appeal Nightmare

Tabbycat

Hi Folks

  It’s my first post on here and I hope that someone can help me with an ongoing ESA LCWRA (Support Group) nightmare before I have a stress related heart attack or stroke. I’m sorry it’s a long post but I’ve tried to supply as much information as possible. Here’s a very brief summery.

After being on ESA LCWRA (Support Group) for many, many years due to an industrial injury I then had….. 

Medical Assessment (Actual DWP Medical) 13.11.2017

Result of Medical Assessment (Failed) 11.12.2017

Mandatory Reconsideration Application 21.12.2017

Mandatory Reconsideration Reply (Failed of course) 05.01.2018

First Tier Tribunal Application ??.??. 2018

First Tier Tribunal (Won) 07.12.2018

DWP Stated on the telephone that I hadn’t won (approx. 11.12.2018)

Upper Tier Tribunal Application (Estimated) 12.05.2019

Upper Tier Tribunal Response (For another first Tier retrial) 18.10.2022

*First Tier Tribunal Re-trial 18th October 2022 (Won appeal with 51 points, told I would be put back in what I was before and given a substantial back payment).* 

* The Judges decision was:

1. The appeal is allowed
2. The Decision made by the Secretary of State on 11/12/2017
3. Mr ****** has limited capability for work related activity. The matter is now remitted to the Secretary of State to make a final decision upon entitlement to ESA
4. In applying the Work Capability Assessment 51 points were scored from the activities and descriptors in schedule 2 of the ESA regulations 2008 made up as follows:
5. No descriptor from Schedule 3 of the ESA Regulations 2008 was satisfied but Regulation 35 of the ESA Regulations 2008 applied. By reason of multiple mental and physical health conditions, Mr ****** is significantly limited, in particular in the above activities. As a result, the above Schedule 2 descriptors are satisfied. Nevertheless he does not satisfy any Schedule 3 descriptors. However, if he were found capable of work related activities, this would result in a substantial risk of deterioration of his physical and mental health. In reaching its decision the Tribunal placed reliance upon the oral evidence of Mr and Mrs ****** and the documents in the Tribunal bundle.

 Any recommendations given below does not form part of the Tribunal’s decision and is not binding on the Secretary of State.

 The Tribunal recommends that the Department does not reassess Mr ****** within 24 months from today’s date.

============

 The DWP representative at the Tribunal told the Judge and myself that the DWP would not be contesting the decision.

  I’m in my 60’s, married and my wife lives with me. Before I failed the medical (13.11.2017) I was paid £365.10 EESA a fortnight. I was/am also receiving IIB at £101.82 pw (in 2017).

  In 2018 my wife had to give up work to care for me 24/7 (and on the advice of the CAB) I applied for PiP and was awarded it at the highest rate and my wife claimed carers allowance.

  Whilst waiting for my appeals (4 years 2019- 2022) I was paid approx. £31 a week ESA.

  Since winning my ESA LCWRA (Support Group?) appeal I’ve been paid twice (two weeks ago and today) at £117.60 per week and this payment is listed as JSA. The IIB has never affected my ESA LCWRA (Support Group) in the past but I think that I read somewhere that now my wife claims carers allowance that the first £20 is discounted and then £50 would be taken from my ESA SG. So, at 2017’s rate of £185 minus £50 for my wifes carers allowance I would have thought I’d be receiving £135 pw and it would be listed as ESA and not JSA?. Also, I have never claimed UC and as far as I know I’m not on UC.

 As yet, I’ve heard nothing from the DWP, not a phone call or a letter.

  I have been given and provided the DWP with Fit Notes from my doctor from 2017 until 2023.

  I haven’t telephoned the DWP yet as I’d rather be armed with some ammunition before they fob me off once again unless of course they’re correct?.

 I'm sorry for the long post and thank you in advance for any help.

calcotti

Tabbycat said:?.. I read somewhere that now my wife claims carers allowance that the first £20 is discounted and then £50 would be taken from my ESA SG.

Your wife’s CA (£69.70) is deducted in full from your ESA but the ESA itself should have a carer premium (£38.85/week) added to increase the maximum entitlement. The net affect is that your ESA is reduced by £30.85/week but as a couple you are £38.85/week better off.

The payment reference of JSA just means that the payments have been made manually rather than generated by the payments system. 

£117.60 is the amount per week for contribution based ESA in the Support Group so is the minimum amount your ESA will reduce too (as you have no pension income over £85/week).

I haven’t got my head around why you were getting the amount of ESA you were getting in 2017 nor why you were getting £31/week while waiting for the tribunal.

poppy123456

Tabbycat said:

  I’m in my 60’s, married and my wife lives with me. Before I failed the medical (13.11.2017) I was paid £365.10 EESA a fortnight. I was/am also receiving IIB at £101.82 pw (in 2017).

Can i just check that this is Industrial Injuries disablement benefit? (IIDB) If so then this does affect Income Related ESA and will reduce it £1 for £1. It doesn't affect contributions based ESA.

Tabbycat

poppy123456 said:

Tabbycat said:

  I’m in my 60’s, married and my wife lives with me. Before I failed the medical (13.11.2017) I was paid £365.10 EESA a fortnight. I was/am also receiving IIB at £101.82 pw (in 2017).

Can i just check that this is Industrial Injuries disablement benefit? (IIDB) If so then this does affect Income Related ESA and will reduce it £1 for £1. It doesn't affect contributions based ESA.

Thank you for your reply poppy, yes, it's Industrial Injury Benefit. I don't know if I'm on contribution based ESA or not?.

poppy123456

Support Group is £117.60/week. I'm with calcotti on this one i don't understand why you were receiving the £365.10/fortnight in 2017. Where you claiming IIDB during that time? If so did ESA know about your IIDB?

Tabbycat

poppy123456 said:

Support Group is £117.60/week. I'm with calcotti on this one i don't understand why you were receiving the £365.10/fortnight in 2017. Where you claiming IIDB during that time? If so did ESA know about your IIDB?

Yes, ESA/DWP knew about everything (in 2017 and now).

Tabbycat

calcotti said:

Tabbycat said:?.. I read somewhere that now my wife claims carers allowance that the first £20 is discounted and then £50 would be taken from my ESA SG.

Your wife’s CA (£69.70) is deducted in full from your ESA but the ESA itself should have a carer premium (£38.85/week) added to increase the maximum entitlement. The net affect is that your ESA is reduced by £30.85/week but as a couple you are £38.85/week better off.

The payment reference of JSA just means that the payments have been made manually rather than generated by the payments system. 

£117.60 is the amount per week for contribution based ESA in the Support Group so is the minimum amount your ESA will reduce too (as you have no pension income over £85/week).

I haven’t got my head around why you were getting the amount of ESA you were getting in 2017 nor why you were getting £31/week while waiting for the tribunal.

I shall have to find the paperwork I was sent with the amounts on it, it started off at over £100 and after deductions it ended up at £30 approx. (went up to £32? over the 3 years?). As I said in my first post, I only gave the short version, this whole sorry mess from when I was failed on medical until now has been a disaster from the start.  I wasn't paid anything for months, then I was back paid what I wasn't paid, even then I was under paid for a year and given another back payment. The first year that I was waiting for my appeal I was paid approx £73 a week (a standard amount whilst waiting on appeal?), then for almost four years I was paid £30-£32 pw.

calcotti

The £73 sounds correct - you get the assessment rate only while waiting for tribunal. I can’t think what would reduce it to £30-£32.

calcotti

Tabbycat said:

poppy123456 said:

Tabbycat said:

  I’m in my 60’s, married and my wife lives with me. Before I failed the medical (13.11.2017) I was paid £365.10 EESA a fortnight. I was/am also receiving IIB at £101.82 pw (in 2017).

Can i just check that this is Industrial Injuries disablement benefit? (IIDB) If so then this does affect Income Related ESA and will reduce it £1 for £1. It doesn't affect contributions based ESA.

Thank you for your reply poppy, yes, it's Industrial Injury Benefit. I don't know if I'm on contribution based ESA or not?.

If you were previously working immediately prior to ESA, or if you transferred from IB, you will be entitled to contribution based ESA with the possibility of receiving additional income based ESA. However, based on the CA and IIDB I think there probably isn’t any income based entitlement.

WhatThe

Tabbycat hi, what a nightmare indeed. Did you receive the correct settlement and LCWRA status following the UTT outcome? A reassessed ESA claim morphs into to JSA on the JSAPS system (and becomes a taxable benefit). What was once an Employment AND Support Allowance becomes Employment Support Allowance - JSA equivalent.