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ESA support to work group-dont i have rights

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10 years 8 months ago - 10 years 8 months ago #124491 by londongrrrl
Hi. I have been unwell for some time and was moved from Income Support with a disability premium to ESA in April 2013.

I have been diagnosed with Primary Sjogren's Syndrome (systemic) Chronic PTSD & Wolff-Parkinson-White syndrome. I have been assessed with having clinical depression, anxiety, lethargy, GERD and various other things.

After being assessed by ATOS (April 2013) I was placed in the ESA support group and my benefit was increased. I was sent a letter confirming all of this. In June this year I had to attend another assessment. I have not heard anything from them since this assessment. Then at the end of July my benefit payment was cut without any warning or information.

Last week I received a letter from Job Centre Plus asking me to attend a Work Focused Interview on 15th September. (‘ESA Initial WF1 12/12’)

I’m not sure but I think it looks like I’ve been transferred from the support group to the work group without being told about it or given any rights to appeal.
I just had a look at the GOV.UK site where it says:

‘You can ask for the decision to be looked at again if you think DWP didn’t have all the facts or got something wrong. This is known as a ‘mandatory reconsideration’.

To get the mandatory reconsideration request form (SSCS1) you ‘must include a copy of the mandatory reconsideration notice’ – which I’ve never been sent.
I downloaded a ‘Mandatory Reconsideration Request’ document from the citizens’ advice web site.
I don’t know what to do. Should I fill in the Citizens Advice document & send it to Job Centre Plus. Hope you can help, many thanks
londongrrrl
Last edit: 10 years 8 months ago by Gordon.

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10 years 8 months ago #124500 by Gordon
londongrrrl

I am afraid it does sound like they have moved you to the WRAG.

You are legally entitled to be informed by the DWP of any Decision they might make on your claim, whilst there are some exceptions, all of these Decision carry the right of appeal.

You do not mention it, but did you receive a new ESA50 to complete prior to the assessment that you attended in June. If you did not, then this could seriously undermine the Decision!

You can appeal this Decision, but must first request a Mandatory Reconsideration, the documentation you have been reading are referring to the process after an MR has been completed.

Have a read of our ESA MR & Appeal guide which explains the process in more detail and includes template letters for you to request the MR and to submit additional information and evidence. See

www.benefitsandwork.co.uk/help-for-claimants/esa1

I am afraid that while you remain in the WRAG you are required to attend WFIs and to participate in Work Related Activity, a failure to do so can result in your benefit being sanctioned. If your attending at a JC+ office will cause you problems, contact the advisor which should be listed on the appointment letter to see whether they will hold the interview over the phone, you should make them aware of your conditions (they are unlikely to have this information) and also that you are challenging the Decision.

If you have additional questions then please reply to this post and we will do our best to help.

Gordon

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

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10 years 8 months ago #124503 by londongrrrl
Replied by londongrrrl on topic ESA support to work group-dont i have rights
Gordon

Many thanks for your reply :)

I did receive a new form (think it was ESA50) before the assessment which I completed & returned.

At my June 2014 assessment, I took confirmation of my Sjogren’s diagnosis from my consultant, letters from other consultants, appointment letters and a letter of support from my GP. I showed him my medications which I had brought in a carrier bag. He said ‘just show me what you use each month’ and I replied ‘this is what I use each month!’

You are legally entitled to be informed by the DWP of any Decision they might make on your claim, whilst there are some exceptions, all of these Decision carry the right of appeal.

I’ve not been informed by letter or telephone of anything! I definitely was never told I was being moved to the work group. The first I realised something was wrong was when my benefit was cut (about 1 moth ago) and then I received the JC+ appointment letter last week! I’ve never been sent a decision letter or a mandatory reconsideration note!!

So I’m trapped in order to get the MR form I need ‘the mandatory reconsideration note’ but to get the note I need a decision letter from the DWP. Legal or not the DWP has not informed me of any decision they have made on my claim.

I noticed in another topic: Moved from Support Group to WRAG. bro58 says:

As you were previously in The SG, the "burden of proof" is on The DWP Decision Maker to give reasons why your limitations have reduced to such an extent that you no longer qualify for the SG.

You should not be referred to the Work Programme, once they are aware that you have requested an MR/Appeal.’


Should I write to the DWP outlining the illegality of this situation, ask for the decision letter & ask them not refer me to the work programme. I would also write to JC+ outlining all of this + include some info about my actual health situation.

I had a look at the template letters but there doesn’t seem to be one that suits my situation.

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10 years 8 months ago - 10 years 8 months ago #124504 by Gordon
londongrrrl

Sorry for the delay in replying, I appear to be the only Mod on and I was called away from the forum by an emergency.

I think there is a danger of your treating what are in fact two separate topics as one. The first is whether you have been notified of the Decision or not, the second is how you challenge that Decision.

The DWP are often incompetent, so it is not impossible that you have not been informed of the Decision on your ESA claim, whilst in the strictest legal terms this is an issue, in practical terms there is not a lot you can do about it and most importantly, if a Decision has been made to move you to the WRAG, it in no way affects the actions you need to take in order to challenge that Decision.

The simple fact is that you must request a Mandatory Reconsideration first, legally you cannot lodge an appeal until the MR process is completed. To be clear there is no MR form, you can make the request in writing using one of the template letter I referred you to previously, once the MR process is completed and on the assumption that the original Decision is upheld, you will be sent to copies of the MR Notice that you need to lodge an appeal.

With regard to Bro's comment, if you have clearly shown that your conditions have not changed or that they have deteriorated since you were last assessed, then the DM does need to justify their Decision, but please do not assume that this is black and white. Each assessment stands in it's own right, it would be unusual for either the ATOS assessor or the Decision Maker to refer to any of the previous assessment documents, their recommendation and Decision is primarily based on the documentation that you provided this time and the results of assessment that you had.

So, what you need to do is to submit a request for an MR in writing, you can either let them look at the Decision again based on what you have already submitted, or submit further information to try and clarify why you meet the SG criteria. Realistically, they are unlikely (although it is not impossible) to change the Decision unless they have ignored something fundamental in your ESA50 or evidence that a new DM finds. If you tell them that you will be submitting further evidence, then it will prolong the process but there is a chance that this will result in the Decision being overturned.

You can request the documents used in the making of the Decision. See

ESA medical – what forms to ask for?

This will give you a better understanding of how the Decision was made, however, you should resist the temptation to pull the report apart point by point as you will only be awarded the SG by showing that you meet one or more of the SG Descriptors and this should be your primary focus.

It might help if you could let us know which Descriptors you think you meet so that we can ensure that you fully understand the requirement, they are all detailed in our ESA Claim guides

www.benefitsandwork.co.uk/help-for-claimants/esa1

As always, if you have more questions, please reply to this post.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 10 years 8 months ago by Gordon.

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