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Exceptional circumstances rule
- Siskins
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9 years 10 months ago #137190 by Siskins
Exceptional circumstances rule was created by Siskins
Hello
I am applying for ESA for the first time, having migrated from IS and SDA, for the last 30 years. I have severe ME and am housebound and sofa bound through severe fatigue. Any work related activity would only worsen my debility. My GP has written a letter supporting this.
My question Is should I state in the form I would like to be assessed under the exceptional circumstances rule, or should I leave that decision to them? I would be grateful of your thoughts of the pros and cons of either approach. My ESA form must be received by them by 9 July, so the pressure is on.
Thank you
I am applying for ESA for the first time, having migrated from IS and SDA, for the last 30 years. I have severe ME and am housebound and sofa bound through severe fatigue. Any work related activity would only worsen my debility. My GP has written a letter supporting this.
My question Is should I state in the form I would like to be assessed under the exceptional circumstances rule, or should I leave that decision to them? I would be grateful of your thoughts of the pros and cons of either approach. My ESA form must be received by them by 9 July, so the pressure is on.
Thank you
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- Gordon
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9 years 10 months ago #137203 by Gordon
If you think that you would qualify for the Support Group under Regulation 35 then there is no harm in you mentioning this in the ESA50, but if you hope to use the Exceptional Circumstances, you must make sure that you understand all of the associated requirements and show that you meet each and everyone in your explanations of how your conditions affect you.
Have a look at the ESA Claim guides, there is a section that deals with the Exceptional Circumstances towards the front.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Exceptional circumstances rule
Siskins wrote: Hello
I am applying for ESA for the first time, having migrated from IS and SDA, for the last 30 years. I have severe ME and am housebound and sofa bound through severe fatigue. Any work related activity would only worsen my debility. My GP has written a letter supporting this.
My question Is should I state in the form I would like to be assessed under the exceptional circumstances rule, or should I leave that decision to them? I would be grateful of your thoughts of the pros and cons of either approach. My ESA form must be received by them by 9 July, so the pressure is on.
Thank you
If you think that you would qualify for the Support Group under Regulation 35 then there is no harm in you mentioning this in the ESA50, but if you hope to use the Exceptional Circumstances, you must make sure that you understand all of the associated requirements and show that you meet each and everyone in your explanations of how your conditions affect you.
Have a look at the ESA Claim guides, there is a section that deals with the Exceptional Circumstances towards the front.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Please Log in or Create an account to join the conversation.
- Siskins
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9 years 10 months ago #137211 by Siskins
Replied by Siskins on topic Exceptional circumstances rule
Thanks for you reply
Are these the requirements you refer to?
If i do apply under the exceptional circumstances rule, do the other descriptors become irrelevant? is there a risk if I don't meet the exceptional circumstances requirement then I will not be considered for the support group using the descriptors?
Should I ask my GP to write another letter confirming there is no medication that I can take that would improve my symptoms?
"There are a number of elements to Regulation 35 you will need to show that you need each of them to stand a chance of qualifying. It reads
(b) you suffer from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if you were found not to have limited capability for work.
and this has been amended to include
- reasonable adjustments being made in your workplace; or
- taking medication to manage your condition that has been prescribed by a registered medical practitioner who is treating you.
So first you must show that your issues are the result of a "specific disease or bodily or mental disablement", basically you need to state the underlying condition that would cause the risk.
Secondly you must show that there would be "substantial risk" to you or someone else if you were required to work, this includes any risks associated with you going to and from work. Substantial is not defined but looking to the dictionary it is stated as being "of considerable importance, size, or worth", you should take it as meaning far more than the average claimant might experience.
Next you need to show that there are no reasonable adjustments that an employer might make to take account of your limitations. Remember ESA considers your ability to do any job not just the one that you may have been doing or one that you are qualified to do, so a labourer might be capable of doing an office job, a wheelchair user might be given office space on the ground floor.
Lastly, you need to show that the risk is not reduced by your taking any prescribed medicine or therapy. The key word here is "prescribed", the DM cannot look up something on the internet and apply it to you, also if there is Good Cause why you would not take any prescribed medicine or undertake a therapy, then you need to make this clear in your submission.
As to evidence, you need it to deal with the issues above and have sufficient knowledge of you for their statements to be credible."
Many thanks
Are these the requirements you refer to?
If i do apply under the exceptional circumstances rule, do the other descriptors become irrelevant? is there a risk if I don't meet the exceptional circumstances requirement then I will not be considered for the support group using the descriptors?
Should I ask my GP to write another letter confirming there is no medication that I can take that would improve my symptoms?
"There are a number of elements to Regulation 35 you will need to show that you need each of them to stand a chance of qualifying. It reads
(b) you suffer from some specific disease or bodily or mental disablement and, by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if you were found not to have limited capability for work.
and this has been amended to include
- reasonable adjustments being made in your workplace; or
- taking medication to manage your condition that has been prescribed by a registered medical practitioner who is treating you.
So first you must show that your issues are the result of a "specific disease or bodily or mental disablement", basically you need to state the underlying condition that would cause the risk.
Secondly you must show that there would be "substantial risk" to you or someone else if you were required to work, this includes any risks associated with you going to and from work. Substantial is not defined but looking to the dictionary it is stated as being "of considerable importance, size, or worth", you should take it as meaning far more than the average claimant might experience.
Next you need to show that there are no reasonable adjustments that an employer might make to take account of your limitations. Remember ESA considers your ability to do any job not just the one that you may have been doing or one that you are qualified to do, so a labourer might be capable of doing an office job, a wheelchair user might be given office space on the ground floor.
Lastly, you need to show that the risk is not reduced by your taking any prescribed medicine or therapy. The key word here is "prescribed", the DM cannot look up something on the internet and apply it to you, also if there is Good Cause why you would not take any prescribed medicine or undertake a therapy, then you need to make this clear in your submission.
As to evidence, you need it to deal with the issues above and have sufficient knowledge of you for their statements to be credible."
Many thanks
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- Gordon
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9 years 10 months ago #137214 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Exceptional circumstances rule
Siskins
The EC's do not replace the normal ESA Descriptors either for the WRAG or the SG, they are only considered if the claimant has not qualified for a group under the Descriptors, so basically it goes;
WRAG Descriptors -> Reg.29 -> SG Descriptors -> Reg.35.
The requirements you have quote are for Reg.29 which only applies to the WRAG. If you are aiming for the SG then it is Regulation 35 that you need to look at (if that was a direct copy from one of my posts can you post a link as it appears to be in error). The key issues are.;
(a) the claimant suffers from some specific disease or bodily or mental disablement; and
(b) by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work-related activity.
- So you must clearly identify the disease, bodily disablement or mental disablement that would lead to the risks in (b).
- You must show that there is substantial risk to you or another person. Neither "substantial" and "risk" is defined in the ESA legislation so you should assume their normal English meanings.
substantial - of considerable importance, size, or worth.
risk - a situation involving exposure to danger
- you must identify the harm that might occur (physical and/or mental) that would occur either to you or another
- finally you must show that risk and the harm are linked to any Work Related Activity (WRA) that you may be asked to carry out if placed in the WRAG, strictly speaking it is the DWP's responsibility to show what WRA you could do, but it will help if you can give some examples. Remember, WRA can be carried out in your home either over the phone or by you being assigned tasks to complete.
Gordon
The EC's do not replace the normal ESA Descriptors either for the WRAG or the SG, they are only considered if the claimant has not qualified for a group under the Descriptors, so basically it goes;
WRAG Descriptors -> Reg.29 -> SG Descriptors -> Reg.35.
The requirements you have quote are for Reg.29 which only applies to the WRAG. If you are aiming for the SG then it is Regulation 35 that you need to look at (if that was a direct copy from one of my posts can you post a link as it appears to be in error). The key issues are.;
(a) the claimant suffers from some specific disease or bodily or mental disablement; and
(b) by reasons of such disease or disablement, there would be a substantial risk to the mental or physical health of any person if the claimant were found not to have limited capability for work-related activity.
- So you must clearly identify the disease, bodily disablement or mental disablement that would lead to the risks in (b).
- You must show that there is substantial risk to you or another person. Neither "substantial" and "risk" is defined in the ESA legislation so you should assume their normal English meanings.
substantial - of considerable importance, size, or worth.
risk - a situation involving exposure to danger
- you must identify the harm that might occur (physical and/or mental) that would occur either to you or another
- finally you must show that risk and the harm are linked to any Work Related Activity (WRA) that you may be asked to carry out if placed in the WRAG, strictly speaking it is the DWP's responsibility to show what WRA you could do, but it will help if you can give some examples. Remember, WRA can be carried out in your home either over the phone or by you being assigned tasks to complete.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Please Log in or Create an account to join the conversation.
- Siskins
- Topic Author
9 years 10 months ago #137217 by Siskins
Replied by Siskins on topic Exceptional circumstances rule
Thank you. That is very clear now.
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