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ESA medical after 2 1/2 yrs in assessment phase

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7 years 8 months ago #164469 by Nationwide
Replied by Nationwide on topic ESA medical after 2 1/2 yrs in assessment phase
Head in a spin!

Update: My son has sent Mandatory Reconsideration. Fit Note from GP for two months and Jobcentre said he doesn't need to sign on whilst signed sick. Housing Benefit have been really efficient - no gaps in payments. ALL positive.

However, yesterday he received a call from Jobseeker staff saying they will not be paying him any money because he has received working tax credits?

Three years ago, when he was on SSP and it ended he made a claim for ESA. He had been in receipt of WTC of aroung £40 a week. When he received his ESA decision it was for around £35 a week and he queried why as he expected assessment phase amount. Staff at JCP said it was because it was made up of WTC and ESA and equalled exactly the same amount as if he was getting ESA Assessment phase amount only. He said that he wasn't working, that he couldn;t go back to that job, but they said that was how it was paid. He never queried (understood) and until a couple of weeks ago, when he was found 'fit for work' it seems it was how he was paid.

Yesterday he telephoned working tax, they cancelled the payments but they've said he will have to repay thousands overpayment for the past three years....

We can't work out what to do. He hasn't technically been overpaid, he received the exact same amount of money each week as he would have it it were ESA Assessment alone.

What do we do?

- about the Jobseekers payments (he has no money and does''t know procedure)
- about alleged WTC overpayment
- about ESA Assessment phase underpayment

He's terrified he will lose his house if they try to recover these £££, but I am sure that there has to be a way that ESA repay WTC and he isn't in debt.

We feel completely out of our depth now... :sick:

ANY advice gratefully received

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7 years 8 months ago - 7 years 8 months ago #164499 by Gordon
Nationwide

My best advice is for your son to get advice from a trained advisor, he will need someone who can look through all of the relevant paperwork which we obviously cannot do on the forum.

Do an internet search for "welfare advice" with his postcode, town or county.

From your post the overpayment is for the WTC which is handled by HMRC, the fact that his overall payment has remained the same will not be taken into account as they will not be concerned with the reduction in his ESA.

There are also issues with his continuing to receive the WTC that the advisor should look at.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 7 years 8 months ago by Gordon.
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7 years 2 months ago - 7 years 2 months ago #181280 by Nationwide
Replied by Nationwide on topic ESA medical after 2 1/2 yrs in assessment phase
This is an URGENT shout out for advice.

Matthew, my son, suffers acquired brain injury following successful surgery to remove three brain tumours. He has associated pain/balance/mobility and cognitive issues following this surgery, prior to which he did not suffer. He has depression and some Post Traumatic Stress Disorder. He lives independently by choice,, but close to family.

We were advised to Welfare Rights for help with Matthew’s Tribunal against the decision that found him ‘fit for work’ in July 2017 as we were all, but most especially Matthew, overwhelmed by the sheer volume of documentation received following the WCA. We had discovered that the Medical Professional on the day had either misrepresented what Matthew had said, misunderstood, and on a couple of instances lied outright, to highlight this I will give an example:

Matthew had explained during the interview/medical that he can no longer lie flat on his back due to the scar he has from one of the three tumours removed. This scar runs on the left side of this head at base of his skull and he has severe nerve damage. If he rolls onto that in his sleep it causes numbness, pain and other uncomfortable effects. He said he does not have any pressure against the back of his head (bed/sofa/chair. The medical practitioner appeared to type this into the computer. She later asked Matthew to complete some physical tests. She said she needed him to lie flat on a bed for her. Matthew politely said that she could lie on the bed thing, but would be on his right side because he can’t lie on the scar. The Practitioner said that he could not then complete that task and excused him from it. This was all witnessed by Matthew’s companion, but more importantly it should be clearly heard on the official DWP recording of the WCA.

We contacted Welfare Rights and Matthew continued to claim ESA at assessment rate because the Jobcentre staff said that as he was unable to say he could fulfil the Jobseekers Agreement due to being unable to travel 90 mins each way for work, and fulfil the arduous job searching criteria because of his cognitive issues. They said that as he was appealing a decision he should go back to ESA until Tribunal.

We awaited contact from Welfare Rights, we’d been informed that the normal practice is to meet with a client, help them understand these legal bundles from the DWP and work out with Client what needed addressed on the day of the Tribunal.

Matthew moved house, and informed Welfare Rights in October 2016 of is new details and asked when he may hear from them. He received a response on 10 October from
This message contains confidential information

as follows:
Hi Matthew

Thank you for your email regarding your address change, I have updated your records.

We have received your appeal papers from the DWP which I be reviewing in due course, please be aware that papers are checked in chronological order therefore people who already have appeal dates take priority, at present you do not have a date so please do not panic, I will be in touch with you to discuss your case prior to your tribunal.

Kind regards,

This message contains confidential information



Matthew as assured by the email, we all were. He received his Tribunal Appointment Date towards the end of 2016 and obviously became more anxious. We kept asking had he heard from Welfare Rights but Matthew kept referring back to the email of 10 October and said that he would wait for them (Welfare iRights) to contact him.

By January 16th 2017 Matthew had not heard from Welfare Rights, again, following advice from folk who said that this was unusual as they should be working with Matthew to help him understand the descriptors and how they apply to him in preparation for the day, we emailed [removed] asking when we might meet with her,

Her response came on 17th January:

Good morning Matthew,

We also have your appeal date which has been added to our diary, unfortunately due to our heavy workloads we are unable to meet until the day of your hearing, as your caseworker I review your paperwork and identify which of the ESA descriptors best apply to you, I will also give you a call to discuss your appeal and what to expect at the hearing prior to the 7th.

On the day of your hearing we ask that you attend 20 minutes prior to your allotted time, during this time you will have a short consultation with your Representative who will have also reviewed your paperwork and have my case notes for information.

Your appeal is about the decision that was made in July 2016, the tribunal will focus on the information within your papers particularly your claim form and the assessment, they often go through your ‘typical day’ which is on page 112 of your papers so it is a good idea to familiarise yourself with this information and make a note of anything you dispute or disagree with.

I will be in touch in due course.

Kind regards,


This message contains confidential information



Matthew hadn’t understood the gravity of the response. He didn’t fully understand what was required of him, and didn’t tell us what the email response contained until 31 January when we all flew into a panic, because it appeared to us that [removed] didn’t understand that Matthew struggled with reading/cognitive matter, wasn’t managing paperwork etc. We assumed she didn’t have a copy of Matthew’s ESA50 or Mandatory Reconsideration Document so an email was written to [removed] of 1st February saying that Matthew was panicking and enclosing all the forms (as we had electronic copies).

Her response, dated, 3rd February stated:

Hi Matt

You will be meeting my colleague. [removed], if you can arrive 15-20mins before your hearing she will have a short consultation with you.

Please try to worry too much, the process is a lot less formal than people think, you basically sit across a table to a panel of two people – a Judge and a Dr – who will ask you questions about your health conditions and how these impact on your daily life and prevent you from being able to work. The tribunal are likely to ask you about the typical day section in your papers so you will have an opportunity to dispute what the Healthcare Professional wrote. The tribunal are there to decide whether the decision made the DWP to find you fit for work was right or wrong, they are not there to say you have done anything wrong, it is another opportunity for you to show that you do qualify for ESA and are entitled to the benefit.

I did try to call you on the 27th of January but the call was ended. We have all the relevant documents that we need, the ESA50 and your medical are within the appeal papers we received from DWP.

Thanks

NOTE: Matthew has no missed calls on the date stated by Ms Hunt

Matthew was, again, reassured by this. He assumed that as they had all the documents they were able to represent him accurately on the day. We still had some misgivings regarding his being able to describe a ‘typical day’, if he was under pressure, anxious or stressed. Together we wrote a document for submission the Tribunal, it was written on 6th February.

We arrived at the Tribunal a good half hour in advance of the appointment time. [removed]r arrived to meet Matthew 14 minute prior to his appointment time, we were beginning to think she wasn’t turning up. She was completely unaware that Matthew had difficulties with reading documents, she kept asking him what descriptors he disagreed with and whether he’d read the ream of paperwork sent after WCA decision. He said he couldn’t understand it. We said that this was the reason we’d approached Welfare Rights for help. We said we didn’t know how to address the Medical Professional’s misrepresentations and lies on the WCA, and I asked whether she had heard the recordings. She had no idea there was a recording and rudely inferred we’d illegally recorded the WCA. She admitted that the Welfare Rights had no copies of the recording. Clearly this indicates that despite [removed] assurances they had all information required, it was a nonsense.

It was a very fraught meeting in which we all felt completely stunned and Matthew just said that he he’s not a liar or cheat he just wanted to go into the Tribunal and get it over with.

He was out within 25 minutes and informed it would be a postal decision.

Matthew says the descriptors regarding cognitive/mental health/tasks were not even asked. These are the most important matters which affect his daily life. He said the Tribunal kept asking him why he wasn’t getting help with his balance issues – he’s never been offered any, he was told after his operation he’d have to learn to live with it as it may never get better. He didn’t say that because it never occurred to him, this is why he needed the correct representation.

On Friday 10th Feb, Matthew received a postal decision refusing his appeal, he still has the 6 pointe for mobility, but as we feared the cognitive and mental health descriptors were all overlooked.

We don't know how to proceed.

Matthew says that as he is unable to manage forms/use a computer, and cannot travel alone or for up to 90 mins each way he cannot legally sign a Jobseekers Agreement that indicates he can. He fears that in doing so he may very swiftly, due to the nature of his current disability, fall foul of the sanctioning regime.

I assume no-one can claim Jobseekers on his behalf?
I assume no-one else can complete his Agreement, write his CV, use Jobsearch or complete applications and attend interviews on his behalf? Can they? If, as I suspect it's clearly a 'no'. What happens to him?

What do we do about his housing benefit and his council tax relief?

We are completely at a loss and desperate right now.

Can we take any action over the fact that Matthew spent over 3 years in Assessment phase, on just over £70 a week only to have this result...clearly there were very clearly defined periods when he would have been in the support group because he couldn't walk or get out of bed. That changed as time went on, but he should, we feel, still have at least a WRAG result here.

ANY help would be gratefully received.
Last edit: 7 years 2 months ago by Gordon.

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7 years 2 months ago #181345 by Gordon
Nationwide

OK

I have had to remove the numerous references to people at the advice agency, if you post again please do not include these or I may have to refuse the post/

First request a Statement of Reasons from the Judge of the appeal.

Tribunals – Requesting a Statement of Reasons

You will need to show that there has been an Error of Law in the making of the Decision.

What is an Error of Law?

It's a long shot but you can also ask for a Set Aside on the basis that that your son has brain damage and received inadequate representation at the hearing. This would be an issue of Natural justice. You need to complete the following form.

What is an Error of Law?

I would make a formal complaint to the Advice Agency.

Only your son can claim JSA and whilst he can negotiate a reduced Claimant Commitment he will need to be able to meet this requirement if he is to continue to receive the benefit.

It is possible to receive Housing Benefit on the basis of nil income, contact the Local Authority.

I'm afraid he can't make a new claim for ESA unless he can show a new condition or a deterioration in his current conditions that would likely lead to am award, even then the DWP withhold payment of the Assessment rate until a new assessment is done.

There is no required period within which an assessment is required to be completed, whilst I agree that three years is unacceptable, it's unlikely to be a matter that you can pursue, the DWP will simply argue that as no award was made (confirmed at Tribunal) then your son received the Assessment rate for a considerable period when he would not of actually done so if an assessment had been done earlier.

Gordon

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