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Contesting an ESA decision via an appeal

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7 years 2 months ago #183415 by aspiealton
Contesting an ESA decision via an appeal was created by aspiealton
Hello all,
I was on ESA from the Autumn of 2013. I attended a medical in 31/10/2016. I foolishly went on my own. I was notified of the decision on 02/12/2016.
The DM said that:
  • They were satisfied that I have a disability.
  • However, I didn't score enough points (the dreaded 0 out of 15).
  • They told me that the supporting evidence stated what I cannot do rather where there's a restriction. Therefore, I'm fit for work

Due to my deterioration to my mental health, there's no way I'm fit for work.
I requested an MR. The written result of which I got yesterday (02/03/2017), which stated there was no change on the original decision. Two days prior to that my sister and myself went for a PIP assessment. Surprisingly, the assessor not only supported my PIP claim, she actually found that my fitness to work to be a joke.

I'm in the process of lodging an appeal against this wrongful decision.
Here are worries and concerns:
  1. Do I submit any supporting documents along with the SSCS1 & MRN?
  2. Do I need to see my GP for any fit notes (which he'll quite happily supply to me, because he knows about my circumstances)?
  3. How do I submit any documentary evidence from professionals and others?
  4. As (point 3) above when do I do so?
I understand that once they receive my notice of an appeal I can revert back to ESA (at the Assessment Rate). I'm currently receiving JSA.
My questions are:
  1. How do I know they've received it?
  2. What are the procedures to going back on ESA AR?
If you have any questions to ask, feel free to do so.
In advance thanks for your help.

I'm looking forward to hearing from you.

Alton

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7 years 2 months ago #183430 by Gordon
Replied by Gordon on topic Contesting an ESA decision via an appeal
aspiealton

One immediate point. You mention a deterioration in your mental health, this cannot be considered as part of an appeal, they will only look at how you were when the Decision was made.

To answer your questions.

1. You do not need to provide evidence with the SSCS1.

Once your appeal is accepted the DWP will prepare their submission to the hearing and send you a copy, whilst you should wait until you receive this to finish and submit your own, you should start to prepare your own case, an increased award will only be made by your showing that you score the extra points for one, so I would start by going back through your PIP2, the assessment report and the PIP Claim guide to see how you might show this is the case.

2, Yes you will need a Fit Note to enable payment of the ESA Assessment rate. To avoid potential problems make sure that it is not for more than three months, this means that you may need to provide additional notes depending on how quickly your appeal is heard.

3. See (1) above

4. See (1) above. Your papers must be with the TS no later than seven days before any hearing.

5. The TS will confirm your request for appeal to you and notify the DWP, I would leave it at least three working days and then contact the ESA Helpline (0345 608 8545).

6. You need to authorise the closure of your JSA claim, they should do everything else.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: aspiealton

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7 years 2 months ago #183478 by aspiealton
Replied by aspiealton on topic Contesting an ESA decision via an appeal
Gordon,
Thanks for your prompt and informative reply.
Before I go any further my sister is helping and supporting me with the appeal. I’m going to tell her about this site.
One immediate point. You mention a deterioration in your mental health, this cannot be considered as part of an appeal, they will only look at how you were when the Decision was made.
What I meant is that my mental health had deteriorated from the start of 2016 (which was before my ESA assessment). I even showed the assessor the state of my home. That was ignored.
To respond to your answers.

1. You do not need to provide evidence with the SSCS1.

What you’re saying is that I should submit the SSCS1 and MRN, and collate together my evidence whilst I’m waiting. Then when TS gets back to me I submit them.

so I would start by going back through your PIP2, the assessment report and the PIP Claim guide to see how you might show this is the case.

I have both a hard and soft copy of the PIP2 form. Although my GP, clinical physiologist, former care coordinator and the Atos assessor all support my case; the problem is that DWP is saying that the evidence is not satisfactory as they relate to PIP and not ESA. In other words they don’t (to the DWP) state how I have limited capacity.

2,

Yes you will need a Fit Note to enable payment of the ESA Assessment rate. To avoid potential problems make sure that it is not for more than three months, this means that you may need to provide additional notes depending on how quickly your appeal is heard.

I have two one month Fit Notes (for Jan & Feb 2017). So should I go to the surgery and get one for March (or longer). An issue here is that I don’t have one between 2nd (when my ESA claim closed) and 30th December 2016.

3. You’ve answered it (as per point 1).

4. Okay, that makes sense.

5. Thanks for that.

6.

You need to authorise the closure of your JSA claim, they should do everything else.

I have no problem with that, I wanted to know if it was done automatically or if I have to do it myself.

Once again thanks.
I’ll let you know of any further occurrences.

Alton

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7 years 2 months ago #183480 by aspiealton
Replied by aspiealton on topic Contesting an ESA decision via an appeal
I forgot to add that I had my PIP assessment on 28/02/2017. So, I'm not expecting a reply until April.

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7 years 2 months ago #183507 by Gordon
Replied by Gordon on topic Contesting an ESA decision via an appeal
aspiealton

If the deterioration was before your Decision then it's not a problem.

1. Yes.

The Descriptors for PIP even where they crossover with ESA are still different. This doesn't mean that you can't use your PIP evidence but it may not carry the same weight as you hoped.

2. As you were on JSA it's not so important to have Fit Notes covering this period as the rate for JSA is the same as the ESA Assessment rate so I would not expect any back payment for this period.

Gordon

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

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