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Moved out of Support Group to WRAG, following WCA

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6 years 5 months ago #201283 by Gordon
LAyla

There is a sample MR Letter in the Submissions document.

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

I would actually contact the DWP about the payments, if necessary ask for it to be escalated to a manager, this usually requires a call back, this is an error or law no of decision and should be sortable without you having to go through an MR process.

If you do decide to do an MR then do it separately from the SG to WRAG one, or you risk it being sent to the wrong department or missed completely.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: james baldock, layla28

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6 years 5 months ago #201371 by layla28
My GP provided information in two separate letters to DWP earlier on this year, and also completed Form FRR2 stating that my condition has worsened following the sudden unexpected death of my Mum, and also informed DWP that stressful situations precipitate and make my condition worse. In Form FRR2 my GP advised DWP that I am at risk of my mental health worsening if stressful situations arise. I am finding the current situation extremely stressful, it seems as though the Decision Maker has only used the HCP's information/report, but has not taken any of my GP's information into account - the Decision Maker hasn't even referred to information provided by my GP. I believe I may have originally been placed into support group in 2014 under the exceptional circumstances, and I believe this still applies to me now as my condition has become worse, as confirmed to DWP by my GP. Is there any point in me asking DWP what eligibility criteria they applied when they put me into support group in 2014? My letters from 2014 only state that I meet the eligibility criteria for support group, but don't state the criteria they applied. I never even had an assessment in 2014, I was placed straight into support group following DWP's receipt of my GP's letter. I don't understand how they can move me from support group to wrag, when my GP has informed them that my condition has worsened? Sorry this is a long message, but I wanted to know whether I should ask DWP whether the exceptional circumstances was applied to me in 2014, would it help me to know and include this information in my mandatory reconsideration letter? Thank you in advance for any advice you can give me.

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6 years 5 months ago #201373 by layla28
Hello Gordon, thank you so much for your reply below, I've only just seen it. Your message is very helpful and I hadn't even thought about it in terms of being an error of law and I now have some hope that the payments part might be sorted without the MR process. I realise that the MR process is the only way to challenge my move from support group to wrag, but I haven't even felt able to begin drafting a letter for that yet. Thanks again for your help so far, it is very much appreciated.

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6 years 5 months ago - 6 years 5 months ago #201388 by Gordon
Layla

The DWP guidance in regard to the Substantial Risk criteria was updated last year and is now a lot more strict than it was when you were last assessed and this may be why you have been moved to the WRAG. All you can do is go back to basics to show that you meet the criteria.

An appeal panel is not bound by the DWP guidance, but will need to explain why they are not following, so I would expect them to have a far wider view of what qualifies as risk.

It can't hurt to know how you qualified before but the information may not be available in time for your MR, give the DWP office dealing with your claim a call to see if it is in your current file.

Be careful, any deterioration in your condition cannot be taken into account by the MR or an appeal, any new evidence that is produced must make it clear that it refers to your conditions as they were when the Decision was made.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 6 years 5 months ago by Gordon.
The following user(s) said Thank You: layla28

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6 years 4 months ago #201945 by layla28
Hello Gordon, thank you for your reply, sorry I've only just seen it, I've not been coping very well ever since I found out about the recent Decision dated 9th November to move me into WRAG. I phoned DWP and they sent me my ESA85A from 2014, which shows that I was originally placed in Support Group in 2014 because it was determined by the assessor that there would be a subtantial risk to my mental health if I were not found to have limited capability for work related activity - advice from my GP was taken into account as follows: long history of recurrent anxiety disorders and depression with agoraphobia, and that stressful situations precipitate and make my condition worse. I believe that the assessor for my case in 2014 took into consideration the recurrent nature of my condition / my vulnerability to relapse. I have only realised this week that the Decision Maker's Reasons dated 9th November have not taken any of my own Doctor's evidence provided during my re-assessment into consideration, the Decision Maker has basically just copied the HCP's Personalised Summary Statement. It also looks to me from the HCP's Report that he was not made aware by the DWP of my own Doctor's evidence provided to DWP during my re-assessment this year - the HCP was not made aware of the recurrent nature of my anxiety disorders and depression / my vulnerability to relapse. I now realise that it would have helped my case if I had given him copies of the medical evidence provided by my own GP during my re-assessment, but I didn't realise that DWP would not have made him aware of my GP's information. The Decision Maker's reasons have failed to take any of my Doctor's evidence provided during my re-assessment into account - my Doctor stated my long history of recurrent anxiety disorders and depression, and also stated that my anxiety and mood have worsened since end-2015. If the Decision Maker's reasons had acknowledged my GP's evidence stating that my condition has worsened, I think they would have found it difficult to justify moving me to WRAG. The Decision Maker's reasons have not ackowledged any of my Doctor's evidence - I think my own Doctor's evidence has to take precedence over and above anything else? I am going to have to force myself to phone DWP today to request that my GP's evidence is taken into account, and also ask them to take into account the recurrent nature of my condition / my vulnerability to relapse. Please let me know if you think there is anything else I should make sure I say on the phone to DWP when I do make the call? Thank you for your advice so far.

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6 years 4 months ago #201946 by layla28
Hello again, just to let you know I did as you advised, I phoned DWP and asked for the payments issue to be escalated to a manager, and I received a call-back on Tuesday morning to say it was being looked into, they said it was a complex matter and will take time to look into my case, but I have still not heard anything back all week.

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