Going to ask for ESA85a & other questions

Hi again group Thanks for all your help thus far, I love the fact this forum is so friendly, I have been on some benefit forums where you are made to feel really small and pathetic, so is a refreshing change to be on here.

Okay, I know people have mentioned here to appeal straight away but I am concerned if I do that they may make a decision that goes against even my WRAG, as I hear they make a re-decision prior to appeal (as mentioned in your appeals PDF, page 4, that there is a risk). So I am deciding now what to do. I didn't want to do anything before I have my ESA85a.

I just have a few questions........

1. In the same appeals PDF as mentioned above, it says the decision is looked at again automatically, if I appeal, even before the appeal papers are made up. So am I right to worry this decision may be made before I have anything to challenge them on ? At the moment I have no idea what my ESA85a says. I don't want any decision to be changed (unless in my favour of course, ha) until I have submitted more information to them as it could work against me, even if just taking months off my work prognosis.

2. I haven't been to my GP in a while as my health issues are 12 years old now without improvement, so there is not much I need to go for as I exhausted all that over many years, I have boxes upon boxes of pain pills that I got prescribed a while back that are still lasting. Also my GP has recently retired (about 3 weeks ago), so I am not even sure who my new one is yet. On an appeal I had previously they asked my GP for a response, which they gave, but what will happen now ? I have seen many specialists so used to mainly see my GP to get an appointment with them, but none of my specialists have been on an on-going basis, except in the early days. My health issues don't come under any specific single banner (such as MS, ME, cancer, etc).

3. I seem to remember in my last appeal book back in the IB days, there was a load of text from a DM or the DWP I guess, putting up their case of why I shouldn't get the benefit (I still have that MASSIVE binder in my bookshelf somewhere). Does that get sent to me straight away or is that later on down the line after I have written my appeal ? Or are things different now I have benefit but just want to change groups ? Before I was kicked off IB altogether after 5 years until I successfully appealed, so I had nothing to lose then and it was a slightly different situation.

4. I mainly want to get my ESA85a just to see what my prognosis is. If it says 2 years or more does this mean I will be left alone until at least September 2013 ? Or will I still have to go to 6 WFI's ? Does the work programme only kick in when you are 6 months to the end of your prognosis (even if that was 2 years) or does it only occur for those where it mentions 3 to 6 months ?

5. I am sure it differs, but just as an average, how long should a ESA85a take to arrive if phoned up today (Thursday) for ? Also who do I phone to ask for it, do I need to be put through to a specific dept ? Also is that the only paper I need, as I didn't have a medical so don't think anything else was made ?

Thanks all. Sorry for the questions but as I am edging ever so closer to my cut off appeal date I am trying to get as much info in asap. I have an appeal cut off date of around the 21st October.

Benson

Benson wrote:

Hi again group Thanks for all your help thus far, I love the fact this forum is so friendly, I have been on some benefit forums where you are made to feel really small and pathetic, so is a refreshing change to be on here.

Okay, I know people have mentioned here to appeal straight away but I am concerned if I do that they may make a decision that goes against even my WRAG, as I hear they make a re-decision prior to appeal (as mentioned in your appeals PDF, page 4, that there is a risk). So I am deciding now what to do. I didn't want to do anything before I have my ESA85a.

I just have a few questions........

1. In the same appeals PDF as mentioned above, it says the decision is looked at again automatically, if I appeal, even before the appeal papers are made up. So am I right to worry this decision may be made before I have anything to challenge them on ? At the moment I have no idea what my ESA85a says. I don't want any decision to be changed (unless in my favour of course, ha) until I have submitted more information to them as it could work against me, even if just taking months off my work prognosis.

2. I haven't been to my GP in a while as my health issues are 12 years old now without improvement, so there is not much I need to go for as I exhausted all that over many years, I have boxes upon boxes of pain pills that I got prescribed a while back that are still lasting. Also my GP has recently retired (about 3 weeks ago), so I am not even sure who my new one is yet. On an appeal I had previously they asked my GP for a response, which they gave, but what will happen now ? I have seen many specialists so used to mainly see my GP to get an appointment with them, but none of my specialists have been on an on-going basis, except in the early days. My health issues don't come under any specific single banner (such as MS, ME, cancer, etc).

3. I seem to remember in my last appeal book back in the IB days, there was a load of text from a DM or the DWP I guess, putting up their case of why I shouldn't get the benefit (I still have that MASSIVE binder in my bookshelf somewhere). Does that get sent to me straight away or is that later on down the line after I have written my appeal ? Or are things different now I have benefit but just want to change groups ? Before I was kicked off IB altogether after 5 years until I successfully appealed, so I had nothing to lose then and it was a slightly different situation.

4. I mainly want to get my ESA85a just to see what my prognosis is. If it says 2 years or more does this mean I will be left alone until at least September 2013 ? Or will I still have to go to 6 WFI's ? Does the work programme only kick in when you are 6 months to the end of your prognosis (even if that was 2 years) or does it only occur for those where it mentions 3 to 6 months ?

5. I am sure it differs, but just as an average, how long should a ESA85a take to arrive if phoned up today (Thursday) for ? Also who do I phone to ask for it, do I need to be put through to a specific dept ? Also is that the only paper I need, as I didn't have a medical so don't think anything else was made ?

Thanks all. Sorry for the questions but as I am edging ever so closer to my cut off appeal date I am trying to get as much info in asap. I have an appeal cut off date of around the 21st October.

Benson

Hi,

Whilst we cannot give case specific advice as we are without sight of case papers etc, in general to answer some of your queries:

1. Yes, as part of the appeal process, you claim will be subject of a reconsideration by a different Decision Maker.

Hence there is a chance, albeit in general quite small, that on reconsideration what has already been awarded could be revised downwards. If that does happen, obviously most people would continue onto an appeal tribunal.

Whether it may happen in your case is impossible to say. What we usually advise is to get some face to face advice from a Welfare Rights Agency/CAB etc who can go through your claim and papers in depth to establish the relative safety of any existing award, together with the potential chance of success at an appeal.

See the FAQ's re the potential risks here: www.benefitsandwork.co.uk/faq/general#risk

At least at the appeal tribunal stage, should the panel look to remove an existing award, you should be informed of this fact and offered the chance to withdraw from the appeal process.. Sadly this is not the case with a reconsideration, hence the critical importance of face to face advice. At the end of the day though, the decision of whether or not to appeal is down to you. You must though bear in mind the relevant time limits if asking to appeal.

2. If you have not seen your new GP and/or had little contact with a GP, it maybe advantageous to make an appointment with him/her to explain your current situation. It is also a chance for your GP to meet you as well as you meet him/her. Thus should your GP be written to by such as the DWP, he/she is not just relaying on old notes but have more upto date information to work from.

3. If at the reconsideration stage your award cannot be increased, then all the case papers will be sent to the Tribunals Service. You will also receive a copy of the case papers (often referred to as 'the bundle' or Secretary of State's Submission'. You should receive this in good time to get face to face welfare rights advice to go through 'the bundle' to establish and help with your case.

4. If on the ESA85 it has a prognosis of say 1 year, 2 years etc, that should be the date your claim will be reassessed. although it maybe over-ruled by the Decision maker on making the final decision, depending on what evidence they have). However if you are placed into the Work Related Group you do have to attend the series of Work Focussed interviews (WFI's) usually upto 6. If you fail to turn up for the WFI's without the pre-obtained permission of the DWP you may lose benefit, however you do not have to act on any courses, work etc offered at the WFI's unless you agree to it.

5. It is impossible to say; If you look through or search the forum, you will see people are waiting different lengths of time to receive documents. It maybe wise if you rang to ask for the ESA85 to follow the call up in writing (using recorded delivery if possible). That way you have an audit trail of the documents requested and when, should you later need to complain about non receipt of any documents etc. You need to ring/send the request to the DWP Office dealing with your claim, which should be on the top of the award letter that placed you in the WRAG. You can request a copy of your original ESA50 questionnaire as well if you haven't got one.

Sorry we cannot be more specific but as per the forum FAQ's without having sight of your case papers etc we can only give general advice on how the system should work. For more specific advice you really do need to obtain face to face advice specific to your claim.

Pete

Thanks for the advice.

So lets just say I get my ESA85a form (and I haven't appealed) and it says "unlikely to return to work in the longer term", do the WFI's still happen straight away ? When would a person with this prognosis be reassessed ? I have no idea what mine will say, but just curious.

Benson wrote:

Thanks for the advice.

So lets just say I get my ESA85a form (and I haven't appealed) and it says "unlikely to return to work in the longer term", do the WFI's still happen straight away ? When would a person with this prognosis be reassessed ? I have no idea what mine will say, but just curious.

Hi B,

WFI's are mandatory if you are in the WRAG.

I'm afraid I cannot speculate as to your other question.

With regard to appealing the important issue here is, do you feel that you meet the criteria of entry into the support group ?, if so that will be your main grounds for appeal.

Any discrepancies in your ESA85A, may only aid your appeal, and not necessarily change the decision.

cheers

bro58

Hi,
After 2 attempts I have received my sons ESA85A and I'm glad that I did. The nurse who wrote the report has clearly not read all the evidence submitted including ignoring the fact that he has Aspergers and a degenerative condition of his joints. They state that he will some how be ready for work in 18 months. In the first instance I'm asking for a review. I would say that it is vital that you get that report. My second request for it took 1 week for the report to arrive.

Take care,

Izzy

Thanks Bro and Pete for the advice.

Also thanks Izzy for letting me know how long it took for your report to arrive. I am going to write up notice of an appeal and send it special delivery at the last possible moment, so I give the report enough time to get here. If it doesn't, then I will have to say I am going to write my appeal reasons when I have seen the report. Hopefully they will allow me to send in details of my appeal after I have seen that report.