ESA WRAG Decision Without A Medical

I received a phone call this morning from DWP. The lady explained that I had successfully migrated from incapacity benefit to ESA and that I will receive a letter in the post to confirm this. I was surprised as I only sent my ESA50 form in to arrive on 1st March (3 weeks ago) and had not been called for a medical.

She told me that I have been placed in the WRAG group, which I told her I felt was wrong as I feel I should have been placed in the support group. She explained that she will refer my claim back to a decision maker for reconsideration. (I had hoped that the exceptional circumstances rule would apply, whereby if I have to exert myself beyond my normal very low activity level, then it would cause harm and my illness would be even worse. My GP had written a letter explaining this which I had also sent with my ESA 50.)

I did ask how many points I had been awarded and I was told that there was no reference to that, just the decision on my claim.

She told me that when I receive the letter I must also write a letter to them stating that I wish to appeal their WRAG decision and to give my reasons why. She told me that by her referring my claim to the DM this will save me time and that if the DM decides I should be in the support group the appeal would just lapse, but if the DM upholds their initial decision, then the appeal will go ahead.
Does this sound right? I don't want to get it wrong! Is there anything else I should do at this stage?

I did explain that there is no way I am well enough to attend WRAG interviews and she said that would not be a problem as they can conduct these over the phone. I didn't know that was possible.

Thanks so much for your prompt response. I know an award of WRAG is better than being found fit for work, but gather, due to the fact that I am married and my husband works full time, that my benefit will stop after 52 weeks. DWP told me that this was due to austerity measures -great! I also gather that I can't then apply for jobseekers allowance as I am not fit for work - so I will be totally stuck.

I will wade my way through all the appeal information and somehow will have to muster the strength and energy to deal with it all. Just keeping my fingers crossed that the DM will look favourably at my claim and that I won't have to go through the appeal.

You are correct in stating that Contributary ESA is limited to 365 days in the WRAG although time in the Support Group is unlimited. If you were moved into the Support Group due to this reassessment or appeal, the clock would be reset to zero and it would be as if you had never been in the WRAG. This could be significant if you were to be placed into the WRAG at any furure reassessment.

The clock will continue ticking while you are awaiting appeal. If this takes longer than 365 days your ESA payments would stop until and unless a decision is made to put you into the Support Group.

12 Month Limit for ESA(CB)

24 hour work rule for ESA(IR)

Asset rule for ESA(IR)

Don't even suggest in your appeal submission that your decision to appeal is anything to do with the 365 day limit of WRAG!

Here's hoping that you get a favourable decision soon.

I have been trying to work out what I should actually state in my appeal for ESA. I know that my brain isn't working as well as it should be and the more I think about it all the more confused I become.

As my ESA claim put me in the WRAG group and I am appealing because I feel I should be in the support group, should I give lots of further information when I initially send off the appeal form, or should I wait until another time?

I have written a history of my illness, because I believe it shows how mis-management (or in reality no management or treatment) by the medical profession for almost 20 years, has contributed to the on-going disabling symptoms and longevity of my illness. I have also written a report of how my illness affects me in my daily life - using a typical day as an example.

I don't want to bore the DWP but I also want to be able to show exactly the repercussions this illness has had and continues to have on my life.

Is this a good idea or should I just stick to the descriptors, which don't really give an overview of my everyday problems?

Any advise gratefully received.

Debs424 wrote: I have been trying to work out what I should actually state in my appeal for ESA. I know that my brain isn't working as well as it should be and the more I think about it all the more confused I become.

As my ESA claim put me in the WRAG group and I am appealing because I feel I should be in the support group, should I give lots of further information when I initially send off the appeal form, or should I wait until another time?

I have written a history of my illness, because I believe it shows how mis-management (or in reality no management or treatment) by the medical profession for almost 20 years, has contributed to the on-going disabling symptoms and longevity of my illness. I have also written a report of how my illness affects me in my daily life - using a typical day as an example.

I don't want to bore the DWP but I also want to be able to show exactly the repercussions this illness has had and continues to have on my life.

Is this a good idea or should I just stick to the descriptors, which don't really give an overview of my everyday problems?

Any advise gratefully received.

Hi D24,

Once you submit an appeal, your ESA WRAG decision will be reconsidered automatically by a different more senior DWP DM.

Only then if the WRAG decision is not changed in your favour will your appeal be sent forward to The Appeals Tribunal Service.

Therefore, to stand the best chance of being successfully placed into The SG at the automatic reconsideration stage, you should supply any supporting evidence ASAP.

In the first instance the important issue is to not miss your one month deadline to appeal. If you wish to provide more information after submitting your appeal, you can mention this in your initial appeal, then supply any further information as soon as you have it prepared.

As far as The DWP are concerned, you must show that you qualify for The SG by fulfilling at least one of The SG Descriptors, as seen below :

SG (LCWRA) Descriptors

Or, if none of those, by qualifying for The SG under Exceptional Circumstances rules, ESA Reg 35 :

ESA Reg 35 for entry to The SG (LCWRA)

There is also an ESA Appeals Guide on this page :

ESA Claims Guides

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