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Mandatory reconsideration disallowed.

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7 years 4 months ago #174503 by Ginny
Am I unique, lucky or wasting my time?
Suffering epilepsy and having won four court of appeals. Again this week I lost my reconsideration appeal. I telephoned and had the dept whom help ESA claimants unable to give me proper answers I was looking for. I was advised she would get me a MR advisor to call me back. Sure enough they did. I happened to get the one that had refused my appeal.
She has given me the opportunity to resubmit my request BUT to stop appealing the Healthcare result and to focus more on proof of WHY my epilepsy stops me working.
I'm pleased and yet curious.
My Doctors say DHSS have to write to them, so won't intervene. My consultant on the other hand will, but they are busy and time is not the essence.
Epilepsy is complex and varied. For instance I cannot 'fit' to order. How can I prove it takes forever to remember yesterday. Whom is able to see my myoclonic jerks in action EVERY Day?
It is hope though as opposed to yet another appeal, and maybe hope for others.

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7 years 4 months ago #174543 by Gordon
Replied by Gordon on topic Mandatory reconsideration disallowed.
Ginny

Just to confirm, you have completed the MR process and the Decision has not been revised?

Were you found Fit for Work or placed in the WRAG but believe you should be in the Support Group.

The ESA MR & Appeal guide has links to the SSCS1 that you will need to complete and instructions on how to complete the form, at this stage you do not have to go into detail about why you are appealing.

I would recommend that you go back through your ESA50, the assessment report (if you do not have this then it will be sent as part of the appeal) and the ESA Claim guides to ensure that you have shown that you meet the criteria to score points.

Be aware some of the Descriptors have multiple elements and you need to meet all of them to score points.

Getting an award for Epilepsy for ESA is easy in some ways and not in others. There is an ESA activity that specifically deals with the issues associated with Epilepsy but it only provides an award for the WRAG there is no associated Support Group Descriptor, so if you are aiming for the SG you either need to do this via another ESA activity or by showing that you meet the requirements for Regulation 35, these are all covered in the ESA Claim guides.

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

Gordon

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

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7 years 4 months ago #174638 by Ginny
Replied by Ginny on topic Mandatory reconsideration disallowed.
Hi Gordon. I have claimed for over 20 years with severe Epilepsy. Since being placed in support group when it first started, it's since then it all went wrong. On each new occasion of assessment I am placed in Wrag. I appeal to the tribunal and win. This time I did the MR, remained in wrag, complained and have been given the opportunity to reply again to the Desicion maker in the MR department..
I know nothing of, or have been told nothing of the sscs1 form. After demanding to speak with the MR department, she has said if I felt I have been misunderstood, I can rewrite and enclose evidence, NOT of my Epilepsy, but why my Epilepsy interferes with my working.
I'm confused why I was not just told to go ahead with a tribunal?
Thank you

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7 years 4 months ago #174643 by Gordon
Replied by Gordon on topic Mandatory reconsideration disallowed.
Ginny

If you have an MR notice from the completed MR then there is nothing stopping you from going onto appeal.

You don't say when you last appealed, but it was in regard to a Decision made before October 2013 then the law has been changed since then and the MR and Appeal are now separate processes.

Before you would have made an appeal (on a GL24 form) and the DWP would have carried out a Reconsideration and if that did not revise the Decision then the DWP would have forwarded your appeal to the Tribunal Service.

Now you have to request the appeal (on a SSCS1 form) directly with the TS.

Do you know the basis of your previous SG awards? As I said in my previous post, Epilepsy on it's own cannot place you in the SG.

Gordon

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7 years 4 months ago #174650 by Ginny
Replied by Ginny on topic Mandatory reconsideration disallowed.
Can you briefly explain please what schedule 3 activities are please as the MR is saying I don't meet any and reg 35 is not applicable in my case.
After my call though the MRN department, the decision maker is giving me the chance to re write to her with my evidence, prior to going through the tribunal route?

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7 years 4 months ago #174652 by Gordon
Replied by Gordon on topic Mandatory reconsideration disallowed.

Ginny wrote: Can you briefly explain please what schedule 3 activities are please as the MR is saying I don't meet any and reg 35 is not applicable in my case.
After my call though the MRN department, the decision maker is giving me the chance to re write to her with my evidence, prior to going through the tribunal route?


Schedule 2 of the ESA Regulations define the criteria for a WRAG award.

Schedule 3 defined the criteria for a Support Group award.

Regulations 35 is a catch all for anybody who does not meet any of the SG / Schedule 3 Descriptors.

The ESA Claim guides list the SG Descriptors and explain Regulation 35.

The Staying Conscious when Awake activity covers Epilepsy. It has a Schedule 2 Descriptor but not a Schedule 3 one.

You must have met one of the Schedule 3 Descriptors or Regulation 35 to have been placed in the SG at your previous appeals.

It's entirely up to you whether you allow the MRN department to look at your claim or whether you go to appeal.

Gordon

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

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