IB to ESA – 1 year on but the end is in sight

My conversion process from IB started in January 2012, had assessment May, got result June, WRAG for 2 years, prognosis - never likely to return to work, appealed to be put in SG. Reconsideration result early Oct – refused, reconsideration was only processed after first WFI, the fact that I had appealed was not on the system at JC+ and it was them chasing it up that put things in motion. There is therefore a direct means of communication between the JC+ and the DM. One year on from when the whole process started received date for appeal, late February.

I was proposing to prepare a statement covering 4 main areas, how I meet the descriptors; identify errors, omissions and conflicting statements in HCP report; make a case under exceptional circumstances and finally point out that I was not a correctly notified person as per regulations so the whole process is void. I wondered what your thoughts were on mentioning the ‘notified person’ issue, Crazydiamond on a previous post was somewhat against it of you did not have professional representation but I do feel that it is a valid point.

My main question is: I have significant problems with both knees and have a tendency to fall; I also have Osteoporosis so preventing falls is very important, this was all mentioned on my ESA50. I had a significant fall early July shortly after ‘my conversion’, can I raise this issue as an example of how finally balanced my situation is or am I better not ‘going there’? I do not have much routine hospital contact and just get referred back when particular problems arise, recent hospitals letters I will be submitting to the Tribunal obviously refer to this specific fall. I feel that I met the appropriate descriptors back in May 2012 and this more recent fall has simply complicated things further.

Many Thanks.

Ortho Tortoise wrote: My conversion process from IB started in January 2012, had assessment May, got result June, WRAG for 2 years, prognosis - never likely to return to work, appealed to be put in SG. Reconsideration result early Oct – refused, reconsideration was only processed after first WFI, the fact that I had appealed was not on the system at JC+ and it was them chasing it up that put things in motion. There is therefore a direct means of communication between the JC+ and the DM. One year on from when the whole process started received date for appeal, late February.

I was proposing to prepare a statement covering 4 main areas, how I meet the descriptors; identify errors, omissions and conflicting statements in HCP report; make a case under exceptional circumstances and finally point out that I was not a correctly notified person as per regulations so the whole process is void. I wondered what your thoughts were on mentioning the ‘notified person’ issue, Crazydiamond on a previous post was somewhat against it of you did not have professional representation but I do feel that it is a valid point.

My main question is: I have significant problems with both knees and have a tendency to fall; I also have Osteoporosis so preventing falls is very important, this was all mentioned on my ESA50. I had a significant fall early July shortly after ‘my conversion’, can I raise this issue as an example of how finally balanced my situation is or am I better not ‘going there’? I do not have much routine hospital contact and just get referred back when particular problems arise, recent hospitals letters I will be submitting to the Tribunal obviously refer to this specific fall. I feel that I met the appropriate descriptors back in May 2012 and this more recent fall has simply complicated things further.

Many Thanks.

Hi OT,

Any fresh evidence that you may have that may help to prove that you are prone to falls, and any substantial risk that may be involved as a result of such falls, should only help.

As you may be aware though, once your appeal is heard by the Tribunal, they will only take into account whether you qualified for The SG at the time of the adverse WRAG decision that you are appealing.

The incident that you have mentioned, could still help to show that you are prone to falls, even though it occured after the date of The WRAG decision.

It's your choice whether to mention it, really.

bro58

Thanks Bro58 for the reply, seems a busy afternoon, might have something to do with the snow!! I will probably refer to it, as I said it is commented on at length on recent consultant letters. There is the possibility that I suffered an osteoporotic fracture when I fell, I am actually waiting for MRI scan results to determine what actual damage I did and what the long term ramifications will be.

I think it was you that mentioned on a previous post that once ESA CB is time limited and you are not eligible for ESA IR and only receive NI Credits, WFI and WRA are not compulsory. Doesn’t this make it more difficult to make a case that you are unable to undertake WRA when they know that after 365 days in a significant number of cases you will not be required to do it?

Many Thanks for all the help and advice available from all at B&W

Ortho Tortoise wrote: Thanks Bro58 for the reply, seems a busy afternoon, might have something to do with the snow!! I will probably refer to it, as I said it is commented on at length on recent consultant letters. There is the possibility that I suffered an osteoporotic fracture when I fell, I am actually waiting for MRI scan results to determine what actual damage I did and what the long term ramifications will be.

I think it was you that mentioned on a previous post that once ESA CB is time limited and you are not eligible for ESA IR and only receive NI Credits, WFI and WRA are not compulsory. Doesn’t this make it more difficult to make a case that you are unable to undertake WRA when they know that after 365 days in a significant number of cases you will not be required to do it?

Many Thanks for all the help and advice available from all at B&W

No, it shouldn't OT.

Whether you are deemed LCW, (WRAG) or LCWRA, (SG) depends on whether you qualify under the corresponding descriptors, and nothing else.

Don't forget also, that if you were successful, the SG award would be backdated to the time of the original WRAG award, and there would be no 365 day entitlement limit, and you would continue to receive payment of CB ESA for as long as you remained in the SG.

bro58