Hi,

We have had a number of cases recently where clients have been refused ESA as not scored enough points after medical so we have submitted appeals asking for the assessment phase payments to continue until the appeal is considered. The clients have then returned to say that their payments have stopped as of ESA refusal date. When we have called DWP to enquire we have been told that there will be no payment issued until a decision maker has looked at the appeal. This would be fine if the DM was looking at it straightaway but we have people waiting weeks and applying for crisis loans due to this.

I would have thought it would have been the same as when reduced rate inc support is claimed where the fact that an appeal has been lodged and received by DWP is enough to start payments?

Has anyone else had any experience of this?

thanks Saima

No experience of this practice, but I can't see any justification for it at all. Other threads have raised the issue that JCP/DWP will want medical evidence pending the appeal, but I cannot see why a valid entitlement is not put into payment. Have you got any forums with local JCP, or contact points, to query and challenge the practice?

Brian

Hi Brian,

I have just emailed one of the customer services managers for our local area to find out - il wait and see what response i get!!

thanks Saima

We had similar problems with our local BDC in the early days of ESA.

ESA Reg 6 means that the 'assessment phase' rate (inc. any relevant premiums) will continue until the appeal is determined by a tribunal.

ESA Reg 30(3) requires that the claimant provides med. ev. within the Medical Evidence Regs.

In practice problems arise because of delay in registering appeals / appeals section not confirming receipt to processing section / processing section not acting on appeals confirmation.

Claimants are not required to request continued payt of ESA at assessment phase rate as part of the appeal process.

There have also been issues about whether a current med cert. etc which covers a period after the 'found fit' decision is still valid or whether the claimant requires a new med cert from the date of decision. There appears to be nothing within Reg 30 or the Med Ev Regs that requires a 'new' med cert until the current one expires.

There have also been issues about whether a 'late appeal' means Reg 6 does not apply. There is nothing within Reg 6 that limits the provision to appeals made within the normal one month time limit only. Equally there appears to be nothing that limits 're-instatement' of ESA payments only from the date the appeal is actually received at the BDC rather than the date payment stopped.

Our local DBC had claimed that some of the above issues arose from internal guidance but have never been able to identify to us what that guidance was.

Therefore, any of the above should be challenged including any delay in 're-instating' payment because of admin delay at / between appeals & ESA processing sections.

Why is it so difficult for JC+ to apply the ESA regs correctly?

thanks for your response - i had a chat with the team leader at ESA benefit delivery centre in our local area and he basically said that the payment cant be issued until a decision maker has looked at it and done a reconsideration decision because the decision could be in clients favour (yeah right like thats going to happen!). He basically said what you had noted above about delays in admin and advised that the only way anything could be done is if clients complained!

In your experience - if challenged has the DWP issued payments sooner?

thanks Saima

That is absolute rubbish! The only two outcomes of a reconsideration are that the decision is not changed, and benefit continues at the assessment period rate, or the decision is changed in the client's favour (and yes, we have had a few where that has happened, although one of those had to die before it was accepted that he did have a limited capability to work) and an increased rate is due. There is no jusification for not paying anything at all other than it probably causes more work to re-instate ESA, and then reassess if the work related or support compoenent is due, rather than do it all at once.

I would suspect this is just a local office approach to dealing with appeal cases and I would suggest putting a complaint "in condfidence" to the BDC manager. Not that he or she will do anything personally, other than get someone to look into it, but it may get a better response.

(Brian)