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ESA mandatory reconsiderations strategies
We are an extremely busy generalist advice centre with very little capacity for appeal representation - we tend to refer most of these onto another organisation. We are overwhelmed with clients who have negative ESA medical decisions.
Staff are divided into two camps
a) we should simply send off a standard brief mandatory reconsideration request for clients and then ask the client to return as soon as they receive the MR decision notice at which point we will complete the SSCS1 and refer their case to a representative. Since ESA decisions at least do not appear on the whole to be positively revised at the point of the MR it is arguably more effective all round to get through this stage as quickly as possible to that the appeal is referred to the Tribunals Service and the claimant can get his/her ESA reinstated.
b) we should assess each case individually, writing a relatively full submission and make requests for supporting medical evidence or otherwise advising the claimant that the case has insufficient merit for us to proceed. Arguably best for claimant but takes up a lot of valuable time and may simply delay the inevitable negative MR decision. We rarely represent so the time taken to prepare a full submission would not save any time further on in the appeal process.
Any views gladly received
Difficult one…..
Obviously, it is to the client’s advantage if the decision is overturned at the MR stage despite the lack of ESA payments whilst the MR runs its course. What about producing a ‘DIY MR’ hand-out/pack you could give to clients in this position? That would save work for your staff (and you could concentrate your resources on the most vulnerable clients) whilst also hopefully ensuring much of the groundwork is done by the time the client reaches the appeal stage (if the MR is unsuccessful).
I am sure there are some examples in the resources section you could download & adapt.
In my last post, we had similar problems of capacity and demand. We trained our front desk to advise clients as to how to lodge an MR themselves, and to encourage them to obtain and forward any relevant evidence, as well as ensuring they were aware of deadlines and timescales, with clear instructions to return if/when MR decided so that we could then intervene properly with lodging an appeal.
It’s not an ideal way to work but it was the most pragmatic solution and for some clients, it’s actually quite empowering for them to begin to understand how to properly dispute decisions and on some occasions to get some success.
I tend to follow the same route as Paul, I send info about the scoring scheme and suggest that the apellant has a good look through it, decide what they feel they should score points for and ask for an MR on that basis. I also suggest that apellants ask their GP for a patient print out as this often provides valuable (and contemporary) evidence of repeated visits with a problem or repeated attempts to clinically manage pain and fatigue. It has proved quite sucessful so far, some MRs have suceeded without any need for an appeal.
The only drawback of only coming in at the SSCS1 stage is that you don’t get a lot of time to write a submission and gather evidence but the patient print outs often mean that no specific evidence is actually needed.
We are a ‘second tier’ specialist welfare right team and (before intro. of MR) took on cases at the appeal stage on referral from front line agencies (and many ‘returning’ clients).
We had a long debate about whether we would accept referrals at the MR stage or only following an unsuccessful MR that had been initiated by the claimant / front line organisation.
We are taking case at the MR stage but it does bring the kind of logistical issues noted above. Principly time scale / constraints.
It seems decision notices (particularly following a WCA) can take well over a week to reach the claimant by snailmail. Then of course there is the need to despatch the MR by snailmail in good time to ensure it is received within the one month deadline (given that DWP will not accept electronic transmition!). This probably leaves a window of about 10 working days if we are lucky!
This window leaves little time to gather additional evidence unless the claimant already has a copy. The suggestion to obtain a print out of a patient summary from GP is a good one.
Whilst it is possible to send additional evidence after submission of the MR request our experience is that often it never ‘catches up’ with the MR as it whirls its way around the DWP/HMRC (and they won’t accept electronically)!
Fortunately we do have the resourses to conduct a full interview with the client and produce a detailed argument on the MR including identifying the appropriate descriptors.
However as we are a county wide service many clients cannot travel to our office or make suitable arrangements to get to us within the available timescale and our resourses for home visiting are very limited. This means in practice we often assist the front line agency to draft an MR and they / client take responsibility for sending it to DWP/HMRC.
We also took a pragmatic view that it was better to get hold of a case at the earliest stage rather than pick it up later on when the MR had gone off ‘half cock’. A particular issue if the claimant / front line agency has already requested additional evidence for GP etc but not asked the appropriate questions (GPs don’t like being asked twice for evidence!).
Then of course there is all the follow up work checking the MR has not been ‘lost’ in the black hole in Wolverhampton! In WCA cases assiting with issues generated by a JSA claim etc etc.
In conclusion? Well time and resourses is a big issue and its all a bit ‘hit & miss’. There may be an ideal way to approach MRs but circumstances never allow for the ideal. And of course it is more time consuming in the long run than being able to go straight to appeal - but then you knew that already!
Just to say thank you for the responses - will take these ideas back to staff team - much appreciated
This raises another question to my mind.
If you provide compelling evidence after the MR what are the chances of DWP revising before an appeal hearing? Appeal hearings tend to happen pretty quickly at the moment which I would imagine reduces the chances of a revision after the MR however I’d be interested to know as I’m soon to become involved in setting up a front line service.
This raises another question to my mind.
If you provide compelling evidence after the MR what are the chances of DWP revising before an appeal hearing? Appeal hearings tend to happen pretty quickly at the moment which I would imagine reduces the chances of a revision after the MR however I’d be interested to know as I’m soon to become involved in setting up a front line service.
We do get the odd case revised pre-hearing once a DM has seen further evidence - but it is very hit & miss - just like the old system! So it can be worth the effort. Its still taking about 3 months from receipt of a submission to a hearing locally!