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Reclaiming ESA after failing to undergo a WCA medical examination
My client was treated as not having limited capability for work because she failed to avail herself of an offer of an appointment for a WCA medical assessment at home. My understanding of this is that if she now makes a new claim for ESA, she cannot be treated as having limited capability for work pending a further WCA medical and therefore she will get nothing until the medical is carried out.
I’m not sure what she will need to do to satisfy the new assessment if she is to requalify for ESA before six months have elapsed since the previous decision. Is it just that she scores 15 points in the new assessment or that she does both that and persuades the DM that her condition has deteriorated since the previous decision? If it is the latter, how does the DM decide if there has been any deterioration when my client failed to undergo her examination in connection with the previous assessment ?
If she satisfies the assessment then presumably her ESA award will be re-instated from the date of her claim, but is the WRA component she was receiving on her previous award also re-instated from the date of her new claim underlinking rules or does she have to wait 13 weeks for that?
And if she fails the new assessment and appeals, will she be paid ESA pending the appeal even though she was receiving nothing before the assessment?
Firstly, she can appeal the decsion to stop her ESA if she thinks she has a good reason for not attending the medical. If this appeal succeed there will be no gap in her claim.
She should also make a new claim for ESA. She will not be paid until the medical assessment. If she fails the medical and appeals she will be entitled to ESA pending her appeal.
I am not sure about the WRAC if she passes the medicall - I would need to look this up…
Putting in a new claim for ESA whilst appealing the original decision is one option. However, what is the client going to live on whilst waiting for the new WCA? Claiming JSA is another option instead of making the new claim for ESA.