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UC equivalent to ESA Reg 35 substantial risk medical evidence
Hi all,
Client clearly too unwell to attend UC work capability assessment and has been given face to face assessment date. I had already sent in supporting letter evidencing substantial risk to health if not assessed as having limited capability for work related activity.
A contact at the local WCA assessment centre who has always been tremendously helpful can’t assist as he said they have nothing on file for client.
Friendly contacts at local job centre have told me simply that they are not sure that there is an equivalent to ESA Reg 35 in UC. Their view is that I need to support client to negotiate with work coach via UC journal.
Have looked at UC legislation this morning and Schedule 9 para 4 Risk to self or others looks remarkably similar to ESA Reg 35.
Am I right in thinking that all I need to do is to replace in my letter “ESA reg 35 substantial risk” wording with “UC Schedule 9 para 4 substantial risk” and push for the work coach to accept supporting letter as sufficient evidence to assess client as having limited capability for work related activity and to then cancel the face to face assessment?
I can’t see any difference in the meaning between ESA and UC exceptional circumstances regulations.
Thank you!
Lee
I think you’re right. You might refer them to para G3020 in the ADM:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/702971/admg3.pdf
This notes the substantial risk route to the LCWRA group, and footnotes UC r40(5), and Sch 9 para 4.
This regulation cannot bite until a decision has been made whether your client has a limited capability for work related activity and/or a limited capability for work. In the meantime your evidence should help your client with negotiating a reasonable claimant commitment. Presumably you are also submitting Med3 certificates (fit notes) which should also help with the claimant commitment negotiations. Your client may need a letter from the GP stating why they cannot attend a face to face assessment.
That’s very helpful Jon and MickD, thank you.
Jon, that document will be very useful to show to others.
MickD, if we send the ESA reg 35 substantial risk letters in with the ESA50 clients are routinely placed in support group without face to face assessment. Likewise if a client has done their own ESA50 and gets a face to face assessment date we send in the reg 35 letter at that stage and again client is routinely placed in support group and assessment is cancelled. I was full of hope that this would continue under UC!
Lee
That’s very helpful Jon and MickD, thank you.
Jon, that document will be very useful to show to others.
MickD, if we send the ESA reg 35 substantial risk letters in with the ESA50 clients are routinely placed in support group without face to face assessment. Likewise if a client has done their own ESA50 and gets a face to face assessment date we send in the reg 35 letter at that stage and again client is routinely placed in support group and assessment is cancelled. I was full of hope that this would continue under UC!
Lee
An alternative is to bypass the DWP email Maximus customer services .(JavaScript must be enabled to view this email address) based in Leeds if there is sufficient time, and make an argument to Maximus for a paper based review based on the evidence you have, suggesting their is an arguable case for LCWRA citing the legislation. Down here customer services will forward the application to medical services in Bristol, and invariably agree and advise DWP that client has LCWRA faced with compelling CMHT evidence, Adult Psychology Services etc.
Hi Andyp5,
Apologies for the late response. Week has flown by.
Thank you, very useful info and good to have another route.
Situation looks to be sorted now. Client choose to attend with and happily assessment was over in less than 10 minutes. Still seems odd that his paperwork couldn’t be seen on system by assessment worker but hopefully a one off situation.
Thankfully we are having a slow build up of people having to claim universal credit.
Thanks again,
lee
Hi Andyp5,
Apologies for the late response. Week has flown by.
Thank you, very useful info and good to have another route.
Situation looks to be sorted now. Client choose to attend with and happily assessment was over in less than 10 minutes. Still seems odd that his paperwork couldn’t be seen on system by assessment worker but hopefully a one off situation.
Thankfully we are having a slow build up of people having to claim universal credit.
Thanks again,
lee
No worries Lee!
Really glad it got resolved quickly!