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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

Supersession of WCA decision

Pete at CAB
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I have a cl. on UC who has an illness which has got worse recently. They are currently in the LCW group but it looks as if they should now be in the LCWRA group instead. They told UC they had got worse and asked that send out a new UC 50 and so forth so that a supersession can be considered.

This was the reply;
“In order for you to be assessed again you need to report a change of circumstances, to tell us about your new health condition. At the moment the only health condition you have declared on the system is for xxxxxxx, the second condition you have declared is a request to be re-assessed, which is not a health condition. You will need to go into the system to tell it that you no longer have a health condition, and then re-declare your health conditions. This should then trigger another assessment, however you will need to provide fit notes from your GP with those health conditions listed.”

I am rather concerned about ‘tell us that you no longer have a health condition’ as this is the exact opposite of what has actually happened and seems to remove even the LCW (because a claimant can’t be treated as as having LCW whilst the cl is waiting for an assessment)

I think that this is not actually legal, s.9 of the SSA 1998 just says that Sec of State can reassess when they get information or a request that indicates that a reassessment is needed.

Is this common practice and am I correct in thinking it is both risky and potentially unlawful

 

JP 007
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I would think you could complete a UC50 (available online) and state worsening conditions that way, provide sick line/ medical evidence with new condition and submit it by post. This should prompt a re-assessment

Va1der
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Funny (not funny) side effects of DWP staff not understanding the system they work under, and trying to invent creative work-arounds

If I recall correctly the CiC health field is a freeform textbox, so your client can just input ‘condition X, but now worse’. I don’t see any reason why that wouldn’t suffice.

The problem (in admin terms, if not legal terms) with JPs approach is that UC50s normally go to CHDA, but they won’t have a case unless DWP has started the process. If you send it to DWP there is all round potential for it getting lost in the post while DWP work out what to do with it. It might work, but I don’t know if it will be any faster.

Pete at CAB
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Va1der - 30 May 2022 01:33 PM

Funny (not funny) side effects of DWP staff not understanding the system they work under, and trying to invent creative work-arounds

If I recall correctly the CiC health field is a freeform textbox, so your client can just input ‘condition X, but now worse’. I don’t see any reason why that wouldn’t suffice.

The problem (in admin terms, if not legal terms) with JPs approach is that UC50s normally go to CHDA, but they won’t have a case unless DWP has started the process. If you send it to DWP there is all round potential for it getting lost in the post while DWP work out what to do with it. It might work, but I don’t know if it will be any faster.

Thanks for the replies, the cl did put that in the Journal and even included the descriptors that should give them the LCWRA component, the reply above is what came back!

Has anyone else run into this somewhat bizarre procedure (if that is what it is?)

Ianb
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This sounds like ‘making it up as we go along’ syndrome. The response equates ‘change of circumstances’ to meaning ‘a new health condition’. That isn’t the same thing, a change in the impact of an existing health condition is a change of circumstances.

“G1020 A WCA may be carried out when
1. the DM has to determine whether the claimant has LCW or LCWRA for the first time..or
2. there has been a previous determination that the claimant has or is treated as having LCW or LCWRA, and the DM wishes to determine whether
2.1 there has been a relevant change of circumstances in the claimant’s physical or mental condition or..”

A relevant change of circumstances in the claimant’s physical or mental condition clearly, in my opinion, covers a deterioration of an existing illness.

Their stance is absurd and would prevent someone with a progressive disease having a new WCA unless they contracted a new illness.

Declaring a deterioration in the existing health condition should be sufficient - if necessary support this with a new Fit Note from GP.

Daphne
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I’d be interested if there are any more cases like this - we’re currently in discussion with the DWP about the difficulty in getting them to issue UC50s when they’re meant to - so any cases - either first assessments or reassessments - will be really useful

Ianb
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Have just noticed this in one of the deposited papers:
https://data.parliament.uk/DepositedPapers/Files/DEP2022-0452/069-Health_conditions_and_disabilities_days_1-29_V13.0.pdf
Note the second bullet point

After the WCA
...
If a claimant provides new medical evidence which supports either of the following:
• a condition that is different from the one on which the WCA decision was made
• a deterioration in the existing condition
The claimant re-joins the health journey and Day 1 conditionality applies. Refer to Work Capability
Assessment outcomes

I think my conclusion is that you need a new Fit Note clearly stating that there has been a deterioration.

Va1der
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Ianb - 31 May 2022 05:34 PM

I think my conclusion is that you need a new Fit Note clearly stating that there has been a deterioration.

Reg 41(4) concerns claimants that have had a decision that they are fit for work - i.e. no LCW. If they already have LCW I don’t see that they need new evidence.

Pete at CAB
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Thanks everyone, the local JC has in fact seen sense and just triggered a new WCA!

JP 007
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Pete at CAB - 01 June 2022 10:33 AM

Thanks everyone, the local JC has in fact seen sense and just triggered a new WCA!

All’s well that ends well in this case. Dis they submit an new Fit Note?

Ianb
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Va1der - 01 June 2022 10:13 AM
Ianb - 31 May 2022 05:34 PM

I think my conclusion is that you need a new Fit Note clearly stating that there has been a deterioration.

Reg 41(4) concerns claimants that have had a decision that they are fit for work - i.e. no LCW. If they already have LCW I don’t see that they need new evidence.

It does raise the question of what is legally required to provide as evidence (I think it’s reasonable that some evidence will be required) when reporting either a deterioration in an existing health condition or diagnosis of a new condition. However my comment was aimed more at being a pragmatic and expedient way of evidencing that there had been a deterioration in the existing condition which would be accepted by UC. My use of the word ‘need’ was possibly not the the best word to use.

Fortunately it appears that common sense has now prevailed.

[ Edited: 1 Jun 2022 at 06:05 pm by Ianb ]