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

Intravenous treatment after decision date.

Carole L
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BABH CAB Pembs

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Total Posts: 7

Joined: 12 April 2011

Cl going from IB - ESA.
Previous illnesses may not gain sufficient points from new descriptors.
Cl informed health care professional at medical Dec 11 that he also had chronic renal failure and had fistula inserted in readiness for dialysis.
Date of decision 18.1.12 nil points.
Appealed 23.01.12.
Cl started dialysis three days weekly 06.02.12.
Reconsidered but dec not changed 02.04.12.
Is that because they are totally ignoring situation or because they had to look at decision date only?
Now listed for hearing.

Should they not take into account change of circs after decision date as it was before recon - especially as they were informed it was planned?
Or do we need new claim?
This is so frustrating seeing that he should now be in SG.

Domino
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Advice Support Project, Lasa

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The Decision Maker could only revise on the basis of the claimant’s circumstances at the time the decision was made.  Similarly the First Tier Tribunal will only be allowed to look at client’s circumstances at the date of the decision, to assess whether the correct decision was made at the time, except that the future circumstance might throw light on the client’s functional limitations at the date of decision. 

I am assuming that they are getting ESA (assessment phase rate) whilst appeal is pending, and if the client’s circumstances have significantly deteriorated or he has a new condition since the decision, he should inform the DWP of that fact (preferably with medical evidence to that effect).  A fresh WCA would then normally be arranged.  If found to have LCW, the claimant can get ESA in the normal way from this point on (including relevant component), but the First-tier Tribunal will still consider the appeal up until this point.  If DWP determines that the claimant still does not have LCW following the new assessment, they remain entitled to ESA pending the appeal he is already pursuing. 

As client was found not to have LCW upon conversion, client should still pursue appeal, in order to qualify for any transitional addition he may be entitled to at the point of conversion, should the appeal be successful.

Carole L
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BABH CAB Pembs

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Total Posts: 7

Joined: 12 April 2011

Thank you for clarifying that for me.  I was hoping that having had line in ready for treatment before decision, and having given evidence of significant change before recon, would have given me an arguement.

1964
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Deputy Manager, Reading Community Welfare Rights Unit

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I’d go with Domino’s advice but I certainly think it’s worth arguing that the renal failure issue/dialysis should be taken into account by the FTT. As you say, the condition was present and documented (and dialysis in the process of starting) at the time the decision was made. I don’t see why the FTT can’t consider it.

Edited to add that if nothing else, there has to be a Reg 29 argument for the ongoing appeal anyway surely?

[ Edited: 24 May 2012 at 10:07 am by 1964 ]