ESA following missing medical then failing medical

I think I know the answer to this but I’ve not actually come across this situation before…

Clients ESA stops because they don’t attend the medical. They make a new claim and aren’t paid until they attend a new medical.

Qyuestion: if they fail this medical and appeal will they get appeal rate ESA until the appeal is heard?

I think not but can’t find it in regs etc

Thanks

Thanks

Yes they have appealed the decision re: failing to attend the first medical.

I’m sure I saw somewhere that if you fail to attend a medical and then reclaim not only do you not get paid until you have a new medical but you also don’t get paid until you pass the medical i.e. either at WCA or appeal. Hopefully you are right though!

Is the same the case if you fail a medical, appeal, lose appeal and reclaim ESA within 6 months of previous medical decision? Do you get appeal rate if you fail the medical and appeal or only when you pass either at WCA or appeal?

Thanks

Hi
In relation to the 2 claims

ESA claim 1.

If the client did not attend the medical assessment, and then appeals on the grounds of “good cause”, unfortunately they are not paid any ESA until the appeal is heard and upheld.

ESA claim 2.

If they then make a new claim within 6 months of being found not to have LCW due to not attending the medical assessment, then they cannot be paid any ESA until they undertake a new medical (unless the condition has deteriorated or they have a different condition – always worth looking into if someone has multiple conditions)

Once they undertake the new medical, if they are then found to have LCW/LCWRA, then they will start getting paid ESA with the relevant component plus the ESA (assessment phase rate) is backdated to the start of claim 2

If they are found not to have LCW/LCWRA, then they can appeal in the usual way and get ESA (assessment phase rate) from the point of the decision until their appeal is heard.

(From experience there will also be further complications involving a period when the claimant has been wrongly advised by the JobCentre to claim JSA, has tried to do this but ended up being sanctioned)

Jo Woodcock - 05 June 2013 01:44 PM

I think I know the answer to this but I’ve not actually come across this situation before…

Clients ESA stops because they don’t attend the medical. They make a new claim and aren’t paid until they attend a new medical.

Qyuestion: if they fail this medical and appeal will they get appeal rate ESA until the appeal is heard?

I think not but can’t find it in regs etc

Thanks

You got me worried so I looked this up.

Reg 30(3) removes the effect of reg 30(2)(b) so the prevention from being treated as LCW is removed once the appeal is submitted.

See also this discussion :

http://www.rightsnet.org.uk/forums/viewthread/4493/

Mind you, in the case I’m looking at we’re still no further on with this….