Claiming ESA while appealing (A guide)

In this article, we discuss whether claiming ESA while appealing is possible.

We talk about what your options are if you cannot get the ESA payments and happens if the DWP changes its decision. 

Can you claim ESA while appealing?

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You can request to get ESA payments whilst you wait for the Tribunal’s decision, should you appeal against the DWP.

That is unless you moved to Universal Credit, Jobseekers Allowance or Income support while mandatory reconsideration. 

If you wish to receive the ESA payments, you do not have to make a new claim and you will be paid at the medical assessment stage rate.

For this, however, you have to continue providing medical certificates, also called fit notes.

You do not have to produce an original claim for ESA. When you’re awaiting your Tribunal, You’ll be paid the Assessment Stage rate.

Can you claim ESA while asking for Mandatory Reconsideration?

You cannot claim ESA payments while uner mandatory reconsideration in the following situations:

  1. You did not attented the Work Capability Assessment.
  2. You did not score enough ESA points.
  3. You did not manage to return the ESA50 form.

The only case in which ESA is continued to be paid during mandatory reconsideration is when someone wants to be transfered to the work related-activity group. 

What other benefits can be claimed while Mandatory Reconsideration?

Other benefits that may be clamed while mandatory reconsideration could be Jobseeker’s Allowance (JSA) or Income Support. 

However, these benefits can be claimed only if the claimant is not already getting other benefit with a severe disability premium (SDP).

These may include: Income Support, income-based Jobseeker’s Allowance, Housing Benefit. 

If someone is not sure that their benefit falls into that category, they should check with the DWP. 

Claiming Jobseeker’s Allowance

To claim Jobseeker’s allowance during an ESA mandatory reconsideration, the claimant also has to be entitled to this award.

This means that they must be fit for work and looking for a new job (even a part-time if the claimant’s condition limits them). 

Claiming Universal Credit

Universtal Credit can be claimed by those who are not eligible neither for Jobseeker’s Allowance or Income Support. 

However, a very important thing to mention: If a claimant decides to request Universal credit while awaiting for the mandatory reconsideration, they cannot go back to ESA payments afterwards, no matter the outcome of their appeal. 

Claiming ESA while appealing (A guide)

Possible outcomes after a Mandatory Reconsideration

If they haven’t already, a different decision-maker from the Department for Work and Pensions will look at the decision and decide whether it should be changed.

If after the mandatory reconsideration the decision-maker arrives to the conclusion that  they can’t change the original decision, your appeal will carry on.

If the decision-maker states that they were wrong in the first place, they will send you another letter with the new outcome. 

Next, if you agree with the new conditions and are satisfied with the DWP’s new decision, the appeal will stop. 

If you still disagree with the new decision, your appeal will carry on, but now it will be against the new decision.

Send your ESA appeal on to Tribunal Service

If your appeal carries on, your appeal form will be sent to HM Courts and Tribunals Service, who run the First Tier Tribunal.

The benefit office will also include their response. This explains:

  • How they came to their decision
  • What information they used
  • What benefit law they based their decision on.
The First-Tier Tribunal

The First-Tier Tribunal will decide if you are legally entitled to a benefit and can change a decision if they think it is wrong.

The tribunal could make a decision that leaves you worse off so it is often best to seek advice before deciding whether to appeal.

The tribunal cannot:

  • Change the law
  • Deal with administrative complaints, like delay or poor service 
  • Consider changes in circumstances that have taken place since the decision was made.

You can still claim ESA even if you are appealing the DWP’s decision, however there are certain conditions you must satisfy. 

First, you will not be paid ESA during your appeal if at the reassessment stage you claimed other benefits such as Universal Credit or Jobseekers Allowance. 

Second, if you want to go back to ESA, you must  provide fit notes to the Department.

The medical certificates should cover and be backdated including the mandatory reconsideration period. 

You don’t need to make a new claim for ESA in this case, but you still have to contact the DWP and follow their indications. 

What is Universal Credit?

Universal Credit is a benefit you can claim if you’re on a low income or unemployed. 

It might be worth claiming Universal Credit if:

  • you’re struggling to pay the bills
  • you’ve lost your job and have no income
  • you have a disability or illness that stops you working
  • you have expensive childcare costs
  • you’re caring for someone

Eligibility for Universal Credit

To get Universal Credit you must:   

  • be 18 years old or over – or in some cases 16 or 17 
  • be under State Pension age 
  • live in the UK – there are extra rules if you’re not a British citizen
  • have less than £16,000 in savings

You can get Universal Credit if you’re self-employed.

You can’t get Universal Credit if you’re getting or recently stopped getting a benefit with a severe disability premium (SDP).

If you’re appealing a benefits decision, it might be worth waiting for a decision on your appeal or mandatory reconsideration before claiming Universal Credit.

If you make a claim for Universal Credit, you might not be able to go back to your other benefit even if your appeal succeeds. 

If you’re eligible for Universal Credit, you’ll usually have to apply online.

Conclusions

In this article, we discussed whether claiming ESA while appealing is possible.

To summarize, you can be paid ESA until the appeal is heard if you’re appealing a decision that found you failed the work capability assessment.

However, your ESA won’t be paid during your appeal if you claimed another benefit during the reconsideration.

Instead, you’ll stay on the other benefit unless you withdraw your claim for it.

And important to remember: If you claim Universal Credit while you’re waiting for a decision about your ESA, you won’t be able to back to ESA – even if your appeal is successful.

Please feel free to leave any comments on the content or questions you may have, in the comments section below. 

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FAQ about claiming ESA while appealing

Can I get ESA while appealing?

You can get ESA while appealing if you’re appealing a decision that found you failed the work capability assessment.

However, your ESA won’t be paid during your appeal if you claimed another benefit during the reconsideration.

Instead, you’ll stay on the other benefit unless you withdraw your claim for it. 

What is the success rate of ESA appeals?

The success rate of ESA appeals is 73%, the highest rate ever recorded. After the appeal, the claimant is getting a better award than they originally received from the DWP.

How long does an appeal take for ESA?

An appeal for ESA, regardless of whether you request an appeal or a reconsideration, may take four to 11 weeks.

You will receive a letter from the DWP informing you of this. 

Why would my ESA be stopped?

Your ESA would be stopped if you would fail a medical assessment.

If this is the case, you will either need to sign on for Job Seekers Allowance or make an appeal.

Another common reason why ESA payments are stoped is because of a sanction.

A sanction normally means Jobcentre Plus stops your JSA for a certain period, although in some cases they can reduce it instead.

Can I cancel my ESA assessment?

You can cancel your ESA medical assessment one time.

You will need to attend any rearranged medical assessment or you risk having your claim closed.

How long do I have to appeal ESA decision?

You have one month from the date of the decision to ask for a mandatory reconsideration or to make a claim for an appeal.

Recommendations

  1. Employment and Support Allowance: A Guide to ESA for People with a Disability or Long Term Health Condition, Their Families, Carers and Advisors 
  2. Positive Behavior Supports for Adults with Disabilities in Employment, Community, and Residential Settings
  3. How to Write An Appeal Letter / Plan of Action 
  4. Social Security, Medicare and Government Pensions: Get the Most Out of Your Retirement and Medical Benefits
  5. Insider’s Guide to Government Benefits

References 

Citizensadvice.org.uk

Gov.uk

Turn2us.org.uk

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