Mandatory Reconsideration for ESA

In this blog post, titled “Mandatory Reconsideration for ESA” we will describe the steps someone should take when challenging a DWP decision.

I will give you advice on things like what to say in your application form, and what to do if you missed a deadline.

What is a mandatory reconsideration for ESA?

A mandatory reconsideration for ESA is a process by which the decision related to your benefit claim, is looked at again, usually by a different decision-maker from the Department for Work and Pension (DWP). 

You can ask for a mandatory reconsideration in the following scenarios: you have been informed that you are not entitled to ESA, you were put in the work-related activity group instead of the support group and you disagree, or you ESA payments have been stopped because you are getting a sanction.

How do I apply for a mandatory reconsideration for ESA?

If you want to apply for a mandatory reconsideration for ESA, it is best to do this in writing, so that you can prove that you have done this within the correct time period, and you have a record of what you say.  

You have a month from the date on your original decision letter to apply for a mandatory reconsideration.

You will not be given longer than a month unless specific circumstances, such as a bereavement, Otherwise, the DWP has a legal right to reject your request for reconsideration. 

We recommend you to use the CRMR1 request form when applying for a mandatory reconsideration for ESA.

What to say in your form 

In your form, you have to say why and how you disagree with the decision made by the DWP. 

Find and read carefully the DWP’s decision letter where you will find a written statement that explains what were the decision-maker’s reasons and thinking.

The statement of reasons is a very good place to start if you want to find more evidence.

You main goal should be  to give the DWP more information about those specific points where you disagree with them.

In any case, more medical evidence is highly relevant and can make a difference.

A letter from your own doctor, nurse, or healthcare assistant will help the DWP understand more about how your condition affects you. 

If you manage to get more evidence from your GP, nurse, social worker, occupational therapist or another healthcare professional,  make sure the new information gets to the DWP within the one-month deadline.

If you are sending it late, it might not be taken into consideration at your ESA mandatory reconsideration. 

I missed the deadline for a mandatory reconsideration for ESA. What can I do? 

In some cases, the DWP can accept your request for mandatory reconsideration even if you’ve missed the one-month deadline.

If this is the case, you can try and ask the DWP if they would revise your case.

However, it’s very important to specify why you are late.

What was your reason and why should they take it into consideration and extend the deadline? 

Usually, if the DWP agrees to extend the deadline, this can be done up to 13 months after the original decision.

The longer you wait, the less chances you have.

The DWP will accept a late reconsideration if it is reasonable and you couldn’t ask earlier because of special circumstances.

Will I continue to receive ESA during the mandatory reconsideration process?

You will not receive ESA during the mandatory reconsideration process if:

• You didn’t score enough points at your medical assessment 
• You didn’t go to your medical assessment
• You didn’t return the capability for work questionnaire (ESA50 form)

You will continue to receive ESA during the mandatory reconsideration process if:

• You’re challenging the DWP’s decision to put you in the work-related activity group

Other benefit payments

If you don’t get any ESA payments during the reconsideration, you might be able   to claim Jobseeker’s Allowance (JSA) or Income Support while waiting for a decision on your mandatory reconsideration if:

• You’re entitled to a severe disability premium (SDP) with any of your benefits or you were entitled to it in the last month, and
• You still meet the conditions of entitlement of the SDP

Claiming these benefits during a mandatory reconsideration shouldn’t affect your ESA reconsideration request. 

How will I receive my ESA mandatory reconsideration decision?

An ESA mandatory reconsideration decision will be posted to you as soon as the DWP makes the decision.

This letter is called a mandatory reconsideration notice and should include the decision-maker’s reasons for deciding to change the initial decision or not.

It should also state if you have the right to appeal this second decision or not. 

If the mandatory reconsideration notice states that you will be awarded ESA, your benefits payments will start from the date on the official letter.

If during the reassessment period you claimed another benefit, such as  Jobseeker’s Allowance or Income Support you will have to notify the DWP and proceed as they advise.

What do I do if I am not happy with the result of the ESA mandatory reconsideration?

If the DWP doesn’t change its decision, you can appeal the decision to an independent tribunal.

You will need to complete form SSCS1 and send it to the address given on the form accompanied by a copy of the Mandatory Reconsideration Notice.

Again, you will have a one-month deadline and you will have to request an appeal directly with Her Majesty’s Courts and Tribunals Service (HMCTS) instead of with the DWP. 

Will I continue to be paid ESA until the appeal is heard?

You can be paid ESA until the appeal is heard if:

• The Tribunal has told you it’s got your appeal
• This is the first time the DWP has decided that you’re fit for work, or the first time since the DWP decided that you have limited capability for work
• You give the Jobcentre fit notes from your doctor

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.

Then you can contact the DWP and ask them to pay you ESA instead.

You won’t need to start a new claim for ESA.

You can always stay on the other benefit if you decide to.

Conclusions

In this blog post, titled “Mandatory Reconsideration for ESA” we described the steps someone should take when challenging a DWP decision.

The important thing that one should remember is that the ESA payments might stop during the reconsideration process, but you can request other benefits such as Jobseekers allowance in the meantime. 

Also, if you are not happy with the DPW’s decision on your mandatory reconsideration, you can always appeal to an independent tribunal. 

Around 74% of appeals for an Employment and Support Allowance award are successful. 

Did we manage to answer all your questions?

Please feel free to comment on the content or ask any questions in the comments section below.

FAQ about ESA mandatory reconsideration

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. Providing Employment Support for People With Long-Term Mental Illness: Choices, Resources, and Practical Strategies
3. Positive Behavior Supports for Adults with Disabilities in Employment, Community, and Residential Settings
4. Investigation into errors in Employment and Support Allowance
5. Guide to Government Benefits: Social Security, Medicare, Medicaid, Unemployment Insurance, Disability

References

1. Recommendations for ESA – Benefits, and work
2. Challenging decisions – Welfare and Benefits
3. ESA – Citizens Advice