Benefits Information - ESA

Anyone who is in the Work Related Activity Group (WRAG) and has been on contribution-based ESA for 365 days anytime from 30th April onwards will have an opportunity for transfer to means-tested ESA (if they are eligible), otherwise their benefit stops. Yet another rubbish outcome from the Welfare Reform Act.

If you are in the Support Group (SG) no such time limit applies.

If your condition has got significantly worse since you made your claim, it is possible to ask for them to consider a change of circumstances and see if you can be assessed to go into the Support Group now (which requires higher levels of functional disability). You will need supporting medical evidence.

To check whether you could score enough points to go into the SG, look at direct.gov.uk/prod_consum_d...

Points for WRAG are on pages 17-23, and points for SG are pages 24-26. You can only count any mental health descriptors if you have been diagnosed with a MH condition such as depression and are being treated for it.

You do need to understand that they are quite tough about where they score you, so they won't apply if you just occasionally have a problem - but they are supposed to score what you can achieve reliably, repeatedly, safely and in a timely fashion - if you can't do something 51% of the time, it should apply. Lupus fatigue is hard to pin down, but it often means you can score because you either might not be able to do something in the first place, or it would cause such a serious after-effect that you couldn't repeat it or do anything else for the entire day.

An alternative method is to show you come under the Exceptional Circumstances Rule (ESA Regulation 35), which means you should get medical evidence to support a statement that there would be a substantial risk to your physical or mental health if you were found to be fit for WRAG.

Actually you need to ensure you can get supportive medical evidence right from the start - it is very helpful as long as it is specific, and not just a general confirmation that you have Lupus.

Once the DWP has decided which group you belong in, you have a calendar month from the date of their decision letter in which to appeal. You need to say why their decision is wrong, and provide evidence that shows what the correct decision should be and why.

If you got your decision much longer ago, you can still appeal up to 13 months later as long as you can show reasonable cause for the delay - but this has to be an exceptional reason such as death or serious illness, not just because you didn't know you could appeal. You will only be allowed to go ahead with a late appeal if they think you have a reasonable chance of success.

I would suggest getting helping from an advice agency to appeal.

2 Replies

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  • Many thanks for this information.

  • Good article and I have copied it to help me when I go to my back to work interview.it really is a joke, I filled out my questionnaire and waited for my medical interview which I thought I would get. No I got a letter saying the decision was to put me on the back to work programme, so I wrote and objected asking again if I could have an interview I felt surely if someone met me in person they would understand I am not fit to go back to work. I have synced phone them several times and have been told I have to attend the interview and who ever interviews you will make the decision. There seems to be two groups the support group which to qualify I think you must be near to death or totally paralysed noting In between. To top it off I have just finally been contacted to explain why I am in the group I am, I am not seen to be ill enough they appreciate I have serious health issues but in some time maybe in the future I may be able to work. What planet are they on. I have had this illness for 30 yrs and I have only got worse. SLE, fibromyalgia, SS and three TIA, so far I can't work far because I get out of breath. Where is the quality of life. At the end of the telephone interview I was then told that my particular claim I am only entitled to one year then I have to reclaim and that will be based on the household income. I live with my partner we are not married. What is upsetting me is I will I believe loose my disability badge. That is my life line if I go out. I feel so upset I have barely been out of the house for ten weeks due to repeated infections and a TIA. I feel sorry for anyone just making there first claim. Sorry have gone on and ranted but had to get it off my chest. Will try and calm down. X

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