My Employment and Support Allowance diary ESA

Transcription

1 My Employment and Support Allowance diary ESA

2 When mandatory reconsideration came in we knew that claimants were going to find it difficult to keep track of their claim. We had the idea of designing something that advisers could give out to help clients through the process, prompting them to keep a note of what had been done and telling them what they should expect to happen. I worked with Amanda Leadbeater at Derby Citizens Advice and Law Centre to create a short diary to use in our bureaux. We are excited to see that Citizens Advice has extended the idea and made it available nationally. We hope you find it helpful. Eastre Leedham, South Derbyshire Citizens Advice Bureau April 2014 Produced by Citizens Advice the operating name of the National Association of Citizens Advice Bureaux. Registered charity number

3 Introduction 3 This diary is intended to help you to make a claim for Employment and Support Allowance (ESA) and help us identify which parts of the application process need to change. It contains a step by step overview of the process along with links to further information and support. You can fill in information at each stage to help us find out more about people s experiences of claiming ESA and note down important dates or events during your claim. If you need more space please use the notes pages at the back or continue on additional sheets of paper. We hope that this diary will help you keep on top of your claim as it progresses and check that the Department for Work and Pensions (DWP) and Atos are sticking to their agreed timescales. If you have a problem with your claim, this diary will also help you to complain and remember details of your contact with ESA staff. There are a number of pages at the end of this diary to make a record of any paperwork or information that goes missing or is lost by DWP during this process and a section where you can record people you have spoken to in case you need to follow up on your conversations. Once you have finished this diary, please return it to your local CAB or post it to us using our Freepost address (details on inside back cover) so that we can use your evidence in our national campaign.

4 4 Claimant process overview I receive a ESA50 form to complete. The assessor makes a recommendation on prognosis to DWP. Assessment phase of ESA. I receive my first payment. Someone calls me to arrange a WCA appointment at an Assessment Centre I ring Jobcentre Plus to claim ESA. They take information to complete my claim and explain what will happen next. I attend the Assessment Centre for a face-toface assessment. Face to face assessment not needed if recommendation can be made on paper evidence. I receive a letter telling me what will happen next, explaining the importance of completing the ESA50 questionnaire, providing any additional information and attending the WCA appointment The Decision Maker calls me to discuss their decision and the reasons for it. I am advised of my options and am able to provide further evidence or ask for a mandatory reconsideration if I feel the decision is incorrect. If I wish to claim JSA I am transferred to someone who takes my claim details. Following the call I receive a letter informing me I have not been allowed to claim ESA and the reasons for this decision.

5 5 The Jobcentre contacts me to arrange a Work Focussed Interview (WFI). I attend my WFI. I am supported by Jobcentre Plus. 12 I receive a call from the Decision Maker to tell me the outcome of my assessment and what will happen next. ALLOWED WRAG Evidence changes decision 16 I receive a letter informing me of my benefit award. 11 Claimants in the Support Group can volunteer for back to work support at any time. DISALLOWED CHANGED A DWP decision maker makes a decision on ESA entitlement SECOND OPINION 10 Support group I ask for a second opinion on my decision. My benefits stop. 17 UNCHANGED Someone contacts me with appeal hearing date. 18 I write a letter of appeal. I am referred to a Work Programme provider. I am referred to Work Choice. APPEALS 19 I receive a notification advising me of the new decision. I receive a notification advising me of appeal outcome and options.

6 6 Other sources of advice If you need assistance with your ESA claim we can help. Speak to someone at your local Citizens Advice Bureau. Go to Adviceguide to get more information: If you live in England call If you live in Wales call Additional information: DWP ESA overview: DWP guide to ESA (Jan 2013): DWP Customer Charter: National Association of Welfare Rights Advisers guide to filling in your ESA50 form: Disability Rights UK guide to mandatory reconsideration and appeal: Useful contacts Atos Work Capability Assessment line: DWP primary benefit enquiry line (landline calls): OR (for Welsh speakers) Textphone: (for English and Welsh speakers) DWP primary benefit enquiry line (mobile phone calls): OR (for Welsh speakers) Textphone: (for English and Welsh speakers)

7 About you 7 You don t have to provide any of this information, but it helps us to see how the ESA process affects different people in different ways. None of your personal information will be shared or used in a way that can identify you unless you specifically give us permission. Name: Sex: Male Female Age: Under Over 55 Town/city you live in/postcode: Up to now, have you: been receiving Incapacity Benefit been receiving ESA been in work been receiving Jobseeker s Allowance none of the above Are you receiving Disability Living Allowance or Personal Independence Payments? Yes no Do you have children? Yes no

8 8 The ESA journey begins You become too ill to work or are moved on to ESA from another benefit ADVICE: Employment and Support Allowance (ESA) is for people who can t work because of sickness or disability. ESA claimants are split into two groups: the support group, for people who are very ill or severely disabled. People in this group aren t expected to look for work. the work related activity group (WRAG), for people who might get back into work. People in this group are expected to take part in training or employment related activities. Briefly summarise the reasons why you are applying for ESA: What outcome are you looking for? I think I should be placed in the WRAG I think I should be placed in the support group Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally:

9 Start your claim 9 There are two main ways to claim ESA. You can either call Jobcentre Plus or start your claim online by filling in form ESA1. The ESA1 form asks for very basic information about: you the reasons you are making a claim your income your most recent employment. You call Jobcentre Plus on or go online to fill in the ESA1 form at When are you starting your claim? Date: / / If you filled in the form online you should save a copy for yourself. If you started the claim over the phone, what was the name of the person you spoke to? Advice: For more information on how to claim see Adviceguide On the date you first contact DWP or submit your ESA1 form you will become eligible to be paid ESA at the assessment rate. This is currently up to a week (or up to a week if you re aged under 25). The DWP says you should be assessed within the 13 weeks of the date you contact Jobcentre Plus or submit your ESA1 claim form although this doesn t always happen. You will usually receive an ESA50 form within a couple of weeks of starting your claim but there is no set limit to how long this might take. If you have not received a form after two weeks, you should contact the DWP to check it is on its way.

10 10 Provide further details You receive your claim pack, including the ESA50 form. The ESA50 is the application form for claiming ESA. What date did you receive your ESA50 on? / / Was the information provided with the form useful in helping you to fill in the claim form and providing the information you needed to claim ESA? Yes no You can get more information about filling in the ESA50 form on Adviceguide ACTION: Fill in the ESA50 form and return it to the address on the prepaid envelope within four weeks. Warning: If you don t return the form within four weeks without having a good reason for doing so, you will be declared fit for work and will have to make a new claim for ESA if you want to claim this benefit. It is a good idea to check the address where you need to send the form. You can record the address you sent your form to here: DWP say that you should send any medical reports you have, along with the questionnaire, to the address given on the ESA50 form. Most people who are not severely disabled will be called for a face-to-face assessment.

11 11 Did you send in any medical evidence? Yes no If yes, what did you send? Did you have to pay for this? Yes no If so, how much? Did you say which health or social care professional you would like the DWP to contact about your condition? Yes no If yes, who did you say you wanted to comment on your condition? How did you find the process of filling in the ESA50 form? Did you get help from anyone with filling out the form? If so, who?

12 12 What date did you send your ESA50 to the DWP on? / / If you sent it by recorded delivery or to the Jobcentre record details below What date did the DWP say they received your form? / / Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally:

13 Your Work Capability Assessment 13 Within 13 weeks, Atos should look at the information you have sent in and call or write to you to let you know if they think you need a face-to-face Work Capability Assessment (WCA). The WCA is a medical assessment carried out by a healthcare professional that will assess your ability to perform a range of particular activities. It looks at physical factors or mental health problems you may have that make you unfit for work. It may take longer than 13 weeks for Atos to contact you with a date for your WCA but you will continue to be paid ESA at the assessment rate during this time. What date did Atos contact you regarding your WCA? / / Did you receive a call or a letter? A phone call a letter What was the result? I have been found fit for work on the basis of my ESA50 (go to page 23) I have been found eligible for ESA as a result of my ESA50 (go to page 22) I have been invited to a face-to-face WCA (go to page 14) Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally:

14 14 Arranging your face-to-face Work Capability Assessment You get a phone call to arrange your face-to-face WCA or a letter telling you the date of the examination What date was your WCA scheduled for? / / Were you asked about reasonable adjustments for your face-toface assessment? (Reasonable adjustments are things that will make it easier for you to attend, such as wheelchair access or an interpreter if you will need help to understand the questions.) Yes no If yes, what reasonable adjustments have you asked for? Were you asked if you would prefer to have the assessment at home? Yes no Did you want to have your assessment at home? Yes no Will your assessment take place: At home at an assessment centre

15 15 Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: ADVICE: For more information on what to expect from your WCA see Adviceguide Showing you have limited capability for work To discuss or rearrange your appointment for a WCA with Atos call

16 16 Your face to face Work Capability Assessment You attend your face-to-face WCA. This should take place at a venue that you can access easily. It should take between 20 and 60 minutes. However, you are advised to set aside two hours just in case it takes longer. At the assessment, a healthcare professional will ask you questions and talk to you about your day-to-day life to find out how you spend your time and what you can and can t do. The questions are designed to find out if you are fit for work. You may be asked to perform certain actions with your limbs, neck and back to see if you have difficulty using them. For example, you may be asked to move your head to the left and right or forwards and backwards to see if you have full movement. You can take someone with you to the appointment and ask for it to be recorded if you want. What date did your WCA take place on? / / Was the venue you were asked to attend easy for you to travel to? Yes no How long did it take you to get there? Did the healthcare professional: make you feel welcome and at ease? introduce themselves and wear a name badge? describe the purpose and nature of the assessment? encourage you to bring a friend or relative to the assessment if they want to?

17 17 allow you enough time to talk about your health condition? carry out the assessment gently to avoid any unnecessary discomfort to you? answer any reasonable questions? Did you get any reasonable adjustments that you requested? Yes no How did you feel about the assessment overall? If you found the face to face assessment a negative experience, you can complain. You should get full details about how to complain about poor service when you attend the assessment. More details are also on page 32 of this guide.

18 18 Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: The healthcare professional will write a report giving an opinion on whether you meet the descriptors and circumstances that are used to decide if you are fit for work. Descriptors are a standard set of phrases used to describe how well you can move about, cope mentally and carry out the activities of daily living, such as washing and dressing. Each descriptor carries a point score. You have to get a certain number of points in order to get ESA. The DWP uses this report to make a decision on whether you are fit for work.

19 The decision 19 If the decision maker needs further information from you, you may get a phone call before the decision is made and sent to you. A DWP decision maker will then write to you with the decision on your claim. Your ESA assessment rate payments will stop at this point. You will either move onto the correct level of ESA or be told you are fit for work. If you are told you are fit for work your ESA will stop and you will be told about other benefits you can apply for. If you have been found unfit for work and it took more than 13 weeks from when the DWP received your ESA1 to reach this point, the increase in your benefit payment will be backdated to week 14 of your claim. What date did you get the decision letter on? / / Did you get a phone call before the letter was sent? Yes no Did the DWP refer to any additional evidence that they had found on your behalf? Yes no What was the decision? I was found fit for work (go to page 23) I was found eligible for ESA and placed in the WRAG (go to page 20) I was found eligible for ESA and placed in the support group (go to page 22)

20 20 The work related activity group If you are placed in the WRAG you will be entitled to up to per week in ESA. Do you think this was the correct decision? Yes no If you think the decision is wrong and you should be in the support group you can dispute the decision. The letter telling you the decision will tell you how to ask for a mandatory reconsideration. Another decision maker will look at the decision and see if it can be changed. You must ask for a mandatory reconsideration within one month of the date on the decision letter. Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: Do you plan to dispute the decision? Yes (go to page 24) No (go to page 21) ADVICE: For more information on challenging the decision, see the Adviceguide page on Appealing against an Employment and Support Allowance decision

21 The work-focused interview 21 If you are placed in the work related activity group, the Jobcentre Plus will contact you to arrange a work focused interview. What date did the Jobcentre contact you on? / / What date is your work focused interview? / / You attend your work focused interview How was your work focused interview? What was the outcome of your work-focused interview? Referred to Jobcentre Plus Referred to work choice Referred to the work programme Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: ACTION: If this is the end of the process for you, please return this diary (or a copy of it) to your local CAB or post it to our freepost address (contained on the back inside cover of this booklet)

22 22 The support group If you are placed in the support group, you will receive up to a week. You won t have to attend any work focused interviews and won t be asked to take part in work-related activity. In the future you may be asked to go for another examination and may be moved into the work related activity group. Do you think this was the correct decision? Yes no Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: ACTION: If this is the end of the process for you, please return this diary (or a copy of it) to your local CAB or post it to our freepost address (contained on the back inside cover of this booklet)

23 If you are found fit for work 23 If you are found fit for work, you will get a letter telling you that you are not eligible for ESA. The letter should tell you the reasons why this decision has been made and how to dispute it if you don t agree with it. What date did you receive this letter on? / / Do you think this was the correct decision? Yes no If you think the decision is wrong and you should get ESA you can dispute the decision. The letter telling you the decision will tell you that you can ask for a mandatory reconsideration and how to do this. This means it will be looked at again by another decision maker to see if it should be changed. You must ask for a mandatory reconsideration within one month of the date on the decision letter. ADVICE: For more information on challenging the decision, see the Adviceguide pages Appealing against an Employment and Support Allowance decision Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: Do you plan to dispute the decision? Yes (go to page 24) No (go to page 21)

24 24 Challenging a decision If you are unhappy with the outcome of your claim you can ask for an explanation of the decision and a mandatory reconsideration of your decision by phone or in writing using the contact details provided in your decision letter. You will receive an acknowledgement that your request for a reconsideration has been received. The decision maker may contact you for further information. You can submit further evidence at this point if you think it will help your claim. When did you request the mandatory reconsideration? Date: / / While your claim is being reconsidered, which of the following positions are you in? Found fit for work all ESA withdrawn Found eligible for WRAG receiving lower rate ESA What information or advice were you given about what to do during your mandatory reconsideration? Do you have any other source of income? Yes no

25 25 While your claim is being reconsidered, which of the following do you plan to do? Contact a health professional about your illness or disability to get help or treatment Contact a health professional to get medical evidence to support your ESA claim Apply for Jobseeker s Allowance (JSA) Update your Universal Credit claim Visit a Citizens Advice Bureau Visit a foodbank Borrow money from friends or family Take out a loan Other: IF you decided to claim Jobseeker s Allowance: What date did you submit a claim? / / What date did you receive a decision? / / Were you awarded JSA? Yes no How did the interview go? What did the adviser say to you about your claim?

26 26 Were you offered the chance to decide what work you could apply for or to change your claimant commitment to reflect your ability to look for a job? Yes no If you agreed to apply for a certain number of jobs or spend a certain amount of time looking for work, please tell us below: Number of jobs to apply for each week: Number of hours to spend looking for work each week: How many jobs did you apply for while your claim was being reconsidered? How many hours do you think you spent looking for a job each week? Did you submit additional medical evidence? Yes If yes, what? no Did you have to pay for this? Yes no If so, how much?

27 27 What impact has losing your ESA payments had on you over the past two weeks? Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally:

28 28 Mandatory reconsideration decision After another decision maker has looked at your claim, you will receive a Mandatory reconsideration notice (MRN) with the new or confirmed decision. This will include details of how to appeal if you don t agree with the decision. You can only appeal against the decision when you have received an MRN. What date did you receive the outcome of your mandatory reconsideration? / / Did the mandatory reconsideration find you: fit for work eligible for the WRAG eligible for the support group Do you think this was the correct decision? Yes No Do you plan to appeal against this decision? Yes (go to page 29) no Compared to how you normally feel, are you feeling physically: Compared to how you normally feel, are you feeling emotionally: ACTION: If this is the end of the process for you, please return this diary (or a copy of it) to your local CAB or post it to our freepost address (contained on the back inside cover of this booklet)

29 Appealing against the decision 29 If you would like to appeal, you can download the appeal form SSCS1 at If you can t download a form you can get one from your local Citizens Advice Bureau or other advice agency. Send your appeal to Her Majesty s Courts and Tribunal Service (HMCTS) along with a copy of your Mandatory reconsideration notice. What date did you post the appeal form? / / HMCTS will contact you usually within 28 days to find out whether you want an oral or paper hearing. ADVICE: If you ask for an oral hearing you will attend the tribunal and tell them how your condition affects you. If you ask for a paper hearing, the tribunal will meet and make a decision based on the evidence you have submitted without you being there. If you can, it is better to attend an oral hearing so that you have the chance to explain your situation to the judge. You can get advice about how to prepare for your hearing from your local Citizens Advice Bureau or another advice agency. What date did HMCTS contact you on? / / Did you request an oral or a paper hearing? Oral paper Why did you make this choice? What date was your hearing set for? / /

30 30 Did you submit additional medical evidence? Yes no If yes, what? Did you have to pay for this? Yes no If so, how much? How was the hearing?

31 The final decision 31 You will receive a copy of the appeal response from DWP by post. This should be sent within 28 days of the date HM Courts and Tribunals Service tell DWP that you have appealed. What date did DWP provide your appeal response on? / / What was the result of your appeal? I was found fit for work I was found eligible for the support group I was found eligible for the WRAG How do you feel about this decision? Compared to how you normally feel, are you feeling physically Compared to how you normally feel, are you feeling emotionally What do you plan to do now? ACTION: If this is the end of the process for you, please return this diary (or a copy of it) to your local CAB or post it to our freepost address (contained on the back inside cover of this booklet)

32 32 Additional Complaints process If you feel that any part of the process of claiming ESA was badly managed or discriminatory, you can complain. If you are unhappy with the outcome of your ESA decision you will need to submit an appeal, not a complaint. Making a complaint will not jeopardise an on-going claim there is no link between the complaints procedure and the decision making process. You can get support to complain from your local CAB. How to complain: Contact the Jobcentre Plus office you have been dealing with if you are unhappy with the service you have received - their details will be at the top of any letters they have sent you. You will need to explain what has happened, how this has affected them and what they want to happen to put things right. Jobcentre Plus will try to resolve the issue over the phone or deal with the complaint within 15 working days. If the complaint is not resolved, you will be asked if you want your complaint sent to the Director General of Operations for the Department for Work and Pensions. They aim to deal with complaints within 15 working days. If you are still unhappy, you can then ask the Independent Case Examiner ( to investigate - they ll be impartial and this is free. If you are unhappy with the response from the Independent Case Examiner, you can ask your MP to send the complaint to the Parliamentary and Health Service Ombudsman (

33 33 If you are unhappy about your Work Capability Assessment you can also complain to the WCA provider which is Atos until the end of It is usually most effective to complain in writing. Phone: Post: A leaflet is available from Atos which includes a complaint form, or you could send a letter of complaint to: Customer Relations Manager Atos Healthcare Block 1 Wing G Government Buildings Otley Road Lawnswood Leeds LS16 5PU Details on how to complain should also be included in all letters and phone calls you receive from the DWP, Atos or Jobcentre Plus.

34 34 Additional Loss of paperwork If the DWP didn t receive your form or it got lost, please answer the following questions. There are a number of these pages to allow you to record the loss of any paperwork during the claim or appeal process. Which form? What date did you send it? What date did you find out it was lost? What reason did they give for the loss? What have you been advised to do next? What was the impact of this delay on you? Have you complained/do you plan to complain?

35 Additional Loss of paperwork 35 If the DWP didn t receive your form or it got lost, please answer the following questions. There are a number of these pages to allow you to record the loss of any paperwork during the claim or appeal process. Which form? What date did you send it? What date did you find out it was lost? What reason did they give for the loss? What have you been advised to do next? What was the impact of this delay on you? Have you complained/do you plan to complain?

36 36 Additional Calls record You can use these pages to keep a record of any conversations you have with the DWP, the Jobcentre or other professionals about your claim. You can make additional copies if needed. Name of person Organisation Date They called me I called them Time Subject of conversation What did they say they would do? Name of person Organisation Date They called me I called them Time Subject of conversation What did they say they would do?

37 37 Name of person Organisation Date They called me I called them Time Subject of conversation What did they say they would do? Name of person Organisation Date They called me I called them Time Subject of conversation What did they say they would do?

38 38 Name of person Organisation Date They called me I called them Time Subject of conversation What did they say they would do? Name of person Organisation Date They called me I called them Time Subject of conversation What did they say they would do?

39 Thanks you for filling in this diary for your ESA claim. We hope you found it helpful. Please return it to us at the Freepost address below so that we can ensure your experiences inform our campaign. None of your identifying details will be made available publicly. Campaigns team Citizens Advice Freepost Nat 9971 London N1 9BR

40 The Fit for work campaign If you become sick or disabled and lose your job you want to know that you will be supported. But we believe poorly designed rules make it difficult to determine who is fit for work and who isn t. This diary is part of our Fit for work campaign which is calling on the Government to improve ESA. Find out more at