I won the ESA tribunal, what happens next?

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This blog post will explore what happens once you have won the ESA tribunal hearing and appeal. 

We will also explore what is ESA, the criteria of eligibility and the process of applying for an ESA award.

I won the ESA tribunal, what happens next?

Once your appeal for Employment and Support Allowance has been revised by the Tribunal and you have won, based on the decision made and the evide, you will be assigned to two groups:

  • A work-related activity group: This is to prepare employees who with some support are able to return to work. If you are in the work-related activity group, your contributory ESA will stop after one year. 
  • A support group: This group is for people who are unable to return to work due to their illness of disability.

And the group you are in will influence the amount you are awarded. You will get a letter telling you if you’ll get ‘new style’ ESA and how much.

Once you start getting your ESA, you will have to give updates about your health and circumstances. 

Awards

After the tribunal, you will be paid your award along with any expenses that cost you during the period of the hearing, the amount that is owed due to the period of appeal dated since your claim, and the amount you are to be awarded every four weeks. 

The awards that you might receive include:

  • Income related Employment and Support Allowance which depends on issue such as your age, living condition, your role as a care giver, your income and that of your partners, your saving as well as that of your partners, mortgage, and whether you have had your Work Capability Assessment, and whether you are in the work-related activity group or the support group when your claim process started. This allowance is not taxed.
  • Contributory Employment and Support Allowance which depends on your age, whether you have had your Work Capability Assessment yet and whether you are in the work-related activity group or the support group when your claim started.This allowance is taxed. 
  • Before the Work Capability Assessment, you get your personal allowance based on your age which is usually the following rates:
  • Under 25: £59.20 per week
  • 25 and over: £74.70 per week
  • After the Work Capability Assessment, the amount you get depends on which group you are in and the date as to when your claim process started.
  • If you are in the work-related activity group and your claim started before 3 April 2017 you will receive £104.40 per week, You also qualify for a £10 Christmas Bonus every year. 
  • If you are in the Work-related activity group and your claim started on or after 3 April 2017 you will receive £74.70 per week. You also qualify for a £10 Christmas Bonus every year. 
  • If you are in the Support group, irrespective of when your claim started, you will be awarded £114.10 per week
  • The amount you get may be influenced by your pension payments, councillors allowance, or another benefit payment that you have been reviewing.

Employment and Support Allowance (ESA) and awards will be paid directly into your bank or building society account or through the Payment Exception Service and it will be paid every two weeks, usually. 

Groups

In the ESA support group, people with disabling conditions that cause disability where they are in no condition to work are present. 

In this ESA support group there will be no interviews or activities as it will be unreasonable to require people in this ESA support group to work whilst they claim ESA.

People in this ESA support group will have periodic medical assessment reviews which are usually every three years at a maximum. This is done to see if their condition has improved and they can now resume work. 

Depending on the outcome of your medical assessment you could then be removed from the  ESA support group which required you to not attend any interviews or meetings and be placed in the work-related  ESA support group.

If you have been put in the work-related ESA support group after your assessment finds that you are capable of working, you will have to engage in a work-related activity.

The DWP will usually let you know if there are any suitable work-related activities within the region you are in which you can join.

What is an ESA?

Employment and Support Allowance (ESA) is a benefit award or monetary support for people who have limited capability to work because of medical conditions and for those who do not get Statutory Sick Pay.

There are two types of allowance under the ESA:

  • income-related Employment and Support Allowance that is being replaced by Universal Credit. It is not taxable.
  • Contributory/New Style Employment and Support Allowance. It is taxable.

The ESA scheme applied for citizens of  England, Northern Ireland, Scotland and Wales and for people who are over 16 and under the state pension age.

Once you have filed for a claim of Employment and SUpport Allowance at the Department of Work and Pensions, UK, the process of assessments for your eligibility begins. 

The ESA assessments also known as the Work Capability Assessment, done by the ESA department of DWP, UK, involves two steps: 

  • A questionnaire for you to complete
  • A medical assessment for you to attend

What are the Eligibility criteria to win the ESA award?

The eligibility criteria for availing ESA includes the following. These criteria have been referred from the Employment and Support Allowance (ESA) Gov.UK website.

You can apply for ‘new style’ Employment and Support Allowance (ESA) if you’re under State Pension age and you have a disability or health condition that affects how much you can work.

You also need to have both:

  • worked as an employee or have been self-employed
  • paid enough National Insurance contributions, usually in the last 2 to 3 years – National Insurance credits also count

You are eligible if you get Income related ESA or  Universal Credit, you could get ‘new style’ ESA at the same time however, you get both benefits, your Universal Credit payment is reduced by the amount you get for ‘new style’ ESA.

  • If your Statutory Sick Pay (SSP) is due to end in 3 months. 
  • If you’re working or in and out of employment.

Note that You cannot get ‘new style’ ESA or is not eligible if you:

  • claim Jobseeker’s Allowance
  • claim Statutory Sick Pay

What is the process of the ESA assessment?

The process of the ESA assessment is as follows:

Limited Capability for Work (LCW) questionnaire

Once you have filed for a claim of Employment and Support Allowance, you are sent a Limited Capability for Work (LCW) questionnaire (ESA50) to complete and return.

If you have filed for a claim of Universal Credit and submit sick notes from a medical professional, you will be sent a UC50 to fill out which will take around 3 months after you have filed and handed in your medical notes. 

These questionnaires are sent through work coaches and if you have not received the form after three months, you should ask your work coach to send you one.

The form explores your medical condition and also the effects that any physical disabilities or any mental health problems and intellectual difficulties have on certain activities. You can also supply extra information from yourGP, consultant or other professional. 

If you do not complete this form the DWP will automatically refuse or stop your ESA unless you show ‘good cause’ for failing to return it. 

Medical assessment

Next, once you have returned the completed questionnaire you will be asked to attend a medical assessment either in person or you might be assessed over the phone or on a video call if mobility is an issue. 

This medical assessment looks at your responses given on the questionnaire and the verbal and physical evidence that you provide via the assessment. 

If you don’t attend the assessment, it is likely the Department for Work and Pensions (DWP) will decide that you are fit for work. If you cannot attend an assessment, it is important to contact the assessment centre and rearrange the appointment.

Following this assessment, the healthcare professional will send their report to the DWP for a decision to be made about your claim and whether you are eligible to avail ESA. 

Decision making

Now, Your completed ESA50, the medical assessment report and any other evidence you have provided will be taken into consideration and reviewed by a decision maker at the DWP. 

During this process the decision maker will determine whether you are sick enough to avail ESA and what group you fall into. 

If your ‘limited capability for work’ test determines that you are eligible, your decision maker will determine whether you have ‘limited capability for work related activity’ or not.

This particular process should take 4-6 weeks since you filed your claim if there is no change in process and no issues that hinder the process. 

If you haven’t heard anything after 8 weeks from the date of your assessment, contact the DWP to ask them what’s happening. You can ask them by:

  • writing to the address on any ESA letters you’ve received
  • calling Jobcentre Plus at Telephone: 0800 169 0310 or Textphone: 0800 169 0314

Conclusion

This blog post has explored what happens once you have won the ESA tribunal hearing and appeal. 

We have also explored what is ESA, the criteria of eligibility and the process of applying for an ESA award.

FAQ related to I won the ESA tribunal, what happens next?

What happens if you win your ESA appeal?

If you win the appeal you’ll get the payments of your original ESA claim backdated to the original date of your claim or the date when your original ESA stopped. 

Do you get extra money if you have limited capability for work?

Yes. You’ll get extra money if you have limited capability for work and you need not have to look for work to get awarded. 

How long does a tribunal hearing take?

The PIP tribunal hearing usually lasts around 30 to 40 minutes and the decision making might take a few mins as well unless the judge notifies you that you will be informed of the decision in a few days. 

What happens if DWP fails to respond to the tribunal?

It is possible for the DWP to fail to respond to the tribunal when an appeal has been made. When this happens the tribunal can move forward with the appeal and the hearing without considering the input or the presence of a DWP member and pass on their decision after the hearing. 

Can the DWP overturn a tribunal decision?

The DWP cannot overturn the decision made by the first tier tribunal. 

They can only appeal or overturn a decision if only there is evidence related to an Error of Law in the decision making process. 

Even in this case, this appeal by the DWP will be revised by the Upper Tier tribunal and if they do not agree with the appeal of the DWP, their appeal will be rejected, 

References

Employment and Support Allowance (ESA) – What is Employment and Support Allowance (ESA)?. Turn2Us. Retrieved on 10th january 2022. https://www.turn2us.org.uk/Benefit-guides/Employment-and-Support-Allowance/What-is-Employment-and-Support-Allowance

How much Employment and Support Allowance (ESA) will I get?. Turn2Us. Retrieved on 10th january 2022. https://www.turn2us.org.uk/Benefit-guides/Employment-and-Support-Allowance/How-much-Employment-and-Support-Allowance-will-I-g#guide-content

Employment and Support Allowance (ESA). Gov.UK. Retrieved on 10th january 2022. https://www.gov.uk/employment-support-allowance/print

What is an ESA assessment? Healthassured. Retrieved on 10th january 2022. 

https://www.healthassured.org/blog/employment-and-support-allowance-esa-assessment/

ESA Support Group: Eligibility and rates.homecare uk. Retrieved on 10th january 2022. 2021.https://www.homecare.co.uk/advice/esa-support-group-eligibility-and-rates

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