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Brief answers to some of the most common questions that our Infoline receives about benefits.
Your benefits may be changing because the benefit you are currently getting is being phased out or because of a change in your personal circumstances.
It’s best to get advice about your circumstances from a benefits specialist. You only have one calendar month from the date of a decision to ask for it to be looked at again.
Most people have no choice but to move from incapacity benefit onto ESA but not everyone gets the same type or rate of ESA and you may want to challenge a decision on this (see below). If you are due to retire by 2014 you should be allowed to remain on your existing benefit.
From 1st April 2013 legal aid is no longer available for advice on how to challenge benefits decisions, but there is legal aid for advice for people who risk losing their home because of debt. Also legal aid funding can sometimes be made available for exceptional cases. For example, where the law is particularly complicated and a person has disabilities that make it hard for them to manage without advice and representation, and the consequence of not having advice are particularly serious. You will need help from an adviser to access exceptional funding.
Personal Independence Payment (PIP) is the replacement for DLA. It is available to adults whose disability has a long term effect on their life, whether they are in work or not.
To receive PIP you are likely to have to have a face-to-face meeting with a healthcare professional to assess your level of need. They will determine whether you are eligible for payments to support your daily living or mobility needs, or both. (See ‘Personal Independence Payment’ in the terminology section for details).
If you are assessed as ineligible for PIP, you may want to appeal against the assessment. You have the right to ask the DWP to look at their decision again (reconsider) and if you still do not agree with their decision to appeal to an independent tribunal.
As with ESA (see below) you have a limited time to appeal. If you miss the deadline for asking for a revision or an appeal, act quickly and get advice. If you have been unwell or have a mental health condition that made it difficult for you to act in time this can be a good reason for not meeting a deadline.
See www.gov.uk/pip/appeals for details on how to appeal.
If you need help filling in a form, it’s best to do this face to face, preferably with someone who knows you and your condition. You can contact your local Citizens Advice or your local Disability Information and Advice Line (DIAL) or your Local Mind, who should be able to provide you with, or direct you to, more specialist benefits advice.
It is always good to send in supporting medical evidence at any stage, whether or not you are asked for it but make sure you keep a copy of any information you send in.
Most people claiming ESA are asked to attend a Work Capability Assessment (WCA) and your claim should not be turned down without being offered one. Assessments are carried out by Atos Healthcare. An assessment doesn't mean the information provided on your claim form is being treated as suspicious or that your claim will be turned down.
While you are waiting for a decision about your claim for ESA, it is important to keep your medical certificates (confirming that you are unfit for work) up to date and ensure that if one runs out a new one is provided.
If you're unfit to travel or you live more than a 90 minute journey from the nearest centre, the assessment can be done at home.
If you do not go to the assessment and cannot show “good cause”, you will be treated as not having limited capability for work so you won’t get ESA. If you cannot go to the assessment for health reasons, it is important to explain this and arrange for your GP or other medical professional or counsellor to confirm this to the DWP.
If it would help, you can take someone to the assessment to support you.
For more advice about attending the Work Capability Assessment, read our fact sheet on medical assessments.
If you don’t agree with a decision about your claim, you have the right to ask the DWP to look at it again to see if it can be changed (revision). You also have the right to appeal to an independent tribunal. The written decision should explain your rights. It’s best to get specialist help but you only have one calendar month from the date of the decision and it is important to act within this.
For more information about this process read our fact sheet. You may also wish to contact a Citizens Advice Bureau, or local advice centre
If you miss the deadline for asking for a revision or an appeal, act quickly and get advice. If you have been unwell or have a mental health condition that made it difficult for you to act in time this can be a good reason for not meeting a deadline.
If you disagree with the decision on your claim, you need to ask for it to be looked at again or to appeal, and it is important to get advice about this. There are strict time limits.
If you are not happy with the way the assessment was carried out and want to complain about the conduct of the Atos Healthcare staff, you can write or email:
Atos Healthcare Customer Relations
Wing G, Government Buildings
Leeds LS16 5PU;
email: [email protected].
To complain about DWP staff, you should start by contacting the office manager of the Job Centre Plus and if this doesn’t resolve matters follow the DWP’s complaints procedure.
If you think the process was more difficult for you because of your mental health condition or that Atos or DWP have discriminated against you because of your disability, you can make a complaint (see above) or seek more detailed legal advice. Both Atos and the DWP must comply with the Equality Act 2010. If you would like to read more about the Equality Act, please see Mind’s briefing on the Equality Act.
Using the complaints procedure or taking action about disability discrimination will not change a benefit decision and you must use the reconsideration and/or appeal procedure to do this.
If you tell the DWP that you want to appeal against a decision that you do not have limited capability for work, you will be entitled to the basic rate of ESA until the Tribunals Service tells Jobcentre Plus of the outcome of the appeal.
If you ask the DWP to look again at a decision to put you in the Work-Related Activity Group rather than the Support Group, you will receive ESA at the Work-Related Activity Group rate pending the outcome of the reconsideration and any appeal. For further advice see the DWP Employment and Support Allowance Claimant Journey Guide.
If you are appealing against a decision that you failed to attend an assessment without “good cause”, you will not get ESA in the meantime.
If your benefit has been stopped it is important to contact Jobcentre Plus to find out why this has happened and to get specific advice about what steps you need to take from a specialist local advice centre or Citizens Advice. Sometimes councils also run welfare benefits advice services.
If you have children and cannot resolve your benefit difficulties and need a payment to tide you over, you can approach your local authority’s children’s services for help. Adult social services also have powers to provide subsistence payments to disabled people who have no other means of support.
If social services refuse to help, seek advice from a community care legal adviser. You could use the Gov.UK Civil Legal Advice (CLA) to get further help with community care problems.
The new total benefits cap limits income from benefits and tax credits. It has been introduced in 4 London boroughs in April 2013 and will be extended to other areas.
It sets a limit on the total amount of money you can get if you’re of working age. It is aimed at ensuring that workless families (couples and people with children) cannot claim more than £500 per week and single people without children £300 per week.
There are a range of exceptions based on disability benefits and when someone last worked. The online benefits cap calculator at www.gov.uk/benefit-cap can tell you how it might affect you but it is always advisable to get specialist benefit advice about your circumstances.
See our Useful Contacts page for other organisations who may be able to help.
This information was published in November 2016.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.