Employment & Support Allowance - Claims and Appeals - The View of a Professional - By: Daren Cari

The actual value of the medical assessments undertaken on behalf of the Department of Work and Pensions (DWP) to determine entitlement to Employment & Support Allowance (ESA) still leaves much to be desired, depending on the cases that I see.

To become entitled for ESA the applicant should pass 15 points threshold. Those that have been denied generally obtain assistance to appeal their specific case yet still fail. Nevertheless, it's very seldom as much as my personal experience is concerned not to ever locate the necessary 15 points anytime I assist my clients in going through the test.

Although the verdict still depends with the tribunal there are a few aspects which actually can be considered in enhancing the probabilities of approval. First of all, I deem that it's not advantageous to pull out each possible point instead I recommend my client to be honest and be credible when acquiring the test. Additionally, it's of great essence that I believe in the actual credibility of my client. If on my part I already find maybe a trace of uncertainty, what more with the tribunal? It will help if appropriate medical proof could be presented but obtaining them will demand a combination of luck as well as skill. Even more, it is worth studying the ESA50 enquiry form and the "health care professional" (HCP) report with the client. Review precisely what the client stated in his application with the HCP and what the remarks of the latter were. Finding factual discrepancies and improving it can be helpful in persuading the tribunal that they should reconsider the application.

On the other hand, I find that majority of the clients who have scored nil points can easily pass the separate test to generally be placed in the "support group". Whenever it gets accepted, the client will be spared of "work-focused interviews" and also other demands to do "work-related activity" thus preventing financial sanction. Actually staying in the support group marks a financial advantage as compared with "work related activity group" as the latter will merely have 12 months entitlement effective April 2012. Immediately after, they can acquire means-tested benefits for instance income related ESA, housing benefit or council tax benefit which unfortunately they might be unable to qualify either in case their spouse or they have some other sources of income for instance pension or any other earnings.

My personal priority in many of the appeals is to successfully shift the case into a support group and it is rather gratifying should the decision maker will recognize the medical evidence presented by my client without the need for tribunal hearing.

At any rate, an element of success can also be viewed if the case is advised to be place in front of the tribunal whereby it will be heard by two panels made up of a judge and a doctor. As the tribunal is also human, both may have a distinctive tactic to the evidence presented to them. Some members may be more even-handed than others and so the possibility of a favourable outcome improves. On the other hand, a few may perhaps struggle with "giving benefit of the doubt" and this can consequently alter the result of the case.

In view that I usually attend hearings, I have noticed that some representatives choose to just make a submission before the tribunal. This might help since it is possible to bother the tribunal immediately when the representative talks a lot. But based on my experience, I choose not to send submission. Judges usually ask question not presented to them in writing and therefore answers to which have to be as certain as well as precise in order to persuade them completely. I don't consider "trying it on" and therefore suggest claims. Alternatively, I go after appeals which I consider have worth.

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