Do you not agree with the outcome of your work capability assessment?
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If requesting a mandatory reconsideration for a work capability assessment outcome ‘do not’ agree for this to be actioned over the phone, always complete this in writing so that you can provide evidence to challenge the original decision maker’s decision. |
From experience often the reason claimants are found to ‘not to have limited capability for work’ is because they have focused too much on their conditions, rather than highlight the impact of their symptoms. They also fail to understand the work capability assessment process and the descriptors that are used by both the assessor to make their recommendation and the decision maker to support the awarding outcome. Sometimes not having substantial medical evidence to support their claim to either demonstrate diagnoses or that they are going through investigative stages is another factor. We always advocate honesty too and if you feel with your conditions and symptoms you should have been awarded LCW and LCWRA. Then the guidance below will provide you with information to challenge this.
You have up to 13 months to request a mandatory reconsideration, as long as you can provide ‘good reason’ for this being submitted later than the standard one month.
I have been deemed as I do ‘not have limited capability for work’, I do not agree with this decision, where do I begin?
The first action you need to take, is to contact universal credit on 0800 328 5644 and request a copy of the assessor’s report. You need to state that you will be requesting a mandatory reconsideration and will be completing this in writing.
It usually takes approximately two weeks to receive a copy of the assessor’s report. If you haven’t received within two weeks, give the UC helpline a call back to see what is causing the delay.
Have a read through the work capability assessment link on our website whilst waiting for the report, to be sent to see if you can identify where your claim may have been unsuccessful.
This is also the ideal time to gather any further medical evidence to support your claim.
I’ve been awarded LCW, but disagree and feel I should have been awarded LCWRA, what should I do?
Firstly look at the LCWRA descriptors to see if you feel you would meet the guidelines for any one of these.
If so then follow the steps as above and below, to complete a mandatory reconsideration.
You need to be mindful that your whole assessment will be reviewed again by a second decision maker and therefore, do risk losing your current LCW award.
I’ve received the assessor’s report and I disagree with several comments and have identified several errors how do I challenge this?
Firstly prepare yourself with a pen, paper, a highlighter and set yourself some time aside to do this, away from any distractions.
Go through the assessor’s report and highlight any points you disagree with. Then on a separate piece of paper begin drafting down why you disagree with each point you have highlighted and then provide the correct information.
The key point here, is that you need to explain how your symptoms impact your daily activities before during and after. Then link these into both the LCW and LCWRA descriptors.
LCW Descriptors.
https://www.legislation.gov.uk/uksi/2013/376/schedule/6/made
LCWRA Descriptors.
https://www.legislation.gov.uk/uksi/2013/376/schedule/7/made
To be awarded LCW you would need to score 15 points overall.
To be awarded LCWRA you would need to meet LCW, plus any one of the LCWRA descriptors.
You can then either create a typed or hand written letter, both methods are perfectly acceptable.
A friend or relative or local advice agency can write the mandatory reconsideration letter on your behalf, acting as your representative.
When creating your final letter here are some key points to remember.
These are all important points you need to consider, as any contradictions will simply leave the assessor with no option, but to deem that you do ‘not have limited capability for work’, unless you can demonstrate otherwise and also show that you meet the descriptors too.
I’ve completed my mandatory reconsideration, where do I send this?
Always send your mandatory reconsideration 1st class signed for delivery, so that you can track this and ensure this has been received. Then if any issues do arise, you have evidence to prove that this has been received.
The postal address is:
Canterbury Benefit Centre
Mail Handling Site A
Wolverhampton
WV98 2EA
Once I have sent the mandatory reconsideration, what happens next?
When your mandatory reconsideration has been received, this will be reviewed by a second decision maker.
The decision maker will look at your UC50 form, any new and existing medical evidence, the assessor’s report and your mandatory reconsideration letter.
The first guidelines the decision maker will follow is to see if you meet the eligibility requirements for LCW or LCWRA. If they still determine you do not have limited capability for work they will then consider would you then qualify for LCW or LCWRA using the substantial risk guidelines. To qualify for this the decision maker would need to determine that if you were not awarded LCW or LCWRA you would be at substantial risk to yourself or others. This isn’t just looking at the safety or yourself and others within the workplace, but also includes getting to and from work.
Once the decision maker has reviewed your claim and decided if to uphold the original decision, or change this to LCW or LCWRA, you will receive the outcome of this through your UC online journal.
I’ve received the outcome what does this mean?
Limited capability for work (LCW)
If you have been awarded LCW (limited capability for work), this is otherwise know as the work preparation group. This means you will not be expected to look for work immediately, but when you and your work coach feel you are ready, they will support you in taking steps to do this. This could include creating a CV, training courses etc. There are no additional payments when awarded LCW, but all the above rules still apply.
You will only receive an additional payment of £126.11 each month, if you were awarded LCW before 3rd April 2017, either through UC or were previously on ESA so transitional protection was applied.
When you do return to work you there are no restrictions on how many hours you can do. You will also be given the work allowance, before the 63p per £1 deduction. Just be mindful the work you undertake does not contradict the reason you claimed.
If you have been found to have LCW at mandatory reconsideration stage and you do not agree, you can then proceed to tribunal to have your claim then reviewed by an independent panel.
Limited Capability for work and work related activity
If you have been awarded LCWRA (limited capability for work and work related activity), this is the no work group. This means you will not be required to look for work. This element will be added to your UC monthly statement with an additional £341.92 on top of your current payment.
If this is a new claim there is a 3 full month waiting period, before payments begin.
If you are owed back payments this will only date back to your 4th assessment period from the first date of submitting fit notes.
If your already during an assessment period for UC when submitting your first fit note, unfortunately you cannot include this month, for the waiting period.
You are allowed to work and there is no restriction on hours. You will also be given the work allowance, before the 63p per £1 deduction. Just be mindful the work you undertake does not contradict the reason you claimed.
Fit for work (Not have limited capability for work)
If you have been found fit for work, all commitments will apply and you will be expected to look for work.
If you have been found fit for work at mandatory reconsideration stage and you do not agree, you can then proceed to tribunal to have your claim then reviewed by an independent panel.
You have up to 13 months to request a mandatory reconsideration, as long as you can provide ‘good reason’ for this being submitted later than the standard one month.
I have been deemed as I do ‘not have limited capability for work’, I do not agree with this decision, where do I begin?
The first action you need to take, is to contact universal credit on 0800 328 5644 and request a copy of the assessor’s report. You need to state that you will be requesting a mandatory reconsideration and will be completing this in writing.
It usually takes approximately two weeks to receive a copy of the assessor’s report. If you haven’t received within two weeks, give the UC helpline a call back to see what is causing the delay.
Have a read through the work capability assessment link on our website whilst waiting for the report, to be sent to see if you can identify where your claim may have been unsuccessful.
This is also the ideal time to gather any further medical evidence to support your claim.
I’ve been awarded LCW, but disagree and feel I should have been awarded LCWRA, what should I do?
Firstly look at the LCWRA descriptors to see if you feel you would meet the guidelines for any one of these.
If so then follow the steps as above and below, to complete a mandatory reconsideration.
You need to be mindful that your whole assessment will be reviewed again by a second decision maker and therefore, do risk losing your current LCW award.
I’ve received the assessor’s report and I disagree with several comments and have identified several errors how do I challenge this?
Firstly prepare yourself with a pen, paper, a highlighter and set yourself some time aside to do this, away from any distractions.
Go through the assessor’s report and highlight any points you disagree with. Then on a separate piece of paper begin drafting down why you disagree with each point you have highlighted and then provide the correct information.
The key point here, is that you need to explain how your symptoms impact your daily activities before during and after. Then link these into both the LCW and LCWRA descriptors.
LCW Descriptors.
https://www.legislation.gov.uk/uksi/2013/376/schedule/6/made
LCWRA Descriptors.
https://www.legislation.gov.uk/uksi/2013/376/schedule/7/made
To be awarded LCW you would need to score 15 points overall.
To be awarded LCWRA you would need to meet LCW, plus any one of the LCWRA descriptors.
You can then either create a typed or hand written letter, both methods are perfectly acceptable.
A friend or relative or local advice agency can write the mandatory reconsideration letter on your behalf, acting as your representative.
When creating your final letter here are some key points to remember.
- You need to include your name, NI number, address, telephone number and date on your letter.
- Keep your mandatory reconsideration factual, formal and avoid inflammatory words, or the second decision maker will most likely just uphold the original decision.
- You can include wording like ‘i disagree with point......... This is because my current symptoms are........(then link this into the relevant descriptor and state how this impacts your daily activities before, during and after).
- If you take any medication or undergoing any treatment you can also write about, how these impact you managing and completing daily activities.
- ‘Substantial risk’ is another factor to mention, if your conditions and symptoms may cause harm to yourself and/or others.
- If you are currently completing activities like attending the job centre to see your work coach, how do you manage this, but wouldn’t be able to cope in the work place?
These are all important points you need to consider, as any contradictions will simply leave the assessor with no option, but to deem that you do ‘not have limited capability for work’, unless you can demonstrate otherwise and also show that you meet the descriptors too.
I’ve completed my mandatory reconsideration, where do I send this?
Always send your mandatory reconsideration 1st class signed for delivery, so that you can track this and ensure this has been received. Then if any issues do arise, you have evidence to prove that this has been received.
The postal address is:
Canterbury Benefit Centre
Mail Handling Site A
Wolverhampton
WV98 2EA
Once I have sent the mandatory reconsideration, what happens next?
When your mandatory reconsideration has been received, this will be reviewed by a second decision maker.
The decision maker will look at your UC50 form, any new and existing medical evidence, the assessor’s report and your mandatory reconsideration letter.
The first guidelines the decision maker will follow is to see if you meet the eligibility requirements for LCW or LCWRA. If they still determine you do not have limited capability for work they will then consider would you then qualify for LCW or LCWRA using the substantial risk guidelines. To qualify for this the decision maker would need to determine that if you were not awarded LCW or LCWRA you would be at substantial risk to yourself or others. This isn’t just looking at the safety or yourself and others within the workplace, but also includes getting to and from work.
Once the decision maker has reviewed your claim and decided if to uphold the original decision, or change this to LCW or LCWRA, you will receive the outcome of this through your UC online journal.
I’ve received the outcome what does this mean?
Limited capability for work (LCW)
If you have been awarded LCW (limited capability for work), this is otherwise know as the work preparation group. This means you will not be expected to look for work immediately, but when you and your work coach feel you are ready, they will support you in taking steps to do this. This could include creating a CV, training courses etc. There are no additional payments when awarded LCW, but all the above rules still apply.
You will only receive an additional payment of £126.11 each month, if you were awarded LCW before 3rd April 2017, either through UC or were previously on ESA so transitional protection was applied.
When you do return to work you there are no restrictions on how many hours you can do. You will also be given the work allowance, before the 63p per £1 deduction. Just be mindful the work you undertake does not contradict the reason you claimed.
If you have been found to have LCW at mandatory reconsideration stage and you do not agree, you can then proceed to tribunal to have your claim then reviewed by an independent panel.
Limited Capability for work and work related activity
If you have been awarded LCWRA (limited capability for work and work related activity), this is the no work group. This means you will not be required to look for work. This element will be added to your UC monthly statement with an additional £341.92 on top of your current payment.
If this is a new claim there is a 3 full month waiting period, before payments begin.
If you are owed back payments this will only date back to your 4th assessment period from the first date of submitting fit notes.
If your already during an assessment period for UC when submitting your first fit note, unfortunately you cannot include this month, for the waiting period.
You are allowed to work and there is no restriction on hours. You will also be given the work allowance, before the 63p per £1 deduction. Just be mindful the work you undertake does not contradict the reason you claimed.
Fit for work (Not have limited capability for work)
If you have been found fit for work, all commitments will apply and you will be expected to look for work.
If you have been found fit for work at mandatory reconsideration stage and you do not agree, you can then proceed to tribunal to have your claim then reviewed by an independent panel.
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