In this blog, we will discuss what an ESA appeal letter for depression is and how to appeal for ESA.
ESA Appeal Letter for Depression
If you disagree with the decision the DWP has made regarding your claim for the ESA award, the first thing you can do is to apply for Mandatory Reconsideration. Here is a sample of ESA letter for Depression when asking for mandatory reconsideration:
ESA letter for Depression when asking for mandatory reconsideration (sample)
To: [Insert: Address of office that made the decision]
Date: [Insert: date]
Dear Sir/Madam Re: [Insert: Your Name]
NINo: [Insert: National Insurance Number]
I would like to request a reconsideration of your decision of [insert: date of decision, i.e. date given on the decision letter] that I am [not eligible for ESA/that I should be placed in the Work-Related Activity Group].
If this applies: I was not happy with the assessment that I attended on [insert: date of assessment] because [please note the specific areas of disagreement, point by point].
If this applies: There was no attempt to establish the reliability with which any task could be accomplished, or on the number of days a week it could be attempted. I believe that the following points should have been awarded:[List each of the points that you think should apply to you, and then give an explanation of why it applies. In the example below you can see an illustration of this.]
1a Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid is normally, or could reasonably be, worn or used = 15 points. This is because of my severe arthritis.
My mobility distance is limited for most days, although I do on occasion attempt more. There are after-effects as I suffer from increased pain and greatly reduced mobility when I attempt more, and this can lead to me being virtually housebound for the following few days. I cannot self-propel a manual wheelchair.
If these points are awarded, it is clear that I should now be [entitled to ESA/placed in the Support Group rather than the Work-Related Activity Group].
I will be seeking further evidence in support and will forward it to you as soon as I can.
I look forward to hearing from you.
Yours faithfully [NAME]
ESA appeal letter for depression (sample)
Submission – Mrs Ann Example
NINo: AA 11 11 11 A
ESA hearing: xx/xx/2017 at 00:00
I want to appeal the decision that I do not have limited capability for work /to place me in the Work-Related Activity Group [delete as appropriate] for Employment and Support Allowance (ESA).
The decision was made on xx/xx/xxxx. A Mandatory Reconsideration was issued on xx/xx/xxxx. I lodged my appeal with her Majesty’s Courts and Tribunal Service on xx/xx/xxxx.
I suffer from the following health conditions [list your health conditions].
My medication is as follows [list your medication].
Basis of appeal
I scored x points under the Work Capability Assessment (WCA). I think that the decision-maker has not understood the full effect of my health conditions on my ability to complete the activities under the WCA. I believe the following points should have been awarded:[List each of the points that you think should apply to you, and then give an explanation of why it applies. In the examples below you can see illustrations of this. These are examples only – it is not a suggestion of what to write, which should be about you.] [Include the following paragraph if you think it applies]
I believe that being found fit for work would present a significant risk to my health because [explain your reasons].[Include the following paragraph if you think it applies]
I think I am eligible to be placed in the Support Group because [list any of the Support Group activities that you think applies to you]:[Include the following paragraph if you think it applies]
I believe that being placed in the Work-Related Activity group would present a significant risk to my health/ present a significant risk to the health of others [delete as appropriate] because [explain your reasons].[Your Name]
Key points to remember
In your ESA appeal letter for depression, you need to say why you think the decision is wrong, and how you think you meet the criteria for a different award. It is extremely helpful if you can provide additional medical evidence at this stage. You are unlikely to get a decision changed just because you think it should be – the person who makes the decision (the ‘decision-maker’) needs a reason to think the original decision was wrong.
You need to send your ESA appeal letter for depression including any supporting evidence to the benefits office that your decision letter was from. It gives them a chance to look at your file again, and they can change their decision at this time. When they have made a decision, they will send you what is called a Mandatory Reconsideration Notice – this is their final decision and you will need this if you want to go on to appeal.
If you are still unhappy with the decision made, you may want to complete an appeal form. However, you need to check that you have a right of appeal; some decisions have no right of appeal, but it should say so in the decision letter.
You can get an appeal form (called SSCS1) by asking the Department of Work and Pensions for a copy by phone or letter, or by downloading it here. There is a blank version as well as an example version in the list on the right, which you can use as a guide for how to fill the form in.
This form has to be sent directly to HM Courts & Tribunals Service – the address in Bradford is on the form. Keep a copy of everything you send, and obtain proof of posting which the Post Office will provide for free.
An appeal form does not give you very much space to explain why you want to appeal a decision, so you may want to attach additional sheets. If you do, please remember to put your name and National Insurance number on every page, and to sign it.
Appealing for ESA
In order to make an appeal, it is not enough to just say that you think they have got the decision wrong. You will need to say why and explain exactly how you think you meet the legal rules for entitlement.
If you have been turned down for Employment and Support Allowance because you have failed the Work Capability Assessment, unfortunately, it will not make any difference whether your GP thinks you are unfit for work.
For Employment and Support Allowance you will need to explain which points should have been awarded and why. If you think you should be in the support group, you will need to say exactly what grounds you have for thinking so.
This means you need to have a good understanding of the rules of entitlement. You may need some help to understand this.
The legal rules for entitlement for Employment and Support Allowance can be found online here. The points system is outlined on pages 17 to 27.
For Disability Living Allowance or Personal Independence Payment (PIP), you need to explain which component (mobility or care/daily living) you are appealing against. If you are happy with the decision that has been made about one component, please be very careful to explain that.
You also need to suggest which rate you think should have been awarded and why. Again, this means you need to have a good understanding of the rules of entitlement, and you may need some help to understand this.
How to win an ESA appeal for depression
When claiming ESA, people are often asked a set of questions at their medical assessment. These questions are related to a set of descriptors. The DWP uses these descriptors to determine the level to which the claimant’s disability or illness affects their ability to work.
Some ESA assessment of mental health questions include:
- Do you know what you are here for?
- What are your medical conditions?
- How long have you had these conditions?
- How do these conditions affect you?
- Is there an upstairs or downstairs bathroom?
- How often do you shop?
- Do you do shopping on your own?
- Do you drive?
- Is the car automatic or manual?
- How long can you drive for?
- Do you have any hobbies or interests?
Some activities relating to the physical health assessment include:
- Mobilizing and navigation.
- Picking up and moving.
- Manual dexterity.
Try to answer these questions in order to be prepared for the medical assessment. You can always contact your local Citizens Advice office for more information, advice, and guidance.
In this blog, we discussed an ESA appeal letter for depression and we shared with you two samples of letters for either mandatory reconsideration or ESA appeal letter for depression.
The most important aspect to remember is that, in your ESA appeal letter for depression, you need to say why you think the decision is wrong, and how you think you meet the criteria for a different award. It is extremely helpful if you can provide additional medical evidence at this stage. You are unlikely to get a decision changed just because you think it should be – the person who makes the decision (the ‘decision-maker’) needs a reason to think the original decision was wrong.
Please leave any comments on the content or any questions in the comments section below.
FAQs about ESA appeal letter for depression
What is an ESA tribunal?
An ESA tribunal is where ESA appeal cases are head.
Will I get paid during the ESA appeal?
Yes, you will usually continue getting paid the undisputed part of the ESA during an appeal. You may also be able to reclaim ESA during the appeal process if you are suffering from a new or worsening condition.
Is depression classed as a disability?
Depression is classed as a disability. In the Social Security Administration (SSA) Impairment Listing Manual, or “Blue Book,” the condition is considered under Section 12.04 Affective Disorders.
Who is entitled to ESA allowance?
A person entitled to ESA allowance is a person who has a health condition that makes it difficult or impossible to work.
What is an ESA 50 form?
An ESA 50 form is called the capability for work questionnaire. This questionnaire is your chance to tell the DWP how your illness or disability affects your ability to work.
Does ESA contact your GP?
Yes, the DWP may contact your GP or healthcare professional to obtain medical evidence when you submit a PIP or ESA claim, but in many cases they will not.
- Overcoming Depression – Get Happy Again: The Self-Help Workbook for Understanding Depression, Anxiety and Panic Attacks
- Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions
- Social Security Legislation 2019/20 Volume I: Non-Means Tested Benefits and Employment and Support Allowance
- GUIDE TO THE EMPLOYMENT AND SUPPORT ALLOWANCE ASSESSMENT PHASE: How best to avoid a medical
- Employment and Support Allowance: A Guide to ESA for People with a Disability or Long Term Health Condition, Their Families, Carers and Advisors