ESA Contribution based

I am sending the following letter:-

Dear Sir,
I recently had some dental treatment and I assumed that, because I get ESA, I would qualify for free dental charges but I have received a demand for £319 from NHS Dental Charges which says that I do not qualify for free dental care.

I queried this and have found that as my ESA is Contribution related (C) I do not qualify. Some of my ESA needs to be Income related (IR) for me to get NHS treatment free.
Because this is too complicated for me I asked for advice.

After obtaining advice I found that I should have been getting ESA Contribution related and ESA Income related since I was transferred from IB to ESA because, at the time that I was transferred, I was already getting DLA at the Higher Rate for care. This should have triggered payment of Enhanced Disability Premium. (EDP)

For some reason the Decision Maker did not assess my eligibility for ESA (IR) at the time that I was transferred so I was only awarded ESA (C) and this is contrary to the guidelines.

As I find this to be too confusing I have been advised just to refer you to the following:

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www.rightsnet.org.uk/?ACT=39&fid=3&aid=8...5lcDDnohU&board_id=1

Response to "Caffas"
Submitted by Category Response to
Gabby Caffas
on 29.01 at 10:57
Page 1 of 1
Public
See noticeboard 05.06.13
05.06.13
IB Reassessment, TA and ESA time limiting
We have received several guidance queries asking if a TA awarded on conversion from IB to ESA(C) remains in payment when ESA(C) terminates due to time limiting, and ESA(IR) is awarded instead. Another common question is whether ESA(IR) can be backdated to the date of conversion.
DMs are reminded that the TA is part of the award of ESA(C) ? see DMG 45690. It therefore terminates when ESA(C) terminates. It cannot be transferred to ESA(IR), because a TA is only included in a converted award of ESA(IR) where the claimant was previously entitled to IS.
DMs are also reminded that, where the claimant's existing award(s) of IB, IS or SDA qualify for conversion to ESA, the first step in calculating the amount of ESA to be awarded is to calculate how much ESA (IR as well as C) would be awarded if a claim had been made ? see DMG 45581
Where a claimant was previously entitled to IB, the DM should therefore consider whether they are entitled to ESA(IR) as well as (C) on conversion even if they were not entitled to IS. If this is not done at conversion, and the claimant would have been entitled to ESA(IR) at that date, the conversion decision should be revised for official error.
The guidance in DMG- Chapter 45 will be expanded as soon as possible to make this clearer.

There is also an entry in the Decision Makers Guide with a worked example: www.dwp.gov.uk/docs/dmgch45.pdf

45413 The claimant’s duty to disclose information relevant to their existing award of benefit is modified to enable the Secretary of State to require from the claimant information or evidence for the purposes of determining whether that award should be converted to ESA1.

45414 This enables the Secretary of State to establish whether a claimant whose existing award is IB or SDA, and who is not entitled to IS, might be entitled to ESA(IR) as well as ESA(Cont) on conversion.

Example
Carlton is entitled to IB of £91.40. During the conversion phase the Secretary of State establishes that he has no other income. Following application of the WCA, Carlton is placed in the support group. On conversion, Carlton is entitled to ESA of £110.50 made up of ESA(Cont) of £96.85 and ESA(IR) of £13.65 (EDP).

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The example of "Carlton" mimics my situation:- I was on IB and was then converted to ESA. I had no other income (other than DLA). I had the WCA and was placed in the Support Group.
I should, therefore, be getting the EDP payment and it should have been awarded when I was first converted to ESA. (Entitlement to payment, because DLA HRC pre-dates transfer to ESA, only kicked in when I was transferred - as IB did not enable the payment of any premiums.)

The advice I have been given is that this award should be backdated and would also mean that I would get ESA(IR) and so be entitled to NHS treatment such as the dental work I had done.

Please look into this for me as I find it far too confusing.

Hello again Gordon,
I sent the letter to the ESA people to ask for my daughter's claim for ESA income related to be assessed again but did not receive a reply so I rang them and, after having to ask three times, they admitted that they had not received the letter. I've lost count of the times this has happened with letters and forms. I sent them a copy and covering letter by registered post.

I got a call a week later and had a conversation with someone who took a long time to understand what it was all about but finally agreed that my daughter should have been getting what you said she should have been getting. He said that (again after much deliberation and asking a superior) that it was fully back-dateable as you said.

He said that he would send an ESA3 form to my daughter. This has arrived and I have helped her to complete it but have not posted it yet as I couldn't understand why it needed to be completed as what she was claiming was already part of her claim because it should have been sorted out when she was transferred from IB to ESA in 2011. It should therefore not require any further information to help to decide it.

Because she has now moved in with her boyfriend (Dec '14) she is no longer entitled to the income related ESA - so is the ESA3 form necessary so that they can sort it out up to Dec'14 and then stop it because of the change of circumstances?
Should I send the completed form?

Gordon - my daughter LOVES you!
I did as you said and the ESA people responded quickly and asked for the ESA3 form to be completed. They have agreed that you were right and my daughter should have been getting ESA (IR) since being transferred from IB in Sept 2011.

She has now received a letter from them to this effect and a back-payment of £1184 65. They say that this is for the period from 29.11.11 to 27.01.15. and that she no longer qualified after 08.12.14 (when she moved in with her boyfriend.)

I was expecting the amount to be higher than this as the period covers more than three years. (about 40 months) so the average is only about £7 a week.
Is there any way that I can check what the rates were from 2011?
Thank you again,
A's Dad

My daughter has now shown me the letter she got and one of the things it states is that "We cannot pay you ESA from 8th December 2014." (The date she moved in with her boyfriend)
Underneath this it says, "You are not getting any more Income Related ESA".

True to their word they have not paid her ESA into her bank that was due on the 10th of February.
Surely, she is still entitled to her ESA contribution related even though she will no longer get ESA IR?