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Don't qualify for ESA support group through ESA NI

  • panther50
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10 years 2 months ago - 10 years 2 months ago #117177 by panther50
Hi wonder if you can help. I was asked to call my Job Centre this week (apparently they need to keep in touch from time to time). I'm on contributions based ESA, I went past 365 so now am only getting NI credits paid. I thought that as there has been no break in my benefit this meant that if my condition changed and got worse I could still apply for the Support group and would then receive benefit as well as NI credits. She told me that this definitely wasn't the case and that the NI credits would only cover my pension and the only way I'd qualify for contributions based ESA again is by working for 3 years. I've got a chronic long term fluctuating condition and my partner works (so I won't get income based ESA). I checked with the DWP and they said the same?!?! Is this how you understand it to work?
Last edit: 10 years 2 months ago by . Reason: Tick.

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10 years 2 months ago #117178 by Gordon

panther50 wrote: Hi wonder if you can help. I was asked to call my Job Centre this week (apparently they need to keep in touch from time to time). I'm on contributions based ESA, I went past 365 so now am only getting NI credits paid. I thought that as there has been no break in my benefit this meant that if my condition changed and got worse I could still apply for the Support group and would then receive benefit as well as NI credits. She told me that this definitely wasn't the case and that the NI credits would only cover my pension and the only way I'd qualify for contributions based ESA again is by working for 3 years. I've got a chronic long term fluctuating condition and my partner works (so I won't get income based ESA). I checked with the DWP and they said the same?!?! Is this how you understand it to work?


I think this is the fourth time this week we have had a post where staff from either the DWP, JC+, or both have provided a claimant with fundamentally flawed information.

So to answer your question.

Providing you maintain your current Limited Capability for Work status, which will involve you having a continuous claim, completing any further ESA50 and attending any assessment so that you are still found to meet the criteria for the for WRAG, then at any time you can ask to be re-assessed on the basis that you believe you now meet the criteria for the Support Group.

The burden of Proof will lie with you and you will need to provide evidence that your condition has deteriorated since your last assessment or that you have a new condition that should qualify you for the SG.

As to re-qualifying for ESA(CB) through a new claim, whilst it cold be longer as the rules are quite complicated, you need one year of new NI Contributions not three.

Gordon

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  • panther50
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10 years 2 months ago - 10 years 2 months ago #117220 by panther50
Hi Thanks for that reply. When I spoke to DWP person they said that I could be put in SG but it'd make no difference to the money I received because it went on my NI contributions and because I'd been in receipt of ESA benefit until Aug '13 I wouldn't have enough contributions for the previous year to qualify? :S

Is there any way I can prove what your saying to them? I found the JCP sheet (below) called Changes To contributions-based ESA I think says it would be reinstated but the JC person interpreted it differently and said it referred to people who'd had a 12 wk break and had paid enough contributions in that time?!? Do you have any other government references to it that explain this in writing?
Welfare Reform Act 2012 pdf doc
I think you're right but I'm at a loss as to what to do because the whole team down here agreed with her and so did DWP.
Last edit: 10 years 2 months ago by Gordon.

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10 years 2 months ago #117228 by Gordon
panther50

There are two discreet scenarios which have different rules.

If you ask to be re-assessed for the SG, having had your ESA(CB) stopped due to the time limit, then you do not need to re-qualify on your NI Contribution as it is classed as being a continuation of your previous claim.

If you attempt to re-qualify for ESA(CB), irrelevant of group, then you do need to re-meet the NI Contribution conditions because it is classed as a new claim.

The following has the DWP guidance on the subject.

www.dwp.gov.uk/docs/m-13-12.pdf

Paragraphs 26-38 cover the first example and 21-25 the former.

Gordon

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  • panther50
  • Topic Author
10 years 2 months ago #117239 by panther50
Hi Gordon
Thanks for that. My understanding is exactly as you have explained it. The first scenario is exactly what I'm asking about.

However, I've looked at the DWP guidance you attached, but para 27 seems to say what they're saying that its dependent on the relevant tax year:

"DMs are reminded that they should always firstly consider whether a
claim could succeed because one of the tax years for the second contribution
condition is later than those on which the earlier award was based, before
consideration is given to a further award solely based on deterioration in their health" Even the example I hoped would prove it mentions contributions from a later year.

It seems they're being instructed to treat the deterioration as a second fresh condition and new application which I think is what they were telling me and why they were going on about contributions.

I'm sorry if I'm being thick - I do find it incredibly confusing it's literally giving me quite a headache! Please can you give me the exact para that would explain it to them beyond doubt.

I thought my NI credits would satisfy the requirements even if they did look at it afresh, but apparently not.

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10 years 2 months ago - 10 years 2 months ago #117252 by Gordon
panther50

You are misreading the paragraph, all it is saying is that if the claimant meets the Contribution conditions afresh then they can award ESA(CB) based on this, it is not saying that this condition has to be met as well as you being placed in the SG, this has relevance to back payments (see below), the example in paragraph 30 covers your situation exactly.

In your scenario, there will be no back payment as any Decision to put you into the SG will only apply from when the Decision that you meet the SG criteria is made, however, if you qualified under the Contribution conditions then it will apply from when entitlement occurred which could lead to back payments. WRAG payments will be re-instated from when entitlement occurred and the re-assessment for the SG will then be processed, possibly leading to back payments.

Just to be clear, in both these examples a "new" claim for ESA is usually required as their previous claim is closed on the ESA computer system if they go to NI Credits only, but it is only the latter situation that is treated as a new claim the former is treated as a continuation.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 10 years 2 months ago by Gordon.

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