ESA & RECUPERATION/CONVALESCENCE

Does anyone know the ESA rules regarding recuperation and convalescence, in relation to conditions like ME/CFS?

Eg. If ME/CFS goes into 'remission' would they allow one to keep claiming ESA for a certain period to help sustain the recovery. How do they deal with a claimant that feels in reasonable health, but the cumulative exertion of work (and a busier lifestyle) could lead to a relapse.

fil501 wrote: Does anyone know the ESA rules regarding recuperation and convalescence, in relation to conditions like ME/CFS?

Eg. If ME/CFS goes into 'remission' would they allow one to keep claiming ESA for a certain period to help sustain the recovery. How do they deal with a claimant that feels in reasonable health, but the cumulative exertion of work (and a busier lifestyle) could lead to a relapse.

Hi f501,

As with PIP (and DLA) it is not the medical condition itself that may or may not result in an ESA award, it is the limitations/disabilities suffered as a result of the medical condition that are assessed !

When you are assessed, it is on whether you score the requisite minimum 15 points for a WRAG Award under : The Functional WRAG (LCW)Schedule 2 Descriptors

Or if you can't, by fulfilling : ESA Reg 29 for entry to The WRAG (LCW)

PLUS Post 28/01/13 Amendment of :

(3) Paragraph (2)(b) does not apply where the risk could be reduced by a significant amount by—

(a)reasonable adjustments being made in the claimant’s workplace;

or

(b)the claimant taking medication to manage the claimant’s condition where such medication has been prescribed for the claimant by a registered medical practitioner treating the claimant.”.

From : www.legislation.gov.uk/uksi/2012/3096/regulation/3/made

Or, for entry to the Support Group (SG) whether or not you fulfil at least one of : The Functional SG (LCWRA) Schedule 3 Descriptors

Or, via : ESA Reg 35 for entry to The SG (LCWRA)

If you can't carry out any of the ESA "Activities"/"Descriptors" as above, repeatedly, reliable and safely for The Majority of the Time or for The SG, On the Majority of Occasions that you attempt them, then you should not be assessed as being able to carry them out at all.

When carrying out any of the "Activities" you must also be able to do so without suffering severe pain, discomfort, fatigue or breathlessness.

Again, if you can't, then you should be classed as not being able to carry them out at all.

So, what you have to consider is, when you are in remission, does that mean that you can carry out the above "Activities" for the Majority of The Time repeatedly, reliably and safely without suffering severe pain, discomfort, fatigue or breathlessness when you do so. .

The majority of the time is greater than 50% of the time, i.e. more than 12 hours in a day, 3.5 days in a week, more than 15/16 days in a month, more than 6 month in a year

If you can, then you would need to inform DWP ESA of a Change of Circumstances (C of C) which would result in a reassessment.

If you can't, then you would not have to report a C of C.

This is explained further in our : ESA Claims Guides

bro58