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4 years 4 months ago #241846 by grace
Replied by grace on topic Fighting for temporary ESA+HB, or UC?
LET’S PRETEND FOR THIS POST THAT MY LOCAL AUTHORITY ARE NOT INSISTING I CLAIM UC (I’m going to leave HB for a separate post):

If it was more than one month, even by one day then you may have to claim UC, however, and this is where the confusion starts, I have seen an internal DWP memo that states that they should consider whether a claimant would have been eligible for the SD Premium within the previous month if they had been entitled to payment of a relevant benefit, if this is accepted then again you should be able to make a new claim for ESA(IR) and HB.

If you lost entitlement to your ESA(IR) and HB in May and could not re-claim until September, whether the ESA and HB continued to be paid or not, then you are way outside the one month that the law as written covers so you are going to have to hope that the DWP's interpretation of the law as defined by the memo I mentioned is considered.

ESA: What is the criteria for being eligible for receiving the SDP? I thought it was high rate care for DLA, which I receive. I’m still not quite understanding the 1 month thing in relation to my situation: I was still eligible for the SDP in May (when I notified them my capital had increased above £16,000), and in September (when I notified them my capital had depleted to £16,000), and still now. (And the SDP was still being paid with my ESA until the ESA SG payments stopped in August but this is when my capital was still above £16,000). Are you saying because I wasn’t “entitled” to receive ESA in August – which is 1 month before September – that I therefore wasn’t eligible for the SDP? What about October then?...within 1 month before October, my capital was below £16,000 and therefore I was eligible for both ESA and SDP?...and therefore to claim HB?
In my letter to ESA last week, I enclosed my PIP extension confirmation letter as evidence that I was too ill to complete that on time, and explained that as a result of having strained my brain for months on PIP I am definitely too ill to complete a new ESA/UC claim. And I enclosed a copy of medical evidence by my specialist explaining more about my illness and how it takes me much, much longer to complete cognitive tasks and that they have witnessed that these assessments make my health deteriorate. I also told them in last week’s letter, it’s nonsensical for me to do a new claim because 1) their continued payments from May to August should be offset against the payments they should have started from September (when my capital depleted to £16,000); and 2) my capital will increase again within a few months when ESA would then have to be stopped again.

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4 years 4 months ago #241852 by Gordon
Replied by Gordon on topic Fighting for temporary ESA+HB, or UC?
Grace

To answer I must distinguish between being eligible for something and being entitled to payment, the two are not the same.

To be eligible for the Severe Disability Premium you must meet the following;

- you must be receiving an enabling benefit such as DLA MRC or HRC or PIP Daily Living (there are others)
- you must be living alone or considered to be living alone
- no one must be receiving Carers Allowance against the enabling benefit.

To be entitled to payment you must be receiving an Income Related benefit such as ESA(IR) but not Universal Credit.

The legislation that bars a claim for UC requires the claimant to have been receiving or entitled to receive the SD Premium in the month before any claim for UC. You were eligible to receive the Premium but were not receiving or entitled to receive it in August as you had no claim for ESA(IR).

The DWP memo seems to equate eligibility with entitlement and under these circumstances, you would be able to claim ESA(IR) and hopefully HB.

Even though the DWP continued to pay you for the three months you still had no entitlement to ESA(IR), entitlement to ESA(IR) is black and white, either you do or you do not and your exceeding the £16,000 limit means that you did not.

My advice would be to make a claim for ESA(IR), backdated by the maximum of three months allowed on the basis that you were/are eligible for the SD Premium and let the DWP argue that you are not entitled. The same for Housing Benefit.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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4 years 4 months ago #241859 by grace
Replied by grace on topic Fighting for temporary ESA+HB, or UC?
Gordon, I SO appreciate your technical help!

When you say “make a claim for ESA(IR)”, do you mean continue with waiting for a reply to my letter last week (incl September’s). Or are you meaning phone them up for an ESA claim form/get one locally and complete it? Because I’m so ill, I’m keen to first pursue their action/reply to my letter because they might just not make me complete a new form.

What do you think about my option of suggesting to ESA (after I receive their reply) that I claim ESA(IR) from October, because I will then have been in the month prior (Sep) both eligible for the SDP and entitled to receive it because I would have an entitlement to receive ESA(IR) when my capital depleted to £16,000?

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4 years 4 months ago #241864 by grace
Replied by grace on topic Fighting for temporary ESA+HB, or UC?
Continued from my last post...

If you're meaning my completing a new claim form, then how would that work with both the reduced 12-week assessment phase rate and the deduction of £1 per £250 (for capital £6,000-£16,000)?

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4 years 4 months ago #241877 by Gordon
Replied by Gordon on topic Fighting for temporary ESA+HB, or UC?
Grace

I'm sorry if this seems pedantic but you were not entitled to ESA(IR) in October (or September) you were just eligible, the DWP may decide that this means that you are still able to claim ESA(IR) but that is for them to Decide.

I would certainly pursue them to restart your claim from when you contacted them, your approach must be "I was eligible for ESA(IR) and therefore I was entitled to an award".

If that fails then a new claim backdated by three months on the basis that you are eligible for the SD Premium and a Mandatory Reconsideration in regard to the Decision not to award from an earlier date.

Yes, a new claim will mean that you are only entitled to the Assessment rate plus any payable Premiums, the SD Premium for certain, there will also be a new ESA50 but based on your post, you will go back over the limit before you are actually reassessed.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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4 years 4 months ago #241901 by grace
Replied by grace on topic Fighting for temporary ESA+HB, or UC?

I'm sorry if this seems pedantic but you were not entitled to ESA(IR) in October (or September) you were just eligible, the DWP may decide that this means that you are still able to claim ESA(IR) but that is for them to Decide.

Not pedantic, I appreciate your correcting me! However, I now don’t understand why I wasn’t “entitled” to receive ESA(IR)?...September (when my capital depleted to £16,000) was only 4 months after May when I was I still receiving my ESA(IR) before it had to be ‘stopped’ (when my capital increased above £16,000): none of my circumstances had changed, especially not i.r.t. to a severe long-term illness like mine, except my capital. Are you saying because no assessment had been done in September to ‘prove’ I was “entitled” (based on my illness meeting criteria), that this is why I am only “eligible” and not “entitled”?

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