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ESA continuation question
- Indybear
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11 years 10 months ago - 11 years 10 months ago #108011 by Indybear
ESA continuation question was created by Indybear
Can anyone help lease - was on IB for 7 years and transferred to ESA which stopped on Dec 27th due to time limiting - I have still been ill and recieving treatment form my doctor - I asked for a reconsideration on my time limiting and was deemed unfit for work for the next 18 months by the decision maker to run from dec 12 onwards - I have read that if you are still ill you can reapply for your benefit to be re instated for the 12 months to start again - not put in a fresh claim but if you have deteriorted you can get a follow on so as to speak - can anyone help please
Last edit: 11 years 10 months ago by .
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- Gordon
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11 years 10 months ago #108013 by Gordon
I am assuming that you have checked to see whether you are eligible for Income Related ESA.
There are only two ways for your payments to be re-instated.
First, on the assumption that you were actually re-assessed in regard to the 27 December Decision, then you can appeal this Decision if you believe that you should have been placed in the Support Group, you will receive no money whilst you appeal and payments will only be re-instated if you are placed in the SG.
Secondly, if you can show that your condition has deteriorated or you have a new condition, such that you now meet the requirements for the Support Group, and providing that you have maintained your claim and are still regarded as having Limited Capability for Work, then you can ask the DWP to re-assess you. You will need to show that the deterioration has occurred since you were last assessed (Dec 27?) and provide medical evidence to support this. Payments will only be re-instated if you are placed in the SG and you will not receive any payments while you wait for a Decision to be made.
If you require more information about these options, then please reply to this post.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic ESA continuation question
Indybear wrote: Can anyone help lease - was on IB for 7 years and transferred to ESA which stopped on Dec 27th due to time limiting - I have still been ill and recieving treatment form my doctor - I asked for a reconsideration on my time limiting and was deemed unfit for work for the next 18 months by the decision maker to run from dec 12 onwards - I have read that if you are still ill you can reapply for your benefit to be re instated for the 12 months to start again - not put in a fresh claim but if you have deteriorted you can get a follow on so as to speak - can anyone help please
I am assuming that you have checked to see whether you are eligible for Income Related ESA.
There are only two ways for your payments to be re-instated.
First, on the assumption that you were actually re-assessed in regard to the 27 December Decision, then you can appeal this Decision if you believe that you should have been placed in the Support Group, you will receive no money whilst you appeal and payments will only be re-instated if you are placed in the SG.
Secondly, if you can show that your condition has deteriorated or you have a new condition, such that you now meet the requirements for the Support Group, and providing that you have maintained your claim and are still regarded as having Limited Capability for Work, then you can ask the DWP to re-assess you. You will need to show that the deterioration has occurred since you were last assessed (Dec 27?) and provide medical evidence to support this. Payments will only be re-instated if you are placed in the SG and you will not receive any payments while you wait for a Decision to be made.
If you require more information about these options, then please reply to this post.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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- Indybear
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11 years 10 months ago - 11 years 10 months ago #108016 by Indybear
Replied by Indybear on topic ESA continuation question
When you say maintained my claim - is the fact that I have been assessed by the job centre decision makers as being unfit for work form the 27th of dec - good enough to cover this ??/ many thanks
Last edit: 11 years 10 months ago by Gordon.
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11 years 10 months ago #108018 by Gordon
Yes, you should be receiving NI Credits at the moment, and as long as this is the case it means that your claim has not been closed by you or the DWP.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic ESA continuation question
Indybear wrote: When you say maintained my claim - is the fact that I have been assessed by the job centre decision makers as being unfit for work form the 27th of dec - good enough to cover this ??/ many thanks
Yes, you should be receiving NI Credits at the moment, and as long as this is the case it means that your claim has not been closed by you or the DWP.
Gordon
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- Indybear
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11 years 10 months ago - 11 years 10 months ago #108024 by Indybear
Replied by Indybear on topic ESA continuation question
Application made after award has terminated
41862 Where
1. entitlement to ESA(Cont), including under the youth provisions, has been
terminated as in DMG 41810 or 41815 because it exceeded 365 days and
2. the claimant
2.1 reports a deterioration in their health condition or
2.2 makes a further claim for ESA(Cont) and
3. the claimant had, or is treated as having had, LCW since the previous
entitlement ended and
4. the claimant satisfies the basic conditions of entitlement (see DMG 41012)
and
5. the DM determines that the claimant has, or is treated as having, LCWRA
the claimant is entitled to an award of ESA(Cont), even though they do not satisfy
the contribution conditions1
. The award is regarded as an award of ESA(Cont) for all
other purposes, for example amounts payable2
.
1 WR Act 07, s 1B(1); 2 s 1B(2)
Example
Bogdan’s award of ESA(Cont) ended on 30.4.12 as it exceeded 365 days.
Entitlement was based on tax years 2008/2009 and 2009/2010. He is not entitled to
ESA(IR) as he has a partner in full–time remunerative work. He remains entitled to
NI credits. Bogdan makes a further claim to ESA(Cont) from 10.7.12 on the grounds
that his condition has deteriorated. As the PLCWs link, the tax years on which
entitlement could be based do not change. The claim cannot be decided until the
DM determines whether or not Bogdan has, or is treated as having, LCWRA.
Following application of the WCA, the DM determines that Bogdan has LCWRA. He
is entitled to ESA(Cont) and the support component from 10.7.12. He does not have
to serve waiting days or the assessment phase.
Sorry to be a pain about this - this is what i have been looking at - is this what my claim would be based on ? I am not seeing that I have to prove I have deteriorated from 27th of Dec- or can you point out where it is - I just want to double check I have it all correct - sorry again
41862 Where
1. entitlement to ESA(Cont), including under the youth provisions, has been
terminated as in DMG 41810 or 41815 because it exceeded 365 days and
2. the claimant
2.1 reports a deterioration in their health condition or
2.2 makes a further claim for ESA(Cont) and
3. the claimant had, or is treated as having had, LCW since the previous
entitlement ended and
4. the claimant satisfies the basic conditions of entitlement (see DMG 41012)
and
5. the DM determines that the claimant has, or is treated as having, LCWRA
the claimant is entitled to an award of ESA(Cont), even though they do not satisfy
the contribution conditions1
. The award is regarded as an award of ESA(Cont) for all
other purposes, for example amounts payable2
.
1 WR Act 07, s 1B(1); 2 s 1B(2)
Example
Bogdan’s award of ESA(Cont) ended on 30.4.12 as it exceeded 365 days.
Entitlement was based on tax years 2008/2009 and 2009/2010. He is not entitled to
ESA(IR) as he has a partner in full–time remunerative work. He remains entitled to
NI credits. Bogdan makes a further claim to ESA(Cont) from 10.7.12 on the grounds
that his condition has deteriorated. As the PLCWs link, the tax years on which
entitlement could be based do not change. The claim cannot be decided until the
DM determines whether or not Bogdan has, or is treated as having, LCWRA.
Following application of the WCA, the DM determines that Bogdan has LCWRA. He
is entitled to ESA(Cont) and the support component from 10.7.12. He does not have
to serve waiting days or the assessment phase.
Sorry to be a pain about this - this is what i have been looking at - is this what my claim would be based on ? I am not seeing that I have to prove I have deteriorated from 27th of Dec- or can you point out where it is - I just want to double check I have it all correct - sorry again
Last edit: 11 years 10 months ago by Gordon.
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11 years 10 months ago #108028 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic ESA continuation question
Indybear
It is crucial that we understand what actually happened in December 2012 as it affects your options.
If the Decision was the result of a Reconsideration and not an assessment, I would not have expected to them to say that you would be Unfit for Work for a further 18 months if this was the case. Then you can either lodge an appeal based on the premise that you should have been placed in the Support Group at your previous assessment (Dec 2011?), assuming you think that was the case, or you can request that you are re-assessed, the technical term for this is a Supersession, because your condition has deteriorated or you have a new condition and you now believe that you meet the criteria for the Support Group, the change must have occurred since your last assessment (Dec 2011?).
If the latest Decision (Dec 2012) was the result of a re-assessment, then you can appeal this Decision as above, or ask for a re-assessment based on a changed condition, however, in this case the deterioration must have occurred since December 2012.
A Supersession is always based on a Change of Circumstances since the last Decision on a claim.
Gordon
It is crucial that we understand what actually happened in December 2012 as it affects your options.
If the Decision was the result of a Reconsideration and not an assessment, I would not have expected to them to say that you would be Unfit for Work for a further 18 months if this was the case. Then you can either lodge an appeal based on the premise that you should have been placed in the Support Group at your previous assessment (Dec 2011?), assuming you think that was the case, or you can request that you are re-assessed, the technical term for this is a Supersession, because your condition has deteriorated or you have a new condition and you now believe that you meet the criteria for the Support Group, the change must have occurred since your last assessment (Dec 2011?).
If the latest Decision (Dec 2012) was the result of a re-assessment, then you can appeal this Decision as above, or ask for a re-assessment based on a changed condition, however, in this case the deterioration must have occurred since December 2012.
A Supersession is always based on a Change of Circumstances since the last Decision on a claim.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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