IS following missed WCA

My client failed to attend a WCA in November so failed to convert from SDA to ESA. He says he did not get the letter (to be fair, he does always tell me when he gets a letter so I believe him).

Good cause MR has failed and client wishes to appeal. He and his wife are both carers so I have asked DWP to instate the previously underlying entitlement to CA and continue to pay IS on grounds of being a carer, as opposed to having a disability. No DLA or PIP in payment for either.

Am I right in thinking that 6 months after he failed to attend the WCA he could claim ESA again and be paid and be on the same rate as IS? Couple amount + 2 carer premiums.

few thoughts here:

1 were the re-claim rules not relaxed for reclaims for those who failed to attend a WCA rather than those who failed it?
2 unless one was in the support group are they not better off on is as a carer anway?  (this would also depend on dla rates etc)
3. will the payment of carers affect any sdp due?

Hi there,

Thanks for replying. Here are my thoughts.

1.The rules now mean that only those who fail to attend or return a form can claim after 6 months - failing a medical means you can’t reclaim after 6 months now unless you have a different condition or significant deterioration.

2.  They don’t get a disability premium as neither is on DLA/PIP and SDA isn’t in payment as he failed to convert to ESA

3. SDP was in payment, hence why CA was underlying. Now it has stopped, CA needs to be reinstated.

So I’m thinking that he can’t claim and be paid for 6 months as he failed to attend the medical but after 6 months he can claim and be paid assessment-rate with carer premiums. If he passes the WCA he will get a component on top and if he fails he can go back to IS but no disability premium will be payable.

You seem to be on the right track.

Staying on IS for 6 months is probably the sensible thing to do. After that point they can decide if they want to shut down the claim and claim ESA. That gives them a chance at a component.

Before they shut down the IS claim, you will probably need to re-assess as depending on the stage of UC rollout in your area, there might be some chance that surrendering the IS claim or failing the medical might leave them stuck in the lobster pot, potentially without a transitional addition. (I haven’t really looked into the transitional rules but I would imagine that if you voluntarily relinquish your claim and are then forced into claiming UC, you don’t benefit from the transitional provisions - you would have to check).

Just to clear up - who are they each caring for? I think I wrongly read your post as two DLA/PIP claimants caring for one another.

Sorry - the couple are caring for their sons - one each but the couple don’t get PIP or DLA themselves. By their own admission, although they have mild learning disabilities, they don’t have care or mobility needs.

Yes, I hadn’t considered UC. I think the gateway conditions for this area would make them ineligible in the immediate future but things can change in 6 months.

Elliot Kent - 10 February 2016 02:51 PM

I would imagine that if you voluntarily relinquish your claim and are then forced into claiming UC, you don’t benefit from the transitional provisions - you would have to check.

Which transitional protection would be provided? As far as I can see, the same elements would be included in a UC claim as in a claim for IS/ESA - carer elements and limited capability for work elements. Would the be transitional benefits to being migrated onto UC?

Yeah I think you’re right Edmund, I was still thinking in terms of SDP.

Carer elements and LCW elements cannot be paid at the same time in UC as I understand it - they would get two carer elements, but no LCW element (the carer element is higher).

One could get carer element and one could possibly get LCWRA

They could, but LCW element is less than carer element. Only LCWRA element is higher

Brian JB - 10 February 2016 04:20 PM

Carer elements and LCW elements cannot be paid at the same time in UC as I understand it - they would get two carer elements, but no LCW element (the carer element is higher).

Of course, you’re right. So, for ESA it might make a difference, but not for Income Support.

Under UC the carer and LCW elements can’t be paid to the same person but while it’s still ESA both can be paid to one person. It’s only when UC comes in that one person needs to choose the element that’s worth most to them if they are eligible for both.