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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

CB-ESA 365 limit and Repeat claims

Kfleur
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Health Outreach, Sefton CAB

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Joined: 8 December 2014

I have a client who made a claim for CB-ESA in August 2015, decision in February 2016 and appeal in June 2016 stated unfortunately she was fit for work. However after the decision the client has deteriorated with their mental health and looking into a repeat claim. It has been more than 12 weeks between the DWP decision and repeat claim so I am assuming the 12 week linking rules do not apply.

The client can requalify for CB-ESA as one of her tax years was not considered in the previous claim (different benefit years).

The client had around 10 months of her CB-ESA for her last claim and I was wondering whether she would get another 365 days in WRAG group or would it be for only 2 more months?

Any authorities for your replies will be useful, thank you.

flair
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Welfare rights officer - Linstone Housing Association

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As far as I’m aware you are correct and she would qualify for a further 365 days of Conts based, irrespective of how much was paid on previous claim, as the new claim is based on a later tax year than the earlier claim.

See DMG Volume 8 Chapter 41 Para 41847

Kfleur
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Health Outreach, Sefton CAB

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No I agree, that does suggest she can have another 365 days in WRAG group. Thank you

Tom H
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Newcastle Welfare Rights Service

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Hang on.  So Aug 2015 - June 2016 is the 10 months, right?  That comprises a period of Limited Capability for Work (pLCW) of 6 months spent waiting for the WCA, and a pLCW lasting 4 months whilst waiting for the tribunal.    The 2nd of those pLCWs is treated as a continuation of the first so that there is a pLCW lasting 10 months which ended just recently when the award of cb-ESA stopped shortly after the unsuccessful tribunal.  So it’s nothing like 12 weeks since the pLCW ended.  The contribution conditions look at pLCWs so it’s not 12 weeks since the WCA decision, here Feb 2016, but 12 wks since the end of the pLCW, here June 2016.

Edit: And you’re obviously confident you’ll demonstrate significant worsening, otherwise even if you wait until, say, start of Oct 2016 to make your new claim for cbESA you might find that client is found straight away to fail the WCA on the strength of the previous medical.

[ Edited: 21 Jun 2016 at 07:13 pm by Tom H ]