Client claimed ESA awarded credits (didn't have sufficient NI contributions) as partner's earnings/hours etc etc, and is appealing a WCA decision.

Client has now left partner, would be eligible for IR-ESA, can we argue she should now receive payments, without putting in a new claim (WCA decision within the last 6 months).

Any help really appreciated.

If she is appealing a decision over whether she has limited capability for work, she can claim ESA at the assessment rate whilst waiting for her appeal to be heard. She will still need to be covered by a med cert to claim. I would imagine that she would still need to make a new claim to get this as she is unlikely to have claimed income related ESA when she originally claimed if her partner was working. A new claim can be backdated up to 3 months.

Thanks Scott for replying.

At this stage (i'm seeing client tomorrow) its possible on past experience with Call Centre's her claim may have been treated as a claim for IR ESA and Conts ESA.

The query was on the basis that her claim may have been treated as a IR ESA, if so could we argue change of income/capital etc circumstances, get her payments while awaiting appeal to be heard?

The BDC in question has not come to terms with ESA yet (e.g. struggled with the concept of premiums being paid during the assessment stage), and the client in question is under the local CMHT diagnosed with Bipolar Affective Disorder, very vulnerable it appears, and i'm looking for the least line of resistance to get her payments. I'm worried about them misconstruing this scenario as 'new claim made within 6 months of a LCW decision' as opposed to a purely payment issue stemming from her leaving her husband. Hence the fact i'm desperate for ideas.

Andy

If she had made a claim for income related ESA Ithis would have been refused by the Decision Maker. It would not be possible to supercede a decision to refuse benefit if the change took place after the date of the decision so I would suspect she would still need to make a new claim.

Mmmmmmm me too, damn i wanted to be told something different.

Thanks Scott for your help, really handy

This client should still have a claim on the JSAPS system for ESA whilst the appeal is going through. Although she was not entitled to any monies, she still had the underlying entitlement, therefore the NI credits were being awarded.

She now has a change of circumstance and should phone the ESA telephone team to notify them. They will then send ESA1 for change of circs, and client should complete it to ask for ESA IR from the date her partner left.

She should not have to make new claim. It is a change of circs.

Thanks Lilacpig.

So you worked at Hastings aka St Leonards wotsit office, i had dealings with the IB section between 1999 - 2004 when it covered bits of South London, my favouritist DWP office of all time. Welcome aboard the good ship Welfsnet.

Andy

Thanks for your welcome Andy! Yes, I remember the Croydon area very well. I'm glad we were helpful!

Becky

Thanks Scott and Becky (inside info invaluable) followed both your advice and erm nothing, so resubmitted everything via local MP and ESA payments made from date of separation mid Oct 2009.

But as always seems to be the case with the BDC in question they say they have not received the med certs from........., anyway we have copies which we are forwarding (recorded delivery - costing us loads) via the customer service manager.

Andy