Further entitlement to CBESA after time-limiting

Where entitlement to ESA(Cont), has been terminated because it exceeded 365 days and the claimant reports a deterioration in their health condition or makes a further claim for ESA(Cont) and the claimant had, or is treated as having had, LCW since the previous entitlement ended and the claimant satisfies the basic conditions of entitlement and 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 conditions.

So, if someone reports a deterioration via a new claim (as opposed to a request for a supersession), the only route would be a new claim for NSESA. Would the claim, if successful, then be NSESA rather than old style ESA, even though it will be linked to the original contribution years through continuous PLCW’s?

.

It’s a new claim for ESA, so will be NSESA. PLCW’s can continue by virtue of Art 10 of the No. 9 Commencement Order.

By the way, entitlement by this route does not work by using the linking rules anyway. It’s a new entitlement under s.1B of WRA2007.

Also, even if the change is simply reported as a deterioration, it will still technically be a new claim. See DMG Chapter 41 Para. 41863 (ADM equivalent is Chapter V2 Para. V2063)..

Thank you Charles. My thinking was that if CBESA was brought back into payment by a supersession on the existing award, keeping it as old style, the claim could subsequently include an award of IRESA (potentially allowing SDP to be included).

If CBESA was brought back after a new claim and converted to NSESA, there would be no IRESA.

Application made after award has terminated !!!
V2062 Where
1.  entitlement to ESA, including under the youth provisions, has been terminated
as in V2010 or V2015 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 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 ADM Chapter
U1) and
5.  the DM determines that the claimant has, or is treated as having, LCWRA
the claimant is entitled to an award of ESA, even though they do not satisfy the
contribution conditions1
. The award is regarded as an award of ESA 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 ended on 5.5.15 after 365 days. Entitlement was based on
tax years 2012/2013 and 2013/2014. He continues to have LCW for the purpose of
NI credits. Bogdan makes a further claim to ESA from 6.7.15 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 and the support component from 6.7.14. He does not have to
serve waiting days or the assessment phase.
V2063   Where the claimant reports a change in their condition other than by making a claim,
the DM should consider whether the contact satisfies the conditions for claiming
ESA1
(see ADM Chapter A2).

Thanks, Diogenes, that’s the material I was wrestling with.

OK UBT , but I read it as you did , that an award can be made where the claimant was on credit only and gets put into the support group. and an award can be made even though the claimant does NOT satisfy the NI conditions,
have I misunderstood it then ?????