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

New Style ESA - reclaiming after 365 time limit

csmk
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Welfare Benefits Specialist, Frenkel Topping

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Total Posts: 81

Joined: 16 May 2017

Hi all,

I have a client who was getting NS-ESA in the WRA group up until 30th June 2019. They have continued to get NI credits for LCW following this date (no WCA as of yet). No entitlement to UC or other means tested due to partner’s income by the way.

They have just recently finished a course of chemotherapy for cancer and after looking at possibilities for claiming, I found this: Welfare Reform Act 2012 Sec 52(1B):

“1B.—(1) Where a person’s entitlement to a contributory allowance has ceased
as a result of section 1A (1) or (4) but–
(a) the person has not at any subsequent time ceased to have (or to be treated
as having) limited capability for work,
(b) the person satisfies the basic conditions, and
(c) the person has (or is treated as having) limited capability for work-related
activity,
the claimant is entitled to an employment and support allowance by virtue of this
section.

I’m assuming this would mean the NI contribution conditions wouldn’t have to be met if this Section is applicable and that the basic conditions are over 16yrs, under SP age, not getting JSA, in Great Britain etc.

Now I advised the client to give it a try, to claim on the basis that he’s continued to have LCW under credits, meets the basic conditions and due to recovering from cancer treatment he could be treated as having LCWRA (although I wasn’t sure if a WCA needed to be done first).

They’ve refused to complete the claim, which I expected really, but I wanted to make sure that I’m correct in my thinking that they can make a claim and it would just be a case of arguing with the telephony agent on the line, or if I’ve missed the mark here and it’s better just to leave this alone?

[ Edited: 21 Nov 2019 at 04:10 pm by csmk ]
csmk
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Welfare Benefits Specialist, Frenkel Topping

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Total Posts: 81

Joined: 16 May 2017

I think I might have found my answer in ADM Chapter V2 at V2062 - gives example of claimant making a new claim after time limiting ends. Claim won’t be decided until a decision is made awarding LCWRA after a work capability assessment.

Could anyone confirm at all? Thank you.

Ianb
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Macmillan benefits team, Citizens Advice Bristol

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csmk - 21 November 2019 04:18 PM

I think I might have found my answer in ADM Chapter V2 at V2062 - gives example of claimant making a new claim after time limiting ends. Claim won’t be decided until a decision is made awarding LCWRA after a work capability assessment.

Could anyone confirm at all? Thank you.

I agree with your interpretation. Would just note that where automatic entitlement to be treated as having LCWRA applies it is not a WCA that is carried out although DWP choose to use the UC50 form to confirm the relevant medical information.

csmk
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Welfare Benefits Specialist, Frenkel Topping

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Total Posts: 81

Joined: 16 May 2017

Thank you very much for the response Ianb, really appreciated as my client has been very distressed after two hour call with DWP telling them the opposite (I think they went along the lines that a credits claim is still ESA and a new claim can’t be made).

Thanks for the point about WCA v UC/ESA50s too, shall stop using this phrase for the process if this is incorrect.

Ianb
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Macmillan benefits team, Citizens Advice Bristol

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Total Posts: 958

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csmk - 22 November 2019 08:46 AM

Thanks for the point about WCA v UC/ESA50s too, shall stop using this phrase for the process if this is incorrect.

DWP thinking on this seems to be muddled as I tried to describe here https://www.rightsnet.org.uk/forums/viewthread/15203/