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

ESA claim stopped - UC or ESA?

EmmaB
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A4U Shrewsbury

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Joined: 27 January 2022

I have a client who due to being homeless and very poor mental health has not attended 3 WCA.  He is on IRESA and his mother is an appointee but the client leads a very chaotic life and has severe social anxiety.  For the first two WCA the mother explained that he was too unwell to have an assessment but for the third WCA she says she was not informed about it and also missed a phone call from the Decision Maker to discuss reasons for non-attendance.  As a result the ESA claim was stopped and a MR put in which has been unsuccessful. 
I believe that the client will now have to make a claim for UC as no new ESA claim can be made and even if he appeals the decision to stop his claim once on UC he won’t be able to go back onto ESA? is that the case? - any help with this would be appreciated.

I have found the following in a guide to ESA MR and Appeals which suggests that he may be able to make a new claim for ESA - The rules restricting a claimant’s right to reclaim ESA also do not apply if the reason you
were refused ESA initially was that you failed to return your ESA50 or UC50 form (the limited capability for work questionnaire) or you failed to attend a face-to-face assessment. In these circumstances, you can reapply and be paid at the assessment phase rate even if your condition has not deteriorated and you do not have a new condition. You should also consider challenging the decision to refuse you ESA.

[ Edited: 31 Aug 2023 at 09:37 am by EmmaB ]
Elliot Kent
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Shelter

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He has essentially two options.

One is to claim UC. If he claims UC, there is no going back. An appeal could still be pursued - if successful it may result in ESA back pay and potentially the LCW or LCWRA element being included from day one of the UC award.

The other is not to claim UC. Obviously this would leave a large gap in his income but if his appeal were successful, then his ESA would be reinstated and would continue indefinitely until he is forced into the UC fold either by another WCA failure, some other change of circumstances or managed migration.

The material that you are looking at is not really relevant to the circumstances at hand. It’s not possible for your client to make a new claim for irESA because nobody can make one anymore as a result of UC. What you are looking at relates to the ‘revolving door’ provisions which were intended to stop people applying for ESA, being found fit for work and then just applying again on the same facts. They don’t have any continuing relevance because new claims for irESA can’t be made at all.

EmmaB
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A4U Shrewsbury

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Total Posts: 8

Joined: 27 January 2022

Thanks so much for this quick reply - the clarification is much appreciated