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

New style CESA; ‘terminally ill’ claims not registered or registered as UC claims

 < 1 2

 

Jeremy Barker
forum member

Citizens Advice North Lincolnshire

Send message

Total Posts: 66

Joined: 7 September 2010

John Bott - 05 June 2018 08:25 AM

I have received a DWP New Style ‘Desk Aid’ from an ESA NS Claims Manager, I am particularly concerned with paragraph 1 - this explains to me why the DS1500 and claims are not being processed (not valid according to ESA) - I will share it word-for-word:

New Style ESA desk aid

1. When a customer indicates that they want to claim ESA C and you establish that they live in a full service UC area their claim is treated differently and is referred to as New Style (NS ESA) or Dual (Receipt of UC & NS ESA). To claim NS ESA, customers have to request a specific UCESA 1 form by calling UC on 0800 328 5644 (choosing option 2 & 6). Once these forms are completed, the customer should be advised to call UC on the same number and follow the same sequence to book a work coach appointment. The customer will be advised to bring their completed form supporting documents to their pre-arranged appointment. This is so that ID can be verified and a customer commitment agreed and more importantly that the claim form can be sent in the proper way to the Centralised site tasked with processing these types of claims (Belfast). UNDER NO CIRCUMSTANCES should the customer be advised to post this form. THE CLAIM IS NOT VALID IF THESE STEPS ARE NOT TAKEN.

Terminally ill or not - this is their script

What on earth is supposed to happen if the claimant cannot attend an interview, for example, if they are in hospital. This is completely ridiculous and suggests that no one is thinking about reality when writing this guidance. In addition it seems to me that a lot of the internal guidance is based on the DWP’s ideas of how things should work rather than what the law (the various regulations) actually says!

     
Income Max
forum member

Weymouth & Portland Citizens Advice

Send message

Total Posts: 84

Joined: 2 January 2018

Jobcentre can do home or hospital visits for UC initial interview. Can they do that for NS ESA as well?

     
Jon (CHDCA)
forum member

Welfare Benefits, Craven CAB, N Yorks

Send message

Total Posts: 1192

Joined: 16 June 2010

The whole thing is a mess when you try to square it with the rules. Just to belabour the point:

Making a claim for an employment and support allowance in writing

15.—(1) A claim for an employment and support allowance may be made to the
Secretary of State in writing on a form authorised by the Secretary of State for that
purpose and must be completed in accordance with the instructions on the form.

Is the ESA1 form authorised by the SoS for the purpose of claiming ESA? If someone downloads a blank one from rightsnet and sends it in on spec, then I don’t know… But where it is issued to someone who rings up and asks to claim, how can it be anything other than an authorised form?

(2) A written claim for an employment and support allowance, which is made on
the form approved for the time being, is properly completed if completed in accordance
with the instructions on the form and defective if not so completed.

The SoS could have chosen to include on the form instructions about providing evidence of ID, say,  or arranging JCP appointments, but she has not. if all the questions on the form are answered, then it can not be defective.

Date of claim for an employment and support allowance where claim made in writing
16.  In the case of a written claim for an employment and support allowance, the date on which the claim is made is to be the first date on which—

(a)a properly completed claim is received in an appropriate office;
(b)a person first notifies an intention to make a claim, provided that a properly completed claim form is received in an appropriate office within one month, or such longer period as the Secretary of State considers reasonable, of first notification; or

Para (b) should allow the date of the phone call to set the date of claim. Para (a) should cover anyone who downloads or otherwise obtains an approved form and sends it in on spec, and assuming they have somehow divined which office is appropriate to receive it.

Making a claim for a jobseeker’s allowance: attendance at an appropriate office
19.  A person wishing to make a claim for a jobseeker’s allowance, unless the Secretary of State otherwise directs, is required to attend for the purpose of making a claim for that allowance, in person at an appropriate office or such other place, and at such time, as the Secretary of State may specify in that person’s case.

This is the JSA rule, there is simply no equivalent to this requirement in the ESA claiming rules. The closest being the evidence requirement, which as Andrew says is not part of setting the date of claim.

     
Andrew Dutton
forum member

Derbyshire Welfare Rights Service

Send message

Total Posts: 1268

Joined: 12 October 2012

‘Is the ESA1 form authorised by the SoS for the purpose of claiming ESA? If someone downloads a blank one from rightsnet and sends it in on spec, then I don’t know… But where it is issued to someone who rings up and asks to claim, how can it be anything other than an authorised form?’

I can’t see any reason why an ESA1(UC) should not be accepted even if not requested via DWP’s preferred method. There’s nothing there to say it cannot be accepted.

We have also had a couple of cases in which an old-style ESA1 has been sent in,  with the the error being corrected shortly after and the correct form sent in.

In one case ESA was awarded from the date that the ESA1(UC) was received but the old-style ESA1 was ignored.

My argument is that the ‘old’ ESA1 is surely a statement of intention to claim, and if it is not acceptable per se, it should trigger the ‘defective claim’ rule and the claimant should be notified and given time complete the correct form.

I put this to DWP some weeks ago. There has been no reply.

It appears to me that in all this (as, in the past, DWP’s demands that JSA claims should be telephone-only when the legislation said otherwise) DWP administrative convenience is being mistaken, knowingly or unknowingly, for the requirements of the law.

     
ASH
forum member

Welfare Officer, St Christopher's Hospice, SE London

Send message

Total Posts: 94

Joined: 16 June 2010

So -  from the above it seems that the way to make a claim work is to:

1. Make the call to UC asking for the form.  You may need to explain that ‘new style’ cESA does exist. 

2. Fill in the form - you may need another visit if you need to wait for the posted or emailed copy.

3. Ring again to make an appointment with the jobcentre.  You may need to explain that ‘new style’ cESA does exist and that this is the procedure. 

I have been told that they are putting aside extra long appointments for this once they have agreed it is what needs to be done.

4.  Make sure the claimant attends the appointment with all their evidence, sick notes and DS1500 and makes sure the jobcentre properly notes that they are terminally ill and should be exempt from the wca

It seems a bit cruel and unnecessarily drawn out to me. 

I haven’t quite worked out what happens if the claimant is too sick to attend the jobcentre, (quite a few of my clients),  the DS1500 was sent with the PIP claim by another party with no copies available or the claimant does not want to acknowledge the extent of their illness.  As said before I have had variable success with just sending the form with a ds1500.

I tried getting a home visit once.  They came relatively quickly but the visitor did not have a clue and only took the id details - did not want sick notes or my heavy hints that was special rules claim. 

 

 

     
John Bott
forum member

Derbyshire Welfare Rights Service

Send message

Total Posts: 8

Joined: 7 September 2010

Just as an update (Terminal claimants) - I am having success by submitting DS1500’s with claims direct to Belfast and getting decisions on the day and most importantly payments start, (credit where it’s due - Belfast have been very helpful) , I know there are many issues around the CESA NS which needs ironing-out, but for the moment on DS1500’s and claims, I am going to continue this way. It does seem too good to be true but I am hoping I can keep getting quick common sense decisions this way.

     
Jon (CHDCA)
forum member

Welfare Benefits, Craven CAB, N Yorks

Send message

Total Posts: 1192

Joined: 16 June 2010

Welfare Rights Adviser - 22 May 2018 05:29 PM

A customer telephones 0800 328 5644.

The contact centre part complete the form over the phone and email it to the customer.

But the important part is that this has been registered then as their date of claim.

If the customer doesn’t have an email address then they will post a form out to the customer – but this still registers the date of claim.

We need to obtain more detail, but we now have a case where the possible sequence of events is: client telephoned to obtain ESA1, then deceased before submitting it. Query from the estate on whether any arrears can be paid.

From what I can see, the UC etc version of the claims and payment regs (see reg 56 ) has removed the possibility of a claim on behalf of the deceased that might have existed under the equivalent 1987 regs, so it would now becomes crucial to know whether the initial phone call stands as the claim. I suspect not, but am unsure ...

     
Hattie S
forum member

Macmillanbenefits - Croydon CAB

Send message

Total Posts: 15

Joined: 8 December 2015

Income Max - 06 June 2018 11:57 AM

Jobcentre can do home or hospital visits for UC initial interview. Can they do that for NS ESA as well?

Yes, I have recently arranged one for a client. They are sometimes difficult about agreeing to it so I always tell my clients that they might have to insist and not take no for an answer if someone tries to fob them off!

     
Jon (CHDCA)
forum member

Welfare Benefits, Craven CAB, N Yorks

Send message

Total Posts: 1192

Joined: 16 June 2010

edited out ... will update this thread when I have more info ...

      [ Edited: 20 Jun 2018 at 02:35 pm by Jon (CHDCA) ]
Jon (CHDCA)
forum member

Welfare Benefits, Craven CAB, N Yorks

Send message

Total Posts: 1192

Joined: 16 June 2010

Jon (CHDCA) - 13 June 2018 04:04 PM
Welfare Rights Adviser - 22 May 2018 05:29 PM

A customer telephones 0800 328 5644.

The contact centre part complete the form over the phone and email it to the customer.

But the important part is that this has been registered then as their date of claim.

If the customer doesn’t have an email address then they will post a form out to the customer – but this still registers the date of claim.

We need to obtain more detail, but we now have a case where the possible sequence of events is: client telephoned to obtain ESA1, then deceased before submitting it. Query from the estate on whether any arrears can be paid.

From what I can see, the UC etc version of the claims and payment regs (see reg 56 ) has removed the possibility of a claim on behalf of the deceased that might have existed under the equivalent 1987 regs, so it would now becomes crucial to know whether the initial phone call stands as the claim. I suspect not, but am unsure ...

Just as an update .. a would-be claimant requested new-style ESA claim, there were some admin difficulties, required more than one phone call before the form was eventually issued. Claimant then sadly deceased before they could sign the application. Application form sent anyway by bereaved family with support of local JCP. An award for ESA arrears has been made, local JCP say because the “application process was begun” before his death, and there is flexibility to allow it to continue. A result for the client, but I have no idea how that squares with the rules.