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

Backdating IR-ESA claim in full-service area

allanr
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Welfare rights officer - Derby Advice, Derby Homes

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Joined: 17 June 2010

We became a full service area on 11 July and I have someone who would have been entitled to IR-ESA prior to this and could get a backdated fit note.
I’m aware that the general consensus on here is that an ESA claim made now would terminate entitlement and a UC claim would have to be made. However, I’m also aware that some people had said they have managed successfully to submit paper claims for ESA with backdated fit notes and had them accepted. Is there anyone who currently believes this is possible, or was it just local offices erroneously accepting claims?
Also, assuming my client now has to claim UC, is there any mechanism for having ESA paid for any period covered by the fit note prior to 11 July? It seems that he has actually been missing out on ESA for a long time, so 3 months backdating would have been possible, had UC not intervened.

HB Anorak
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Benefits consultant/trainer - hbanorak.co.uk, East London

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I think any claim for ESA has the effect of abolishing ESA(ir) for the period in respect of which the claim is made.  This means that, once full service UC has started, you have to rely on the limited backdating provisions in UC itself and you cannot initiate a backdated ESA(ir) claim.

PaddyC
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Welfare rights officer - Islington Council

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We became full service 20.7.18. I met with someone this week who has anxiety issues. She’s getting HB, but no other income (living off reducing capital). She’s nervous about UC and very reluctant to claim.
As a stop-gap (and without researching the legalities) I persuaded her to make a telephone claim for backdated ESA. The DWP have accepted the claim and the call handler expects the award to go back 3 months, but end on 19.7.18.
I have 2 questions:
1. Are they likely to pay for the period quoted?
2. If the ESA claim is allowed and no claim for UC is made, is there any possibility of the award continuing after 19.7.18?
While awaiting your answers I’m researching the issue myself, but I’m finding it difficult to find legislation that specifically address the issue - help finding it will be very much appreciated.

Liz S
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Welfare specialist and appeals officer - Herefordshire Council Welfare Rights Team

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We are experiencing similar issues here - how can a retrospective back-dated claim for ESA be refused if submitted? DWP are not even issuing a full decision letter to refuse award just notifying the claimant has to claim UC from the date we moved to full service. Historically as long as the claim was backed by medical evidence we could make a retrospective back-dating request for ESA, I understand UC only offers one month in comparison.

All advice appreciated.

HB Anorak
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Benefits consultant/trainer - hbanorak.co.uk, East London

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The applicable local WRA 2012 commencement order (usually Article 4) appoints a day for the abolition of ESA(ir) and JSA(ib) to come into force.  That day is the first day of any period in respect of which an ESA/JSA claim is made.
For example, Article 4 of the No 24 Order, which covered about half the country, says that the “amending provisions” come into force as a consequence of a claim for ESA or JSA.  The “amending provisions” are defined as the bits of the WRA 2012 that abolish ESA(ir) and JSA(ib).

Article 4(3) specifes the date on which this happens:

The day appointed in relation to a claim referred to in paragraph (2), and any award that is made in respect of the claim, is the first day of the period in respect of which the claim is made

The No 24 Order originally only applied where the claimant met the gateway conditions.  But every Wednesday this year up until 25 July the Order was “modified” so as to remove any reference to the gateway conditions in some of the postcodes it covers.  For example, the most recent modification order is 2018/532

 

PaddyC
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Welfare rights officer - Islington Council

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Thanks Anorak,

I’m still trying to get my head around this, but on my first glance at the commencement order, it looks like ESA is abolished for a claim made or treated as made on or after the date introduction of full service UC. In this case, the claim is backdated and so treated as made before that date.

Please let me know if I’ve misunderstood.

HB Anorak
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Benefits consultant/trainer - hbanorak.co.uk, East London

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See Article 2(5) to (7) of the No 24 Order: the JSA/ESA claim cannot be treated as made on an earlier date except in the limited circumstances referred to in paras (6) and (7) which I think (without checking) will probably refer to an intention to claim or a defective claim already submitted before the date referred to in the Order.  See also Article 2(4) and (5) of the Modification Order, which contains similar rules.

I think the combined effect of all that is that if you make yourself known for the first time after full service has started, backdating legacy benefits is not possible.