LCWRA after appeal

Am I missing the point here?... I though the LCWRA was included from the start in this case

Client was on ESA in 2017, failed WCA in August 2017, went onto JSA and then UC (after an EPS).  Successful tribunal and decision made in August 2017 revised to give LCWRA from this date. 

Client has been paid arrears of LCWRA up to date of UC claim (after adjustment with DP paid with JSA) and I have asked UC to pay arrears of this element from date of UC claim in December 2017 up to April 2018 when he had a new WCA and found to have LCWRA which was paid from that point.

I put a note on the journal and this was the response:

When a work capability decision is made, three full assessment periods must pass before any payment is made. 
I can see that the award of limited capability for work and work-related activity was added to your claim with effect from 14 December 2017, which was the start of your claim. 
As a result of the three month policy, you would have been entitled to the additional benefit award for LCWRA in your payment received 20 April 2018. 
I have checked your claim and can see that you received this additional award from that date.
You are not therefore due any additional payment.
Regards

This should be a straightforward application of regulation 19 of the Universal Credit (Transitional Provisions) regulations 2014.

As it’s now been established that the claimant had LCWRA in ESA immediately before the date of UC claim the waiting period does not apply and LCWRA should be paid from the beginning of the UC award.

Thanks Maree, I have had a look, are they covered by this?
(4) Where, on or before the relevant date, it had been determined that the claimant was entitled to the support component—
(a)regulation 27(3) of the Universal Credit Regulations does not apply; and
(b)the claimant is to be treated as having limited capability for work and work-related activity for the purposes of regulation 27(1)(b) of those Regulations and section 19(2)(a) of the Act.

Does it matter that he was not actually receiving ESA but rather JSA at point of making UC claim.  Is the fact that the LCWRA element was paid up to the date of UC claim sufficient?

I’d missed the JSA bit - normally claimants would have reverted to ESA assessment rate whilst waiting for their tribunal.

However I think the critical thing is that the tribunal decision has reinstated his ESA claim (for the period prior to claiming UC) and so it should apply.  Otherwise he wouldn’t have been able to get the backdate of the LCWRA as this isn’t attached to a JSA award.

Interestingly they paid the LCWRA up to the date of UC claim, he had been paid disability premium but they paid the arrears as difference between the DP and the LCWRA

That sounds rights - as Maree says the tribunal decision meant he was entitled to ESA continuously from when they stopped it up until the UC claim. They then paid the backdated ESA but offset any JSA already paid (in this case basic plus DP)

Daphne - 25 July 2019 12:57 PM

That sounds rights - as Maree says the tribunal decision meant he was entitled to ESA continuously from when they stopped it up until the UC claim. They then paid the backdated ESA but offset any JSA already paid (in this case basic plus DP)

This is confirmed by DMG paragraph 03348 and D&A Regs, Reg 3(5G), as the JSA decision is revised.
http://www.legislation.gov.uk/uksi/1999/991/regulation/3

Thanks for all the posts.  Nice outcome for a change, spoke to local JCP Thurs afternoon who agreed LCWRA should have been paid, offered to speak directly to senior CM, arrears of almost £1000 UC paid to client on Friday!
Now just waiting for the flowers and chocolates…

I’m jumping on this one and hope Daphne can answer!  Similar case but decision changed on late ESA MR but client had sadly already claimed UC so waiting for them to pay the additional element from day 1. 

My question is, the ESA MR stated no reassessment for 18 months from 18/06/2019 but client has just returned her UC50 (2 days prior to the MR decision), can this be passed over to UC as well as the LCWRA? 

Thank you!

I may not be the best person to answer but I’m sure others can chip in too…

I would point out to them the new MR decision and ask them to take that into account and not carry out a WCA. But at the end of the day they always have the power to refer to a health care professional which then gives them the power to carry out a supersession. However, they need to give reasons for any different decision.

Ok thanks

JojoMitchell - 05 August 2019 10:57 AM

I’m jumping on this one and hope Daphne can answer!  Similar case but decision changed on late ESA MR but client had sadly already claimed UC so waiting for them to pay the additional element from day 1. 

My question is, the ESA MR stated no reassessment for 18 months from 18/06/2019 but client has just returned her UC50 (2 days prior to the MR decision), can this be passed over to UC as well as the LCWRA? 

Thank you!

The UC-instigated WCA should just be dropped when this is pointed out to them.

Thank you - was hoping this was the case!