Any way back??

Hi all, looking for some advice/opinion if possible please.

Client was on ESA with Support Group and DLA. In July last year he had a decline in his mental state and essentially locked himself in his flat for 2 months and did not engage with anybody. During those 2 months, he was sent a ESA50 to complete and also the invite to move from DLA to PIP. He didn’t reply to either of these.

ESA still arranged a medical assessment but he did not attend as he was not opening his post. Basically after 2 months he improved, went to the bank and realised all of his money had stopped.

He panicked, called ESA and discussed it with them. They took an MR from him, where he explained what had happened, and they advised that they would lodge this, but he would have to claim UC. So he made a claim.

We got involved at the request of Adult Social care because he had been in touch with them complaining he had no money etc.  We lodged a PIP claim for him and tried to make some headway in to his UC claim, as he previously had SMI towards a small mortgage he has on his home and we were trying to get arrangements made for his appointments etc as he has poor mobility and couldn’t get to the Jobcentre easily.

ESA have now accepted good cause for failure to attend and after sending out an ESA3, have paid him back ESA from July 2019 to the start of his UC claim.

So im trying to establish:

1) is there any scope at all to have UC claim ended and ESA re-instated? He has had payments of UC so I don’t know if this is an option.
2) Am I right in thinking that the Support Group/LCWRA should now be added to the UC claim, back to the start of the claim? He has been sent a UC50 but im wondering if this can be avoided?
3) Should he be considered to have served the relevant waiting period for SMI on UC as he has served this on ESA?

Any suggestions will be much appreciated.

thanks

(1) To even get out of the starting blocks on this sort of argument, you would need to show an SDP entitlement when the UC claim was made. There doesn’t seem to have been one when the claim was actually made (as ESA and DLA both seem to have stopped by then) so the best you could do would be to have both ESA and DLA/PIP reinstated for this past period leading to a retroactive SDP entitlement for this period.

This has been done for ESA - but I’m struggling to see how it is possible to get DLA/PIP paid for this period. There is a procedure for ending DLA on the failure to make a claim for PIP set out at regs 7-11 of the PIP (Transitional Period) Regs. There are a number of stages at which the SSWP can grant extensions to the time to claim, but once you have reached the end of the road at reg 11, there doesn’t seem to be any way back onto DLA at all. A new PIP claim could be made but it wouldn’t be backdated. So I think that is the end of the road.

Even if DLA/PIP could be reinstated for this period, I think that DWP are reluctant to accept that this sort of retrospective SDP entitlement invalidates a claim which was valid when it was made -so I think it would be a battle to get this UC claim “undone” in any event. It would at least bring your client within the scope of the compensation scheme and/or legal challenges.

(2) Yes - if he had an LCWRA assessment for ESA, this is effective from the beginning of his UC claim. He should still comply with the UC50 unless DWP can be persuaded otherwise. Normally when an FTA decision is revised, DWP will want to re-assess the person immediately.

(3) If he was entitled to a loan for mortgage interest when the UC claim was made, then in general the qualifying period does not need to be served again. On the face of it, this would seem to mean that if his ESA was ended but has now been revised, and if the revised award included LMI, then this would continue from the start of his UC award. I am not sure whether ESA would have done this automatically when the ESA3 was actioned so if he wants the loan, he might need to request this specifically.

Thanks Elliott.

The revision from ESA does state that his file will be referred back to the assessor to arrange a medical assessment, but with the claim being closed, I am not sure whether this will happen.

He has a non-digital claim so my plan is to call them today and see if we can get it resolved, but I wanted to get it clarified so I can manage his expectations.

thanks for your help.