New style ESA claim ends after 365 days but client should have been in LCWRA group

Client aged 62 married (complicated living arrangements, not living with husband who is on SRP and occupational pensions, non committal about returning to him). She lives with her daughter in order for the daughter to ” provide care and for ease of medical appointments”. She has significant health issues and has applied for PIP.  She had an income from NS ESA up until February 2023 when it ended after 365 days - she was in work related group.  She gets small amounts of money from husband if she asks for it. She would like support making a late appeal to go into the Support group and get ESA reinstated. She satisfies at least 2 of the support group descriptors (and did so whilst in the WR group)

The potentially quicker option seems to be that she requests that her ESA claim is reinstated, which she can do if she is deemed to have had NI credits due to LCW even if she is not receiving a relevant benefit.  She does not have an active NI credits only claim. Cpag 956 says, that she would have to contact JCP if she does not currently have an NI ESA claim to do this, however would it be better just to make a new NS ESA claim - is that even possible in these circumstances? Or do you have to get the NI credits in place to be able to do this? I am wondering if it would also be an issue that the relevant tax year has already ended?

The other option is to put in a late MR for the wrong grouping under previous ESA claim. This approach would seem simpler now but would probably take a longer time to get a decision/award.

I would be interested to know which option you would consider to be the best or if you have tried and been successful with either of these approaches and have any tips.

Thank you

If your client is still within absolute time limit to request MR and the evidence is in favour of Support Group rather than WRAG at the date of decision, that’s certainly going to be the most financially advantageous outcome.

HelenL - 02 May 2023 02:48 PM

The potentially quicker option seems to be that she requests that her ESA claim is reinstated, which she can do if she is deemed to have had NI credits due to LCW even if she is not receiving a relevant benefit.  She does not have an active NI credits only claim.

Are you positive she doesn’t have a ‘credits only claim’? I thought that when cbESA ends after 365 days, the client continues to have LCW for the purposes of NI credits. If this is the case, so long as client can now demonstrate she now has LCWRA, then she can qualify for payments of cbESA again without needing to satisfy the contribution conditions (see CPAG p965).