CESA time-limiting start date

Hi all,

Probably a rather daft question but here goes…

Client claims CESA - start date of claim 18 November
Payment of CESA begins on 21 November (after the 3 waiting days)

Does the counting of 365 days for time-limiting of CESA start from the date of claim or the start of payment?

Thanks in advance

Chaos

Hi, I would have thought that the 365 days starts after the 3 working days. Time spent in the assessment phase can count towards the 365 day time limit, and the assessment phase begins on the first day of entitlement to ESA, i.e. the first day of limited capability for work after the service of waiting days.  Any other thoughts?

Agree completely.  Whilst the period of limited capability for work starts from day 1 (ie the first of the waiting days), ESA entitlement only starts on day 4 (ie after the expiry of the 3 waiting days).

Maybe it wasn’t such a daft question after all, I agree with your thoughts but is their any regulation that would confirm this?

Not a daft question at all. 

Para (1) of Reg 144 sets out the rule and para (2) its exceptions.

“144.—(1) A claimant is not entitled to an employment and support allowance in
respect of 3 days at the beginning of a period of limited capability for work.

(2) Paragraph (1) does not apply where–

(a) the claimant’s entitlement to an employment and support allowance
commences within 12 weeks of the claimant’s entitlement to income support,
incapacity benefit, severe disablement allowance, state pension credit,
a jobseeker’s allowance, a carer’s allowance, statutory sick pay or a
maternity allowance coming to an end;

(b) the claimant is terminally ill and has–
(i) made a claim expressly on the ground of being terminally ill; or
(ii) made an application for supersession or revision in accordance with the
Social Security and Child Support (Decisions and Appeals) Regulations
1999 which contains an express statement of being terminally ill; or

(c) the claimant has been discharged from being a member of Her Majesty’s
forces and 3 or more days immediately before that discharge were days of
sickness absence from duty, which are recorded by the Secretary of State for
Defence, or

(d) the claimant is the other member of a couple to whom regulation 4I(2) of the
Social Security (Claims and Payments) Regulations 1987 applies and the
former claimant was not entitled to an employment and support allowance
in respect of 3 days at the beginning of the period of limited capability for
work which relates to the former claimant’s entitlement; or

(e) the claimant is entitled to an employment and support allowance by virtue
of section 1B of the Act (further entitlement after time-limiting).”

Note, that para (1) above should be read alongside Reg 145(1) below:

“145.—(1) Any period of limited capability for work which is separated from another
such period by not more than 12 weeks is to be treated as a continuation of the earlier
period.”

The effect is that there is no need to serve the 3 waiting days where your new period of limited capability for work (pLCW) starts within 12 weeks of the old one ending.  It follows, that your ESA entitlement that would normally start on day 4 would start on day 1 where you’ve re-claimed within 12 weeks of the old award ending.

Section 1A(1) & (2) WRA 2007 provide that the 365 days are in respect of a period of “entitlement”.  As stated above Reg 144(1) excludes the waiting days from any period of entitlement.

Fabulous, thank you very much Tom. This assist greatly in a convoluted catalogue of issues for one client and his ESA.