Hospital whilst waiting for ESA Appeal

I’ve a couple of clients who are waiting for their ESA appeals to come around. In the meantime they are due to have operations at hospital. Do they need to make fresh ESA claims to be treated as having LCW under reg 25 or can they get WRAC added onto their appeal rate so long as it applies, simply by sending evidence of their hospital stay/expected recuperation period in to the DWP?

Thanks
Sam

The WRAG is not paid automatically.  I understand the Dept will only start paying the component if they carry out a LCW assessment AND find that the person does have actual LCW.  In that event I understand that they backdate the component to week 14 of the award of ESA pending appeal regardless of the fact that the claimant may have first become a hospital in-patient later than week 14 (I’d have to dig out the guidance concerned).

If the person was determined not to have LCW in any new assessment then that determination would be treated as if it had not been made whilst the person is appealing the original decision - see Reg 147A.  The claimant would continue receiving ESA at the assessment rate in that situation despite being treated as having LCW under Reg 25.

However, in reality the DM is likely to resist any attempt to make a new LCW determination whilst the appeal is outstanding citing Reg 147A(2).  The question would be whether the hospital admission/treatment was evidence of a new or significantly worsened condition so as to get round the ban which 147A(2) presents.

My understanding is that being treated under Reg 25 does not by itself get you a WRAG.  Without a new LCW determination, Reg 25 simply exempts you from the medical evidence gathering requirements, eg sick notes, ESA50, without getting you any extra money.