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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

ESA – migration cases – inaccurate IRESA assessments?

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Andrew Dutton
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Welfare rights service - Derbyshire County Council

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This scenario keeps cropping up:

- claimant was on IB without IS top-up
-migrated to ESA and placed in Support Group
- receives ESA decision which includes what appears to be an IRESA assessment
-this assessment tells them that their CESA level is, for instance, £112.05 -  this includes a ‘top-up’ (transitional amount)
- it also states that their applicable amount for IRESA is £106.50 (£71.70+34.80)
- therefore they cannot get IRESA
-the assessment does not include Enhanced Disability Premium
-some do not include Severe Disability Premium where client is on relevant DLA etc
-claimant is locked in to this situation as they will not know, without advice, that anything is amiss

We have dealt with individual cases, lodged appeals, made complaints – but it seems as if there are more than just a few of these cases about, and that there may be many people (nationwide?) who have been underpaid or not paid IRESA because premiums have been missed.

As far as I can see, JC+ should be checking cases like these for possible entitlement to IRESA but it would appear at least in some cases that something’s going wrong.

Is anyone else finding this?

Ali Lord
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Hi Andrew, we have seen a few of these cases come through on the advice line. Can I ask which JCP office you’re dealing with as ours seem to be quite localised.

Mick Quinn
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[
As far as I can see, JC+ should be checking cases like these for possible entitlement to IRESA but it would appear at least in some cases that something’s going wrong.

Is anyone else finding this?
]

Check out chapter 45 Vol 8 of DMG: 45413 -45414 the example should be tattooed onto the DWP foreheads!

Andrew Dutton
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I just happen to have this about my person, so to speak….


DMG Chapter 45
http://www.dwp.gov.uk/docs/dmgch45.pdf

1 ESA (Trans Provs) Regs,
Person who has an existing award
45214 A person who has an existing award is excluded from making a claim for ESA1. This
applies from 27.7.082.
1 ESA (Trans Provs) Regs, reg 3(1); 2 reg 1(2)
The conversion process
45320 The conversion process begins when the claimant is notified that they are in the
conversion phase – see DMG 45410. The claimant is then required to satisfy the
conditions of entitlement for ESA, including the WCA. The basic conditions are
modified for the purposes of conversion. In particular, the condition that the claimant
is not entitled to IS does not apply for the purposes of making conversion decisions.
Claims
45355 No claim to ESA is required when the claimant is entitled to an existing award1 which
is subject to conversion2. See DMG 45204 for the meaning of existing award.
1 WR Act 07, Sch 4 , para 11; 2 ESA (TP, HB & CTB)(EA)(No. 2) Regs, Sch 2, para 18(b);
SS (C&P) Regs, reg 3(k)
Obtaining information
45413 The claimant’s duty to disclose information relevant to their existing award of benefit is modified to enable the Secretary of State to require from the claimant information or evidence for the purposes of determining whether that award should be converted
to ESA1.
1 ESA (TP, HB & CTB)(EA)(No. 2) Regs, Sch 1, para 13(a); SS (C&P) Regs, reg 32(1)
45414 This enables the Secretary of State to establish whether a claimant whose existing
award is IB or SDA, and who is not entitled to IS, might be entitled to ESA(IR) as well
as ESA(Cont) on conversion.
Example
Carlton is entitled to IB of £91.40. During the conversion phase the Secretary of
State establishes that he has no other income. Following application of the WCA,
Carlton is placed in the support group. On conversion, Carlton is entitled to ESA of
£110.50 made up of ESA(Cont) of £96.85 and ESA(IR) of £13.65 (EDP).

Andrew Dutton
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Sorry Ali - missed replying to you - our decisions for this are made at Derby Benefit Centre. In Nottingham.

I would be fascinated to know if this is widepread or isolated phenomenon.

Mick Quinn
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From our units experience of IB/ESA conversions it’s widespread in Northumberland.
And ESA section don’t seem to learn after repeated appeals being successful…..

Dan_Manville
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I’ve seen a few in Wolverhampton too.

Another permutation is where someone’s passed 365 days and drops onto IRESA, tehn wins an appeal to get into the Support Group and they’re dropped back onto CESA with no consideration of continuing IRESA arising from EDP or SDP.

I remember a few years back, close to the inception of ESA there were a lot of problems with the SDP being paid during the assessment phase (they were mixed up between components and premiums; an easy mistake…)

The Disability Benefits Consortium stepped in and there was a caseload trawl to fix it.

I wonder whether; with the new administration in place, the DBC could still persuade DWP to pull their socks up.

Ali Lord
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Andrew, I was hoping it was just a rogue DM in the Clydebank office, but it appears that it’s deep rooted.

adviceplus
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Yes we have the same issues

We have been told that claimants should be send an ESA 3 form at conversion but that this is by no means automatic

What we came across as well is that when Disability and Carers Service visitors identify at what ever time that claimant should receive the top up,  they put in for the review but do not consider the back date e.g one severely disabled claimant transferred from IB in youth in 2012 now visited by JC+  because of new ESA 50 ,given top up but no backdate
When we pick up than appeal or now ask for mandatory review, the back date is given.

Our office for the initial migration is Aberdeen BDC , the office for appeals is LLanelli BDC and they revise to date of claim but when we pick them up they are mostly already in Caerphilly BDC as the ongoing local office .
 

Andrew Dutton
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I’m beginning to wonder if a national caseload trawl is exactly what is needed if this is widespread.

Views?

1964
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Agree. We’ve had similar cases here too.

Rosie W
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adviceplus - 06 February 2014 05:46 PM

When we pick up than appeal or now ask for mandatory review, the back date is given.

Wish we had the same DMs then - got one appeal on the go just now which is on its fourth set of directions, judge completely not getting the point, about to go for an interlocutory hearing to try and get it sorted out.

Mick Quinn
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Very much agree.

Think they could also consider trawling IBy /ESAy claimants who turned 20 within the 196 day QP when they were paid IS as incapable of work. DWP missed sending out IBy22 form so claimants stay on IS (instead of floating off due to IBy increasing)

Obviously nowhere near as many as IB/ESA conversions, but the few case I’ve come across did highlight how much clients had missed out on financially.

Tom H
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Interesting that you should raise the IS to IBy conversion issue in this thread Mick.  Not only do I have a case at the UT on that very issue at present (you obviously had more luck persuading the DM or Newcastle tribunal than I did - and you’re right it’s a big amount of cash those youngsters lost), but I am also at the UT on the very subject of this thread, ie backdating of IRESA for those whose existing award was” IB-only” pre conversion who are subsequently placed in SG and qualify for IRESA at that point due to EDP.

Dan_Manville
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Andrew Dutton - 07 February 2014 10:04 AM

I’m beginning to wonder if a national caseload trawl is exactly what is needed if this is widespread.

Views?

You’re right, but I fear they won’t accede so easily as last time

Ken Barber used to be our point of contact with the Disability Benefits Consortium but I can’t find his email address on the forum search.

Andrew Dutton
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Given DWP’s determination to reduced error in decisions, I’m sure they will be co-operative.

Vide DWP website: New benefit fraud and error campaign: ‘Benefits. Are you doing the right thing?’

Well. Indeed.