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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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I’m still clanking away about this - slow progress, though….

Mick Quinn
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Andrew Dutton - 07 April 2015 01:44 PM

I’m still clanking away about this - slow progress, though….

Hi Andrew, Any update mate? Still regularly coming across fairly recent conversion cases where the DWP have cocked up.

Pete C
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Sorry , I forgot to post the results of the FoI request, here it is;
 
 
 
 
 
 

7 May 2015

      FoI 1044


Dear Mr Carey,

Thank you for your Freedom of Information request received on 17 March 2015.  I apologise for the delay in replying.  You asked :-

i) Background.

Since the introduction of Employment and Support Allowance in 2008 the DWP have engaged in a rolling programme to migrate existing Incapacity Benefit and Severe Disablement Allowance claimants to ESA.

In some circumstances a person being migrated can, after migration, be entitled to Income Related ESA (IR-ESA)as well as Contribution Based ESA (CB-ESA). This is particularly common when the claimant is placed in the Support Group and is therefore eligible for the Enhanced Disability Premium (EDP). Under the Incapacity Benefit/Income Support rules the claimant may not have been eligible for any means tested benefit but after migration and with the entitlement to the EDP added they are now eligible for IR-ESA

There is anecdotal evidence that claimants in this position have not been awarded IR- ESA and may not have been aware that they were now entitled to IR –ESA and this unhappy situation has continued until they have been alerted to possible entitlement by the CAB or similar.

The purpose of this request is to see if there are potentially a large number of claimants who might not be aware that they are entitled to IR-ESA and, consequently, have lost out on entitlement to free prescriptions and other health care costs

ii) Freedom of Information Request.

From the date that the migration process began;


a) What steps did DWP take to inform claimants being migrated that they may have been entitled to IR-ESA.


The national IB reassessment process commenced in 2011.  In order to qualify for Employment and Support Allowance claimants were first referred for a Work Capability Assessment to establish if they had limited capability for work. The assessment also established whether or not they had limited capability for work-related activity (the “Support Group”). 

In assessing benefit entitlement the Department firstly considers whether a person entitled to IB or SDA is eligible for contributory ESA and then whether a transitional addition is needed to maintain a claimant’s benefit income. Secondly for those entitled to Income Support consideration is given to eligibility for income-related ESA and again whether a transitional addition is payable to maintain benefit income.

When it is known that IB or SDA recipients have limited capability for work DWP attempts to phone them to give general advice about income-related entitlement so that they can request an application form.  Advice about income-related ESA is also given in the written notification when a claimant’s entitlement is converted to ESA. Depending on the response of claimants they are sent an application form and asked to provide the information necessary to determine income-related entitlement. 

b) Were these steps universal over all benefit Delivery Centres or arrangements made local by the BDCs themselves

These steps were standard to the process and in national guidance issued to relevant benefit centres and contact centres involved in IB re-assessment. Additional steps were subsequently adopted by benefit centres to send claimants a letter or application where attempted phone contact had not been successful. National guidance now requires the issue of an ESA3 application in these circumstances. 


c) How many claimants became eligible for IR-ESA after migration.

Information about the numbers of claimants potentially eligible for ESA(IR) following migration is not recorded. 

d) What steps were/are being taken by DWP to identify claimants who may have not been paid al they were entitled to after migration.

No additional steps have been taken to identify claimants with potential entitlement to higher rates of ESA after migration. However claimants who want to apply for ESA or think they might be due more ESA are able to make a claim or apply for a re-consideration of their existing benefit award.


If you have any queries about this letter please contact me quoting the reference number above. 

Yours sincerely,

Steve Brooke

 

Andrew Dutton
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Hi all - from this end it’s a problem we are not seeing at the moment.

The cases that we did have on hand have been resolved, to the benefit of the claimants, by us being provided with direct contact with a Complaints Resolution Team who have co-ordinated matters, passed on information, and made sure we get answers.

This contact was provided because we were finding that on this and many other headings, the Benefit Centres were simply not responding.  It has been a very helpful practical solution to what was a complete log-jam.

In terms of policy and principle however, nothing has really shifted and the problem could pop up again. The details given in reply to the FoI application indicate they’re trying - but perhaps not hard enough. The onus still seems to be on the claimant to realize they are being under-paid, get an ESA3 and send it in.

‘Advice about income-related ESA is also given in the written notification when a claimant’s entitlement is converted to ESA. Depending on the response of claimants they are sent an application form and asked to provide the information necessary to determine income-related entitlement’ –

But it is the advice about IRESA in the written notification that has been the root of so much of the problem! The ‘advice’ has been totally misleading!

This UT judgement provides some grounds for continuing to press [apologies if I’ve mentioned it before]
http://www.rightsnet.org.uk/welfare-rights/caselaw/item/whether-separate-claims-are-needed-for-contributory-and-income-related-esa
‘It follows, as appears also to be common ground, that… it is not necessary to make separate claims …there is nothing in the legislation requiring separate claims’

benefitsadviser
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A similar issue is when folk placed in the support group of CBESA and they dont get EDP IRESA top up.

Im talking about new ESA claims, not IB to ESA conversions.

As it was rightly said earlier the DWP attitude is “It serves the client right for NOT claiming it or filling in an ESA3”

When a client gets an award letter saying “The law says you need £73.10 + £36.20 a week to live on” how are they supposed to know about enhanced disability premiums?

Im also sick of Call centre workers acting as gatekeepers.

They frequently tell single clients in the support group that £109.30 a week is all they are entitled to, and their current award is correct.

They later blame the claimant for not sorting it….......

Campbell McCrea
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Does CE/277/2014 help? Although drawing the DWP’s attention to this has led to them sending ESA3 & “IS10” forms to my client and I’ve no doubt they will want to restrict consideration to current, rather than backdated entitlement…without a complaint, etc., that is…

[ Edited: 23 Sep 2015 at 03:28 pm by Campbell McCrea ]
Daphne
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Andrew Dutton
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Did I say we weren’t getting these any more? Spoke too soon, didn’t I…..

Dan_Manville
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Andrew Dutton - 06 October 2015 12:59 PM

Did I say we weren’t getting these any more? Spoke too soon, didn’t I…..

I’ve still got loads coming out of the woodwork. I’m hoping that soon I will hammer home that they don’t need an IS10 to award SDP when they’ve got an ESA3 already.

Pete C
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Message for Mick, did you get the FoI request?

Mick Quinn
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Nothing through yet mate

Andrew Dutton
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Still getting these cases.

I just dealt with one where the client was sent an entitlement letter showing ESA of £29.05 a week. I queried this with DWP and they replied that this was the WRAG component that you add to the personal allowance, which wasn’t shown, to get the actual entitlement. Which wasn’t shown.

Taking a deep breath, I replied as follows:


‘On the matter of the ESA entitlement letter, part of which I copied to you, it really is no help at all and just confuses matters. To show the WRAG component in isolation from all other components makes no sense.

I have seen many of these letters where appropriate premiums are missed off, the Contribution-Based amount is represented as the Income-Related amount, entitlement to IRESA is shown as Zero whereas either the Severe Disability Premium or the Enhanced Disability Premium, or both, are missing from the assessment.

The dreaded final page of the entitlement letter also usually refers to entitlement during only one period of time, whereas the claimant may have had varying entitlement during the period covered by the letter, owing to matters such as the ending of the assessment phase and the addition of premiums.

Any entitlement letter covering more than one set of circumstances should surely show changes to entitlement, listed on separate, clearly-labelled pages.

I would be grateful if you could ask your managers to pass this on to whoever is responsible for designing the ESA entitlement letters.’

Dan_Manville
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Andrew Dutton - 08 June 2016 10:34 AM

Still getting these cases.

Me too

Most of mine are due an SDP as well; I’ve seen a good few five figure pay outs.

benefitsadviser
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Still happening.

Got the EDP backdated 4 years for yet another client this week

£3200 underpaid for 4 years. Bugs me that DWP come down like a ton of bricks on overpaid benefits, with civil penalties etc, yet when underpaid my clients dont even get an apology

flair
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I have 3 further cases in at the moment awaiting processing. All going back 3 or 4 years.
I suspect there must be thousands nationwide still out there being underpaid.
An absolute disgrace, the DWP should be reviewing every ESA Support Group case, to see if there is IR entitlement, I won’t hold my breath.