moved to support group asked to complete an ESA1

I have a client who at the end of 52 weeks ESA in WRAG did not qualify for income related. Appeal lodged (late) to try and secure move to support group but evidence indicated a real risk of appeal not succeeding. So, as it was an ongoing live claim, and there was later evidence of additional health issues, med certs were submitted with a request to review the claim and appeal withdrawn as it would have risked the continuation of a contribution based claim.  Also claimed PIP (November) completed ESA50 (January), had medical for PIP (Feb) and in April awarded high rate daily living rate.  Still no ESA medical and I advised her to contact DWP and advise of the successful PIP award.  Has now been told she will be placed in Support Group from May but has to complete an ESA1.

Surely a new claim is not needed?  And I would have thought they would place her in the Support Group from November, the date PIP was awarded from.

Another issue still to be resolved, claim for HB/CTB failed to include disability prem & higher earnings disregard for partner during the period NI credits awarded, only amending from PIP award, they were made aware of ESA still being a live claim even though no payment made.

How are folk supposed to navigate this….nightmare.

I think ESA1 would have been sent to assess entitlement to irESA now that clt would be entitled to EDP in app amt.

HB/CTR will not have included a Dis Premium as clt claiming main phase ESA.

Thank you, just spoken to client and although she had another very confusing telephone conversation with DWP.,it does fit in with what you suspect is behind the need for the ESA1 to be completed.

Apparantly decision is evidence accepted and will be in SG from May last year, form issued to capture information necessary (in this case did not complete the IR section as partner working) but obviously in some cases IR could be due. It also gives department information on what bank the payment is to be made to.

HB/CTR claim should always include the WRAG component even when the 52 weeks has meant benefit ran out as long as still showing credits only claim

We have been trying to get HB to review claim and take this into account, conversation started over a year ago (initially the customer advised them) told by DWP it made no difference, probably taking the period back another 6 months. How does she stand in relation to backdating?

If this question involves a couple where one is an ESA claimant and one is not, and household income exceeds applicable amount, then the following may be relevant:

If the non-ESA partner were to be the lead HB claimant, and their partner is in the assessment phase and gets PIP, then HB should include a couple disability premium in their applicable amount. This is generally worth more than either the work component or no ESA component at all. Therefore, on the HB claim they may be better off switching who is the claimant and who is the partner, depending on which ESA group they are in, and whether there is a disability benefit award. But you can’t have both disability premium and an ESA component.

A bit more detail here:
http://www.cpag.org.uk/content/esa-claimants-and-housing-benefit

I vaguely recall that there was a HB circular which said that LAs should be pro-active in inviting claimants to switch to the most advantageous partner/claimant configuration, and maximise their HB award. Whether this swapping can somehow be allowed retrospectively I don’t know.

If the partner/claimant are the “right” way round, and it’s just a matter of revising or superseding an HB decision so as to include the correct premium or component, then the “relevant benefit” rule should allow for full arrears back to the date of the award of PIP or ESA (D+A regs 7 and 8).

Regarding continuation of work component after 365 day limiting (i.e. “credits only”), I think HB/CTB Circular A3/2012 may be the current guidance, if you want to point the LA at something:

14 Claimants not moving on to ESA (IR) following exhaustion of ESA (C) will have the award element of their ESA terminated, however, they will still be classed as having limited capability for work. This means they can continue to receive national insurance (NI) credits from the date their ESA (C) exhausts.

15 The availability of NI credits for such cases means that claimants will continue to qualify for the work-related activity component within their HB/CTB applicable amount, as well as any transitional addition that might have been awarded as a result of Incapacity Benefit to ESA conversion (see circular HB/CTB A14/2010). Please note, there will be no ESA (C) or transitional amount to take into account as income in the HB/CTB assessment once ESA (C) ceases due to time limiting. It is the component added to the applicable amount, and any transitional addition awarded in the applicable amount that the claimant remains eligible for.

thank you, that may be very useful, it is clear enough guidance 😊