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UC v Contribution based ESA - savings criteria.

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5 months 4 weeks ago #291579 by Gordon
JJ

The relevant Benefit Year is the one in which the claim is made, the Benefit Year for a new claim of NS ESA made 18/5/23 is 2023.

NS ESA is the contribution based benefit equivalent to UC.

Gordon

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The following user(s) said Thank You: JJ

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5 months 3 weeks ago #291625 by Tammy Curtis
Replied by Tammy Curtis on topic UC v Contribution based ESA - savings criteria.
Gordon, Paragraph 3 (f) states that the relevant benefit year is the one immediately preceding the claimant being assessed as LCWRA. This was assessed by uc in 2022 and it would be the same assessment done for NS ESA, as the benefits are equivalent. I’m not sure which advisor it was that JJ spoke to but I most certainly would consider the ‘relevant’ benefit years to be 2021/2022 and allow the claim. I suppose it’s a shame that there is so much scope for assessors to make their own judgment calls when allowing or disallowing claims. I still think the client should make the claim as it can’t hurt anything but if they do the review and the uc claim is disallowed the ‘relevant’ benefit year becomes the one immediately preceding the current claim as LCWRA would need to be reassessed by NS ESA and would be disallowed because the contributions were made too long ago. Tamara

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5 months 3 weeks ago #291627 by Gordon
TC

I am always happy to be proven wrong when it is to the benefit of the claimant, your latest post suggests that this might be the case.

This is the first time we have seen a claimant attempting to apply for NS ESA so long after making an application for UC.

The relevant term here is Limited Capability for Work, not LCWRA as this is what the legislation refers to.

The guidance in the relevant chapter of Advice for Decision Makers is of no help as it does not cover this scenario only refering to ESA, not a PLCW that results from another benefit, namely UC.

It should also be noted that experience suggests that the UC and ESA teams are not actively aware of the "other" benefit being claimed and I think it likely that there are no procedures in place for them to check as part of a claim.

However, is further action in the best interest of the claimant, this does not appear to be JJ.

I am unclear, even after reading the legislation and guidance as to when a new claim for NS ESA would apply from?

If 2022 then it will inevitably create a recoverable overpayment of UC from that date. While it may be expected to be offset against a back payment of the ESA this does not appear to be possible under UC and the most likely scenario is significantly reduced UC payments for a significant period which would be likely transferred to the ESA award if the UC claim is closed.

If the NS ESA starts from the date of claim then an overpayment should be avoided but the claimant receives no financial benefit as the ESA will be deducted £ for £ from their UC unless having fortnightly payments instead of monthly has value.

It is only when and if the claimant's savings and assets exceed £16,000 that the NS ESA claim delivers real value as it would continue after the close of the UC claim. It is unclear whether this is likely or not.

Gordon

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5 months 3 weeks ago #291635 by Tammy Curtis
Replied by Tammy Curtis on topic UC v Contribution based ESA - savings criteria.
Gordon,
I think the scenario you suggest of the clients savings going over the £16000 threshold, is the one that JJ originally asked about. This would mean that the uc claim will be closed and the right to claim NS ESA will be lost so the claim must go in before that happens. Whilst it would cause the inevitable overpayment of uc, the amount would be offset by the NS ESA back pay. The amount is likely to be more than the overpayment as savings are likely to have been reducing the uc payment during the claim already. Whilst the uc overpayment can’t exactly be recovered from the back pay, the claim would be allowed and then once the back pay is issued the client could use that to pay the uc overpayment themselves. The most important issue to address is making sure that the client is not made to give up a benefit entitlement because his savings have reached the threshold for an income related benefit. The client must be allowed to claim a benefit they are entitled to and any assessor worth their salt should be making sure of this. The same thing actually happened to my sister because she was told she had to claim uc and they cancelled her ESA C claim which was an error and it took us months to get it reinstated. Whilst it may seem that there is no benefit to doing this, it is important that every client is receiving the correct benefits at the correct rates. If this happened then the official error bill which runs into the billions, would be much reduced and then the government might stop all these unfair terms being thrown out in haste to the detriment of every benefit claimant. I just wish the whole mess could be cleared up.
Tamara

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5 months 3 weeks ago #291673 by JJ
Thank you both for this interesting insight.

In view of all of this I think it may be advisable for the recipient, then, to make a claim for NS ESA.
It is likely that his financial circumstances will mean future disqualification from UC.
And, I was, indeed, concerned for him to benefit from his previous 30+ years contribution record.

As he was granted the LWRCA in Sept 2022, I am wondering if this would automatically place him in
the Support Group for the NS ESA ? I would hope that a new assessment (health) would not be necessary.

Although we cannot be 100% sure of how the system will deal with his case, as long as he will not be ''out of pocket' to try.
The worst case scenario would be a decision not to allow the NS ESA. In which case he will have to remain on UC until the inevitability of his financial situation ends the entitlement.

This I would find quite sad, as his original entitlement to NS ESA was overlooked by the DWP.

Thank you

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5 months 3 weeks ago #291679 by Gary
Hi JJ

One of the advantages of applying for NS ESA is that it is paid fortnightly, disadvantage is that your UC will be reduced £ for £.

Gary

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