Employment and Support Allowance (ESA)
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what are the disability premiums for ESA and how do you claim or qualify?

magunra2kmagunra2k Member Posts: 43 Connected
Hello 

My youngest brother has Down's Syndrome and it is very severer, it affects his general health,mobility and he requires 24 hour care, we have recently started the ESA claim process, but we are a little in the dark as to what he can claim, how the process works and why it takes so long.
Also it seems that there are premium for people with significant Disabilities but we cant really find much information about them, can anyone explain what the process is step by step and what the premium disability payments are ,how much and how to claim or qualify for them.

to to clarify, he is very severely disabled ,he will never be able to work in any capacity ,he cant function independently and needs constant supervision and is very close to losing the ability to walk due to a degenerative problem with his knees, he has almost no understandable speech and we are exploring the possibility of a dual diagnosis autism and downs.

Replies

  • CockneyRebelCockneyRebel Member Posts: 5,257 Disability Gamechanger
    Hi
    Your brother maybe entitled to PIP ( personal independance payment ) which is the beneftr to help people that have difficulty performing everyday tasks. If he qualifies then he may also qualify for certain premiums to be added to his ESA, if he gets an income related award .
    There is a self test on the B&W site

    http://www.mybenefitsandwork.co.uk/pip/indexxx.php

    which I suggest you do as this will give a good indication how it works and the likelyhood of an award
    Please come back with any questions

    CR
    Be all you can be, make  every day count. Namaste
  • magunra2kmagunra2k Member Posts: 43 Connected
    i think he currently receives the higher rate of DLA  due to his needs, i have looked at the Self test and based on those questions he would be scoring between 4 to 8 points on most of those questions other than feeding and dressing himself, which pays more for disabled people PIP or DLA? 

    Im currently getting more involved in his care, our Mum is his primary carer but due to age and illness she is beginning to struggle, so im starting to take over the financial aspects of his life to ease some of the pressure,shes struggles as more of the benefits process seems to be pushed online and is generally a minefield and difficult to navigate and the government seem hell bent on making it impossible for older generation to claim without the aid of tech savvy teenager. 

    so the question is , if he qualifies for the premiums will they apply them automatically or will we have to apply for those and what provides more money DLA or PIP? 
  • Sam_AlumniSam_Alumni Scope alumni Posts: 7,731 Disability Gamechanger
    There is a benefits calculator here that you can try.

    PIP is replacing DLA for people aged 16 to 64. If you get DLA and your claim has an end date, you'll be asked to claim PIP before your DLA ends. If you get DLA and your claim does not have an end date, you can be asked to claim PIP at any time.

    Scope
    Senior online community officer
  • BenefitsTrainingCoBenefitsTrainingCo Member Posts: 2,692 Pioneering
    Hi magunra2k,

    The four rates of PIP (standard rate daily living, enhanced rate daily living, standard rate mobility and enhanced rate mobility) are the same amounts as the DLA rates (middle rare care, higher rate care, lower rate mobility and higher rate mobility - there is an additional lower rate care in DLA that was effectively abolished for PIP claims) but it is the criteria that is different. Most people end up with a lesser award of PIP than they were receiving for DLA as one of the reasons for the change was to pay out less to benefit claimants. From your description of your brother's difficulties though, I'd be amazed if he doesn't get the enhanced rates for PIP.
    For ESA income-related, when you first make a claim you will be in the assessment phase period. This is normally £73.10 for a single person but will include a enhanced disability premium (£15.90) for anyone getting DLA higher care or PIP enhanced rate daily living. It could also include a severe disability premium (£62.45) if you live alone and don't have a carer claiming Carer's Allowance.
    Once an ESA claimant has had an assessment from the DWP (this is normally face-to-face but could be paper-based in clear cases such as your brother's) an additional premium of £29.05 is added on for those in the work-related activity group or £36.55 for those in the support group. 
    It can be quite complicated to understand if you don't know, or have little experience of the system so I hope I have explained it clearly enough but if you have any further questions please ask and we will advise further.

    Lee
    The Benefits Training Co:
    Paul Bradley
    Michael Chambers
    Will Hadwen
    Sarah Hayle
    Maria Solomon
    David Stickland
  • magunra2kmagunra2k Member Posts: 43 Connected
    Hello Lee ,

    just to be clear, so you would expect someone who is totally incapable of work due to disability, is single, has a round the clock carer to get 
    £73.10 and £36.55 a week ESA ,Assuming they have been placed in the support group. so a total of £109.65 ?

    Now that hasn't happened, the application was done via phone, the statement about the phone application is missing the fact he's Downs, it just lists him as learning difficulties and deaf, no medical forms have been received, no face to face assessment, and he has been placed in the work related activity group and has a meeting with his "work coach" on Thursday. 
  • BenefitsTrainingCoBenefitsTrainingCo Member Posts: 2,692 Pioneering
    Hi magunra2k,

    The support group is for people who may not be able to work for a long time or may never work again. These are the claimants who would get the £109.65 plus the £15.90 to make a total amount of income-related ESA to be £125.55, if they have no other income (DLA, PIP is disregarded)
    The work-related activity group is for people who might be able to think about going back to work in the future, is rehabilitative in nature, and aims to ensure that those currently unfit for work who may be able to work sooner rather than later, are equipped with the skills, knowledge and confidence to be in the best possible position to be able to get a job when that time comes. These claimants will only get £73.10 (I forgot to mention that the work-related activity component of £29.05 has been abolished from new claims but those already getting it will keep it).
    From what you have said your brother should be in the support group and this decision to put him in work-related activity sounds wrong. You need to put in a mandatory reconsideration, and if this fails, an appeal. It would also help if you could provide some medical evidence from his GP and/or any other medical professionals involved in his care.

    Lee
    The Benefits Training Co:
    Paul Bradley
    Michael Chambers
    Will Hadwen
    Sarah Hayle
    Maria Solomon
    David Stickland
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