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Hi @Jamie1965
No, there is no need for a medical to be passed to qualify for couple rate.
What may have happened, is that your contributions based claim has been processed (which is just for you) but the income-related part of your claim (which is what tops the claim up to couple rate where the income/capital in the household is low enough) has not been for some reason.
It might just be that the income-related part is still being processed, but it may be that there is some query over income/capital/etc, as there is much more to check for income-related.
I'd recommend getting back on to ESA - remember that the people who answer the phone are callcentre staff, so not all have knowledge of benefit entitlement, so if it seems that they don't know what they're talking about, ask for a callback from the benefit centre.
Let us know if they're still not making sense!
Kind regards,
Mary
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