Any benefit regulation experts?

lmnop

To cut a long story short; if you’ve already served the wait period for assessment on UC do you need to serve it again on NS ESA? I can’t find the regulations about transitioning this way only that they should accept my LCWRA.

Long story: I’m having major problems with my ESA and I really need some help.

I was claiming UC and awarded LCWRA in Jan. I then found out ESA would pay me more and my ni contributions meant I was entitled so I put in a claim for NS ESA.

This caused massive problems as they weren’t used to people transitioning that way and they kept closing my claim etc. Finally got them to accept I don’t need fit notes and reinstate my claim.

Now they’re saying that they’ll only backdate the LCWRA/support group to 92 days after my claim as I need to serve the wait period. 

I already served this on UC, why do I need to do it again on NS ESA when they’ve already accepted I have LCWRA? 

Does anyone know where I can find the regulations on this? I don’t know whether it is worth appealing. 

Ross_Alumni

Hello @lmnop, how are you? 

I'm not sure of the answer to your question, but hopefully others will be able to advise on this. 

Just wanted to welcome you to the community  

janer1967

Hi and welcome I am no expert either just wanted to say Hi but we do have some people on here who will answer your query when they are next on line

poppy123456

Hi and welcome,

There's a 13 weeek assessment phase even when you've already been assessed as having LCWRA.

lmnop

Not to dispute what you’re saying @poppy123456 but do you know where the regulations are that show that?

If I transitioned from ESA to UC I wouldn’t have to go through an assessment phase again and my LCWRA would stand from the first day of my UC claim. 

Moving from UC (and already having LCWRA) to NS ESA should surely be the same? Why would I need to serve an assessment phase again when I’ve already been assessed? 

The only regs I can find say this but don’t mention whether I should serve another wait period or not:

31.—(1) A claimant is to be treated as having limited capability for work-related activity if— (a)the claimant is terminally ill;

(b)the claimant is— (i)receiving treatment for cancer by way of chemotherapy or radiotherapy; (ii)likely to receive such treatment within six months after the date of the determination of capability for work-related activity; or (iii)recovering from such treatment,and the Secretary of State is satisfied that the claimant should be treated as having limited capability for work-related activity; (c)in the case of a woman, she is pregnant and there is a serious risk of damage to her health or to the health of her unborn child if she does not refrain from work-related activity; or

(d)the claimant is entitled to universal credit and it has previously been determined that the claimant has limited capability for work and work-related activity on the basis of an assessment under Part 5 of the Universal Credit Regulations 2013.

poppy123456

I'm sorry but i can't find anything that backs up my advice.

lmnop

That’s alright @poppy123456 and you’re most likely correct but I’ve learned the hard way not to trust anything they advise me so trying to find the actual regs or legislation one way or the other and it’s starting to seem they just don’t exist.

However my reading of the regs I copied above, I would interpret it to mean I should be treated as having it from the first day. Do you read it differently? 

Thank you for the help! 

poppy123456

That's the UC regulations you've posted there isn't it? at least it looks like it to me. If so then they are different to the ESA regulations.

You are indeed treated as having LCWRA and no fit notes are needed but the 13 week assessment period still applies.

lmnop

No they’re the ESA regulations: https://www.legislation.gov.uk/uksi/2013/379/regulation/31/made
 I just can’t find anything at all that says I should have to serve another wait period when I have a determined award. 

I don’t understand why anyone would need another assessment phase? I served that on UC when waiting for assessment and then payment of LCWRA 

poppy123456

I'm not starting to doubt my own advice but i still can't find anything that specifically states exactly what the regulations are. For this reason i'm going to taga member of our admin team who will hopefully be able to help further.

@Adrian_Scope can you help here please? Thanks in advance

Adrian_Scope

Hi @poppy123456 and @lmnop. 
I'm struggling to find any evidence to back up my thoughts on this so have passed it over to our benefit expert. It may take a few days for us to get back to you but we'll let you know as soon as we find anything.