Employment and Support Allowance (ESA)
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ESA and Group Income Protection

YorkiesYorkies Member Posts: 7 Listener
Hi - i have been on long term sick since 2009 with degenerative disc disease.  I have a group income protection from my work which pays me 50% of my salary (50% of my salary rolled back to when i started having issues, not the date when i was classed as long term sick in 2009). 

In 2009 i was also getting Esa but it was stopped as it was means tested and my partner worked.

Recently ive been speaking with scope as ive applied for PIP - and they mentioned that i should also claim new style esa as it was contribution based and wasnt means tested now, and my group income protection wasnt a factor. I still pay tax and NI contributions from the GIP payment and have done since 2009. I am not doing any work for my employer as i cannot sit or stand for any length of time due to the pain - but they still pay me from the GIP payment. 

So i applied for new style esa and had a letter from the dwp saying i cant claim esa due to the occupational or Personal pension i receive. Im very confused if i can claim this benefit or not. I went back to scope and they have again said GIP isnt a factor as its not means tested. 

Ive also read other cases on the Internet such as this, which sounds very similar to my case. https://www.benefitsandwork.co.uk/forum/10-dla-esa-queries-results/133629-esa-group-income-protection

Point 10 saying that GIP doesnt meet the description. 

Ive also read through the legislation but it seems unclear regarding GIP


DWP have asked for a copy of the GIP policy and a letter from my employer on how this is paid. They have also stated i have a month to appeal this for a mandatory reconsideration.

Could anyone offer any clarity or advise on the situation as im so confused, it would be greatly appreciated. 

Best Regards
 Rich

Replies

  • janer1967janer1967 Community champion Posts: 7,277 Disability Gamechanger
    Hi and welcome I am not too sure anyone can help as this seems quite complex, have you been in touch with CAB or welfare rights

    We do have a member who has great knowledge of benefits and I am sure she will advise when she sees this
  • YorkiesYorkies Member Posts: 7 Listener
    Hi, 

    Thanks very much for the reply, i have just emailed CAB so will see if they can advise. 

    It does seem complex, and ive had so many different answers, im not even sure the DWP know the rules when ive spoken to them :) 

    I think the issue may be around if they class GIP as permanent health insurance, which i cant see how it is as it doesnt last forever unlike a pension payment. 

    Anway thanks for the reply. 


  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    HI and welcome,

    I have fairly good benefit knowledge on a lot of things but unfortunately, i do not know the answer to your question. Hopefully someone else will see this and advise you further.

    If you have a welfare rights local to you then you could ring them to ask. I hope you find the answers you're looking for. Good luck.


    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • YorkiesYorkies Member Posts: 7 Listener
    Ok thanks for the reply
  • Tori_ScopeTori_Scope Community Team Posts: 3,210 Disability Gamechanger
    edited October 2020
    Have you been able to contact anyone else to try and get some answers @Yorkies
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  • YorkiesYorkies Member Posts: 7 Listener
    Hi, 

    Ive been speaking to CAB, who need to see an up to date GIP policy (sent them an old one i have) and the details of how im paid from my employer. Im still waiting for these details.

    CAB say its complex and need their experts to look at it once they have all the information. 

    So just waiting for the information at the moment
  • Tori_ScopeTori_Scope Community Team Posts: 3,210 Disability Gamechanger
    Thank you for the update @Yorkies! Hopefully they'll provide the employment details soon. Let us know how you get on :) 
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  • chiariedschiarieds Community champion Posts: 6,896 Disability Gamechanger
    Hi @Yorkies - I'm sorry you're having difficulties finding exactly where you stand with this issue, & it's good you've sought local advice.
    Just a few thoughts.... the 2nd link you give is to a draft legislation, which gives you a link to this: https://www.legislation.gov.uk/uksi/2013/379/regulation/1/made
    Please then see:
    https://www.legislation.gov.uk/uksi/2013/379/regulation/68/made    which seems to indicate GIP would be disregarded only with regard to the Armed Forces & Reserved Forces.
    I have scanned quickly through the legislation, but this was the only mention of GIP I saw.
  • YorkiesYorkies Member Posts: 7 Listener
    Hi. 

    Thanks for taking time out to try and help. I will forward this onto CAB to see what their experts make of it all
  • Chloe_ScopeChloe_Scope Scope Posts: 10,662 Disability Gamechanger
    Best of luck @Yorkies
    Community Partner
    Scope

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  • liverbird103liverbird103 Member Posts: 2 Listener
    Hi Yorkies, your link to the benefits & work group is indeed a point raised by me. I have examined this situation & would refer you to The Employment & Support Alowance Regulations 2013, which I found in the UK Statutory Instruments, 2013 No. 379, Part 1, Regulation 2.
    It is stated that " permanent health insurance payment" means any periodical payment arranged by an employer under an insurance policy providing benefits in connection with physical or mental illness or disability, in relation to a former employee on the termination of that person's employment.

    As with me, I am employed, on long term sick leave & receive a monthly Group Income Protection salary. The insurers pay my company who deduct pension, tax & insurance & then pay me my salary.

    The key here is that you are EMPLOYED & your employment hasn't been terminated. It's complex & one can understand why the DWP staff struggle with this. 

    I have written to DWP explaining my situation, as a recent ESA claimant. I've been awarded ESA without any challenge. 

    I suggest you locate the legislation I mentioned above & write, recorded delivery, to DWP.

    All the best.
  • YorkiesYorkies Member Posts: 7 Listener
    Hi

    Thanks Liverbird for taking the time to post this information, thats brilliant to hear. 

    Ive just had a very similar response from CAB, so i am very hopeful that it will be a successful application.  I am putting all the information together right now so will let you know how i get on. 

    Which group did they put you in if you dont mind me asking?

    Best Regards
    Yorkies 


  • liverbird103liverbird103 Member Posts: 2 Listener
    Hi Yorkies, I've been in the i initial assessment phase since July & had my formal Telephone Assessment with a HCP yesterday. It was a Dr. I will have to await the outcome of the assessment & see how the 'decision maker' views my situation. 
    My telephone assessment took just 22 minutes. Not sure if that's relevant. I submitted Consultants' reports with my ESA50 application, & they all stated it was unlikely I'd return to work. So, I'm hoping to be put into the Support Group. It's a waiting game isn't it. 

    I hope the DWP process your claim & hope that you feel armed with sufficient evidence to challenge any wrong decisions. 

    Let's know how you get on & I'll also post the outcome of my assessment once I've been informed.

    Take care.
  • YorkiesYorkies Member Posts: 7 Listener
    Hi, 

    Thanks for the reply. 

    Im hoping to also go into the support group.

    Think being prepared helps, and documenting everything. You seem very organised so would like to wish you all the best.

    Ive got all my reports and documentation over the years since 2004. Ive 3 seperate reports from my GP, Specialist and my Insurers specialist, which basically say im unfit to work and my condition wont change.

    Im very hopefully as they would basically have to go against all this evidence. Im more than happy to do any medical assessment they want, so we will see what they say.

    I will keep you updated, and wish you all the best with your application. 

    Thanks everyone
    Yorkies 


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