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Reassessment?

ldeves

Hi, I have been on contribution based ESA since 2018 and was assessed to be in the working group at the time I applied. I was only ever asked to go to two meetings following my assessment and after a year stopped receiving payments because I had exceeded the time limit, I have been too ill to question any decisions and just accepted that I wasn’t eligible for any further assistance.
Fast forward to now and I am on enhanced daily living PIP and standard mobility PIP. I have started to look at what benefits I might be entitled to and I’ve read a bit more about ESA and the different levels and I believe I should have/should be in the support group due to my disabilities. I wouldn’t be eligible for income based ESA because my partner works (earns 40k)but I wondered if anyone knew if it is possible to have my ESA reassessed to see if I should be in the support group?

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SueHeath

Good morning @ldeves welcome to our great group.
Many of us pop in and out of the site during the day, so hopefully you will be greeted by others when they wake up ha ha. I am sure one of our experts in this field will have the in's and out's to your question.
In the mean time if your able have a look around the site, i will just warn you we have had a few technical issues at the moment but people are on the case.
Any other questions please ask.

Sue_Alumni

Hi @ldeves

You would not be able to make a new claim for contribution based ESA you would have to claim "new style" ESA - which is essentially the same thing. There are two national insurance contribution conditions, both of which you must meet, to be entitled to “new style ESA”. The first condition depends on the NI contributions you made in the relevant tax year. For the second condition credited NI contributions as well as paid contributions count. I don’t think you satisfy the first condition.

To satisfy the first contribution requirement you must have paid at least 26 weeks of Class I or Class 2 NI contributions on earnings at the lower limit in one of the last two complete tax years before the start of the relevant benefit year. So if you want to claim "new style" ESA now in June 2022 you will meet the first condition if you earned at least £118 pw for 26 weeks between April; 2019 and April 2020 or at least £120 pw for 26 weeks April 2020 and April 2021. From what you say, as you stopped work in 2018 and claimed ESA you do not satisfy this condition.

flour

Your original ESA claim from 2018 may still be active after it stopped paying out.

This would be because your 'old' ESA claim may still be running in the background - once the payments stopped the NI credits can continue to be awarded. More likely if on the last letters they sent you it said something like 'we may still continue to award you national insurance contributions'.

It is likely to still be open because lots of people claimed contribution ESA just for the NI credits alone (no payments) to protect their entitlement to state pension so you may have moved in to that category.

If so then you should be able to report a worsening of your condition and be re assessed and then you could be put into the support group of your original 2018 ESA claim going forward in 2022.

calcotti

flour said:

Your original ESA claim from 2018 may still be active after it stopped paying out.

No. Although it is often referred to as a 'credits only' ESA claim there is actually no such thing. If there is no payment entitlement the ESA stops. The right to receive NI credits due to Limited Capability for Work is separate from ESA.

Having said that DWP do sometimes treat it as if the ESA is still live so OP may be lucky, but I would not expect it.

flour

I read these 2 threads on rights net which offer advice, but I did use the word 'may' to make sure Ideves knows it might not happen as it may be luck if they send out an ESA50 or not or indeed if they do if they then put it back in to payment.

These are the 2 threads, I've put them below

https://www.rightsnet.org.uk/forums/viewthread/18383/

https://www.rightsnet.org.uk/forums/viewthread/6014/

calcotti

My take is as Elliott says in one of the threads that you reference

Although you are saying that your client has then continued to have “a live esa claim ongoing but no award of benefit”, this is not correct. When ESA stops being in paid, it is over. Although your client may have continued to receive NI credits for having LCW, this is not an ESA award. Confusingly, the DWP will refer to this as “credits only ESA” or similar, but this is just a reflection of the fact that the LCW credits are managed within the same computer system as ESA rather than the actual legal position. You can’t use the fact that you have been in receipt of LCW credits as a basis for resurrecting an old-style ESA entitlement.

I note however that he then says

If your new client had a contributory entitlement which ended due to time limiting, they may now be able to reclaim contributory ESA following the LCWRA assessment.

which would appear to apply.

Your second link includes within the discussion a link to DMG Memo 13/12. Paragraph 30 appears to apply.

Very useful (and promising for OP). Thanks, flour.

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