New Style ESA (support group) reassessment?

Soapkate

Hello
I've now been in post in Welfare Rights for 6 months and learning a lot, however today had a bit of a heated discussion/argument with my colleague who was upset that I had advised one of his ex clients to claim UC, saying it could jeopardise the client's ESA award.

I disagree -  however I would love to get people's opinion/experience from here.

The client is liable for rent.  She claimed new style ESA in 2021 after having to leave work due to ill health.  Was placed in support group.  Has arthritis & fybromalgia. 

She rang us recently saying she can't afford her rent.   I identified an entitlement to UC housing costs element, and she went ahead and claimed UC. I assured client her new style ESA will continue as it already comes within the UC system.

My understanding is that she won't have her ESA reassessed purely on the basis that she has claimed UC.  (Because it's not a change of circumstances that would warrant a reassessment.)   In fact, she should automatically be awarded LCWRA in UC because she is in the support group of ESA.  

Am I right?  My colleague is adamant that DWP will likely reassess her ESA award and she could lose her support group status.

Any thoughts welcome....

calcotti

Claiming Uc doesn't jeopardise the ESA award. As you say, if she is in ESA Support Group then she is entitled to LCWRA element of UC from the outset (although UC may ask for a Fit Note because the administrative process doesn't immediately deal with the ESA). Claimant needs to tell UC they are in ESA Support Group. Note too that the LCWRA element is worth more than the ESA Support component so the UC entitlement is more than just the ESA (unless claimant is under 25) even without housing element.

Your colleague is wrong (but even if they were right I would imagine the help with rent is probably worth more than LCWRA element so I can't help thinking that your colleague is not looking at the bigger picture.

See the following for explicit guidance
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1024547/admg1.pdf

G1005 A UC claimant may already have been assessed for LCW and LCWRA for the purposes of ESA. Where

1. it has been determined that the claimant has LCW or LCWRA following an assessment under ESA legislation1and

2. a claim for UC is made while the determination in 1. is current

the claimant does not have to undergo a separate WCA for the purposes of UC. See G1020 2. for when a further WCA may be required. See ADM Chapter U2 for guidance on assessing LCW and LCWRA for ESA.

DWP can off course carry out a reassessment at any time but with all reassessments currently on hold that is very unlikely.

Slightly surprised that if you are working for an advice agency that you don't have access to better support than having to come on a public forum! (I would recommend familiarising yourself with the guidance
https://www.gov.uk/government/publications/advice-for-decision-making-staff-guide
and for legacy benefits at
https://www.gov.uk/government/collections/decision-makers-guide-staff-guide
(with the proviso that some guidance is legally dubious and open to challenge but the guidance is good material for challenging DWP when needed).

Soapkate

#calcotti  Thankyou very much for the detailed reply.

Just to clarify -  I think my colleague is worried that claiming UC will trigger a reassessment of ESA support group status.  He says he has anecdotal evidence of this happening (but didn't show me examples)

Am I right that a reassessment can't be triggered earlier than the date originally decided by the healthcare professional who assessed the client - unless there is a significant change of circumstances,  and claiming UC isn't one.

calcotti

Soapkate said:

..I right that a reassessment can't be triggered earlier than the date originally decided by the healthcare professional who assessed the client - unless there is a significant change of circumstances, and claiming UC isn't one.

I don't think that is correct, DWP can reassess earlier (but is unusual and extremely unlikely at the moment). Remember that the assessment provider is only providing advice to DWP, the assessor decides nothing.

Going back to your starting point. Even without the problems your claimant is having paying their rent I would say that if there is entitlement to UC in addition to ESA then a client should always be advised of this - it's up to them whether or not they wish to claim. In general I would, when applicable, always encourage somebody to claim  the extra through UC (unless it is minute). At the moment it is especially sensible because being in receipt of UC will give access to the 2023 Cost of Living payments - your client has presumably lost out on those in 2022 because of not claiming UC (of course she may not have been eligible for UC if your circumstances were different back then).

Soapkate

#calcotti

Re. the assessment provider  -   the Disability Rights (UK) Handbook, p.90 section 21 (Reassessments) states:  "The healthcare professional who assesses you will provide advice on when you should next be re-assessed".

So I'm concluding that they will advise the decision maker about a reassessment date (if any),  but the DM can decide differently.

It was just rather disconcerting to hear from my colleague today that reassessments could be triggered by a UC claim.  Also I took it quite personally because the suggestion was that I had potentially done the client harm.  But since discussing with you and also consulting written sources   I've concluded that isn't a genuine concern.   

Thanks again

L_Volunteer

I can hear how this was disconcerting @SoapKate. Not least because you took it quite personally because the suggestion was that you had potentially done the client harm.

This sounds really difficult but I am really pleased to hear that since discussing it with us and consulting written sources you've concluded that it isn't a genuine concern. 

Also, you are welcome. It is the very least you deserve. Please don't hesitate to let us know if there's anything else we can do to support you 

WhatThe

Soapgate,
Hi are you still working in welfare rights?

I understood that an ESA claim would stop once the UC claim was made, as suggested by your colleague. What have you concluded since your post seven months ago?

I know you'll get an email about my post so I hope you will return to this forum, thanks

poppy123456

WhatThe said:

I understood that an ESA claim would stop once the UC claim was made, as suggested by your colleague.

That's not correct. New style ESA is a contributions based benefit only and will continue to be paid along side UC, as advised here by calcotti.

calcotti said:

Claiming Uc doesn't jeopardise the ESA award.

The ESA will continue as normal and be deducted in full from any UC entitlement. The only ESA that stops when you claim UC is Income Related ESA and this will end 2 weeks after you claim UC.

We have many members here that claim both New style ESA and UC.

WhatThe

Ok only Income-related ESA and Housing Benefit payments stop when you claim UC 

poppy123456

WhatThe said:

Ok only Income-related ESA and Housing Benefit payments stop when you claim UC 

Yes as well as Tax Credits. If living in either supported or temporary housing then housing benefit continues.

WhatThe

It's dreadful progress!

HB used to be paid 4 weeks in advance then 2 weeks in advance but UC creates huge rent arrears by design 

Soapkate

Hi WhatThe, yes I'm still in Welfare Rights.  It's been a steep learning curve but hopefully I know a bit more than I did 7 months ago!  

As Poppy said, new style ESA is a contributions-based benefit , not means-tested, so it can be claimed alongside UC though it will be deducted pound for pound from each monthly UC award.

Just thought I'd mention as well in case you weren't aware, that New style ESA gives the claimant class 1 national insurance credits automatically, while UC only gives class 3. 
National Insurance: introduction: What National Insurance is for - GOV.UK (www.gov.uk)  shows you which benefits & pensions the different classes count towards.

WhatThe

Thanks for coming back and I'm sure you do!

Well, I'm one of the many getting no credits at all under UC after getting class 1 for Incapacity Benefit 

poppy123456

WhatThe said:

Well, I'm one of the many getting no credits at all under UC after getting class 1 for Incapacity Benefit 

Yup that will be the mess regarding DWP and NI credits. There shouldn't be anything to be concerned about unless you're reaching state pension age soon.

Thankfully, when i checked my daughter contributions all hers are up to date since i claimed UC for her in Jan 2021.

WhatThe said:

It's dreadful progress!

HB used to be paid 4 weeks in advance then 2 weeks in advance but UC creates huge rent arrears by design 

It works well for some people. Also housing element for UC is more generous than housing benefit in some cases. For example, non dependant deductions are more generous for housing element than they were for HB.

For housing element there's a £77.87/month deduction, regardless of earnings for the non dependant. For HB it's a weekly rate depending on the weekly earnings of the non dependant, the more they earn the higher the deduction. See links for further information.

HB here https://england.shelter.org.uk/housing_advice/benefits/housing_benefit_deductions_when_living_with_non_dependants

H.E here https://england.shelter.org.uk/professional_resources/legal/benefits/universal_credit/deductions_from_universal_credit_for_non-dependants

WhatThe

'Bedroom tax' is deducted from UC though and payments to landlords take much longer than the oft-mentioned delay of 5 weeks for a new claim

WhatThe

My entitlement to class 1 credits stopped upon migration to ESA 

poppy123456

WhatThe said:

'Bedroom tax' is deducted from UC

Yes in the same way for housing benefit.

WhatThe said:

My entitlement to class 1 credits stopped upon migration to ESA 

Why was that? Migration from IB to ESA happened quite sometime ago.

WhatThe

No idea. I joined the forum in the hope of understanding puzzles like this

WhatThe

'Migrated to ESA' in 2011, 2012 and again in 2016. 

It should not have been possible.

poppy123456

WhatThe said:

'Migrated to ESA' in 2011, 2012 and again in 2016. 

It should not have been possible.

That makes no sense. Once you migrate from one benefit to another you can't reclaim the other benefit because it would no longer exist for new claims.

WhatThe

I agree and I did not reclaim at any time

Received IB35 and IB50 forms in 2011
Received another IB50 form in 2012

Told in 2016 that my IB claim was being migrated to ESA (which I'd received continuously since 2011)