ESA (cb) one year rule?

justaquestion

Hi folks,

After reading another thread on here I am slighly confussed If a person is placed in the WRAG after an ESA medical and if they feel they should be in the support group, is there a set time limit to send in an appeal, or can an appeal be sent in any time in the first year after the ESA medical if the claiminat thinks it justified?

Thanks
Justin

Cpt.Scarlet

The normal period to submit an appeal is one month from the date of the Decision, however, you may be able to submit it later if you can show good cause why it is late.

If your condition has deteriorated since the decision and even after your ESA(CB) ceases, and you believe you now meet the Support Group criteria, then you can request a supersession (re-assessment), if you are put in the SG, then your ESA(CB) will be re-instated (if stopped) and you will remain eligible for ESA(CB) as long as you continue to be in the SG. Note, if your ESA(CB) was stopped you must maintain your claim to be eligible to be re-assessed.

de1amo

i think the 1 year is the amount of time you can stay in the WRAG!

Anubis_2

de1amo wrote: »

i think the 1 year is the amount of time you can stay in the WRAG!

Only if it is contribution based. You can stay in WRAG after a year if it's income based.

de1amo

Anubis wrote: »

Only if it is contribution based. You can stay in WRAG after a year if it's income based.

can you explain that in simple terms??

Horseunderwater

Simple: Contribution based is exactly that - 1 year rules now apply.
Income based is either WRAG or Support grouping - and so far as I know you will be given a set time period of say 3 years and be reviewed nearer that time or when PIP comes into force and they want to migrate people over to the new benefit. Or in other words there are 3 types not 2. This was explained to me by a very helpful lady over the phone when I rang them up about their rules and the website being unclear. Everyone intitially goes down contributions route for approx first 13 weeks, during which time you most likely get sent for interview and a medical. Then if you are going for income related, you either pass with a high score of 15 points and get onto Support or if less than 15 but more than a certain amount ( you get told that you will be in WRAG) - no I have no idea what that limit is. But contributions is now £71/week and the others are in the £90+ range. Sorry do not know new levels. In my case I have an illness where it is best for me to do a year of contributions rate so that some medications that I now have to take have a chance to kick in. The hope is to try and get illness into remission.

Anubis_2

de1amo wrote: »

can you explain that in simple terms??

People receive contribution-based ESA (CB ESA) if they have limited capability for work and have paid enough National Insurance contributions - it is not affected by household income, and people receive it regardless of household income.

If in the support group and claiming CB ESA there is no time limit to the claim - the payments can be longer than 12 months providing the person remains in support group.

If put in the WRAG, then the payments last 12 months unless moved to support group.

Income related ESA is paid to people depending on their income and savings - so if household income is above what the law states, you may not receive any or only part of ESA payments. If income is very low or zero, you will likely receive all of the ESA.

However, there is no time restriction for income related ESA, it can still be given after 12 months regardless of group, providing that circumstances remain the same regarding income, savings and limited capability to work.

Anubis_2

Horseunderwater wrote: »

Simple: Contribution based is exactly that - 1 year rules now apply.
Income based is either WRAG or Support grouping - and so far as I know you will be given a set time period of say 3 years and be reviewed nearer that time or when PIP comes into force and they want to migrate people over to the new benefit. Or in other words there are 3 types not 2. This was explained to me by a very helpful lady over the phone when I rang them up about their rules and the website being unclear. Everyone intitially goes down contributions route for approx first 13 weeks, during which time you most likely get sent for interview and a medical. Then if you are going for income related, you either pass with a high score of 15 points and get onto Support or if less than 15 but more than a certain amount ( you get told that you will be in WRAG) - no I have no idea what that limit is. But contributions is now £71/week and the others are in the £90+ range. Sorry do not know new levels. In my case I have an illness where it is best for me to do a year of contributions rate so that some medications that I now have to take have a chance to kick in. The hope is to try and get illness into remission.

This information is completely incorrect on all levels. Please see my post above, and £71 is not the contributary rate, it's assessment rate, (for over 25) while they decide if you are entitled to ESA, and what group you are in (the groups apply to BOTH contributary and income related ESA.)

If they think you are not limited in capability to work, you will not receive ESA and assessment rate will stop. Then you either appeal or claim JSA. If you appeal you get the £71 a week again until appeal decision is decided.

While on assessment rate or while appealing, you may get backpay once it is decided you are entitled to ESA, and what group you are in. You will get backpay for the difference between the £71 and the £99+ rates for ESA.

http://www.direct.gov.uk/en/MoneyTaxAndBenefits/BenefitsTaxCreditsAndOtherSupport/Illorinjured/DG_171896

Miss-Understood_5

Hi.

I am a long time lurker but have a related question which I haven't seen the answer to.

I have been claiming contribution based ESA for 10 months, and initially on assessment was placed in the support group. On re-assessment a decision has been made that I should be in the WRAG, even though my condition has worsened. I have just submitted an appeal against this decision.

If my appeal should be rejected, when will the 12 month period apply?

1 From the date of my initial claim

2 From the date that the assessment phase was completed and I was placed in the support group.

3. From the date that I was assigned to the WRAG.

I have been given conflicting information about this including from the DWP, and am trying to budget without knowing whether my benefit may stop in 2, 5 or 12 months.

I would not be eligible for IR ESA as I am receiving an ill-health retirement pension and still have most of the lump sum in the bank.

de1amo

i would GUESS as they made the assessment to put you in a support group that has to be stood by!! they decided at that time on your health and cant go back on what was 'true' then!

Cpt.Scarlet

It should be from the date you were placed in the WRAG, if your appeal puts you back in the Support Group then the count stays at zero.