esa advice needed

henshan_2

epitome wrote: »

• What date did he make his claim ?
• He presumably has not closed his ESA claim? He should phone up and confirm that his claim is still open for NIC National Insurance Only credits.
• What date did the ESA C exhaust? i.e. what date was he paid up until?

I assume he claimed about or shortly after May 2011
So he was assessed on tax years 08/09 & 09/10
As he worked up until May 2011 his tax year 10/11 is presumably complete.

If he waits 12weeks after they stopped paying him(still getting NIC for those 12 weeks) and he requests to make a new claim to ESA C it will be assessed on tax years 9/10 & 10/11
This is using a new tax year and he may very well qualify for ESA C again for another 365 days.

He should ask for a Call back from the Benefit Centre to discuss what date he should claim again from in order to be assessed on tax years (RITY's) 09/10 & 10/11 and he should ask what the process would be for reappplying, i.e. does he have to phone the new claims line or is it a case of the benefit centre just sending him out a form to complete, or can they not just reassess him using new RITYs without forms being issued?
If the person he speaks to mentions a date about 12 weeks after they stopped paying him then you can assume that person knows what they are talking about. If the person says "you claim again now" and you know it has not been 12 weeks yet, you can assume that person does not know what they are talking about and ask to speak to someone who knows the rules on RITYs and claims linking within 12 weeks.

Basically the thing to say/ask is "I want to apply again for ESA Conts without the claim linking to my previous award, what date do I need to claim from?"

Smileytiger should also take note for their husbands claim

Thank you very much for the advice, does anyone out there think we have any chance of trying to get him into the support group and what do we have to do to get him into that what is the criteria?

Muttleythefrog

McKneff wrote: »

I wouldnt think he would get DLA for depression.

It is for care and mobility

Is he getting help from his GP for his depression.

Depression can lead to symptoms giving rise to qualification for DLA care and theoretically low rate mobility. Supervision criteria or personal care needs could be triggered... the former if posing a risk to self through neglect or worse etc.. the latter if requiring prompting, reminding and encouragement to do things like look after personal care.

If someone has convicned a tribunal that they qualify for WRAG of ESA then it would suggest their symptoms are quite notable due to mental illness... DLA and ESA are very different beasts... but I would take a punt that in this case it won't be so much a question of whether care needs arise but whether they're sufficient (and corroborated) in order to meet DLA care benchmarks.

This is a good link for self assessing whether DLA is realistic. (Supportive medical professional or supporting medical evidence can be crucial to success.. that can't be understated.)
http://www.benefitsnow.co.uk/questions/dlagatewayquestions.asp

This is the depression entry for the DWP A-Z of medical conditions... it gives care/mobility considerations typical for various illnesses. http://www.dwp.gov.uk/publications/specialist-guides/medical-conditions/a-z-of-medical-conditions/depressive-illness/

Muttleythefrog

henshan wrote: »

Thank you very much for the advice, does anyone out there think we have any chance of trying to get him into the support group and what do we have to do to get him into that what is the criteria?

Support group I suspect will be very tricky.. it's always difficult for outsider to say... one person with depression might be running a country.. another might be running a bath to drown themselves... to be blunt.

To get into support group one would have to demonstrate that one (or more) of the following descriptors applies.
http://www.tameside.gov.uk/esa/lcwra

There is also some special circumstance criteria used in 'the system' to catch those who may 'fail' the work capability assessment (WCA) but whom it would be undesirable to expect to seek work... e.g. terminally ill. Some special circs criteria can make you eligible for Support Group... there's only one from memory that could be potentially (and I say potentially... it is unlikely to apply) applicable in this case and that is "The claimant is suffering from some form of specific disease or bodily or mental disablement and, by reasons of such a disease or disablement, there would be a substantial risk to the mental or physical health of any person if they were found not to have limited capability for work." Refer page 114 of the DWP WCA manual. http://www.dwp.gov.uk/docs/wca-handbook.pdf

To get into Support Group will mean successfully appealing a decision the DWP make, being reassessed and found to meet the criteria (reassessment on ESA is regular.. typically every 6 to 24 months), or getting supercession (reassessment of entitlement following changed medical circumstances being reported) and being found to meet S.Gp criteria.

henshan_2

Muttleythefrog wrote: »

Support group I suspect will be very tricky.. it's always difficult for outsider to say... one person with depression might be running a country.. another might be running a bath to drown themselves... to be blunt.


There is also some special circumstance criteria used in 'the system' to catch those who may 'fail' the work capability assessment (WCA) but whom it would be undesirable to expect to seek work... e.g. terminally ill. Some special circs criteria can make you eligible for Support Group... there's only one from memory that could be potentially (and I say potentially... it is unlikely to apply) applicable in this case and that is "The claimant is suffering from some form of specific disease or bodily or mental disablement and, by reasons of such a disease or disablement, there would be a substantial risk to the mental or physical health of any person if they were found not to have limited capability for work." Refer page 114 of the DWP WCA manual.

To get into Support Group will mean successfully appealing a decision the DWP make, being reassessed and found to meet the criteria (reassessment on ESA is regular.. typically every 6 to 24 months), or getting supercession (reassessment of entitlement following changed medical circumstances being reported) and being found to meet S.Gp criteria.

Thank you for your really helpful advice all this is so confusing, my husbands mental health condition has increased due to all the stress this is causing, do you think its worth while going back to our GP (who will probably only increase his medication) and then ask to be reassessed or can you only do this after a certain amount of time.

henshan_2

epitome wrote: »

• What date did he make his claim ?
• He presumably has not closed his ESA claim? He should phone up and confirm that his claim is still open for NIC National Insurance Only credits.
• What date did the ESA C exhaust? i.e. what date was he paid up until?

I assume he claimed about or shortly after May 2011
So he was assessed on tax years 08/09 & 09/10
As he worked up until May 2011 his tax year 10/11 is presumably complete.

If he waits 12weeks after they stopped paying him(still getting NIC for those 12 weeks) and he requests to make a new claim to ESA C it will be assessed on tax years 9/10 & 10/11
This is using a new tax year and he may very well qualify for ESA C again for another 365 days.

He should ask for a Call back from the Benefit Centre to discuss what date he should claim again from in order to be assessed on tax years (RITY's) 09/10 & 10/11 and he should ask what the process would be for reappplying, i.e. does he have to phone the new claims line or is it a case of the benefit centre just sending him out a form to complete, or can they not just reassess him using new RITYs without forms being issued?
If the person he speaks to mentions a date about 12 weeks after they stopped paying him then you can assume that person knows what they are talking about. If the person says "you claim again now" and you know it has not been 12 weeks yet, you can assume that person does not know what they are talking about and ask to speak to someone who knows the rules on RITYs and claims linking within 12 weeks.

Basically the thing to say/ask is "I want to apply again for ESA Conts without the claim linking to my previous award, what date do I need to claim from?"

Smileytiger should also take note for their husbands claim

Thank you I will ring them on monday to find out if we are entitled, great advice.

Muttleythefrog

henshan wrote: »

Thank you for your really helpful advice all this is so confusing, my husbands mental health condition has increased due to all the stress this is causing, do you think its worth while going back to our GP (who will probably only increase his medication) and then ask to be reassessed or can you only do this after a certain amount of time.

To be honest my advice would depend upon when next reassessment is scheduled (assuming this claim is continued) and whether you feel Support group criteria is applicable. If reassessment is some way off then I'd be tempted to try to trigger a reassessment with claimed worsening of problems (supercession) and get GP to state this deterioration in document form (and if appropriate, Support group criteria applicable and why it is applicable.. that would be powerful). (There is no time limits to consider if requesting supercession.. should be requested when circumstances change.) But if Support group criteria isn't relevant then I would give up any thinking of Support Gp and follow advices of epitome regarding keeping claim going..and perhaps take a serious look at DLA which is not means tested.

smileytiger

epitome wrote: »

• What date did he make his claim ?
• He presumably has not closed his ESA claim? He should phone up and confirm that his claim is still open for NIC National Insurance Only credits.
• What date did the ESA C exhaust? i.e. what date was he paid up until?

I assume he claimed about or shortly after May 2011
So he was assessed on tax years 08/09 & 09/10
As he worked up until May 2011 his tax year 10/11 is presumably complete.

If he waits 12weeks after they stopped paying him(still getting NIC for those 12 weeks) and he requests to make a new claim to ESA C it will be assessed on tax years 9/10 & 10/11
This is using a new tax year and he may very well qualify for ESA C again for another 365 days.

He should ask for a Call back from the Benefit Centre to discuss what date he should claim again from in order to be assessed on tax years (RITY's) 09/10 & 10/11 and he should ask what the process would be for reappplying, i.e. does he have to phone the new claims line or is it a case of the benefit centre just sending him out a form to complete, or can they not just reassess him using new RITYs without forms being issued?
If the person he speaks to mentions a date about 12 weeks after they stopped paying him then you can assume that person knows what they are talking about. If the person says "you claim again now" and you know it has not been 12 weeks yet, you can assume that person does not know what they are talking about and ask to speak to someone who knows the rules on RITYs and claims linking within 12 weeks.

Basically the thing to say/ask is "I want to apply again for ESA Conts without the claim linking to my previous award, what date do I need to claim from?"

Smileytiger should also take note for their husbands claim

Thanks but i think as my OH hasn't worked for over 2 years now - (he had been on CB ESA for 2 years before they brought the 365 day rule in) - he won't have enough qualifying conts? - but thanks for the advice anyhow .x

henshan_2

Muttleythefrog wrote: »

To be honest my advice would depend upon when next reassessment is scheduled (assuming this claim is continued) and whether you feel Support group criteria is applicable. If reassessment is some way off then I'd be tempted to try to trigger a reassessment with claimed worsening of problems (supercession) and get GP to state this deterioration in document form (and if appropriate, Support group criteria applicable and why it is applicable.. that would be powerful). (There is no time limits to consider if requesting supercession.. should be requested when circumstances change.) But if Support group criteria isn't relevant then I would give up any thinking of Support Gp and follow advices of epitome regarding keeping claim going..and perhaps take a serious look at DLA which is not means tested.

We have had an app for re-assessment of ESA sent to us today but when I have read the notes it says if you or any-one you are claiming for works more than 24 hours pw we will not be entitled ( I work 31 hours), so I didn't think we should apply, do you think we should apply regardless so that my husbands ESA claim could be reconsidered, do we automatically stay in the system? I don't know if he is due to be re-assessed or are we just left to get on with it if we do nothing? Sorry If I sound 'thick' but its all so new to me.

smileytiger

As far as i know

If you continue your claim although you're not getting any money and continue to attend assessments, WFI's etc then they still credit your OH's NI towards his pension.
If your stop/close the claim you won't get this. x

epitome

henshan wrote: »

We have had an app for re-assessment of ESA sent to us today but when I have read the notes it says if you or any-one you are claiming for works more than 24 hours pw we will not be entitled ( I work 31 hours), so I didn't think we should apply, do you think we should apply regardless so that my husbands ESA claim could be reconsidered, do we automatically stay in the system? I don't know if he is due to be re-assessed or are we just left to get on with it if we do nothing? Sorry If I sound 'thick' but its all so new to me.

He should follow all their instructions to be re-assessed and appeal again if he fails the medical. He is currently getting ESA NIC if he wants to continue getting NIC he has to jump through all the hoops.....or claim JSA C or JSA NIC only.

Strictly speaking staying on ESA for NIC is not needed for his new claim for ESA Conts which I told you about earlier, as that will be assessed on tax years 9/10 & 10/11, these months we are in now will play no effect on that new claim.

Does he need 30 years NIC for his state pension and has he got 30 years already?

So I think he only needs to stay on ESA NIC if he wants to, for state pension purposes.

However there may be something I'm missing, so you should ask the Benefit Centre chappy who calls you back if there would be any problem if he stops claiming now (this avoiding the reassessment for now) and reclaims after 12 weeks have passed since the ESA Conts payments ended