What Happens at the end of a year in the ESA WRAG group?

BlueMurder_2

I was put in the wrag group coming up a year ago, i don't know if it was contributions or income based, i have been on sickness for 5 years getting progressivley worse. i did not get any payment from incapacitty benefit but i did get the n.i. credits part of it. i get HRC HRM for sever needs, round the clock care. i spoke to CAB after i got put in the wrag and they advised not to fight for support group as it takes so long and you get put on lowest rate during this time. they also said with the dwp cracking down it's very few get into support. i was not given a medical assesment, it was decided on evidence and my form alone.

i am worried about what happens after the year, do i need to contact anyone of will i get a new form? or is it finished in that you only get the 1 year of benefit and am not entitled to esa anymore?

Cpt.Scarlet

If you were on IB then you will have been put on contribution based ESA, this means that any payments you are receiving whilst you are in the WRAG, are time limited to 365 days, after which they will cease unless you are also eligible to receive income related ESA.

If your payments stop you will revert to receiving NI Credits as you appear to have received on IB.

You may be assessed at the end on the year, but also may not, it will depend on what ATOS recommended in their assessment report.

While you continue to receive NI credits you will be re-assessed regularly, the longest period between assessments for the WRAG I am aware of is two years.

schrodie

Cpt.Scarlet wrote: »

If you were on IB then you will have been put on contribution based ESA, this means that any payments you are receiving whilst you are in the WRAG, are time limited to 365 days, after which they will cease unless you are also eligible to receive income related ESA.

If your payments stop you will revert to receiving NI Credits as you appear to have received on IB.

You may be assessed at the end on the year, but also may not, it will depend on what ATOS recommended in their assessment report.

While you continue to receive NI credits you will be re-assessed regularly, the longest period between assessments for the WRAG I am aware of is two years.

Am I correct in the following thinking Cpt.Scarlet?

Firstly:-
That whilst receiving NIC but no payment of ESA the claimant can if they think their condition has deteriorated to that of possible Support Group eligibility request a WCA via the requesting of an ESA50 rather than wait until an ESA50 is sent out near the end of the WRAG term? So for example if after a WCA the recommendation from Atos is 2 years in the WRAG. As a result you're paid for the first 365 days then for the remainder of the term receive NICs but during that time your condition deteriorates and think you're SG eligible. So rather than wait until just before the end of the second year for another ESA50 to be sent out (in order to determine continued ESA eligibility) you can request a supersession? Is this correct?

Secondly:-
This can only happen if one has a "live" ESA claim so if you close your claim by stopping the receiving NIC maybe because you have your full whack of them (30 years) as it were then the only route back onto CB ESA is via the NI Contributions route? So if you think that after few years down the line your condition may deteriorate to SG eligibility to be able to reclaim CB ESA you must have continued to be assessed via the issuing of ESA50s even though you're not receiving payment only NIC.

Of course if during a WCA reassessment you're found fit for work and a subsequent appeal fails then naturally you loose all entitlement to reclaim CB ESA via this (Section 52) route and therefore have to reclaim via the National Insurance Contributions route.

JS477

Not to pre-empt Cpt Scarlet's or anyone else's knowledge on this matter but that's how I understand it.

My understanding is even though you may be placed into the CB ESA WRAG for say 2 years following an Atos WCA report you'll only get paid for 1 of those 2 years receiving only NICs during the 2nd year, then before the end of the 2nd year ending you'll be sent another ESA50 and so on and so on until you either make it into the Support Group if your condition deteriorates or you develop a SG condition or are found fit for work.

Cpt.Scarlet

schrodie wrote: »

Am I correct in the following thinking Cpt.Scarlet?

Firstly:-
That whilst receiving NIC but no payment of ESA the claimant can if they think their condition has deteriorated to that of possible Support Group eligibility request a WCA via the requesting of an ESA50 rather than wait until an ESA50 is sent out near the end of the WRAG term? So for example if after a WCA the recommendation from Atos is 2 years in the WRAG. As a result you're paid for the first 365 days then for the remainder of the term receive NICs but during that time your condition deteriorates and think you're SG eligible. So rather than wait until just before the end of the second year for another ESA50 to be sent out (in order to determine continued ESA eligibility) you can request a supersession? Is this correct?

Secondly:-
This can only happen if one has a "live" ESA claim so if you close your claim by stopping the receiving NIC maybe because you have your full whack of them (30 years) as it were then the only route back onto CB ESA is via the NI Contributions route? So if you think that after few years down the line your condition may deteriorate to SG eligibility to be able to reclaim CB ESA you must have continued to be assessed via the issuing of ESA50s even though you're not receiving payment only NIC.

Of course if during a WCA reassessment you're found fit for work and a subsequent appeal fails then naturally you loose all entitlement to reclaim CB ESA via this (Section 52) route and therefore have to reclaim via the National Insurance Contributions route.

Yes, if at any time you believe you meet the SG descriptors you can request a new assessment and if successul your ESA(CB) payments will be re-instated and will remain in payment until while you remain in the SG.

The requirement is that you have maintained your Limited Capability for Work, so whether you are still receiving NI Credits should be irrelevant. To maintain your LCW you must participate in any future re-assessment.

Whilst there is no advantage to continuing to receive NICs, there is no disadvantage either, especially if you believe your condition might deteriorate.

schrodie

Cpt.Scarlet wrote: »

Yes, if at any time you believe you meet the SG descriptors you can request a new assessment and if successul your ESA(CB) payments will be re-instated and will remain in payment until while you remain in the SG.

The requirement is that you have maintained your Limited Capability for Work, so whether you are still receiving NI Credits should be irrelevant. To maintain your LCW you must participate in any future re-assessment.

Whilst there is no advantage to continuing to receive NICs, there is no disadvantage either, especially if you believe your condition might deteriorate.

Thanks Cpt. S

Just a query on the bold part above.

In order to maintain LCW and to participate in any future re-assessments don't you need to be receiving NICs in order for the DWP to know that your ESA claim is still active, otherwise how do the DWP know you're still "on the books" as it were?

Cpt.Scarlet

This is untested, I only know of one person so far who has asked to be re-assessed and they continued to receive NI Credits.

So, if the DWP take the position that by closing your claim, you are stating that you no longer have Limited Capability for Work, then you would need to keep it open in order to be considered for the SG.

Cpt.Scarlet

BlueMurder wrote: »

i spoke to CAB after i got put in the wrag and they advised not to fight for support group as it takes so long and you get put on lowest rate during this time. they also said with the dwp cracking down it's very few get into support. i was not given a medical assesment, it was decided on evidence and my form alone.

You were mis-advised by the CAB, yes it could take a long time for an appeal to be heard, maybe a year, but if you have a good case the Decision might be Revised by the DWP in a couple of months, most imprtantly, you will continue to receive the WRAG rate while you appeal, subject to the 365 day rule, not the reduced Assessment rate, which would still be limited to the year.

schrodie

Cpt.Scarlet wrote: »

This is untested, I only know of one person so far who has asked to be re-assessed and they continued to receive NI Credits.

So, if the DWP take the position that by closing your claim, you are stating that you no longer have Limited Capability for Work, then you would need to keep it open in order to be considered for the SG.

I'm not too sure if my question was clear .

You said that " To maintain your LCW you must participate in any future re-assessment." and that "whether you are still receiving NI Credits should be irrelevant."

So my question is other than recieving NICs how do the DWP know that your ESA claim is still open so they can send out another ESA50 so you can maintain your LCW and participate in any future re-assessment?

It seems to me that it's the receiving of NICs is the only way the that DWP can tell that your ESA claim is still open and can thus send out another ESA50 form in order to determine your LCW or LCWRA. This all means that in order to keep your claim open incase of future deterioration you must continue to receive NICs which in turn satisfies the participation in futre reassessments rule.

Cpt.Scarlet

schrodie wrote: »

I'm not too sure if my question was clear .

You said that " To maintain your LCW you must participate in any future re-assessment." and that "whether you are still receiving NI Credits should be irrelevant."

So my question is other than recieving NICs how do the DWP know that your ESA claim is still open so they can send out another ESA50 so you can maintain your LCW and participate in any future re-assessment?

It seems to me that it's the receiving of NICs is the only way the that DWP can tell that your ESA claim is still open and can thus send out another ESA50 form in order to determine your LCW or LCWRA. This all means that in order to keep your claim open incase of future deterioration you must continue to receive NICs which in turn satisfies the participation in futre reassessments rule.

I'm not disagreeing with you, just saying that the legal requirement as defined in the Welform Reform Act 2012

"the person has not at any subsequent time ceased to have (or to be treated as having) limited capability for work

Continuing to receive NI Credits does not prove this, and conversely, stopping NI Credits does not mean you do not have LCW.

As with a lot of things to do with benefits, there's an easy path (continuing to receive NI Credits), which I would certainly recommend to anybody who thinks their condition may deteriorate, and a more difficult and possibly risky path, which I would not recommend

Gareth56

Cpt.Scarlet wrote: »

I'm not disagreeing with you, just saying that the legal requirement as defined in the Welform Reform Act 2012

"the person has not at any subsequent time ceased to have (or to be treated as having) limited capability for work

Continuing to receive NI Credits does not prove this, and conversely, stopping NI Credits does not mean you do not have LCW.

As with a lot of things to do with benefits, there's an easy path (continuing to receive NI Credits), which I would certainly recommend to anybody who thinks their condition may deteriorate, and a more difficult and possibly risky path, which I would not recommend

Like Schrodie I too have wondered about this part of Section 52 in that unless you recieve NICs then that (as far as I can see) is the only way in which the DWP can determine if your ESA claim is active and thus satisfy "the person has not at any subsequent time ceased to have (or to be treated as having) limited capability for work" part. NIC's tell the DWP that your claim is active and thus send out an ESA50 to determine LCW.

Other than the NIC route I would be interested to find out if there was another mechanism by which the DWP could check if you still had an active ESA claim.

Receipt of NICs don't prove LCW but it triggers the procedure for determining LCW via the issuing of an ESA50.