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ESA - Help and advice needed.


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I am currently off sick and waiting for operation.

 

I am booked to have operation in June.

 

I started claiming ESA in November and attended a medical in early February.

 

According to ATOS medical (Doctor)?????? - I failed.

 

I appealed against the decision in February, and it is now coming to the end of my next claim. (13 weeks).

 

Can anyone advise whether i will automatically receive the increase, or because i am appealing, will they continue to pay at the lower rate?

Or do what they done last time and say i am fit for work, so they dont have to pay the higher amount.? Even thou i have sent certificates confirming i am unfit for work. I have a medical report letter from my Doctor stating I am unfit for work, and have been since November 2009.

 

Also can anyone advice with regards to CONTRIBUTION based ESA.

 

Reason being on my DWP letters they have stated I am on National Insurance Contribution Record.

 

I am self employed. -

 

On my medical assessment,- "the part about your Limited capability for work" it is stating Income Related support allowance.

 

Also on medical assessment "They arrived at their decision"

 

1 - The questionaire I filled in.

2 - The report from the medical assessment I went on.

 

If i am on Contribution based ESA why is it stating Income Related ESA?

 

:confused:

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You won't receive the increase unless you win the appeal. If this happens, you'll get an increase in your payments and it will be backdated to day 92 of your claim. Until then, it will continue to be paid at the lower rate.

 

Edit to add: sorry I can't write more, got to rush. Will pop back in later, in the meantime others should be able to help.

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Still confused - ???????

 

My ESA is based on my National Insurance Contribution record.

 

My ESA is not Income- related ESA.

 

I have letters from DWP before I went for my medical assessment stating this is based on my National Insurance contributions.

 

Can anyone advise the difference between Contribution based and Income based?

 

I appealed to Belfast BDC by recorded delivery, but all I get back are DWP letters. My recorded letter was signed for within the one month time limit..

 

Do they send any confirmation that you are appealing, or do they just contact you once the appeal has been sorted?

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Sorry I let this drop. I'll do my best to answer your questions - until last Friday, I was an ESA processor (just took a new job back in my own field of IT after 4 years with the civil service) but that doesn't make me an expert in all aspects of the benefit.

 

If your ESA is contribution-based, then your entitlement is based on NI contributions you made when you were working. Income related ESA, ESA(IR), is available to those who haven't made the necessary NI contributions and is means-tested - in other words, they consider the amount of money your household has coming in and compare it with what the government says you need to live on.

 

In deciding entitlement to ESA(IR), a lot of things are considered which are not considered for ESA©.

 

I can't possibly list all the differences here, but the key ones for most people would be:

 

 

  • ESA© takes no account of your partner's income
  • it takes no account of any capital (for example, savings accounts) that you or your partner may have
  • it carries no automatic entitlement to Local Housing Allowance, Housing Benefit, or Council Tax Benefit, but you may still be entitled to these - contact your local council for advice
  • if you own your home and need help with mortgage interest payments, the rules get somewhat complex.
  • premiums, such as those for people on DLA, Carers' Allowance and so on are not paid with ESA©

But you can be on both types of the benefit, and this is where it gets hellishly complicated to explain in a message board post. Without having your claim details in front of me, I wouldn't even begin to try to explain this.

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Regarding your appeal, you will be paid at the lower rate until it is decided. Should you win the appeal, the additional amount you would be entitled to will be backdated to day 92 of your claim.

 

If Belfast BDC has signed for your appeal documents, then your payments should be reinstated at the lower rate (the "assessment phase rate") within a week or two. I understand from your posts that this has already happened, if I'm wrong, call Belfast ASAP and complain.

 

The appeals process itself can take several months to complete, but as long as you continue to provide medical certificates, you should be paid, albeit at the lower rate.

 

In the first place, a decision maker at the DWP will look again at your claim. I wouldn't hold out much hope of them changing the decision (they generally don't) but this stage can't hurt you, even if it isn't all that likely to help.

 

If they decide in your favour, all is well, and your benefit will increase from day 92 of your claim. If, as is more likely, they decide against you, the case is passed to an independent tribunal. This is not part of the DWP, and isn't known for being particularly sympathetic to the DWP either.

 

The Tribunals Service should contact you with a date for a hearing. As I didn't work for them, and have never claimed ESA, I am not well placed to advise here, but I am told that it is a very good idea to attend this hearing in person (although it isn't compulsory) and that it can help to seek free advice about how best to handle the hearing. I'm told that CAB and other welfare rights organisations can provide this.

 

One last point was from your first post, when you said this:

 

I appealed against the decision in February, and it is now coming to the end of my next claim. (13 weeks)

The fact that it is 13 weeks since you appealed doesn't make any difference, your payments will continue at the lower rate until the appeal is decided.

 

Edit to add: If you want to know when your appeal is likely to be heard by the Tribunal, you could contact the Tribunals Service directly. Belfast BDC should be able to give you their number.

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Thanks for your help/advice antone

had pre medical assessment yesterday ---- a bit knackered now.

sorry did not respond earlier.

I still have questinos and queries.......hope you dont mind me asking for help - realy appreciate it.

Any other help from anyboby would be appreciated.

 

Thanks again.

 

A little less confused happhamr.

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IMHO starting a separate thread would reduce confusion and crossed postings.

I'm not a qualified welfare rights adviser, but I'm planning on becoming one. I'm no substitute for more competent advice from trained CAB and welfare rights workers - [URL="http://www.consumeractiongroup.co.uk/forum/benefits-tax-credits-minimum/127741-benefits-advice.html"]see this post[/URL] by Joa, great advice and links! I've been running a Crisis Loan campaign and help since Jan 2007 . See my annotations c/o "theyworkforyou". I'm also currently interested by the recent DWP Medical Services reform and the effect this is having on valid claims, seriously - someone needs to be keeping a suicide count.

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I lost my job on the 9th April (contract expired)

we were informed to fill in a joint claim, we sent a esa3 on 13 april but this was never received, belfast bdc were contacted 4 times, 15, 20 22 26 april and they stated they had not received our forms.

I then phoned JSA on 22 April (as i had no money coming in) and applied for jsa my appointment was on the 23rd april. my first sign on was 28th

April and i was also sent on a course with Pinnacle People on 30 April.(regarding job hunting)

I received a letter from JSA stating that my claim would not be paid until they have my previous employment details, ie when i started there and why i had finished. ( i was working as a temp for 15 months). i then phoned and gave them the details, and then received a letter stating i would be getting the allowance of 65.45 per week.

the letter stated on the first page that my claim was from 22 april 2010 and the back page stated 29 april 2010. This is based on stage 1 national contributions. It also states that they would not be paying from 24 October 2010 because my class 1 NIC has run out.????

Also they cannot pay for the first three days of my claim.

Today i received a grand total of £37.odd - is this correct?

I was informed that i could apply for a backdated claim from 12 april when i next go to sign on. not sure if will get anything.

How can they tell if my NIC will run out in October, I have worked for the last 35 years and have only been out of work once before, and i then signed on once and got the job mentioned above before my next sign on.

Can anyone advice as we are struggling with only £65.45 per week from my partners income and me receiving 37. today.??????

have tried phoning 0845 numbers but all they do is keep me on hold and charge charge charge me.

any help appreciated.

frustrated and angry.!!!!!!!!!!!

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I withdraw my previous comment re. new thread seeing as you're doing a joint claim.

From your post #1: "I started claiming ESA in November and attended a medical in early February."
Were you living together then? if so the claim ought to have been a joint claim at the outset and events post 9 April are just a change in your circumstances. Did your partnership only begin immediately following your OH's losing her job? Edited by loan_ranger

I'm not a qualified welfare rights adviser, but I'm planning on becoming one. I'm no substitute for more competent advice from trained CAB and welfare rights workers - [URL="http://www.consumeractiongroup.co.uk/forum/benefits-tax-credits-minimum/127741-benefits-advice.html"]see this post[/URL] by Joa, great advice and links! I've been running a Crisis Loan campaign and help since Jan 2007 . See my annotations c/o "theyworkforyou". I'm also currently interested by the recent DWP Medical Services reform and the effect this is having on valid claims, seriously - someone needs to be keeping a suicide count.

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1 - we have been living together since 2005.

2- i have been on ESA since November 2009.(appealed decision February 2010)

3 - partner lost job 9 april 2010 (contract run out)

4 - ESA3 joint form sent 13 April (never received at Belfast), phoned 15,20,22,and 26 April)

5 - partner enrolled at jobseekers on 23 april 2010.

6 - still no ESA3 received.

7 - reason for claiming jobseekers - no monies coming in, and ESA3 from not received or processed at Belfast.

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I withdraw my previous comment re. new thread seeing as you're doing a joint claim.Were you living together then? if so the claim ought to have been a joint claim at the outset and events post 9 April are just a change in your circumstances. Did your partnership only begin immediately following your OH's losing her job?

 

This only applies to the income-related forms of ESA and JSA. From my reading, they both qualify for the contributory forms based on their individual NI contributions, so they would need to claim separately.

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This all illustrates some of the problems with discussing benefits on message boards - it's not easy to cover all the possibilities and look at all the options. So I'll do my best, but usual disclaimers apply.

 

When you claim JSA, you must claim JSA© (the contribution-based benefit), and you can also claim JSA(IB) (the income related benefit) if you wish. A couple can receive the contributary benefits separately, but the income-based benefits are calculated jointly. So although you made joint claims for both ESA and JSA (did you?), it sounds as if you've each been awarded contribution-based benefits in your own right.

 

If this is indeed the case, it does mean you'll likely get more money between you than you would on the income-related benefits. But as your GF has noticed, there is one thing about JSA© which does not apply to ESA© - your contributions "exhaust" 6 months after the date you're first paid the benefit.

 

This applies to everyone. JSA© considers only recent contributions. For a claim made in April 2010, they'll look at the tax years 2007/2008 and 2008/2009. Other contributions are important for your state retirement pension but won't be considered for JSA.

 

Once the contributions exhaust in October, your GF would need to claim JSA(IB). In this case, your ESA© would count as income and be taken into account when assessing her entitlement. Confused yet? :D As a sample calculation, something like this would work:

 

a) JSA(IB) Entitlement for a couple, both under retirement age and over 25: about £102 per week

b) ESA© Entitlement for single person over 25: about £65

Total payable to her is a-b so about £37. You still get your ESA©.

 

As to the amount she received, the £37 sounds about right, as it's only meant to cover a couple of days. JSA is paid fortnightly in arrears, and the payday is worked out based on the last 2 digits of a claimant's NI number. So because it's the start of her claim, there were probably only three payable days before payday. Her next payment will be the full amount, around £130 for the fortnight.

 

Not paying for the first three days of a claim - this is normal, happens on most new claims (unless they "link" to older claims and we really don't want to go into that) and I've never been given a satisfying explanation as to why it is the case.

 

Finally, have you looked into Council Tax Benefit? Also Housing Benefit/Local Housing Allowance if you pay rent to a landlord. These are administered by your local council, so it may be an idea to contact them.

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Thanks Antone, I would like to apologise for trying to advise on a topic where I was "out of my depth" and thankfully your advice has saved the day.

Just want to mention that happy's OH's JSA CB is subject to the 108 day rule when things become "Income Based", this rule does not apply to ESA.

I'm not a qualified welfare rights adviser, but I'm planning on becoming one. I'm no substitute for more competent advice from trained CAB and welfare rights workers - [URL="http://www.consumeractiongroup.co.uk/forum/benefits-tax-credits-minimum/127741-benefits-advice.html"]see this post[/URL] by Joa, great advice and links! I've been running a Crisis Loan campaign and help since Jan 2007 . See my annotations c/o "theyworkforyou". I'm also currently interested by the recent DWP Medical Services reform and the effect this is having on valid claims, seriously - someone needs to be keeping a suicide count.

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Thanks Antone, I would like to apologise for trying to advise on a topic where I was "out of my depth" and thankfully your advice has saved the day.

Just want to mention that happy's OH's JSA CB is subject to the 108 day rule when things become "Income Based", this rule does not apply to ESA.

 

Hell, I had to add disclaimers to my post - it's not at all certain I've read every aspect of the situation correctly. None of this is easy to advise on at the best of times.

 

And yes, ESA© does not exhaust. I think the logic is that it is harder for an ill person to work and pay NI conts.

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Just thought i'd mention ...

 

Phoned Belfast today Cancelled ESA 3 Claim, still they have not received it.

We cancelled this as we are both claiming seperately.

 

I also mentioned about my appeal, and when i go back to work after my operation, whether the appeal would continue, and they stated that once i went back to work the appeal would cease.????:(

 

Is this correct, if the appeal has not been heard or completed when i go back to work then i wont get any of the monies backdated??????.

 

It seems a bit pointless appealing in the first place.:eek:

 

Off since November, operation in June possible back at work end of July after recovering.

 

Even thou have sent certificates and Doctors letters, specialist letters

MRI scan (Dec) referred in January, the latest certificate stated unfit for work,and the tablets I am taking are starting to affect my health now, been on these since November, how much more information do they require????

 

Does it take this long for a decision to be made?????

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Hello there. For what it's worth and I'm not expert on all benefits, this sounds ludicrous. Belfast may have got it wrong, but I imagine you still have issues with what they've done.

 

I hope some smarter caggers than me will be along this evening.

 

My best, HB x

Illegitimi non carborundum

 

 

 

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I also mentioned about my appeal, and when i go back to work after my operation, whether the appeal would continue, and they stated that once i went back to work the appeal would cease.????:(

 

Is this correct, if the appeal has not been heard or completed when i go back to work then i wont get any of the monies backdated??????.

 

 

This is not the case - you have been advised badly.

 

You are asserting a period of LCW (Limited Capability for Work) from the start of your ESA claim to the point where you either return to work or cease claiming ESA for some other reason, for example by claiming JSA instead.

 

You have provided supporting evidence in the form of medical certificates and other documents from the doctors involved in your care. Your appeal will not cease simply because you return to work. That will only affect your entitlement to ESA after that point. The fact that the Tribunals Service is currently swamped with ESA appeals and is taking ages to process them is neither here nor there.

 

Edit to add: Didn't perhaps make clear, but you should indeed be entitled to backdated payments, even if you've returned to work, for the period you're appealing.

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