Incapacity/ESA and permanent health insurance

Can anyone help or had experience of the following? I am in a possibly slightly unusual situation. i have been unable to work since 2005 due to Mental health issues. I am fortunate in that my employer has permanent health insurance, I receive a % of my salary less incapacity benefit, so I am 'employed' but on long term sick leave. i received phonecall today to say that i cannot have esa on transfer from incapacity benefit, having had the ATOS assessment last week. On the same day i had a call from the insurers who following my most recent assessment (July 2011) I will continue to receive my insurance. DWP dont seem to have come across this before and like everyone else i cannot afford to lose my benefit, so although I am deemed unable to work by the people who assess me regularly DWP seem to have other ideas, has anyone else had this battle?

Purdiepoodle wrote:

Can anyone help or had experience of the following? I am in a possibly slightly unusual situation. i have been unable to work since 2005 due to Mental health issues. I am fortunate in that my employer has permanent health insurance, I receive a % of my salary less incapacity benefit, so I am 'employed' but on long term sick leave. i received phonecall today to say that i cannot have esa on transfer from incapacity benefit, having had the ATOS assessment last week. On the same day i had a call from the insurers who following my most recent assessment (July 2011) I will continue to receive my insurance. DWP dont seem to have come across this before and like everyone else i cannot afford to lose my benefit, so although I am deemed unable to work by the people who assess me regularly DWP seem to have other ideas, has anyone else had this battle?

Hi PP, it seems this is your first posting so welcome.

I am no expert on PHI, however from what you say if the PHI is paid minus any IB/ESA that you get, if you are no longer entitled to the IB/ESA, then wouldn't your PHI have to be reinstated to the full amount allowed.

I am sure one of the other Moderators will have more advice in due course.

cheers

bro58

Purdiepoodle wrote:

Can anyone help or had experience of the following? I am in a possibly slightly unusual situation. i have been unable to work since 2005 due to Mental health issues. I am fortunate in that my employer has permanent health insurance, I receive a % of my salary less incapacity benefit, so I am 'employed' but on long term sick leave. i received phonecall today to say that i cannot have esa on transfer from incapacity benefit, having had the ATOS assessment last week. On the same day i had a call from the insurers who following my most recent assessment (July 2011) I will continue to receive my insurance. DWP dont seem to have come across this before and like everyone else i cannot afford to lose my benefit, so although I am deemed unable to work by the people who assess me regularly DWP seem to have other ideas, has anyone else had this battle?

Myself and 6000 others say the WP stats are in the same boat we might get esa stopped when moved

Purdiepoodle wrote:

Can anyone help or had experience of the following? I am in a possibly slightly unusual situation. i have been unable to work since 2005 due to Mental health issues. I am fortunate in that my employer has permanent health insurance, I receive a % of my salary less incapacity benefit, so I am 'employed' but on long term sick leave. i received phonecall today to say that i cannot have esa on transfer from incapacity benefit, having had the ATOS assessment last week. On the same day i had a call from the insurers who following my most recent assessment (July 2011) I will continue to receive my insurance. DWP dont seem to have come across this before and like everyone else i cannot afford to lose my benefit, so although I am deemed unable to work by the people who assess me regularly DWP seem to have other ideas, has anyone else had this battle?

PP, I should also say that if you have been refused ESA, due to a recent assessment on being migrated from IB, you can appeal the decision.

This should be done using a GL24 appeals form, which you can download from the "MEMBERS ONLY" orange box on the left.

You only have a month to appeal, from the date of receipt of your adverse decision.

Also in the "MEMBERS ONLY" area you will see extensive guides on ESA, and the appeals process.

If you appeal a decision that you are fit to work, if that is actually the case, you will receive assessment rate ESA of £67.50/week.

You may be required to supply Med Certs from your G.P. whilst appealing, check with DWP.

I am not sure how this ties in with regards to PHI though.

cheers

bro58

Purdiepoodle wrote:

Can anyone help or had experience of the following? I am in a possibly slightly unusual situation. i have been unable to work since 2005 due to Mental health issues. I am fortunate in that my employer has permanent health insurance, I receive a % of my salary less incapacity benefit, so I am 'employed' but on long term sick leave. i received phonecall today to say that i cannot have esa on transfer from incapacity benefit, having had the ATOS assessment last week. On the same day i had a call from the insurers who following my most recent assessment (July 2011) I will continue to receive my insurance. DWP dont seem to have come across this before and like everyone else i cannot afford to lose my benefit, so although I am deemed unable to work by the people who assess me regularly DWP seem to have other ideas, has anyone else had this battle?

Contributory ESA is subject to deductions in a similar way to IB. Deductions are made for pensions and payments of permanent health insurance. In this case ESA is reduced by half the amount of any payment in excess of £85. Unlike IB, there is no exemption from this rule for those in receipt of the higher rate care component of disability living allowance.

Hi purdiepoodle,
I have not been switched yet to ESA but I am in the same position as you in that I get PHI and am still employed but off long term sick (15 years). I am subject to regular insurance reviews ie once a year and have even seen Occupational Health Consultants who have confirmed to my employers and the insurers that I am unfit for work. This also means that my NI contributions are fully paid.

Your route has got to be the appeal process because if any one could get out of paying it would be an insurance company any day so the fact that they confirm your illness has got to be a big plus. Let us know how its going.

Good Luck

PS Getting confused from some of the posts as it seems simply by getting PHI you can lose ESA is this right? www.benefitsandwork.co.uk/components/com...moticons/w00t.pngCan anyone confirm in laymans terms what the position is. Thanks.