After ESA (c) ends?

Mrs Hurtyback wrote:


The DWP will continue to subject claimants to periodic reassessments during the time that their ESA claim is 'live', even if they are not receiving any money.

But if your CB ESA has come to an end after 365 days then is it still live (whatever "live" means)? Also how periodic is periodic and can you as the potential claimant request a reassessment inbetween the DWP's periodic reassessments?

Gareth wrote:

Mrs Hurtyback wrote:


The DWP will continue to subject claimants to periodic reassessments during the time that their ESA claim is 'live', even if they are not receiving any money.

But if your CB ESA has come to an end after 365 days then is it still live (whatever "live" means)? Also how periodic is periodic and can you as the potential claimant request a reassessment inbetween the DWP's periodic reassessments?

Hi G,

Once a claimant's 365 day entitlement to CB ESA in the WRAG is exhausted, they may still be classed as having LCW, as their WRAG award may have been for more than the 365 days.

Therefore, even though the CB ESA payments have ceased, they are still deemed as having LCW, and are still classed as being in the WRAG.

They will continue to have their NI Credits payed after the 365 day entitlement is exhausted, and will still be reassessed at regular intervals (depending on the prognosis) under the WCA.

Therefore, as long as they have a live assessment of LCW, they could at anytime ask for a supersession to gain entry to the SG if their limitations have increased or changed due to a deterioration or change in their medical conditions.

If as a result of this supersession they were found to have LCWRA and were placed into the SG, then their payments of CB ESA would be reinstated for as long as they remained in the SG.

Further, if as a result of the regular reassessments they were found to have LCWRA, and were therefore placed into the SG, again payment of CB ESA would be reinstated for as long as they remained in the SG.

Whilst a claimant is in receipt of NI Credits only in the WRAG, they will have to undergo reassessments under the WCA if they wish to keep their award of LCW live, and therefore the continued payment of their NI Credits for SP purposes, but they cannot be compelled to take part in WFI's & WRA.

Therefore, it would be possible for a claimant to be deemed as having LCW and therefore be in the WRAG for several years after payment has stopped due to the 365 day entitlement being exhausted, and because of this, they could be placed into the SG and have their CB ESA reinstated as a result of a reassessment instigated by the DWP, or a supersession/review instigated by the claimant.

Sorry to ramble a bit, and hope this now clarifies it for you.

bro58

Hi Bro

You've certainly clarified more than a certain Peer did when posed the same question!

However just a few points of clarification if I may.


You say that you can be placed in the WRAG for > 365 days, presumably this is done at the initial Atos assessment by the "HCP" or the DWP DM? Is there any maximum length of time that you can you be placed in the WRAG for? I ask because if you can only be placed in the WRAG for say a maximum of 3 years what happens after those 3 years if your condition hasn't deteriorated and you haven't found suitable employment? Will your NICs stop after those 3 years due to you not being able to reclaim CB ESA because you cannot get into the SG?

With respect to NI Credits there will no doubt be many especially those who have been on IB for many years (and thus been getting their NICs paid) be fully paid up as it were so wouldn't need any NICs; so when their 365days comes to an end would their claim stop being live and so not attract the periodic DWP assessments?

So all in all am I correct in thinking that in this situation (No NICs and out of WRAG time) the only way a person can initiate a reassessment would be for them to contact the DWP themselves and request a further reassessment (via an ESA50) under Section 52 if they thought that their condition was now a SG likelihood?

Hope all that made sense!

Gareth wrote: Hi Bro

You've certainly clarified more than a certain Peer did when posed the same question!

However just a few points of clarification if I may.


You say that you can be placed in the WRAG for > 365 days, presumably this is done at the initial Atos assessment by the "HCP" or the DWP DM? Is there any maximum length of time that you can you be placed in the WRAG for? I ask because if you can only be placed in the WRAG for say a maximum of 3 years what happens after those 3 years if your condition hasn't deteriorated and you haven't found suitable employment? Will your NICs stop after those 3 years due to you not being able to reclaim CB ESA because you cannot get into the SG?

With respect to NI Credits there will no doubt be many especially those who have been on IB for many years (and thus been getting their NICs paid) be fully paid up as it were so wouldn't need any NICs; so when their 365days comes to an end would their claim stop being live and so not attract the periodic DWP assessments?

So all in all am I correct in thinking that in this situation (No NICs and out of WRAG time) the only way a person can initiate a reassessment would be for them to contact the DWP themselves and request a further reassessment (via an ESA50) under Section 52 if they thought that their condition was now a SG likelihood?

Hope all that made sense!

Hi G,

You say that you can be placed in the WRAG for > 365 days, presumably this is done at the initial Atos assessment by the "HCP" or the DWP DM? Is there any maximum length of time that you can you be placed in the WRAG for? I ask because if you can only be placed in the WRAG for say a maximum of 3 years what happens after those 3 years if your condition hasn't deteriorated and you haven't found suitable employment? Will your NICs stop after those 3 years due to you not being able to reclaim CB ESA because you cannot get into the SG?

Yes, this is the recommended period before reassessment, (the prognosis) it is given by the ATOS HCP on assessment, it is then supposedly upto the DWP DM as to whether they abide by this or not.

The prognosis recommendations as in the WCA Handbook, are for 3, 6, 9, 12, 18, 24 months or "In the longer term", therefore one would assume that being given a prognosis of "In the longer term" would give an award of 2 years to 3 years. (3 years being the maximum that we have seen, in the SG though, which I believe is down to DWP operating systems constraints)

I think 2 years in the WRAG is the longest LCW award that we have seen on the forum.

If you haven't found employment after the prognosis period, you would face a reassessment, if still found to have LCW, your WRAG award would stay live. You would continue to receive NI Credits only.

With respect to NI Credits there will no doubt be many especially those who have been on IB for many years (and thus been getting their NICs paid) be fully paid up as it were so wouldn't need any NICs; so when their 365days comes to an end would their claim stop being live and so not attract the periodic DWP assessments?

This may be the case, as I believe that once you have 30 years worth of NI C's that is enough.
The LCW status would remain live for as long as you were deemed LCW under the ESA WCA.
Of course, one could opt out if one had accrued the 30 years, but in that case your live assessment of LCW would cease, as mentioned in Section 52 :

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

So all in all am I correct in thinking that in this situation (No NICs and out of WRAG time) the only way a person can initiate a reassessment would be for them to contact the DWP themselves and request a further reassessment (via an ESA50) under Section 52 if they thought that their condition was now a SG likelihood?

If a claimant was currently deemed LCW even if in receipt of NI C's only then they could request a supersession, and they would still be liable to reassessment under the ESA WCA.

If they had opted out of ESA, and therefore did not have a live assessment of LCW they could not then request an assessment to gain access to the SG, the only way that they could again qualify for payment of CB ESA would be to gain the necessary NI Contributions through employment.

bro58

Gentlemen,

If I've understood you boys correctly then..........

(a) if you stop your CB ESA claim by stopping receiving NICs (because you have 30 years worth) you forefiet the right to claim CB ESA in the future even if you become SG eligable unless you have the required employment NICs.

(b) So even after your 365 days in the WRAG has come to an end to satisfy Section 52(1a) you must continue to receive (non required) NICs in order to "stay on the DWP's ESA books" in order to be able to personally request and also recieve periodic WCAs just in case your condition deteriorates.


So at the end of the 365 days keep on claiming the NICs!

If so then this isn't quite the same as what a certain [Tory]Peer said when asked the same question, all he said was "In order for a person to show that they have had (or can be treated as having) limited capability for work they would need to provide medical evidence"

Thanks boys

BTW is all what you've told me written down somewhere?