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Re migration ESA to UC and new UC Health Element
- micksville
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1 year 9 months ago #278412 by micksville
Re migration ESA to UC and new UC Health Element was created by micksville
Hi, Your FAQ on this issue says as follows
I’m currently on income-related ESA, what will happen when I get migrated to UC?
If you are migrated before the UC health element is introduced, possibly in 2026, then you should be put in the equivalent group in UC, either limited capability for work or for work-related activity. Between 2026 and 2029, only new claims will be subject to the new system. We think it is very likely, though we can’t be certain at this stage, that you will be treated as an existing claimant and placed in the limited capability for work or for work-related activity group rather than being considered for the UC health element.
With regard to the above and being put in the equivalent group upon migration, I'm sure I read in DWP rules somewhere that this only applied to claimants who have had a medical whilst on ESA. Many, like me haven't, ( not a face to face anyway) as we keep being re referred on a 2 yearly basis. I was originally migrated from Incapacity benefit in 2012 to Work Related group after filling in the ESA50. No actual face to face medical. In 2013 due to rapid deterioration re my disability and health issues I was put in SG following what was called a "Supersession" Again I was sent ESA50 and ATOS decided there was enough in the paperwork to place me in SG without sending for me.
I have been passed over and simply re referred every 2 years initially due to backlogs with medical assessments then in 2021 due to pandemic. So I wonder if the Supersession would be classed a a medical, as I was already on ESA when that took place, albeit in the lower group. Just curious, as otherwise I fear I might be eventually migrated to UC when the time comes as just on UC i.e. the UC equivalent of job seekers allowance and need to undergo a fresh medical for sickness benefit although I have a long PIP Award for enhanced rate of both components.
I know this has been thrown into confusion with imminent scrapping of WCA but just curious about whether Supersession counts as a medical even though done on paperwork evidence. The rules definitely state that only if you've had a medical whilst on ESA will you be migrated to your current equivalent ESA component of UC. I refer of course to managed rather than natural migration
I’m currently on income-related ESA, what will happen when I get migrated to UC?
If you are migrated before the UC health element is introduced, possibly in 2026, then you should be put in the equivalent group in UC, either limited capability for work or for work-related activity. Between 2026 and 2029, only new claims will be subject to the new system. We think it is very likely, though we can’t be certain at this stage, that you will be treated as an existing claimant and placed in the limited capability for work or for work-related activity group rather than being considered for the UC health element.
With regard to the above and being put in the equivalent group upon migration, I'm sure I read in DWP rules somewhere that this only applied to claimants who have had a medical whilst on ESA. Many, like me haven't, ( not a face to face anyway) as we keep being re referred on a 2 yearly basis. I was originally migrated from Incapacity benefit in 2012 to Work Related group after filling in the ESA50. No actual face to face medical. In 2013 due to rapid deterioration re my disability and health issues I was put in SG following what was called a "Supersession" Again I was sent ESA50 and ATOS decided there was enough in the paperwork to place me in SG without sending for me.
I have been passed over and simply re referred every 2 years initially due to backlogs with medical assessments then in 2021 due to pandemic. So I wonder if the Supersession would be classed a a medical, as I was already on ESA when that took place, albeit in the lower group. Just curious, as otherwise I fear I might be eventually migrated to UC when the time comes as just on UC i.e. the UC equivalent of job seekers allowance and need to undergo a fresh medical for sickness benefit although I have a long PIP Award for enhanced rate of both components.
I know this has been thrown into confusion with imminent scrapping of WCA but just curious about whether Supersession counts as a medical even though done on paperwork evidence. The rules definitely state that only if you've had a medical whilst on ESA will you be migrated to your current equivalent ESA component of UC. I refer of course to managed rather than natural migration
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- Gordon
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1 year 9 months ago #278420 by Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gordon on topic Re migration ESA to UC and new UC Health Element
micksville
All reviews, assessment or not result in a Supersession of the existing Decision and the creation of another one.
To put this in context.
This is a white paper, there will be a consultation which may substantially change the proposals, any new legislation (which would be required), will not be introduced until the next Parliament and this assumes the Tories win the next election.
Gordon
All reviews, assessment or not result in a Supersession of the existing Decision and the creation of another one.
To put this in context.
This is a white paper, there will be a consultation which may substantially change the proposals, any new legislation (which would be required), will not be introduced until the next Parliament and this assumes the Tories win the next election.
Gordon
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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- micksville
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1 year 9 months ago #278428 by micksville
Replied by micksville on topic Re migration ESA to UC and new UC Health Element
Thanks Gordon. What I was asking though is if, as DWP states, you must have had a medical whilst on ESA ( doesn't stipulate whether that's face to face or a medical done on paper evidence alone) to be placed in the equivalent group on UC at point of migration. I am talking about existing migration rules now, not the new proposals in the white paper.
I understand reviews that were referred over for two years would count as a supersession but the time when I was already on ESA work related group and had to be re assessed and put in SG, would that count as a medical? Because unlike the referrals done automatically for another two years with no contact from DWP, on the occasion I was moved from WRA TO SG I had to fill in an ESA 50 again and send evidence. Would that be counted as having a medical in the above context even though ATOS did the medical assessment on weight of paper evidence alone?
I understand reviews that were referred over for two years would count as a supersession but the time when I was already on ESA work related group and had to be re assessed and put in SG, would that count as a medical? Because unlike the referrals done automatically for another two years with no contact from DWP, on the occasion I was moved from WRA TO SG I had to fill in an ESA 50 again and send evidence. Would that be counted as having a medical in the above context even though ATOS did the medical assessment on weight of paper evidence alone?
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- Gary
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1 year 9 months ago #278450 by Gary
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Replied by Gary on topic Re migration ESA to UC and new UC Health Element
Hi micksville
If you are in receipt of the support element you do not need to have an assessment when transferring over to UC.
What can happen is that you may receive a review when you transfer over but whilst waiting for a decision you will still receive the LCWRA element.
In regards to your question, the answer is yes moving from WRA group to Support group would have meant that you had an assessment either paper or phone/face to face.
Completing a ESA50/UC50 form is the first stage for a review, as you have stated ATOS carried out a paper assessment called a UC85.
Gary
If you are in receipt of the support element you do not need to have an assessment when transferring over to UC.
What can happen is that you may receive a review when you transfer over but whilst waiting for a decision you will still receive the LCWRA element.
In regards to your question, the answer is yes moving from WRA group to Support group would have meant that you had an assessment either paper or phone/face to face.
Completing a ESA50/UC50 form is the first stage for a review, as you have stated ATOS carried out a paper assessment called a UC85.
Gary
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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1 year 9 months ago #278454 by micksville
Replied by micksville on topic Re migration ESA to UC and new UC Health Element
Thanks Gary. It was an ESA85 (a) if I remember right. I still have the report from 2013. I'm still on ESA but was just thinking forward to when the managed migration comes. Could have sworn I read you had to have undergone a medical whilst you were on ESA in order to be put in same group when migrated to UC. However, the ESA 85 (a) should show I was assessed on the paper evidence as it was both weighty and conclusive. As you say that probably counts as a medical.
Oddly, though I asked for and received my PIP medical report in 2016 ( face to face in my home), but I recently had my review and was given a 10 year award, both components enhanced whereas previously I had one component enhanced and one standard.
I requested the medical report but was told by PIP Helpline there was no report, as there was no medical as such, because it was done on paperwork alone this time. Must be a different criteria for PIP.
Oddly, though I asked for and received my PIP medical report in 2016 ( face to face in my home), but I recently had my review and was given a 10 year award, both components enhanced whereas previously I had one component enhanced and one standard.
I requested the medical report but was told by PIP Helpline there was no report, as there was no medical as such, because it was done on paperwork alone this time. Must be a different criteria for PIP.
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1 year 9 months ago #278456 by Gary
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by Gary on topic Re migration ESA to UC and new UC Health Element
Hi micksville
We have heard this on the forum when requesting a PA3 only to be told a report was not carried out.
A decision maker cannot remove the WRAG or Support Component unless a further WCA has taken place.
1. Regulation 19 of the UC (Transitional Provisions) Regulations 2014 makes it clear that those who move from ESA onto UC (and who have not been found fit for work), are to have: The LCW Element included in their UC assessment from the start of their UC award if they were in receipt of the Work Related Activity Component in their ESA award, or The LCWRA Element included in their UC assessment from the start of their UC award if they were in receipt of the Support Component in their ESA award. This means that the work capability decision MUST be transferred across from an ESA award to a UC one.
2. Regulation 6(2)(r) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 (for IR-ESA) and Reg 26 of the Universal Credit, PIP, JSA and ESA (Decisions and Appeals) Regulations 2013 (for UC and New-Style ESA), both say that decisions on the WRAG/Support group for ESA and on the Limited Capability for Work/Work Related Activity in UC cannot be superseded - ie taken away - without evidence from a Healthcare Professional.
Therefore, even where the WCA review date has passed, the DWP cannot refuse to include a LCW /LCWRA Element in the UC assessment until a review WCA has been completed, ie evidence from a Healthcare Professional received.
In addition, it would be unfair and discriminatory to penalise a claimant simply because, due to administrative delays within the DWP / the company contracted to organise and carry out Work Capability Assessments, they have not been reassessed on the planned date.
* the claimant is getting Contributory (or New-Style) ESA then the equivalent component that was included with their ESA claim should be transferred to their UC claim ie:
* If they were getting the Work Related Activity Component in their ESA, their UC award should include a Limited Capability for Work (LCW) Element. Regulation 19(2) of the UC (TP) Regs 2014 (old style ESA); or Regulation 39(1)(a) of the UC Regs (2013) (new style ESA).
* If they were getting the Support Component in their ESA, their UC award should include a Limited Capability for Work Related Activity (LCWRA) Element. Regulation 19(4) of the UC (TP) Regs 2014 (old style ESA) or Regulation 40(1)(a)(ii) of the UC Regs (2013) (new style ESA).
We are aware that more often than not the appropriate Element is not included in the UC award - meaning their UC award is less than it should be, in which case you need to request the inclusion of the Element from the start of your claim.
Gary
We have heard this on the forum when requesting a PA3 only to be told a report was not carried out.
A decision maker cannot remove the WRAG or Support Component unless a further WCA has taken place.
1. Regulation 19 of the UC (Transitional Provisions) Regulations 2014 makes it clear that those who move from ESA onto UC (and who have not been found fit for work), are to have: The LCW Element included in their UC assessment from the start of their UC award if they were in receipt of the Work Related Activity Component in their ESA award, or The LCWRA Element included in their UC assessment from the start of their UC award if they were in receipt of the Support Component in their ESA award. This means that the work capability decision MUST be transferred across from an ESA award to a UC one.
2. Regulation 6(2)(r) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 (for IR-ESA) and Reg 26 of the Universal Credit, PIP, JSA and ESA (Decisions and Appeals) Regulations 2013 (for UC and New-Style ESA), both say that decisions on the WRAG/Support group for ESA and on the Limited Capability for Work/Work Related Activity in UC cannot be superseded - ie taken away - without evidence from a Healthcare Professional.
Therefore, even where the WCA review date has passed, the DWP cannot refuse to include a LCW /LCWRA Element in the UC assessment until a review WCA has been completed, ie evidence from a Healthcare Professional received.
In addition, it would be unfair and discriminatory to penalise a claimant simply because, due to administrative delays within the DWP / the company contracted to organise and carry out Work Capability Assessments, they have not been reassessed on the planned date.
* the claimant is getting Contributory (or New-Style) ESA then the equivalent component that was included with their ESA claim should be transferred to their UC claim ie:
* If they were getting the Work Related Activity Component in their ESA, their UC award should include a Limited Capability for Work (LCW) Element. Regulation 19(2) of the UC (TP) Regs 2014 (old style ESA); or Regulation 39(1)(a) of the UC Regs (2013) (new style ESA).
* If they were getting the Support Component in their ESA, their UC award should include a Limited Capability for Work Related Activity (LCWRA) Element. Regulation 19(4) of the UC (TP) Regs 2014 (old style ESA) or Regulation 40(1)(a)(ii) of the UC Regs (2013) (new style ESA).
We are aware that more often than not the appropriate Element is not included in the UC award - meaning their UC award is less than it should be, in which case you need to request the inclusion of the Element from the start of your claim.
Gary
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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