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‘My ESA has ended - help!’
> I have been getting ESA for 365 days

If Universal Credit has been introduced where you live, some of the information in this set of pages may not apply to you (although in practice many of the things, including the Work Capability Assessment itself, are the same. For an introduction to Universal Credit, click here






It's a nasty shock. Suddenly your Employment and Support Allowance is ended, and money you were relying on stops. For many people it is also confusing: why has it stopped? And why do some people in similar situations carry on getting it?

To understand what's going on you need to remember, first, that there are two sorts of Employment and Support Allowance ('ESA' for short):

Now here's the problem:

You can get income based Employment and Support Allowance for as long as your income is low enough, as long as you are still not fit for work.

But...

...this isn't necessarily the case with contributory ESA:


icon-key1.jpgYou can normally only get contributory ESA for 365 days...

Unless
the DWP decides to put you in the 'support' group (because they think that your health problems are especially severe).


Let's see how this might play out in practice.

icon-example1.jpg Amina is 30 years' old. She has worked full time since leaving school, but has recently become ill and has had to leave work because of this. She lives with her husband, Ejaz, who is still in full-time employment: he earns about £250 per week.

Her GP gives her a 'sick note' and she contacts the Jobcentre Plus to claim Employment and Support Allowance.

Shortly after this the Jobcentre Plus contact her to tell her that she has got enough NI contributions to get contributory ESA. She is paid £73.10 ESA per week.

About two months later her capability for work is assessed: she has to fill in a form and attend a medical. The Jobcentre Plus agrees with her that she should be on ESA, but they do not think that her problems are severe enough to put her in the support group: she is therefore placed in the work related activity group. Her ESA goes up to £102.15 per week.

Everything is fine until a year after she first claimed, when she receives a letter telling her that she is no longer entitled to Employment and Support Allowance. She doesn't understand this and phones them up for an explanation.

The person she speaks to says that her benefit has stopped because she has been getting contributory ESA for 365 days. They checked to see if she would be entitled to any income based ESA, but decided that she wasn't, because her husband's income was too high.


There are some important things to notice here:

The last point is especially important and causes a lot of anger, and here's why:

When you are assessed, it doesn't seem to make that much difference whether you are in the work related activity group or the support group. In both cases you carry on getting benefit: the only differences are that your benefit is increased to slightly more in the support group (to £109.30 per week compared with £102.15 for the work related activity group), and you don't have to attend work-focused interviews and (possibly) work-related activities.

Because of this, a lot of people don't attempt to challenge the Jobcentre Plus's decision at this point. It's only months later that they realise that they would have been in a much better position if they were in the support group, but now it is too late to do anything about it.

You are likely to have a couple of questions at this point?

1. Is there anything I can do to avoid this situation?

The answer is likely to be no. But not always.

If you're getting contributory ESA it's especially important to look carefully at the decision the Jobcentre Plus about your capability for work.

If you have been placed in the work related activity group but you think you should be in the support group, it is very important that you challenge this decision immediately. If you do, and your challenge is successful, your contributory ESA will not stop when you've been on the benefit for a year.

To challenge the decision you need to seek a mandatory reconsideration from the Jobcentre Plus, and if this is not successful, appeal to the tribunal service.

icon-warning1.jpg You normally have to seek a mandatory reconsideration within one month of the Jobcentre Plus issuing its decision.
If they don't change their decision in your favour, you then normally have one month to appeal to the tribunal service.

But you need to be realistic. To be placed in the support group your health problems or disabilities must be especially severe.  To check whether you might fit the rules for the support group, click here: 'How does the Jobcentre Plus decide whether I should be in the work related activity group or the support group?'

And remember: this is not a risk-free process:

icon-warning1.jpg If you appeal against the decision, the tribunal has the power to reduce the award as well as increase it or leave it the same.

In other words, there is a risk that they could decide that you are not entitled to Employment and Support Allowance at all.

This is why it's very important to make sure you have a good case before proceeding.

If your appeal is successful, but your contributory Employment and Support Allowance has stopped in the meantime because 365 days have passed, it will be restarted and arrears paid.

2. My contributory ESA has been stopped because I've been on it for 365 days: what are my options?

Sadly, it is quite likely that there is nothing you can do to change the situation. But there are some things you should check:

Firstly, double check that the Jobcentre Plus has actually checked to see if your entitled to income based ESA. And make sure that they have the accurate information about your other income: if you do have other income, but it has decreased, you may now be entitled to income based ESA after all.

Secondly, check to see if you are entitled to any Housing Benefit and/or Council Tax Support. You may well be entitled to these even if you have no entitlement to income based ESA.

Finally, has your condition worsened since your capability for work was assessed? If it has, and you have evidence of this, you could ask the Jobcentre Plus to re-assess you. If they agree that your condition has worsened and that you should now be in the support group, your contributory ESA will start again.

To see if you now fit the rules for the support group, click here: 'How does the Jobcentre Plus decide whether I should be in the work related activity group or the support group?'

icon-warning1.jpg If you ask the Jobcentre Plus to re-assess your capability for work because your condition has worsened, they have the power to reduce the award as well as increase it or leave it the same.

This is why it's very important to make sure you have a good case before proceeding.





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