Have I missed out on disability premium? ESA vis-a-vis JSA

[scotleag]

A little over two years ago I found myself unable to work full-time any longer and started to receive Employment Support Allowance, initially contributions based and subsequently and currently income-related. After around six months on ESA I went for a Work Capability Assessment and was placed into the Work Related Activities Group. I have no quarrel with this as such as while I am not capable of continuing in full-time employment, at the same time I don't think I can claim that I am unable to do work of any kind.

However an associate has suggested to me that as a result of this I have lost out on a payment called disability premium. I have since ran searches for more information and would like to know if what I have found is correct or not.

1 There are premiums for disability paid to those in receipt of certain benefits

2 These are titled basic, severe and enhanced

3 People on income-related ESA and not in the support group do not qualify for any of these premiums

4 People on jobseekers allowance DO qualify for these premiums provided they meet certain criteria

5 As far as the basic premium is concerned qualifying criteria include being in receipt of DLA at any level and having been in receipt of the disabled person's element of working tax credit when working.

My situation is that I have been in receipt of DLA lower level care component for around twenty years (though shortly due to end as I've mentioned on another thread) and for two long spells on working tax credit was in receipt of the disabled person's element. The second of which was still applicable at the point I became unable to work full-time.

Am I right in thinking therefore that if I had been in better health and the work capability assessment said I should be on JSA not ESA that I would have received a disability premium? I find it difficult to believe that if I was capable of working full-time that I would receive greater assistance than if not. Has my colleague got it wrong? Have I misread or misunderstood the information I have gleaned from the DWP's own website concerning this?

Also, while it is my understanding that people on income-related ESA can only receive severe or enhanced disability premium (neither of which I don't think I would qualify for) what is the situation concerning contributions-based ESA? Should I have been receiving a premium while I was on that?

The DWP website says such payments are made automatically so not having received them at any point since becoming unable to work full-time I am presuming I am not and never was eligible at any stage but still have this niggling doubt in my mind and would like to know the definitive position.

Finally, I also read though I cannot remember where exactly, there is so much information to digest and so many websites offering advice it's impossible to keep track of them all, that it's possible for someone on income-related ESA to qualify for a basic disability premium if they have been unable to work for 364 days. I have now been off work for over two years and while I haven't given up hope of returning to full-time employment I also have to recognise the reality of being 63 years old with several chronic conditions and that I may well be fooling myself into thinking the period between now and retirement age of 66 will be anything other than what it is now.

[nukecad]

Hi scotleag,

You have got it partially right, but not quite the whole situation.

All Premiums (ther are more than just the disability ones) are only ever payable with Income Related benefits.
(But with ESA you can have both Contributions Based ESA and Income Related ESA at the same time).

For the moment I'll just concentrate on the Disability Premiums and ESA here.

The (basic) Disability Premium is not payable with ESA but can be paid with other Income Related benefits depending on other benefits you may be getting.

The Enhanced Disability Premium (EDP) is payable with Income Related ESA (or CB ESA with an IR top-up), it can be paid in either group.
If you are in Support Group you qualify automatically, if you are in WRAG then you need to also have DLA higher care, or PIP Enhanced Daily living.
(There are other qualifications such as being treated as living alone, and no-one receiving Carers Allowance for looking after you).

The Severe Disability Premium (SDP) is payable with Income Related ESA (or CB ESA with an IR top-up), it can be paid in either group.
To qualify you need to also have DLA middle of higher care, or PIP Daily living at any rate.
(There are other qualifications such as being treated as living alone, and no-one receiving Carers Allowance for looking after you).

There is no 'time' after which you qualify for EDP or SDP.
(There is with the basic premium in other benefits, but that is not payable with ESA anyway).

Here is the government webpage on the qualifying criteria for each premium:
https://www.gov.uk/disability-premiu...rt/eligibility

In your particular case-

Unfortunately, as you have the Lower rate of DLA then you do not qualify for either the EDP or SDP with your ESA.

Whilst you would have the basic Disability Premium with JSA, that would have course meant that you had full jobseeking commitments and would have to do the usual Jobseeking/applying, go to the Jobcentre fortnightly (or weekly or daily), etc.
That's a bit of an academic point anyway because you can no longer make a new claim for Income Related JSA (unless you already have the SDP).
You would have to claim Universal Credit and Universal Credit does not include any disability premiums.

So to get a disability premium (or both) added to your ESA you would need to either:

1. Be reassessed for ESA and moved to Support Group. (As you are on IR ESA then that would automatically give you the EDP).
2. Get your DLA award increased to middle or higher. (That would give you EDP in WRAG, Higher would also give you SDP in WRAG).
   I'm not sure that you can do that now, I believe you would be 'invited' to claim PIP instead.
3. Change your DLA to PIP, which you will be invited to do soon anyway, and get a PIP Daily Living award. (That would give you SDP, plus EDP if it was Enhanced).

I hope that's made it all a bit clearer.

[scotleag]

Yes, thanks, a lot clearer. It seems that I am indeed not fit enough to receive a premium via JSA but too healthy to receive one via ESA support group! IIRC my work capability assessment included a recommendation for review after one year and this was around 18 months ago but I have heard nothing since. While my health certainly hasn't improved any in the interim I doubt whether it has deteriorated to the extent that would place me in the support group and indeed I suppose it's possible that a re-assessment might actually move me to JSA or UC but without being able to qualify for a premium. I've asked the DWP for copies of all correspondence and discussions related to my WCA. How does re-assessment work? Do I wait for them to contact me? Can I ask for a re-assessment myself? Or should I write reminding them that the recommendation for review is now six months past the date mentioned in the WCA?

[nukecad]

They are probably backlogged on assessments in your area, or you got a longer period than you thought.

It's not a worry, all ESA awards are 'ongoing' and payments will continue.
Payments will only stop if you are found fit-for-work, which can only be done following a face to face assessment.
(Or if you break the rules, eg. failing to attend an assessment).

As you are in WRAG then presumably you are visiting the jobcentre regularly.
You can just ask at your next visit what your 'Prognosis date' is, that's when you are next due to be reassessed.
Just asking won't change it.
They refer you to the assessors a few months before that, who then send you an ESA50.

Or you could ring the ESA enquiry line and ask.
Not all the phone jockeys know where to find the Prognosis date on your file so you may need to ring more than once.

[scotleag]

Yes, I get called in to see the work coach - or whatever the title is - from time to time. I am doing 'permitted work' when I can. Last time they didn't even call me in, just spoke on the phone for a couple of minutes and they seemed satisfied with that. That was just a few weeks ago.

[1066]

I believe that claims made pre 2017 are entitled regardless

[nukecad]

I believe that claims made pre 2017 are entitled regardless

That's a slightly different issue, and nothing to do with the Disability Premiums.

The issue there is that claims originally made on or after 4th April 2017 do not qualify for extra payments of the ESA WRAG component, or the UC-LCW element.
Claims originally made before 4th April 2017 do qualify for those extra payments.

Disability Premiums are still payable with ESA claims made before or after that date provided you meet the other qualifying conditions.

ESA SG and UC-LCWRA are not affected by that and are still paid in all cases if you are awarded those groups.

[scotleag]

I had to give up work in early 2017. It had been about 25 years since I was last unemployed so I was aware the benefits system wasn't the same. I went to CAB for advice and they said to claim ESA which I did. I was put on contributions related ESA. After several months I had a work capability assessment and was put into the work related activity group. At the time I had to give up I'd been in receipt of working tax credit, including the disabled person's premium, for over two years and DLA lower care rate for about 17 years. IIRC I made only one claim for ESA (in February 2017). I have no idea whether the claim was on a contributions basis or income related. I presume I was placed on the former as my NI payments were up to date (I paid the self-employed NI rate) and AFAIK was moved over to the latter at the end of entitlement period automatically. I don't recall ever having to make a fresh application. I simply received a letter saying one was ending and I'd move to the other. By that time I'd been assessed and put into the WRAG.

My understanding of the situation after reading Nukecad's post is that if I'd applied for JSA, not ESA, I'd have received the basic disability premium. My reading of the current situation is that if I were to be found capable of work now, it wouldn't be JSA, it would mean an application for UC and the basic disability premium is no longer paid.

In other words if I'd been capable of work in Feb 2017 I'd have got disability premium but if I'm found capable of work now I wouldn't get any such payment. Maybe the CAB gave me wrong advice. I don't know. I do know though that I had to give up work on health grounds. So if I'd claimed JSA I'd have been doing a 'reverse fiddle.' Telling the DWP I was fitter than I was when what you usually hear about WRT benefits is the opposite way around!

[scotleag]

To be clear I mean Nukecad's original post, he/she having posted again while I was writing the above

[nukecad]

That about right scotleag, as I said above:

Whilst you would have the basic Disability Premium with JSA, that would have course meant that you had full jobseeking commitments and would have to do the usual Jobseeking/applying, go to the Jobcentre fortnightly (or weekly or daily), etc.
That's a bit of an academic point anyway because you can no longer make a new claim for Income Related JSA (unless you already have the SDP).
You would have to claim Universal Credit and Universal Credit does not include any disability premiums.

I think the advice that you got from CAB was correct as they saw it, and I would have advised the same at that time; 'claim ESA'.
That is because with ESA you get paid a group component, rather than the disability premium you would have got with JSA, swings and roundabouts.
OK, you were awarded WRAG which was slightly less than JSA+DP, but if you'd have got Support Group then SG+ automatic EDP would have been more.
Plus with claiming ESA there was no jobseeking/applying to do.

IIRC I made only one claim for ESA (in February 2017). I have no idea whether the claim was on a contributions basis or income related. I presume I was placed on the former as my NI payments were up to date (I paid the self-employed NI rate) and AFAIK was moved over to the latter at the end of entitlement period automatically. I don't recall ever having to make a fresh application. I simply received a letter saying one was ending and I'd move to the other. By that time I'd been assessed and put into the WRAG.

That's correct, CB ESA in WRAG is only payable for 52 weeks, at which time they automatically switch you to IR ESA WRAG with no need for another application/assessment. (Unless you have high savings or a working partner, etc. so don't qualify for IR ESA).