March 2015 Automatic Right to Limited Capability for Work Tightened

08/03/2015

From 30 March 2015, repeat claims will only be accepted if the claimant can show a new health condition or that an existing condition has significantly worsened.

The automatic right to be treated as having limited capability for work (LCW) on a repeat claim for employment and support allowance (ESA) made more than six months after a decision that a claimant is fit for work, is to be removed.

‘Since entitlement to ESA depends on the claimant having, or being treated as having, LCW, this change will mean that claimants in these circumstances will (unless they can demonstrate that there has been a significant worsening in their health condition or that a new health condition has developed) not be awarded ESA pending a fresh WCA...

It is also intended that, where the repeat claim is allowed and results in a fit for work decision and, after mandatory reconsideration, the claimant lodges an appeal, they should not become entitled to receive ESA pending the outcome of the appeal. For these claimants, this serves to align ESA with what happens for all other social security benefits where if a claimant is found not to be entitled, no benefit is paid whilst awaiting the outcome of the appeal. We believe this is reasonable because in their previous claim, the claimant will have had the opportunity to appeal to a tribunal if they disagreed with the decision. Claimants will instead be signposted to JSA as it is the appropriate benefit for someone who has been found fit for work’.

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