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Chapter V2: Duration of ESA award

Contents
V2001:Introduction
V2002:Further awards of ESA
Period of entitlement
V2010:Contribution conditions satisfied
V2011:Relevant maximum number of days
V2015:Youth conditions satisfied
Which days are not included
V2015:Claimant has, or is treated as having, LCWRA
V2022:Waiting days
V2023:Days of disqualification
V2030:Which days are included
V2035:Credits
Repeat claim for ESA
V2040:Introduction
V2045:Claim based on a later tax year
V2045:ESA in youth
V2055:Change in claimant's health condition
V2056:Health condition deteriorates
V2060:Application made during current award
V2062:Application made after award has terminated
V2065:Deterioration identified on routine WCA
V2070:Date award begins
V2075:Health condition improves
V2100:Appeal against time limit decision

Chapter V2: Duration of ESA award

V2001 Introduction

Entitlement to ESA for claimants who are not in the support group is limited to a
period of no more than 365 days (1). This includes awards of ESA made under
1. the youth conditions and
2. the IB Reassessment rules (2).
Note: See DMG Chapter 45 for guidance on duration of ESA awards made under
the IB Reassessment rules.
1 WR Act 07, s 1A; 2 WR Act 07, Sch 4, para 7(2)(f); ESA (TP, HB & CTB)(EA)(No. 2) Regs, Sch 2, para 2A

V2002 Further awards of ESA

There are special provisions allowing claimants to become entitled to a further award
of ESA (1) after a previous award has ended due to time limiting where
1. they satisfy the contribution conditions and
2. in relation to the second condition, at least one of the relevant income tax
years is later than those used for the previous period of entitlement.
See V2045 for further details.

1 WR Act 07, s 1A(3)

V2003

Awards made under the youth conditions are not based on tax years. Any further
claim after entitlement is terminated because of time limiting must be based on the
normal conditions of entitlement (but see V2004 where the claimant's health
condition deteriorates).

V2004 V2003

A further provision also allows claimants whose ESA has ceased as a result of time
limiting to qualify for a further award of ESA where their health condition deteriorates
to the extent that they have, or are treated as having, LCWRA, provided certain
conditions are satisfied (1). See V2056 et seq for further details.
1 WR Act 07, s 1B

[V2005-V2009]

Period of entitlement

V2010 Contribution conditions satisfied V2020 V2022 V2023 V2030 V2040 V2061 V2062

Entitlement to an award of ESA where
1. the first and second contribution conditions are satisfied (1) (see ADM Chapter
U1) and
2. entitlement is based on the same two tax years
cannot exceed the relevant maximum number of days (2).
Note: See V2020 et seq for days which do not count towards the maximum number
of days.
1 WR Act 07, s 1(2)(a) & Sch 1, paras 1 - 3; 2 s 1A(1) & (2)

V2011 Relevant maximum number of days

The relevant maximum number of days is (1)
1. 365
or
2. a greater number of days where specified by order of the Secretary of State.
Note: At present no order has been made, and the maximum number of days is
therefore 365.
1 WR Act 07, s 1A(2)

[V2012-V2014]

V2015 Youth conditions satisfied V2020 V2022 V2023 V2030 V2040 V2050 V2061 V2062

Entitlement to an award of ESA where
1. the youth conditions are satisfied and
2. the claim was made before 1.5.12
cannot exceed 365 days (1). See ADM Chapter U1 (ESA conditions of entitlement) for
guidance on the youth conditions.
Note: See V2020 et seq for days which do not count towards the maximum number
of days.
1 WR Act 07, s 1A(4)

[V2016-V2019]

Which days are not included

V2020 Claimant has, or is treated as having, LCWRA V2010 V2015 V2030 V2076

When calculating the period of entitlement for the purposes of V2010 or V2015, days
where the claimant is
1. a member of the support group (1) or
2. not a member of the support group, but is entitled to the support component (2)
or
3. in the assessment phase (3), when this is immediately followed by a
determination that the claimant is a member of the support group and entitled
to the support component are
not included (4).
Note
: See V2075 et seq for guidance on where the claimant's health condition
improves.

1 WR Act 07, s 24(4); 2 s 2(1)(b); 3 s 24(2); 4 s 1A(5)

V2021

A claimant is a member of the support group from the date the determination is
made that they have, or are treated as having, LCWRA (1). This determination may be
made before or after the effective date of entitlement to the support component.
1 WR Act 07, s 24(4)

Example

Miranda has been entitled to ESA at the assessment phase rate since 15.5.14. On
6.8.14 after application of the WCA, the DM determines that Miranda has LCW and
LCWRA. Miranda is a member of the support group from 6.8.14. The DM then
supersedes the decision awarding ESA and awards the support component from
14.8.14, the 14th week of entitlement. None of the days when Miranda is entitled to
ESA count towards the relevant maximum number of days. Miranda continues to be
entitled to ESA for as long as she has LCW and LCWRA. If her health improves to
such an extent that she is later found to have LCW but no longer has LCWRA, the
365 day count would begin from the date of that determination.

V2022 Waiting days

A claimant is not entitled to ESA for the first three days of a PLCW (1), known as
waiting days - see ADM Chapter U1 (ESA conditions of entitlement). Waiting days
are therefore not included in the period of entitlement at V2010 and V2015.
1 WR Act 07, Sch 2, para 2; ESA Regs 13, reg 85

V2023 Days of disqualification V2032

ADM Chapter U7 (Disqualification) gives guidance on treating the claimant as not
having LCW if they are disqualified for receiving ESA during a period of
imprisonment of more than six weeks (1). These days are not days of entitlement to
ESA, and are therefore not included in the period of entitlement at V2010 or V2015.
1 ESA Regs 13, reg 95

[V2024-V2029]

V2030 Which days are included

When calculating the period of entitlement for the purposes of V2010 or V2015, all
days of entitlement, both before and after 1.5.12, except those in V2020, are
included in the count (1). This also includes days where the claimant is entitled to ESA
paid at the assessment phase rate pending an appeal against a disallowance
following application of the WCA (see ADM Chapter U7).
1 WR Act 07, s 1A(6)

Example

Sally has been entitled to ESA at the assessment phase rate since 8.7.13. On
19.11.13 after application of the WCA the DM determines that Sally does not have
LCW, and terminates her entitlement to ESA from the same date. Sally appeals to
the FtT, and is awarded ESA at the assessment phase rate from 19.11.13 pending
determination of the appeal. As none of these days is excluded from the 365 day
period, her last day of entitlement is 7.7.14, the 365th day, if the appeal is still
outstanding at that time.
If the FtT subsequently allows Sally's appeal, but finds that she does not have
LCWRA, Sally is entitled to arrears of the WRAC from the 14th week of entitlement
for the period 7.10.13 - 7.7.14 only. The decision terminating ESA from 8.7.14
stands.
If the FtT allows the appeal, and finds that Sally has LCWRA, the decision
terminating ESA from 8.7.14 should be revised to reinstate entitlement, and arrears
of the support component paid as normal. As Sally is in the support group her ESA is
not time limited for as long as she has LCW and LCWRA. None of the days from
8.7.13 count towards the 365 day time limit.

V2031

The period of 365 days includes all days of entitlement, including previous periods of
entitlement, which are based on the same two tax years (1). This may be where the 12
week linking provisions apply (2), or where two awards for claims made in the same
relevant benefit year. See ADM Chapter U1 (ESA conditions of entitlement) for
guidance on linking PLCWs.
1 WR Act 07, s 1A(1); 2 ESA Regs 13, reg 86

Example

Roberto was entitled to ESA from 20.1.14. He was found to have LCW, but was not
placed in the support group, so was awarded the WRAC. He returned to work on
3.9.14, and his award of ESA was terminated from that date. On 8.10.14 Roberto
makes a repeat claim for ESA. The PLCWs link, and he is awarded ESA including
the WRAC from 8.10.14. Roberto's entitlement to ESA will end on 23.2.14, the
combined 365th day of entitlement, unless he is found to have LCWRA before that
date.

V2032

DMs should note that the number of days of entitlement includes days where ESA is
not payable, but entitlement continues. This includes days where ESA is not payable
1. for periods of disqualification, for example for imprisonment (see ADM
Chapter U6) or
2. because the overlapping rules apply (see DMG Chapter 17) or
3. because it is reduced to nil through pension payments or councillor's
allowances - see ADM Chapter V1 (ESA amounts).
Note: See V2023 where days of disqualification due to imprisonment exceed six
weeks.

Example

Kylie has been entitled to ESA since 12.5.14. She is not a member of the support
group. On 20.4.15 she is sentenced to a period of imprisonment, and the DM
decides that Kylie is disqualified from receiving ESA which is therefore not payable.
Kylie is released on 22.5.15. Her entitlement to ESA terminates on 11.5.12, even
though on that day it is not payable.

[V2033-V2034]

V2035 Credits

A person whose entitlement to ESA has been terminated after 365 days remains
entitled to NI credits for any day which
1. would have been a day of LCW if the ESA award had not been terminated (1)
and
2. is not a day of entitlement to UC (2).
1 SS (Credits) Regs, reg 8B(2)(a)(iva); 2 reg 8B(2A)(b)

[V2036-V2039]

Repeat claim for ESA

V2040 Introduction

Where
1. an award of ESA has terminated as in V2010 or V2015 and
2. a further claim for ESA is made
the DM should firstly consider whether the guidance on establishing a further 365
days entitlement based on a later tax year in V2045 applies. If not, the DM should
next consider whether the guidance on deterioration in the claimant's health
condition in V2056 et seq applies.

V2041

If neither of those circumstances apply, the claimant cannot be entitled to ESA.
They may be eligible to claim UC instead.

[V2042-V2044]

V2045 Claim based on a later tax year V2002 V2040 V2070 V2077

A further claim for ESA where the claimant has already been entitled for 365 days on
the basis of the contribution conditions can succeed if
1. the claimant satisfies the first and second contribution conditions (but see
ADM Chapter U1 for guidance on relaxation of the first contribution condition)
and
2. in relation to the second contribution condition, at least one tax year is later
than the second of the two years on which the previous entitlement was
based (1).
Note: See V2075 et seq where an award is made and the claimant's condition
improves.
1 WR Act 07, s 1A(3)

Example 1

Nicholas has been entitled to ESA since February 2014. He is not a member of the
support group. His entitlement was based on 52 paid contributions for the tax year
2012/2013 in relation to the first condition, and a combination of paid contributions
and NI credits for unemployment for the tax years 2011/2012 and 2012/2013 in
relation to the second condition. Nicholas's last day of entitlement to ESA is 4.3.15.
Nicholas makes a further claim for ESA on 3.8.15. There has been a break of more
than 12 weeks in the PLCWs for benefit purposes so the contribution conditions can
be considered afresh in the later benefit year. He satisfies the first condition with
paid contributions for the tax year 2012/2013. In relation to the second contribution
condition, the tax years are 2012/2013 and 2013/2014. As one of these years is later
than the years on which his previous period of entitlement was based, Nicholas is
entitled to a further 365 days of ESA as long as he continues to satisfy the conditions
of entitlement.

Example 2

Zelda has been entitled to ESA since she took ill-health retirement in April 2013,
based on the tax years 2010/2011 and 2011/2012. She is not a member of the
support group. Her last day of entitlement is 30.4.14. Zelda finds work on 12.5.14,
but gives this up when her condition deteriorates in March 2016. She makes a
further claim from 14.3.16, and the DM determines that the tax years are 2013/2014
and 2014/2015. Zelda satisfies the first and second conditions, and the tax years are
later than her previous award of ESA.
On application of the WCA, the DM determines that Zelda has LCW and LCWRA.
Zelda is entitled to ESA, with the support component payable from week 14. None of
the days when Zelda is entitled to ESA count towards the relevant maximum number
of days. Zelda continues to be entitled to ESA for as long as she has LCW and
LCWRA. If her health improves to such an extent that she is later found to have
LCW but not LCWRA, the 365 day count would begin from the date of that
determination.

[V2046-V2049]

V2050 ESA in youth

Where an award of ESA based on the claimant satisfying the youth conditions terminates
1. as in V2015 or
2. for any other reason
any further claim must be based on the normal conditions of entitlement. The
claimant cannot benefit from the youth conditions again, even if the PLCWs link. But
see V2056 et seq where the claimant's health condition deteriorates.

Example 1

Fran has been entitled to ESA since January 2011 as a result of an accident while
she was a student. Her entitlement was based on the youth conditions, and she is
not a member of the support group. She continues studying on a part-time basis.
Her entitlement terminates on 30.4.12. On 25.6.14, after finishing her part-time
studies, Fran makes a further claim for ESA. She has never worked, and the DM
determines that she does not satisfy the contribution conditions. Fran is not entitled
to ESA. She may be eligible to claim UC instead.

Example 2

Dipesh has been entitled to ESA since March 2009 when he reached age 16. He
has LCW, but is not a member of the support group. His entitlement terminates on
30.4.12.
Dipesh finds work from 4.6.12. On 19.1.15 he makes a further claim for ESA after
his health deteriorates, and is found to have LCW but not LCWRA. Dipesh is entitled
to ESA for a further 365 days because he now satisfies the relevant contribution
conditions for the tax years 2012/13 and 2013/14. The award will continue for as
long as he continues to have or be treated as having LCW until the 365 day time
limit is reached. If during this time he becomes a member of the support group the
365 day count would stop.

[V2051-V2054]

V2055 Change in claimant's health condition

During the period of an award, the claimant's health condition may deteriorate or
improve to the extent that the DM determines that they
1. have, or are treated as having, LCWRA or
2. no longer have, or are treated as having, LCWRA.
These changes can occur more than once throughout the period of ESA entitlement.

V2056 Health condition deteriorates V2004 V2040 V2050

Where the claimant's health condition deteriorates, this can affect further entitlement
to ESA. The action to take depends on whether an award of ESA has already
terminated before it is determined that the claimant has, or is treated as having,
LCWRA. DMs are reminded that they should always firstly consider whether a claim
could succeed because one of the tax years for the second contribution condition is
later than those on which the earlier award was based, before consideration is given
to a further award solely based on deterioration in their health.

Example

Amy's entitlement to ESA began on 22.4.14, and ended on 21.4.15, as her
entitlement exceeded 365 days and she was not in the support group. Entitlement
was based on tax years 2011/2012 and 2012/2013. She continues to have LCW. On
6.8.15 she makes a further claim for ESA stating that her condition has deteriorated
since her previous entitlement ended. The relevant tax years are 2012/2013 and
2013/2014, and Amy satisfies both the first and second contribution conditions, with
a later tax year for the second contribution condition. The DM awards ESA at the
assessment phase rate from 6.8.15.
Following application of the WCA, the DM determines that Amy has LCW and
LCWRA. The award is superseded to award the support component from week 14.
The deterioration rule does not apply.

[V2057-V2059]

V2060 Application made during current award V2061

A claimant who is already entitled to ESA and the WRAC may apply for
supersession on the basis that they consider they have LCWRA. If, following
application of the WCA, the DM determines that the claimant has, or is treated as
having, LCWRA, the decision awarding the WRAC should be superseded as normal
to award the support component (1). See ADM Chapter A4 (Supersession) for
guidance on the effective date rule.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 26(1) & 35(6)

V2061

The award of ESA may have terminated as in V2010 or V2015 before the
determination of LCWRA has been made. In this case the DM should revise (1) the
decision ending entitlement to ESA, and supersede the previous decision awarding
ESA as in V2060.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 15(5)

V2062 Application made after award has terminated V2065 V2070 V2078 V2078 V2101

Where
1. entitlement to ESA, including under the youth provisions, has been terminated
as in V2010 or V2015 because it exceeded 365 days and
2. the claimant
2.1 reports a deterioration in their health condition or
2.2 makes a further claim for ESA and
3. the claimant had, or is treated as having had, LCW since the previous
entitlement ended and
4. the claimant satisfies the basic conditions of entitlement (see ADM Chapter
U1) and
5. the DM determines that the claimant has, or is treated as having, LCWRA
the claimant is entitled to an award of ESA, even though they do not satisfy the
contribution conditions (1). The award is regarded as an award of ESA for all other
purposes, for example amounts payable (2).
1 WR Act 07, s 1B(1); 2 s 1B(2)

Example

Bogdan's award of ESA ended on 5.5.15 after 365 days. Entitlement was based on
tax years 2012/2013 and 2013/2014. He continues to have LCW for the purpose of
NI credits. Bogdan makes a further claim to ESA from 6.7.15 on the grounds that his
condition has deteriorated. As the PLCWs link, the tax years on which entitlement
could be based do not change. The claim cannot be decided until the DM
determines whether or not Bogdan has, or is treated as having, LCWRA.
Following application of the WCA, the DM determines that Bogdan has LCWRA. He
is entitled to ESA and the support component from 6.7.14. He does not have to
serve waiting days or the assessment phase.

V2063 V2101

Where the claimant reports a change in their condition other than by making a claim,
the DM should consider whether the contact satisfies the conditions for claiming
ESA (1) (see ADM Chapter A2).
1 UC, PIP, JSA & ESA (C&P) Regs, reg 14 & 16

V2064

V2065 Deterioration identified on routine WCA V2070

The guidance at V2062 also applies where the DM determines that the claimant has,
or is treated as having, LCWRA, after application of the WCA where the claimant is
not entitled to ESA.

Example

Mina's entitlement to ESA began on 18.11.08 and terminated on 30.4.12 as it
exceeded 365 days. She is not a member of the support group, and remains entitled
to NI credits on the basis that she would have LCW if her entitlement to ESA had not
ended due to time limiting. On 18.9.14, following a routine WCA, the DM determines
that Mina has LCW and LCWRA, and invites her to make a further claim for ESA.
Mina's claim for ESA, stating she wishes to claim from 10.9.14, is received on
14.11.14. The DM determines that she does not satisfy the contribution conditions,
but is entitled under the deterioration rule. Mina is awarded ESA including the
support component from 10.9.14.

[V2066-V2069]

V2070 Date award begins

Where an award is made as in V2062 - V2065, the claimant does not have to serve
waiting days before entitlement begins (1). The support component is payable from the
first day of entitlement (2). See V2075 et seq where an award is made and the
claimant's condition then improves.
Note: This does not apply if the claimant is entitled to ESA on the basis of a later tax
year as in V2045. See V2077 for further details.
1 ESA Regs 13, reg 85(2)(d); 2 reg 7(1)(d)

[V2071-V2074]

V2075 Health condition improves V2020 V2045 V2070

Claimants who
1. are awarded ESA and
2. are not subject to time limiting for all or part of their award because they are a
member of the support group
can receive a total of 365 days ESA if, on a further application of the WCA, they are
found to have LCW, but no longer have LCWRA.

Example

Lily has been entitled to ESA including the support component since 20.4.11.
Following a routine WCA, the DM determines that Lily has LCW, but no longer has
LCWRA. The award of ESA is superseded to award the WRAC instead of the
support component from 2.10.14. As long as Lily continues to have LCW, her
entitlement to ESA will terminate on 1.10.14, unless she is subsequently found to
have LCWRA again.

V2076

Where entitlement to ESA is based on the same tax years, and the claimant's health
condition changes, the claimant can only be entitled for a maximum of 365 days
during the period of the award, excluding days as in V2020 et seq.

Example

Liam's entitlement to ESA began on 8.11.13. On 20.1.14 the DM determines that
Liam has LCW but does not have LCWRA. Liam is awarded the WRAC from 7.2.14.
Following an accident, Liam reports a change in his health condition on 6.8.14. After
a further application of the WCA, the DM determines that Liam has LCWRA. The
support component is paid from 6.8.14.
Liam's condition improves following surgery. On 12.1.15 the DM determines that
Liam has LCW, but no longer has LCWRA. Taking into account the 274 days
already paid before 9.8.12, Liam's last day of entitlement to ESA will be 15.4.15.

V2077 V2070

Claimants who are awarded ESA because
1. they satisfy the conditions in V2045 (entitlement based on later tax year) and
2. their award includes the support component
can receive a further 365 days ESA if, on a further application of the WCA, they are
found to have LCW but no longer have LCWRA.

Example

Jessica's award of ESA including the WRAC began on 22.3.12, and terminated on
21.3.13 as her entitlement exceeded 365 days. She makes a further claim to ESA on
24.7.13, and the DM determines that she satisfies the contribution conditions based
on different tax years. She is awarded ESA at the assessment phase rate pending
the WCA. On application of the WCA, Jessica is found to have LCWRA. She is
awarded the support component from week 14. None of the days count towards the
relevant maximum number of days, as the assessment phase is immediately
followed by payment of the support component.
On 14.11.14 after a further routine WCA, the DM determines that Jessica has LCW,
but no longer has LCWRA. As long as Jessica continues to have LCW but not
LCWRA, all days of entitlement from and including 14.11.14 count towards the 365
days maximum.

V2078

Where the claimant becomes entitled to an award of ESA as in V2062 et seq, and
their condition improves to the extent that they no longer have, or are treated as
having, LCWRA, entitlement to ESA terminates from the date of the DM's decision.
The claimant is not entitled to a further 365 days of ESA even though they may still
have LCW. This is because they no longer satisfy the condition at V2062 5. i.e. that
they have or are treated as having LCWRA (1).
1 WR Act 07, s 1B(1)(c)

Example

Marvin's award of ESA ended on 30.4.14 as his entitlement exceeded 365 days. He
remains entitled to NI credits on the grounds that he would have LCW had he
remained entitled to ESA. On 13.6.14 he makes a further claim to ESA. He does not
satisfy the contribution conditions. The DM determines that Marvin has LCWRA, and
awards ESA including the support component from 13.6.14 under the deterioration
rule.
Following a routine WCA, the DM determines that Marvin has LCW, but no longer
has LCWRA. The award of ESA is terminated from the date of the decision.
Entitlement to NI credits continues as long as Marvin would have LCW if his ESA
entitlement had not ended.

[V2079-V2099]

V2100 Appeal against time limit decision

Claimants have a right of appeal against a decision terminating ESA after 365 days,
and are entitled to argue on such an appeal that the award should be extended on
the grounds that, on the effective date of that decision, they had LCWRA.

V2101

The DM is not required to make a further determination about LCWRA when making
a decision terminating ESA after 365 days. They can rely on any previous
determination made that the claimant does not have LCWRA.
Note: See ADM V2062 - V2063 for guidance where the claimant states that their
condition has deteriorated since the previous determination was made.

V2102

The FtT is at liberty to consider whether the claimant has LCWRA when hearing an
appeal against the decision to terminate ESA, even if the issue is not raised by the
appeal, provided that the DM is given the opportunity to consider any further
evidence.

V2103

The DM can apply for an appeal against a decision to terminate ESA to be struck out
where there is no dispute about the calculation of the 365 days, and no arguments
are made about whether the claimant is a member of the support group. See ADM
Chapter 06 (Appeals) for guidance about strike out.

Example 1

Bradley is awarded ESA from 12.6.14, and following application of the WCA, on
14.1.15 the DM determines that Bradley has LCW but not LCWRA. Bradley is placed
in the WRAG from 11.9.14. Bradley is notified on 11.6.15 that his entitlement to ESA
is to terminate from 12.6.15 as he has received ESA for 365 days. Bradley applies
for reconsideration of the decision of 11.6.15, on the grounds that he should be in
the support group. The DM refuses to revise, as the evidence provided does not
show a change in Bradley's health condition since the previous LCWRA
determination was made, or indicate that it was incorrect.

Example 2

Miranda is awarded ESA from 13.8.14. Following application of the WCA, on
11.12.14 the DM determines that Miranda has LCW but not LCWRA, and places her
in the WRAG from 12.11.14. On 12.8.15 Miranda is notified that her entitlement to
ESA terminates from 13.8.15 as she has now received this for 365 days. Miranda
applies for reconsideration of the decision of 12.8.15, on the grounds that she should
be in the support group. Medical Services advises that the evidence shows a change
in Miranda's health condition, and she is referred for the WCA. The DM determines
that Miranda now has LCWRA. The supersession decision terminating entitlement is
revised, and Miranda is entitled to the support component from 13.8.15, the date
from which the original decision took effect.

[V2104-V2999]