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Chapter V8: ESA transition

Contents
V8001:Introduction
Definitions
Meaning of ESA
V8002:New style ESA
V8003:Old style ESA
V8004:Meaning of Pathfinder Group
When provisions for claiming new style ESA apply
V8011:Introduction
V8012:Claims for new style ESA
V8016:Claims for UC or ESA on or after 29.4.13

Claim for UC on or after 29.4.13 - claimant gives incorrect
V8018:information
V8020:Couple treated as making UC claim
V8022:Former joint claimants - UC claim required
V8024:UC claim not required - earned income
V8025:UC claim not required - former joint claimants
V8041:Claimant moves out of relevant district or not in Pathfinder Group

Reassessment of IB and SDA
V8051:Introduction
V8052:Claims and awards of UC
V8053:Old style ESA provisions apply again
Transition from old style ESA
V8071:Introduction
V8074:Modifications
V8075:Definition - limited capability for work
V8076:Assessment phase - previous claimants
V8077:Support component or WRAC payable from first day of entitlement
V8078:Condition relating to youth
V8079:Determination of limited capability for work
V8080:Treated as having limited capability for work
V8081:Determination of LCWRA
V8082:Exempt work
V8083:Waiting days
V8084:Appeal against determination of no limited capability for work
V8085:Temporary absence
V8086:Temporary absence - receiving medical treatment
V8087:Misconduct
V8088:Imprisonment or detention in legal custody
V8089:Limitation to no more than 365 days
V8090:Assessment phase
Transition from new style ESA
V8101:Introduction
V8104:Modifications
V8105:Definition - limited capability for work
V8106:Assessment phase - previous claimants
V8107:Support component or WRAC payable from first day of entitlement
V8108:Condition relating to youth
V8109:Determination of limited capability for work
V8110:Treated as having limited capability for work
V8111:Determination of LCWRA
V8112:Exempt work
V8113:Waiting days
V8114:Appeal against determination of no limited capability for work
V8115:Temporary absence
V8116:Temporary absence - receiving medical treatment
V8117:Misconduct
V8118:Imprisonment or detention in legal custody
V8119:Limitation to no more than 365 days
V8120:Assessment phase
Sanctions
V8131:Introduction
V8132:Meaning of relevant failure
V8136:New award
V8138:Reduction period
V8141:Continuing award
V8143:Reduction period
V8146:Escalation of sanctions
V8151:Termination of new style ESA sanctions
V8161:Appeals

Chapter V8: ESA transition

V8001 Introduction

This Chapter gives guidance on :
1.
when the provisions for claiming new style ESA apply (see V8011 et seq) and :
2.
what happens when a claimant is no longer in a relevant district or in the UC
Pathfinder Group (see V8041 et seq) and
3. reassessment of IB and SDA for new style ESA (see V8051 et seq) and
4. transition from old style ESA (see V8071 et seq) and
5.
transition from new style ESA (see V8101 et seq) and
6. sanctions (see V8131 et seq) and
7. appeals (see V8161 et seq).
Definitions
Meaning of ESA
New style ESA

V8002 V8003

New style ESA is ESA as amended to remove ESA(IR)1.
1 WR Act 07, Part 1; WR Act 12, Sch 3 & Sch 14, Part 1; WR Act 12 (Commencement No. 9 etc.) Order, art 2(1)

V8003 Old style ESA

Old style ESA is ESA as it applies before the amendments referred to in V8002. It
includes ESA(Cont) and ESA(IR)1 (see DMG Volumes 8 & 9 for detailed guidance).
1 WR Act 07, Part 1; WR Act 12 (Commencement No. 9 etc.) Order, art 2(1)

V8004 Meaning of Pathfinder Group V8016 V8018 V8041

A person is in the Pathfinder Group if they :
1.
live in the postcode districts in the Appendix to ADM Chapter M1 (Pathfinder
Group - claims for UC) and :
2.
meet certain requirements (see ADM Chapter M1 (Pathfinder Group - claims
for UC)1.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 2(2); UC (TP) Regs, regs 5 - 12

[V8005-V8010]

When provisions for claiming new style ESA apply

V8011 Introduction V8001

V8012 et seq give guidance on when the provisions for claiming new style ESA
apply. However, the new style ESA provisions apply only for as long as the award
continues. On any subsequent claim, DMs will have to consider again whether the
new style or old style provisions apply. Also, DMs should note that the new style ESA
provisions may no longer apply if the claimant's circumstances change (see V8031
et seq).

V8012 Claims for new style ESA V8011 V8013 V8015 V8016

[See ADM memo ADM 17 14] The new style ESA provisions apply from :
1.
the first day of the period in respect of which the UC claim is made or treated
as made (1) as in V8016 - V8023 or :
2.
the day on which the person becomes entitled to UC (2) as in V8024 - V8025.
Note: When a UC claim is made, one of the conditions for being in the Pathfinder
Group is that a person does not have LCW. Therefore, in practice, the new style
ESA provisions will apply only where a person receiving UC reports a change of
circumstances that they have fallen ill and claim ESA.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(3)(a); 2 art 4(3)(b)

V8013

[See ADM memo ADM 17 14] Where V8012 1. applies the first day of the period for which
the claim is made is the first day of the period for which a claim may be backdated (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 5(4);

UC, PIP, JSA & ESA (C&P) Regs, reg 26(2); SS (C&P) Regs, reg 19 & Sch 4

V8014 V8015

[See ADM memo ADM 17 14] An award of UC includes (1)
1. any claim for ESA
1.1 where V8016 is not satisfied and
1.2 which is made, or treated as made, during the period of the UC award
and
2. any conversion notice (2) issued during the period of the UC award and
3. any award of ESA
3.1 made in respect of the claim or
3.2 in respect of a conversion notice issued as in 2.
where, for a claim, V8015 is satisfied.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(4); 2 ESA (TP, HB & CTB) (EA) (No. 2) Regs, reg 4

V8015 V8014

[See ADM memo ADM 17 14] A claim, for the purposes of V8014, is one made, or treated
as made, for a period which begins on or after the date from which the new style
ESA provisions apply as in V8012 in respect of
1. where the award of UC is made in respect of a claim as in V8016 - V8023,
that claim and the award or
2. where the award of UC is made as in V8024 - V8025, the award (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(5)

V8016 Claims for UC or ESA on or after 29.4.13 V8012 V8014 V8015 V8017 V8052 V8073 V8102

[See ADM memo ADM 17 14] The new style ESA provisions apply (1) from the first day of
the period of the claim where a person :
1.
makes a claim, or is treated as making a claim, for UC or ESA for a period on
or after a date detailed in the Appendix to ADM Chapter M1 (Pathfinder Group
- claims for UC) and :
2.
on the day on which the claim is made or treated as made
2.1 lives in a relevant district and
2.2 is in the Pathfinder Group.
When determining whether a person is in the Pathfinder Group, a claim for UC also
includes a claim for ESA (2).
Note 1: See V8004 for the meaning of Pathfinder Group.
Note 2: See V8012 for details of when, in practice, the new style ESA provisions will
apply.
1 WR Act 12 Commencement Orders; 2 WR Act (Commencement No 9 etc.)

Order, art 5(2); UC (TP) Regs, Part 2, Chapter 2

V8017

[See ADM memo ADM 17 14] For the purposes of V8016
1. the guidance in DMG Chapter 02 applies (1) for deciding
1.1 whether a claim for ESA is made or treated as made and
1.2 the day on which the claim is made or treated as made (2) and
2. the guidance in ADM Chapter A2 (claims) applies (3) for deciding
2.1
whether a claim for UC is made or treated as made and
2.2
the day on which the claim is made or treated as made (4).
1 SS (C&P) Regs; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 5(1);
3 UC, PIP, JSA & ESA (C&P) Regs; 4 WR Act 12 (Commencement No. 9 etc.) Order, art 5(3)

V8018 Claim for UC on or after 29.4.13 - claimant gives incorrect information V8019 V8041 V8073 V8102 V8138 V8161

[See ADM memo ADM 17 14] The new style ESA provisions apply (1) from the first day of
the period in respect of which the UC claim is made, or treated as made, where :
1.
a person makes a claim, or is treated as making a claim, for UC for a period
on or after a date detailed in the Appendix to ADM Chapter M1 (Pathfinder
Group - claims for UC) and
2. the person
2.1 did not
2.1.a
live in a relevant district or
2.1.b
fall in the Pathfinder Group
on the day on which the claim is made and
2.2 gave incorrect information about
2.2.a
living in a relevant district or
2.2.b
being in the Pathfinder Group and
3. after
3.1 a decision has been made that the person is entitled to UC and
3.2
one or more payments have been made
the DM discovers that the person gave incorrect information.
Note: See V8004 for the meaning of Pathfinder Group.

1 WR Act 12 Commencement Orders

V8019

[See ADM memo ADM 17 14] For the purposes of V8018 the guidance in ADM Chapter
A2 (claims) applies (1) for deciding
1. whether a claim for UC is made or treated as made and
2. the day on which the claim is made or treated as made (2).
1 UC, PIP, JSA & ESA (C&P) Regs; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 5(3)

V8020 Couple treated as making UC claim V8021 V8041 V8073 V8102 V8138 V8161

[See ADM memo ADM 17 14] The new style ESA provisions apply from the first day of the
period in respect of which the UC claim is made, or treated as made, where (1) :
1.
a single UC claimant forms a couple and, as a result, their UC award is ended
and :
2.
the other member of the couple was not entitled to UC as a single claimant
and :
3.
they are treated as making a joint claim as a couple.
Any old style ESA(Cont) becomes new style ESA and any old style ESA(IR) ends
from the start of the first assessment period appropriate to the joint claim.
Note: See ADM Chapter M1 (Pathfinder Group - claims for UC) for full guidance on
couples treated as making UC claim.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(1) & (2)(c);

UC (TP) Regs, reg 3(4); UC, PIP, JSA & ESA (C&P) Regs, reg 9(8)

V8021

[See ADM memo ADM 17 14] For the purposes of V8020 the guidance in ADM Chapter
A2 (claims) applies (1) for deciding
1. whether a claim for UC is made or treated as made and
2. the day on which the claim is made or treated as made (2).
1 UC, PIP, JSA & ESA (C&P) Regs; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 5(3)

V8022 Former joint claimants - UC claim required V8023 V8041 V8073 V8102 V8138 V8161

[See ADM memo ADM 17 14] The new style ESA provisions apply from the first day of the
period in respect of which the UC claim was made, or treated as made, where (1) :
1.
an award of UC to joint claimants ends because they separate and :
2.
the claimant who is not exempt from the requirement to make a claim makes
a claim, or is treated as making a claim, for UC within one month, starting
from the date they notify the Secretary of State that they ceased to be a
couple.
Note: See ADM Chapter M1 (Pathfinder Group - claims for UC) for full guidance on
when a UC claim is required from former joint claimants.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(1) & (2)(d);

UC (TP) Regs, reg 3(2); UC, PIP, JSA & ESA (C&P) Regs, reg 9(6)

V8023 V8012 V8015 V8052

[See ADM memo ADM 17 14] For the purposes of V8022 the guidance in ADM Chapter
A2 (claims) applies (1) for deciding
1. whether a claim for UC is made or treated as made and
2. the day on which the claim is made or treated as made (2).
1 UC, PIP, JSA & ESA (C&P) Regs; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 5(3)

V8024 UC claim not required - earned income V8012 V8015 V8052 V8073 V8102 V8138 V8161

[See ADM memo ADM 17 14] The new style ESA provisions apply from the day on which
the person becomes entitled to UC where (1) :
1.
they are no longer entitled to UC solely due to the level of earned income, but
become entitled again within six months or :
2.
on a claim for UC, they are not entitled to UC solely due to the level of earned
income, but become entitled within six months.
Note: See ADM Chapter M1 (Pathfinder Group - claims for UC) for full guidance on
when a UC claim is not required in these circumstances.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(1) & (2)(e); UC, PIP, JSA & ESA (C&P)
Regs, reg 6(1) & (2)

V8025 UC claim not required - former joint claimants V8012 V8015 V8052 V8073 V8102 V8138 V8161

[See ADM memo ADM 17 14] The new style ESA provisions apply from the day on which
the person becomes entitled to UC where (1)
1. a UC joint claim couple separates and the person
1.1 does not notify the change of circumstances or
1.2 notifies it after the other member of the couple has notified the change (2)
or
2. a joint award has ended because of the death of the other member of the
couple (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 4(1) & (2)(f);
2 UC, PIP, JSA & ESA (C&P) Regs, reg 9(6) & (7); 3 reg 9(10)

[V8026-V8040]

V8041 Claimant moves out of relevant district or not in Pathfinder Group V8001 V8042 V8043 V8053 V8072 V8103 V8151

[See ADM memo ADM 17 14] Where :
1.
a person has or had a new style ESA award and
2. for any period of the new style ESA award the person
2.1 makes a claim, or is treated as making a claim, for UC or
2.2 applies for a supersession of the decision relating to the new style
award on the grounds of a relevant change of circumstances that would
have related to ESA(IR) and
3. the person would have been entitled to ESA(IR) and
4. the person does not have an award of UC for the period for which the
application for supersession is made and
V8018 5. , V8020 or V8022 do not apply to any claim for UC and :
6.
on the day on which the claim is made or the application for supersession is
received, the person
6.1 does not live in a relevant district or
6.2 is not in the Pathfinder Group
the new style ESA provisions no longer apply from the first day of the period of the
claim for UC or application for supersession of ESA (1). This means that the person will
need to claim an existing benefit (see ADM Chapter M1 - (Pathfinder Group - claims
for UC)) instead.
Note:
See V8004 for the meaning of Pathfinder Group.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 6(1) & (2)

V8042

For the purposes of V8041 :
1.
the period in respect of which the application for supersession is made begins
with the day from which the superseding decision takes effect (1)
2. where the time for making a claim for UC is extended (2) the first day of the
period is the first day of the extended period (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 6(4); SS Act 98, s 10(5);
UC, PIP, JSA & ESA (D&A) Regs, reg 35 & Sch 1; 2 UC, PIP, JSA & ESA (C&P)

Regs, reg 26(2); 3 WR Act 12 (Commencement No. 9 etc.) Order, art 6(5)

V8043

[See ADM memo ADM 17 14] For the purposes of V8041 6.
1. the guidance in ADM Chapter A2 (claims) applies (1) for deciding
1.1
whether a claim for UC is made or treated as made and
1.2
the day on which the claim is made or treated as made (2) and
2. when determining whether a person is in the Pathfinder Group, a claim for UC
also includes a claim for ESA (3).
1 UC, PIP, JSA & ESA (C&P) Regs; 2 WR Act 12 (Commencement No. 9 etc.)
Order, art 6(3)(a); 3 art 6(3)(b); UC (TP) Regs, reg 5 - 12

[V8044-V8050]

Reassessment of IB and SDA
[See ADM memo ADM 19 14]

V8051 Introduction V8001

From 11.10.10, the Secretary of State began to make decisions on whether the
awards of claimants who, on or after that date, have an existing award of IB, SDA or
IS, qualify for conversion to ESA. The process of conversion is known as
reassessment. V8071 et seq gives guidance on the effect of reassessment of IB and
SDA on new style ESA.
Note: See DMG Chapter 45 for detailed guidance on reassessment.

V8052 Claims and awards of UC

[See ADM memo ADM 17 14] Unless V8053 applies, from
1. the first day of the period of the claim made or treated as made (1) as in V8016 - V8023or :
2.
the day on which the person becomes entitled to UC (2) as in V8024 - V8025
the normal rules for conversion to ESA (3) apply as modified (4).
1 WR Act 12(Commencement No. 9 etc.) Order, art 9(1) & 4(2)(a) - (d); 2 art 9(1) & 4(2)(e) - (f);
3 ESA (TP, HB & CTB) (EA) (No. 2) Regs; 4 WR Act 12 (Commencement No. 9 etc.) Order, Sch 4

V8053 Old style ESA provisions apply again V8052

Where V8041 applies so that the old style ESA provisions apply again (1), the normal
rules for conversion to ESA (2) apply without modification (3).
1 WR Act 12(Commencement No. 9 etc.) Order, art 9(2) & 6(2); 2 ESA (TP, HB & CTB)
(EA) (No. 2) Regs; 3 WR Act 12 (Commencement No. 9 etc.) Order, Sch 4

[V8054-V8070]

Transition from old style ESA

V8071 Introduction V8001 V8051 V8072 V8074

Where
1. a claimant makes, or is treated as making, a claim for new style ESA (1) and

V8072 2.

is satisfied
the new style ESA provisions (2) are modified as in V8074 et seq.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(1)(a); 2 ESA Regs 13

[V8072]

V8071applies where
1. the claimant
1.1 had previously made or
1.2
was treated as having made a claim for old style ESA (1) or
2. a conversion notice (2) was issued in respect of old style ESA (3) or
3. the claimant previously had a new style ESA award but
3.1 did not live in a relevant district or
3.2 was not in the Pathfinder Group
in accordance with V8041 so that the old style ESA provisions applied again (4).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(1A)(a); 2 ESA (TP, HB & CTB) (EA) (No. 2) Regs, reg 4;

3 WR Act 12 (Commencement No. 9 etc.) Order, art 10(1A)(b); 4 art 10(1A)(c)

V8073 V8074 V8085 V8086

V8074 et seq also applies where a claimant has an award of old style ESA(Cont)
immediately before a UC
1. claim
1.1 is made on or after 29.4.13 in accordance with V8016 or
1.2 is made on or after 29.4.13 and the claimant gives incorrect information
in accordance with V8018 or
1.3 is treated as made by a couple in accordance with V8020 or
1.4 is required from former joint claimants in accordance with V8022 or
2. award is made where a claim is not required in accordance with V8024 or V8025(1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(1)(b)

V8074 Modifications V8072 V8073

Where V8071 or V8073 apply the new style ESA provisions (1) are modified in
accordance with V8075 - V8090.
1 ESA Regs 13

V8075 Definition - Iimited capability for work V8074

The modifications mean that the definition of period of LCW includes a period
(unless it is outside the prescribed time for claiming) that throughout which the
claimant has, or is treated as having, LCW for old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(a);
ESA Regs 13, regs 2 & 3; ESA Regs; SS (C&P) Regs, reg 19 & Sch 4

V8076 Assessment phase - previous claimants

The modifications mean that, where the old style and new style awards link, then, in
calculating the end of the assessment phase, the days of entitlement to old style
ESA in the linked award are included in that calculation (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(b);
ESA Regs 13, reg 6(2)(b)(v) & (c)(iii); ESA Regs, reg 30

V8077 Support component or WRAC payable from first day of entitlement

The modifications mean that, where the old style and new style awards link, then, in
determining whether the support component or WRAC is payable from the first day
of entitlement, any "earlier period of LCW" in respect of which the claimant was
entitled to ESA includes the period of entitlement to old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(c); ESA Regs 13, reg 7; ESA Regs, reg 30

V8078 Condition relating to youth

The modifications mean that the conditions relating to youth include entitlement to
old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(d); ESA Regs 13, reg 11

V8079 Determination of limited capability for work

The modifications mean that a determination of LCW can include
1. a determination of LCW for old style ESA (1) and
2. being treated as having LCW for old style ESA (2) where a person
2.1
satisfies certain conditions (3) or
2.2
is a hospital in-patient (4) or
2.3
is receiving certain regular treatments (5) or
2.4
has exceptional circumstances (6).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(e)(i); ESA Regs 13, regs 15(7)(a);
ESA Regs, Part 5; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(e)(ii);
ESA Regs 13, regs 15(7)(b); 3 ESA Regs, reg 20; 4 reg 25; 5 reg 26; 6 reg 29

V8080 Treated as having limited capability for work

The modifications mean that for the purposes of treating a claimant as having LCW
until a determination has been made, the six months rule includes having, or being
treated as having, LCW for old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(f);
ESA Regs 13, reg 26(2)(b) & 26(4)(c); ESA Regs, regs 22 & 23

V8081 Determination of LCWRA

The modifications mean that for the purposes of a fresh determination as to whether
a person has LCWRA, that determination can include a determination on LCWRA
for old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(g); ESA Regs 13, regs 30(4); ESA Regs, Part 6

V8082 Exempt work

The modifications mean that for the purposes of exempt work, old style ESA is a
relevant benefit (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(ga); ESA Regs 13, reg 39(6) & (7)(b)

V8083 Waiting days

The modifications mean that, where an old style award of ESA becomes a new style
award of ESA, then, for the purposes of claimants not having to serve waiting days
where their entitlement to new style ESA commences within 12 weeks of the end of
an award of a specified benefit, that entitlement to ESA includes the period of
entitlement to old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(gb); ESA Regs 13, reg 85(2)(a);
ESA Regs, reg 144(2)(a)

V8084 Appeal against determination of no limited capability for work

The modifications mean that an appeal against a determination that a claimant does
not have LCW includes such a determination for old style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(h); ESA Regs 13, reg 87(1)

V8085 Temporary absence

The modifications mean that where
1. a claimant had an old style ESA award immediately before a UC claim or
award (1) as in V8073 and
2. a period of temporary absence from GB began when the claimant was entitled
to old style ESA (2) and
3. the first 4 weeks of temporary absence had not ended immediately before the
first day of entitlement to new style ESA
the period of 4 weeks for which the claimant continues to be entitled to ESA during a
period of temporary absence includes both the period for which there was
entitlement to old style ESA and the remainder of that 4 week period where there
was entitlement to new style ESA (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(1)(b); 2 ESA Regs, reg 152;
3 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(i); ESA Regs 13, reg 89

V8086 Temporary absence - receiving medical treatment

The modifications mean that where
1. a claimant had an old style ESA award immediately before a UC claim or
award (1) as in V8073 and
2. a period of temporary absence from GB to receive medical treatment began
when the claimant was entitled to old style ESA (2) and
3. the first 26 weeks of temporary absence had not ended immediately before
the first day of entitlement to new style ESA
the period of 26 weeks for which the claimant continues to be entitled to ESA during
a period of temporary absence to receive medical treatment includes both the period
for which there was entitlement to old style ESA and the remainder of that 26 week
period where there was entitlement to new style ESA (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(1)(b); 2 ESA Regs, reg 153;
3 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(j); ESA Regs 13, reg 90

V8087 Misconduct

The modifications mean that a claimant is to be disqualified for receiving new style
ESA (1) for a period decided by the DM for the purposes of old style ESA (2) less any
days of that period of disqualification already served. However, this does not apply if
a claimant is :
1.
a person in hardship (3) or :
2.
disqualified for receiving ESA under certain legislation (4) (loss of benefit
provisions).
Also, the DM should not disqualify a claimant for receiving new style ESA if the
reason for the disqualification has already been decided for the purposes of old style
ESA (5).
Note: See ADM Chapter U6 (ESA disqualification) for the meaning of person in
hardship.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(k); ESA Regs 13, reg 93(5); 2 ESA Regs, reg 157(2);
3 ESA Regs 13, reg 93(3)(a); 4 reg 93(3)(b); SS Fraud Act 01, s 6B & 7; 5 ESA Regs 13, reg 93(6)

V8088 Imprisonment or detention in legal custody

The modifications mean that a claimant is also to be treated as not having LCW if
1. they are disqualified for receiving old style ESA(Cont) during a period of
imprisonment or detention in legal custody and
2. new style ESA has effect during the period of
2.1 imprisonment or detention in legal custody and
2.2 6 weeks from the day on which they were first disqualified under 1. and
3. the total of the period of disqualification of
3.1 old style ESA(Cont) and
3.2 new style ESA
is more than 6 weeks (1).
Note 1: See ADM Chapter U2 (ESA Limited capability for work and Limited
capability for work-related activity) for guidance on treated as not having LCW during
a period of imprisonment or detention in legal custody. However, DMs should note
that the relevant legislation has been modified (2).
Note 2: See ADM Chapter U6 (ESA disqualification) for guidance on disqualification
for imprisonment or detention in legal custody.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(2)(l); ESA Regs 13, reg 95(2); 2 reg 95(1)

V8089 Limitation to no more than 365 days

The modifications mean that when entitlement to ESA(Cont) is limited to 365 days,
days of entitlement to new style ESA as well as days of entitlement to old style ESA,
where appropriate, are included in that limit (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(3) & (4); WR Act 07, s 1A & 1B

V8090 Assessment phase V8074

The modifications mean that where
1. a claimant has an award of old style ESA(Cont) and
2. the award of old style ESA(Cont) had not been preceded by an award of new
style ESA
the beginning of the assessment phase is the first day of entitlement to old style
ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 10(5); WR Act 07, s 24(2)

[V8091-V8100]

Transition from new style ESA

V8101 Introduction V8001 V8102 V8104

Where a
claimant
1. a claimant makes, or is treated as making, a claim for old style ESA (1) and

V8102 2.

is satisfied
the old style ESA provisions (2) are modified as in V8104 et seq.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(1)(a); 2 ESA Regs

[V8102]

V8101applies where
1. the claimant
1.1 had previously made or
1.2
was treated as having made a claim for new style ESA (1) or
2. a conversion notice (2) was issued in respect of new style ESA (3) or
3. the claimant previously had an award of old style ESA(Cont) immediately
before a UC
3.1 claim
3.1.a is made on or after 29.4.13 in accordance with V8016 or
3.1.b is made on or after 29.4.13 and the claimant gives incorrect
information in accordance with V8018 or
3.1.c is treated as made by a couple in accordance with V8020 or
3.1.d is required from former joint claimants in accordance with V8022or
3.2 award is made where a claim is not required in accordance with V8024
or V8025 (4).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(1A)(a); 2 ESA (TP, HB & CTB) (EA) (No. 2) Regs, reg 4;

3 WR Act 12 (Commencement No. 9 etc.) Order, art 11(1A)(b); 4 art 11(1A)(c)

V8103 V8104 V8115 V8116

V8104 et seq also applies where a person with a new style ESA award
1. does not live in a relevant district or
2. is not in the Pathfinder Group (1)
in accordance with V8041 so that the old style ESA provisions apply again.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(1)(b)
Modifications
[See ADM memo ADM 17 14]

V8104 V8102 V8103

Where V8101 or V8103 apply the new style ESA provisions (1) are modified in
accordance with V8105 - V8120.
1 ESA Regs 13

V8105 Definition - Iimited capability for work V8104

The modifications mean that the definition of period of LCW includes a period
(unless it is outside the prescribed time for claiming) throughout which the claimant
has, or is treated as having, LCW for new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(a);
ESA Regs, reg 2(1) & (5); ESA Regs 13; UC, PIP, JSA & ESA (C&P) Regs, reg 28

V8106 Assessment phase - previous claimants

The modifications mean that, where the new style and old style awards link, then, in
calculating the end of the assessment phase, the days of entitlement to new style
ESA in the linked award are included in that calculation (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(b); ESA Regs, reg 5;ESA Regs 13, reg 26

V8107 Support component or WRAC payable from first day of entitlement

The modifications mean that, where the new style and old style awards link, then, in
determining whether the support component or WRAC is payable from the first day
of entitlement, any "earlier period of LCW" in respect of which the claimant was
entitled to ESA includes the period of entitlement to new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(c); ESA Regs, reg 7; ESA Regs 13, reg 26

V8108 Condition relating to youth

The modifications mean that the conditions relating to youth include entitlement to
new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(d); ESA Regs, reg 10

V8109 Determination of limited capability for work

The modifications mean that a determination of LCW can include
1. a determination of LCW for new style ESA (1) and
2. being treated as having LCW for new style ESA (2) where a person
2.1
satisfies certain conditions (3) or
2.2. is a hospital in-patient (4) or
2.3
is receiving certain regular treatments (5) or
2.4
has exceptional circumstances (6).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(e)(i); ESA Regs, regs 19(7)(a);
ESA Regs 13, Part 4; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(e)(ii);
ESA Regs 13, regs 19(7)(b); 3 ESA Regs 13, reg 16; 4 reg 21; 5 reg 22; 6 reg 25

V8110 Treated as having limited capability for work

The modifications mean that for the purposes of treating a claimant as having LCW
until a determination has been made, the six months rule includes having, or being
treated as having, LCW for new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(f);
ESA Regs, reg 30(2)(b) & (2)(b)(iii); ESA Regs 13, regs 18 & 19

V8111 Determination of LCWRA

The modifications mean that for the purposes of a fresh determination as to whether
a person has LCWRA, that determination can include a determination on LCWRA
for new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(g); ESA Regs, regs 34(4); ESA Regs 13, Part 5

V8112 Exempt work

The modifications mean that for the purposes of exempt work, new style ESA is a
relevant benefit (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(ga); ESA Regs, reg 45(4)(a)(ii) & (10)

V8113 Waiting days

The modifications mean that, where a new style award of ESA becomes an old style
award of ESA, then, for the purposes of claimants not having to serve waiting days
where their entitlement to old style ESA commences within 12 weeks of the end of
an award of a specified benefit, that entitlement to ESA includes the period of
entitlement to new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(gb); ESA Regs, reg 144(2)(a);
ESA Regs 13, reg 85(2)(a)

V8114 Appeal against determination of no limited capability for work

The modifications mean that an appeal against a determination that a claimant does
not have LCW includes such a determination for new style ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(h); ESA Regs, reg 147A(1)

V8115 Temporary absence

The modifications mean that where
1. a claimant had a new style ESA award immediately before a UC claim or
award (1) as in V8103 and
2. a period of temporary absence from GB began when the claimant was entitled
to new style ESA (2) and
3. the first 4 weeks of temporary absence had not ended immediately before the
first day of entitlement to old style ESA
the period of 4 weeks for which the claimant continues to be entitled to ESA during a
period of temporary absence includes both the period for which there was
entitlement to new style ESA and the remainder of that 4 week period where there
was entitlement to old style ESA (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(1)(b); 2 ESA Reg 13, reg 89;
3 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(i); ESA Regs, reg 152

V8116 Temporary absence - receiving medical treatment

The modifications mean that where
1. a claimant had a new style ESA award immediately before a UC claim or
award (1) as in V8103 and
2. a period of temporary absence from GB to receive medical treatment began
when the claimant was entitled to new style ESA (2) and
3. the first 26 weeks of temporary absence had not ended immediately before
the first day of entitlement to old style ESA
the period of 26 weeks for which the claimant continues to be entitled to ESA during
a period of temporary absence to receive medical treatment includes both the period
for which there was entitlement to new style ESA and the remainder of that 26 week
period where there was entitlement to old style ESA (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(1)(b); 2 ESA Regs 13, reg 90;
3 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(j); ESA Regs, reg 153

V8117 Misconduct

The modifications mean that a claimant is to be disqualified for receiving old style
ESA (1) for a period decided by the DM for the purposes of new style ESA (2) less any
days of that period of disqualification already served. However, this does not apply if
a claimant is :
1.
a person in hardship (3) or :
2.
disqualified for receiving ESA under certain legislation (4) (loss of benefit
provisions).
Also, the DM should not disqualify a claimant for receiving old style ESA if the
reason for the disqualification has already been decided for the purposes of new
style ESA (5).
Note:
See DMG Chapter 53 for the meaning of person in hardship for old style ESA.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(k); ESA Regs, reg 157(2); 2 ESA Regs 13, reg 93(2);
3 ESA Regs, reg 157(3)(a); 4 reg 157(3)(b); SS Fraud Act 01, s 6B & 7; 5 ESA Regs, reg 157(5)

V8118 Imprisonment or detention in legal custody

The modifications mean that a claimant is also to be treated as not having LCW if
1. they are disqualified for receiving new style ESA during a period of
imprisonment or detention in legal custody and
2. old style ESA(Cont) has effect during the period of
2.1 imprisonment or detention in legal custody and
2.2 6 weeks from the day on which they were first disqualified under 1. and
3. the total of the period of disqualification of
3.1 new style ESA and
3.2 old style ESA(Cont)
is more than 6 weeks (1).
Note 1: See DMG Chapter 42 for guidance on treated as not having LCW for old
style ESA during a period of imprisonment or detention in legal custody. However,
DMs should note that the relevant legislation has been modified (2).
Note 2: See DMG Chapter 53 for guidance on disqualification for old style ESA for
imprisonment or detention in legal custody.
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(2)(l); ESA Regs, reg 159(2); 2 reg 159(1)

V8119 Limitation to no more than 365 days

The modifications mean that when entitlement to ESA(Cont) is limited to 365 days,
days of entitlement to old style ESA as well as days of entitlement to new style ESA,
where appropriate, are included in that limit (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(3) & (4); WR Act 07, s 1A & 1B

V8120 Assessment phase V8104

The modifications mean that where
1. a claimant has an award of new style ESA and
2. the award of new style ESA had not been preceded by an award of old style
ESA
the beginning of the assessment phase is the first day of entitlement to new style
ESA (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 11(5); WR Act 07, s 24(2)

[V8121-V8130]

Sanctions

V8131 Introduction V8001

There are modifications to sanctions provisions for transition from old style ESA With
regard to this

V8136 1. V8132 V8137 V8146 V8147

et seq gives guidance where there is a new award

V8141 2. V8138 V8142 V8147

et seq gives guidance where there is a continuing award and :
3.
V8146 et seq gives guidance on escalation of sanctions.
In addition, V8151 gives guidance on termination of new style ESA sanctions.

V8132 Meaning of relevant failure

Relevant failure means the failure which led to an old style ESA sanction (1). For new
style ESA (2) the relevant failure is treated as sanctionable (3).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 14(2)(a) & 15(2)(a); 2 ESA Regs 13, Part 8;
3 WR Act 07, s 11J

[V8133-V8135]

V8136 New award V8137 applies where
1. a claimant
1.1 is entitled to new style ESA
1.2 was previously entitled to old style ESA that was not in existence
immediately before the start of the new style ESA award (1) and
2. immediately before entitlement to old style ESA ended, payments were
reduced because of a sanction (2).

1 WR Act 12 (Commencement No. 9 etc.) Order, art 14(1)(a); 2 art 14(1)(b); ESA Regs, reg 63

V8137 V8132

Where V8136 applies
1. the relevant failure is treated as a sanctionable failure (1) for new style ESA (2) and
2. the new style ESA award is reduced because of the relevant failure (3) and
3. the reduction for new style ESA (4) is treated as a sanctionable failure (5).
1 WR Act 12, s 11J; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 14(2)(a); 3 art 14(2)(b);
ESA Regs 13, Part 8; 4 ESA Regs 13; 5 WR Act 12 (Commencement No. 9 etc.) Order, art 14(2)(c);
WR Act 12, s 11J

V8138 Reduction period

The reduction period for the new style ESA sanction is the length of the fixed period
for the relevant failure (1) less
1. the number of days, if any, that the amount of old style ESA was reduced and
2. the number of days, if any, between the end of the old style ESA award and
the start of the new style ESA award (2).
1 ESA Regs, reg 63; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 15(3) & (4); ESA Regs 13, reg 51(1) & (3)

[V8139-V8140]

V8141 Continuing award V8142 applies where (1)
1. a UC
1.1 claim
1.1.a is made on or after 29.4.13 and the claimant gives incorrect
information in accordance with V8018 or
1.1.b is treated as made by a couple in accordance with V8020 or
1.1.c is required from former joint claimants in accordance with V8022or
1.2 award is made where a claim is not required in accordance with V8024
or V8025 and
2. immediately before the date on which the conditions at 1. are satisfied, the
claimant had an award of old style ESA(Cont) and
3. immediately before the date on which the conditions at 1. are satisfied,
payments were reduced because of a sanction (2).

1 WR Act 12 (Commencement No. 9 etc.) Order, art 15(1); 2 ESA Regs, reg 63

V8142 V8138

Where V8141 applies
1. the relevant failure is treated as a sanctionable failure (1) for new style ESA (2) and
2. on or after 29.4.13 the new style ESA award is reduced because of the
relevant failure (3) and
3. the reduction for new style ESA (4) is treated as a sanctionable failure (5).
1 WR Act 12, s 11J; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 15(2)(a); 3 art 15(2)(b); ESA Regs 13,
Part 8; 4 ESA Regs 13; 5 WR Act 12 (Commencement No. 9 etc.) Order, art 15(2)(c); WR Act 12, s 11J

V8143 Reduction period

The reduction period for the new style ESA sanction is the length of the fixed period
for the relevant failure (1) less the number of days, if any, that the old style ESA was
reduced (2).
1 ESA Regs, reg 63; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 15(3) & (4); ESA Regs 13, reg 51(1) & (3)

[V8144-V8145]

V8146 Escalation of sanctions V8147

V8147 - V8148 applies to (1)
1. a new style ESA award as in V8136 or
2. an old style ESA award at any time before the new style award.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 16(1)

V8147 V8146 V8148

Unless V8148 applies, for the purposes of determining the period of a low-level
sanction (1), for a person to whom V8146 applies
1. a reduction of ESA for a new award or a continuing award and
2. any reduction of old style ESA for which there is no reduction for a new award
or a continuing award
is to be treated as a sanctionable failure for which the reduction period is the same
as an old style ESA fixed period (2).
Note 1: This does not apply in relation to a failure which is treated as sanctionable (3)
for a new award or a continuing award.
Note 2: See V8136 et seq for guidance on new awards and V8141 et seq for
guidance on continuing awards.
1 ESA Regs 13, reg 52; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 16(2);

ESA Regs, reg 63; 3 WR Act 12 (Commencement No. 9 etc.) Order, art 14 & 15

V8148 V8146 V8147

When determining the period of the sanction in V8147, DMs should not take
account of
1. a reduction from a new award or continuing award if, at any time after that
reduction, a person was entitled to
1.1 old style ESA or
1.2 old style JSA or
IS (1) 1.3
or
2. a reduction of old style ESA if, at any time after that reduction, a person was
entitled to
2.1 UC or
2.2 new style ESA or
2.3
new style JSA and was subsequently entitled to old style ESA, old style JSA or IS (2). 1 WR Act 12 (Commencement No. 9 etc.) Order, art 16(3)(a); 2 art 16(3)(b)

[V8149-V8150]

V8151 Termination of new style ESA sanctions V8141 V8152

V8152 applies where
1. a new style ESA award ends while there is an outstanding reduction period (1)
and during that period the claimant becomes entitled to an old style ESA
award or IS (2) or
2. a new style ESA award continues as an old style ESA award where a claimant
2.1 does not live in a relevant district or
2.2 is not in the Pathfinder Group
in accordance with V8041 and there is an outstanding reduction period on the
last day of entitlement to new style ESA (3).

1 ESA Regs 13, reg 55; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 20(1)(a); 3 art 20(1)(b)

V8152 V8151

For the purposes of V8151 the new style ESA reduction period (1) will
1. no longer apply and
2. end on the first day of
2.1 an old style ESA award or
2.2 entitlement to IS (2).
1 ESA Regs 13, reg 55; 2 WR Act 12 (Commencement No. 9 etc.) Order, art 20(2)

[V8153-V8160]

V8161 Appeals V8001 V8162

V8162 applies where
1. a UC
1.1 claim
1.1.a is made on or after 29.4.13 and the claimant gives incorrect
information in accordance with V8018 or
1.1.b is treated as made by a couple in accordance with V8020 or
1.1.c is required from former joint claimants in accordance with V8022or
1.2 award is made where a claim is not required in accordance with V8024
or V8025 and
2. the claimant is notified of a new style ESA decision and
3. the date of notification of the decision is before 28.10.131.

1 WR Act 12 (Commencement No. 9 etc.) Order, art 21(1)

V8162 V8161

Where V8161 applies there are transitional provisions for
1. late appeals and
2. the making of an appeal and
3. appeal outstanding at appellant's death (1).
1 WR Act 12 (Commencement No. 9 etc.) Order, art 21(2) & (3)

[V8163-V8999]