ESA and Income Protection

scotsguy

Hi

I'm so confused right now and stressed. Last year I was put on ESA contributions based then changed to income based.

It was stopped because I was told I was working.
I sent my wage slips that showed that this is income protection and not a wage. The policy was between my work and them. I get 66% of my salary less ESA.
So it was restarted again contribution and Income.

Now a team has phoned me and said it's stopping again.

The problem I have. I don't know who is right. I read various stories saying they get Income and Cont ESA and others that don't. 

They quoted regulation 104. The insurance company advised me that I should still get ESA Contributions and Income as they cannot regard the IPI payment as income.

I'm totally lost. 3 different answers of helpline.
Sorry for ranting.

Any advice?

BenefitsTrainingCo

Hi there, 
As far as I can tell, the answer to this depends on whether the IPI payment counts as 'permanent health insurance'. If it does, then according to Disability Rights UK, then if it pays more than £85 a week, then your contributory ESA payment is reduced by half the amount over this limit. However, the income based part of your ESA will be affected pound for pound by this IPI payment. 
It may be best to request a full written decision that refers to which regulations they are using, and you can then ask for a mandatory reconsideration of the decision if you think they're wrong. While you're waiting for the decision, call the Scope helpline to try and get the contact details of any local advice agency which may be able to help you sort this out.
It might be best to insist on a written explanation for their decision, rather than keep getting inconsistent replies from the helpline, as this is not a straightforward case! Good luck, and I hope this helps. My colleagues from the Benefits Training Company may also have opinions on this.....

Jayne

scotsguy

Hi 

Many thanks. I did contact my local agencies CAB. Local office and central helpline and they also give me two different answers. But thank you 

gnmeads

Hi and welcome to the community
Sounds quite complex, so I've done a bit of digging and found a few links for you to look at. Hope there useful :
https://www.benefitsandwork.co.uk/employment-and-support-allowance/esa-glossary/1488-what-is-contribution-based-employment-and-support-allowance-esa
https://www.gov.uk/employment-support-allowance/types-of-esa

scotsguy

Thanks 

BenefitsTrainingCo

Hi scotsguy,

I agree with my colleague. Health insurance payments can affect contributory ESA and income-related ESA. A permanent health insurance policy arranged by your previous employer which provides payments because of your ill health or disability after your employment ends would definitely affect your benefit. 

It affects contributory ESA as my colleague describes. Another thing to bear in mind is that unless you are in the support group, contributory ESA lasts for 52 weeks. 
As my colleague explains, the income from the health insurance, if it does count as that, is taken into account in full for income-related ESA. Regulation 104 of the ESA regs is simply the regs which states that income other than earnings is taken into account. 

I think Jayne's suggestion that you get a written explanation is a good one, as you should then be able to see exactly what is going on, particularly if you are still getting both types of ESA.

Will

scotsguy

Hi.  I'm still employed. My employer gets the payment from insurance company then I pay tax etc and I'm in a support group.

I was just advised that IPI is classed as pensionable income and as I'm still employed it cannot be taken into consideration.

I will take your advice and get it writing. However I have spoken to a few people in DWP and I get different opinions. So I'm still lost. 

I do appreciate all the advice

ScottishGIrl40

Hello Scotsguy,

Did you ever get a resolution to all of this?

I am in the EXACT same situation at the moment - they have stopped my ESA payments (during a pandemic) and I have been advised 2 days in a row I would get a call back from a decision maker. 

I am off my work long term sick (years) I get a monthly payment from my employer and they get it from their insurance company. It's called Group Income Protection. I was advised that it cannot be counted as income as I am still employed (by Aviva). They deduct 350/400 a month from the payment to account for me receiving ESA. I only get 700 a month (50%) of my salary and 400 from ESA. I have a huge mortgage and I am single. Without the 400 I am not going to be able to eat or pay bills. I am worried. 

When I called they said it's been stated as a pension payment. I said it's not a pension payment. I am 40 and I am still employed!!!

Regulation V4017 states ...

Earnings do not include:

payments made for periods when an employee is on maternity leave, 

paternity leave, shared parental leave, adoption leave, or is away from work 

due to illness

So the last thing regards me. They should not be counting this payment as an income.

Any info from ANYONE would be much appreciated. 

Regards,

poppy123456

@ScottishGIrl40 Hi and welcome,

Did you read the comments from the BenefitsTrainingCo? This is what they said. Please read both of the comments above. It doesn't have to be a pension for those payments to affect your ESA.

Health insurance payments can affect contributory ESA and income-related ESA. A permanent health insurance policy arranged by your previous employer which provides payments because of your ill health or disability after your employment ends would definitely affect your benefit.

Here's a link to a thread on the benefits and work forum that may also be useful https://www.benefitsandwork.co.uk/forum/10-dla-esa-queries-results/116607-esa-health-insurance-query-help

ScottishGIrl40

@poppy123456

Thanks for the reply.

Yes I read it. I have read everything on this matter for the last 48 hrs.

I am still employed with my employer. All regulations state that I am entitled to esa whilst employed and off long term sick. If I wasn't entitled to it my GIP would not already deduct it from my payment. 

There are so many grey areas. It's very confusing. I have read numerous posts on other websites with people in the same boat as me and they still get esa payments and they are on 50% of a £40,000 policy ...

How can they expect me to pay a mortgage, council tax, gas, elec, bills, life insurance, home insurance and debt with 700 a month? They are going to cause me to get even sicker! 

Regards, 

Nikalee

Hi all,

@ScottishGIrl40

did you have any resolve with this?
I currently have a claim going through and they are saying I may not receive the full
amount because I haven’t contributed into my employers private health insurance as it was paid in full by them. 

I am not an ex employee, I am still employed and off sick due to a stage 4 cancer diagnosis last year. Now in remission but on long term maintenance treatment. 

Really want to know if I have an argument here. It’s a very grey area on the web

Thanks 
? 

ScottishGIrl40

Hi Nikalee,

I now get ESA BUT at the reduced amount of £68 a week ... It is ESA income related and I get some sort of disability payment that covers some of my income. If my earnings go up a few pounds a year my ESA comes down a few pounds. It is better than nothing - but I still think I am entitled to more. I have been told I will be entitled to PIP ... but during the pandemic it was a nightmare to get through to and I just couldn't find another way.

I hope this helps.