Clwyd ME Support Group

The Department of Work and Pensions (DWP) Benefits System

Benefits are monies paid to you while you're unable to work or go to school. One important guideline to remember is that:

IT'S VERY IMPORTANT TO ALWAYS KEEP COPIES OF EVERYTHING YOU SEND.

It is also very important to check out what benefits you are entitled to and to check that you are completing the forms correctly.

Advice on benefits can be found on the Citizens Advice website and on the Benefits and Work website which both contain useful information on all benefits and how to claim them.

The list of benefits available and a brief explanation of how they apply is as follows:-

Disabled Living Allowance - DLA

This is split into 2 parts or components and each of these is split into sub sections:

Firstly, the Care Component which is split into these 3 Parts:

Low Rate:Part-time care/supervision or unable to cook a full meal for oneself using a proper cooker ie: oven and hob.

Middle Rate: Moderate/Severe: Care helping with all aspects: Personal such as bathing/hair washing, helping with exercises, preparing meals, getting medicines or assisting with them, the list is endless.

High Rate: Day and Night Care: Constant Care Both Day and Night.

Secondly, the Mobility Component which is split into 2 Parts:

High Rate: Virtually unable to walk (Do you use a wheelchair?)

Low Rate: Needs Someone to Supervise (For example if you are unsteady or confused).

With DLA once the DWP decide to look at your claim they may decide to send one of their own doctors to look at you, this doctor is called an E M P (Examining Medical Practitioner) -they are usually GP’s from out of your area, who work for and are being paid by the DWP they only have one interested party and it isn’t You.

DLA is not a means tested benefit.

Statutory Sick Pay - SSP

This is awarded after you have been off ill from an employer for more than 3 days and it will be paid until 26 weeks

Your employer has to pay you SSP for this period but whether or not he pays you any further amount (for example to make the amount up to your normal wage) depends on employment terms and conditions. You need to check your employment contract or the letter you received when you were offered the job.

SSP is not a means tested benefit.

Incapacity Benefit (IB)

Prior to April 2009 there are 2 rates for this benefit. The lower rate is awarded in place of SSP if not enough National Insurance Contributions are on your record. You do not get both SSP and I/B.

The higher rate is awarded after you have been ill for 26 weeks, when the SSP or lower rate IB ends.

IB only applies to people who started claiming it before April 2009. Since then ESA has taken over - see below.

IT IS YOUR RESPONSIBILITY TO PROVIDE THAT EVIDENCE. THE DWP WILL NOT NOTIFY YOU WHEN ANOTHER SICKNESS CERTIFICATE IS DUE. THEY WILL STOP YOUR BENEFITS IF YOU DO NOT PROVIDE ANOTHER CERTIFICATE IN TIME.

Employment Support Allowance (ESA)

This has replaced Incapacity Benefit and will be paid on initial claim at the lowest rate. Each person should be assessed by the thirteen week period at which point a decision by the DWP will be awarded either into the Support Category or the Work Category. At this stage a further enhancement payment will be made on top of the basic allowance. Evidence of continuing illness will have to be provided to the DWP at all stages unless they tell you different.

Carers Allowance (CA)

Can only be paid if the person that the carer is claiming for has been awarded Attendance Allowance (AA) or DLA at Middle Rate Care.

I/S (Income Support)

Income Support is a means tested benefit (subject to what money is coming into the home by whatever means) for people who were claiming before April 2009. Since that time ESA income related has replaced this benefit. For more information on this go the websites listed above. If you are assessed as qualifying you will also be able to receive full housing benefit and council tax, if you own your home you will be entitled to help with the mortgage payments again this is down to the criteria.

It is very important to check if you qualify because on top of the basic money the DWP also give premiums, so if you are a carer with carers allowance you would be entitled to extra premium if income support is your only funding.

If you are in receipt of DLA you are entitled to extra premium this will increase the amount of money you would have coming in.

Applying for benefits

The DWP have an agenda to get people back to work if at all possible.

With this in mind trying to fill the forms in on your own is a mine field. Use the professionals if at all possible and if not read up all relevant advice on the Benefits and Work and the main ME Charity websites too. The Citizens Advice can often assist you to complete forms and take the strain off you, or help you appeal.

With CFS/ME unfortunately many are refused on the initial application, the trouble then is too many people give up, when had they appealed the system to get their entitlement they may well have resulted in them having the decision overturned and also would have opened more doors to help them ease the financial strain of having CFS/ME. If you are too unwell to work - you are entitled to benefits and the above can advise you,

Case Histories:

Recently within our group there was a case of a Young Person’s(YP) DLA being cut having had already been receiving at middle rate care and high rate mobility, this being overturned in favour of low rate care and low rate mobility the YP went to appeal but the decision was upheld.

Welfare Rights took the case to the commissioners in London who found in favour of the YP and the award was reinstated and back paid, this would not have happened if Welfare Rights had not been involved the whole process took 18 months, it was Welfare Rights that did the work, so the strain was on them not on the YP(which is not to say that it was not stressful only it would have been more stressful had the YP and family had to do it on their own)

We hope this page has been useful to you and we would welcome your comments or case histories.