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The rules effectively mean that you can only get ESA if you have appealed against an initial refusal of ESA or the disallowance of an existing award.You cannot get ESA if you are appealing against a decision on a repeat claim, unless your existing condition has significantly worsened or you have a new condition that limits your capacity to work.You should be sent a form ESA83 to complete asking for details of how your medical condition has changed since your previous work capability assessment.
The special rules referred to below when you transfer from legacy benefits onto UC are mostly set out in . You are claiming a legacy benefit and experience a change of circumstances which, before UC, would have prompted you to claim another legacy benefit. You can no longer claim legacy benefits because you live in a UC full service area, or a gateway area and you satisfy the gateway conditions for claiming UC. You are getting income-based jobseekers allowance (IBJSA) and housing benefit (HB) when you have your first child and become a lone parent.Claiming JSA during an ESA dispute If you live in a UC 'gateway area', you can claim jobseeker’s allowance (JSA) while you are disputing an ESA dispute without prejudicing your case that you are entitled to ESA.You must, however, satisfy the jobseeking conditions and need to be aware of the restrictions you can place on your jobseeking activity without risking a disallowance or sanction.The rules mean that you cannot get ESA pending a decision on whether you have LCW, if a previous decision was that you did not have LCW because you failed to score enough points and could not be treated as having LCW, unless since that decision was made, you are have a new or significantly worsened medical condition.There is no legal definition of a ‘new’ or ‘significantly worsened’ condition, although case law suggests that a condition has only ‘significantly worsened’ if you are likely to satisfy the work capability assessment (see ).
The DWP may seek additional evidence from your doctor or advice from Maximus.