Secretary of State's Response
Section 1: Personal details
Name:
<Title> <Forenames> <Surname>
Address:
NI No:
<NINo>
Benefit:
<Benefit Type>
Date of decision:
<Decision Date>
Date decision notified:
<SODN>
Date of reconsideration:
zDateRecon
Date appeal received:
<Date Lodged>
Decision maker’s name
<Decision Maker>
and address:
Name and address of the
decision maker’s
representative (if any):
Address where documents for the decision maker may be sent or delivered:
Name and address of any
<RepName>
other respondents and
their representatives (if
any):
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Section 2: Schedule of evidence
Comment [M1]: List all evidence
included in the submission
Document Date of
Date of
Brief description of document
No.
document receipt/issue
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Section 3: The decision
Section 4: The facts of the case
1. <Title> <Surname> is a single/married/civil partnership <manwoman> and was born on
Comment [M2]: Apply as appropriate
<DoB>. <HeShe> claimed Employment and Support Allowance from and including zClaimDate.
<Title> <Surname>’s own doctor completed a medical certificate (Form Med*) on (Date) and
Comment [M3]: Insert Form name
confirmed the diagnosis as zMedCon.
2. On <Decision Date> the Decision Maker considered all the evidence and decided that <Title>
<Surname> is not entitled to contribution-based Employment and Support Allowance, and has
not claimed or is not entitled to Income Related Employment and Support Allowance, from
zClaimDate because *
Comment [M4]: Use appropriate
paragraph from examples below
*<Title> <Surname> has not paid Class 1 or Class 2 contributions in respect of any of the last
three complete tax years before the beginning of the relevant benefit year.
*OR
*The earnings factor derived from earnings upon which primary Class 1 contributions have been
paid, or treated as paid, by <Title> <Surname> is less than the lower earnings limit multiplied by
25 in each of the last three complete tax years.
*OR
* <Title> <Surname> has not paid Class 1 or Class 2 contributions or been credited with
earnings in respect of any of the last three complete tax years before the beginning of the
relevant benefit year.
3. <Title> <Surname> made an appeal on the approved form, on the grounds that
Comment [M5]: Summarise
customer’s grounds of appeal only
addressing the points raised in the
4. The decision of <Decision Date> was reconsidered on zDateRecon but not revised.
appeal
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Section 5: The response
The disputed decision was made in accordance with the following Acts and Regulations.
1. A person under pensionable age is required to satisfy the relevant contribution conditions
(conditions relating to national insurance) for entitlement to Employment and Support Allowance.
Welfare Reform Act 2007, Section 1(2)(a).
2. The relevant contribution conditions for Employment and Support Allowance are set out in the
Welfare Reform Act 2007, Schedule 1, Part 1 (conditions relating to national insurance):-
The
first condition is that:-
(a)
the person must have actually paid contributions of a relevant class in respect of
one of the last 3 complete years before the beginning of the relevant benefit year,
and
(b)
those contributions must have been paid before the relevant benefit week;
and
(c)
the earnings factor must not be less than that year’s lower earnings limit multiplied
by 25.
Welfare Reform Act 2007, Schedule 1, Part 1, paragraph 1(1).
3. The first day of <Title> <Surname>’s period of limited capability for work was zClaimDate.
Therefore the relevant tax years for the purposes of the first contribution condition are zTax1,
zTax2 and zTax3
In order to satisfy the first contribution condition <Title> <Surname> must have paid national
insurance contributions, as per paragraph 5 of this submission, in any one of those tax years.
* <Title> <Surname>’s national insurance record shows that <heshe> has not paid
Comment [M6]: Apply one of the
contributions of a relevant class in respect of one of the last 3 complete years before the
following three paras as appropriate
beginning of the relevant benefit year.
*OR
<Title> <Surname>’s national insurance record shows that although <heshe> has paid
contributions of a relevant class in respect of one of the last 3 complete years before the
beginning of the relevant benefit year, those contributions were not paid before the
relevant benefit week.
*OR
<Title> <Surname>’s has paid contributions of a relevant class in respect of one of the
last 3 complete years before the beginning of the relevant benefit year and those
contributions were paid before the relevant benefit week. However, <hisher> national
insurance record shows that the earnings factor is less than that year’s lower earnings
limit multiplied by 25.
Consequently the decision maker has decided that <Title> <Surname> does not satisfy the first
contribution condition and is not entitled to Employment and Support Allowance.
Welfare Reform Act 2007, Schedule 1, Part 1, paragraph 1(1).
4. In order to be entitled to Employment and Support Allowance, <Title> <Surname> must satisfy
both contribution conditions. As <Title> <Surname> did not satisfy the first contribution condition,
the second contribution condition has not yet been determined.
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5. Should the Appeal Tribunal find that <Title> <Surname> does satisfy the first contribution
condition, the Appeal Tribunal is respectfully advised that <hisher> claim will have to be remitted
to the Secretary of State for Work and Pensions to determine whether the second contribution is
satisfied before <Title> <Surname>’s claim to Employment and Support Allowance can be
decided.
6. In conclusion, it is respectfully requested that the Appeal Tribunal make findings on the
following matters:
1.
Does <Title> <Surname> satisfy the first contribution condition?
2.
Can <Title> <Surname> be treated as satisfying the first contribution
condition?
3.
Should the decision that <Title> <Surname> is not entitled to Employment
and Support Allowance dated <Decision Date> be upheld
Access to statute and case law for appellants
Copies of the law referred to in this response are available at some libraries.
It can be accessed on-line via the DWP's website at
http://www.dwp.gov.uk/publications/specialist-guides/law-volumes/the-law-
relating-to-social-security/
Reported decisions of the Social Security Commissioners from 1991 can be
accessed on-line via the DWP's website at
http://www.dwp.gov.uk/commdecs/index.asp
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