You can get employment and support allowance (ESA) if your ability to work is limited by ill health or disability. ESA replaced both incapacity benefit (IB) and income support (IS) paid on the grounds of incapacity for new claims from 27 October 2008.
If you are claiming ESA you must:
When you make a claim for ESA you have to have an initial assessment. This assessment usually takes place over 13 weeks, but can be longer. During the assessment phase you will undergo a work capability assessment and a work focused interview.
The ESA work capability assessment (WCA) is carried out by a health care professional working on behalf of the Department for Work and Pensions. It is intended to:
The ‘limited capability for work’ test is used to see if you can stay on ESA. Points are scored based on your ability or inability to carry out a range of physical or mental health activities as appropriate. If you score 15 points you are deemed to have limited capability for work and can stay on ESA. If you do not pass this test you would need to consider appealing this decision and/or claiming jobseeker’s allowance instead.
The 'limited capability for work-related activity' test is used to decide whether you are placed in the support group of claimants or the work-related activity group (see 7). The test has a list of 46 descriptors, relating to both physical and mental functions. If at least one of them fits, you will be placed in the support group of claimants.
The ‘work-focused health-related assessment’ (WFHRA) is used if you are placed in the work-related activity group. It collects information about your ‘functional capacity’ to carry out tasks. This focuses on the things you can do as opposed to the limited capability for work assessment, which focuses on the things you cannot do.
The WFHRA also collects information about any health interventions that could improve your functional capacity and thus support a move back into work. This could include the use of appropriate aids and adaptations. The information collected in the WFHRA is put into a ‘capability report’ which is used in the work-focused interview.
For more information see our Factsheet F32 - employment and support allowance medical tests and Factsheet F33 - employment and support allowance activities,descriptors and points.
You are expected to attend an initial ‘work-focused interview’, unless you are terminally ill. This will normally take place during the 8th week of your ESA claim. At this interview a ‘personal adviser’ will discuss your work prospects, the steps that you are willing to take to move into work and the support available to you. As a guide, the personal adviser will be using the capability report that was produced in the work-focused health-related assessment.
The interview can be waived if you are likely to be starting a job or returning to work. The personal adviser can also defer an interview if, because of your condition, it would be inappropriate at that particular time.
You will need to have paid enough National Insurance contributions in specific tax years to satisfy this test. If you do pass the test you will receive a flat-rate benefit payment for yourself.
Contributory ESA has no age-related additions or additions for dependents (such as a wife, husband or civil partner or child) premiums or allowances for housing costs. In order to get additions for your partner, premiums or housing costs you will need to also satisfy the low income test (see 5).
If you need extra money to look after a child, you should claim child tax credit .
If you have limited capability for work and claim ESA before the age of 20 (or 25 if you have been in education or training) you do not have to satisfy the contribution conditions.
The amount of contributory ESA you get will be reduced if you have have an occupational pension of over £85 per week. There are some exceptions to this rule. For more information see our Disability Rights Handbook.
This is a test similar to income support. In brief, your needs (and those of your partner if you have one) are compared with your resources, such as your income and savings, and the income-related allowance worked out from this comparison.
You cannot get income-related ESA if your capital or savings (or you and your partner's capital or savings) is above an upper savings limit of £16,000.
Your benefit will also be affected if your capital or savings (or you and your partner's capital or savings) is above a lower savings limit of £6,000. If you are permanently in a care home this lower limit is £10,000.
If it is decided that you have a limited capability for work-related activity, you will be placed in the support group of claimants. If you are placed in this group, you will not have to undertake work-related activities (though you can volunteer to do so if you want).
If it is decided that you do not have a limited capability for work-related activity, you will be placed in the work-related activity group of claimants. You will have to adhere to strict work-related conditions in order to continue receiving the benefit in full. This will involve attending a series of five further work-focused interviews in addition to the initial work-focused interview.
These interviews will normally take place each month and at them the personal adviser will try to help you back into work. As with the initial work-focused interview, the adviser will be using the capability report as a guide. The adviser will draw up an ‘action plan’, which will outline the activities that you could undertake to help you move into work.
During the assessment phase you are paid a ‘basic allowance’. This is set at a similar level to that of jobseeker’s allowance. If you are aged under 25 you will receive a reduced rate of this basic allowance. Once you have completed the assessment period the reduction for under 25s does not apply.
If you are on contribution related ESA you will get:
under 25 – £50.95
age 25 and over – £64.30
If you are on income-related ESA you may get:
single and under 25 – £50.95
single and age 25 and over – £64.30
lone parents age 18 and over - £64.30
couples age 18 and over - £100.95
You may also be able to get additional premiums (pensioner, severe disability, carer and enhanced disability premiums). For more detailed information see Disability Alliance's Disability Rights Handbook. There is no disability premium with ESA.
After the assessment phase you can receive one of two additional payments depending on whether you are placed in the work-related activity group or the support group.
If you are placed in the work-related activity group you will receive a work related activity component of £25.50 included in your payment.
If you are placed in the support group you will receive a support component of £30.85 included in your payment. If you are terminally ill this component will be paid to you during the assessment phase.
If you are on contribution based ESA you may get:
under 25 – £89.80
age 25 and over – £89.80
If you are on income-related ESA you may get:
single and under 25 – £89.80
single and age 25 and over – £89.80
lone parents age 18 and over - £89.80
couples age 18 and over - £126.45
You may also be able to get additional premiums and housing costs.
If you are on contribution based ESA you may get:
under 25 – £95.15
age 25 and over – £95.15
If you are on income-related ESA you may get:
single and under 25 – £108.55
single and age 25 and over – £108.55
lone parents age 18 and over - £108.55
couples age 18 and over - £151.10
Everyone in the support group, who is on income-related ESA, gets the enhanced disability premium (included in the figures above). You may also be able to get additional premiums and housing costs.
You can get extra amounts in the form of premiums if you satisfy certain conditions.
You can get any or all of the following premiums if you satisfy the rules for them:
carer premium
enhanced disability premium
pensioner premium
severe disability premium
You or you partner must be entitled to carer's allowance, even if you are not actually paid it because you receive another benefit. This premium is payable for each person who qualifies.
You or your partner must satisfy one of the following:
If you have a partner you will be paid a higher couple rate of this premium.
You or your partner must be aged 60 or over. If you have a partner you will be paid a higher couple rate of this premium.
You or your partner must satisfy all of the following:
There is a couple rate if both of you qualify.
For more information on employment and support allowance premiums see the latest Disability Rights Handbook.
You cannot get income-related ESA if your capital or savings (or you and your partner's capital or savings) is above £16,000. Your benefit will be affected if your capital or savings (or you and your partner's capital or savings) is above £6,000 (£10,000 if you live permanently in a care home).
If your capital is between the lower and upper limits, a ‘tariff income’ is assumed. One pound a week for every £250 (or part of £250) above the lower limit is included as your income.
For example, if you have capital of between £6,250.01 and £6,500, £2 a week is included as your income. Each time capital gets into the next block of £250 (even by as little as one penny) an additional £1 is included as income.
You should phone the national contact centre:
Telephone: 0800 0 55 66 88
Textphone: 0800 0 23 48 88 (i)
Welsh language: 0800 0 12 18 88
Lines are open from 8:00 am - 6:00 pm, Monday to Friday. Charges may apply to calls from mobile phones, but the contact centre will call the customer back if requested.
You can also get a claim form (ESA1) from your local Department for Work and Pensions office or Jobcentre Plus office or download it from the Jobcentre plus website at www.jobcentreplus.gov.uk.
You can also make an online claim at www.dwp.gov.uk/eservice/.
You will also be expected to provide medical certificates (if you are claiming contributory ESA because you are under 20/25 these certificates must also cover the 196 day period).
If you are working but do not get statutory sick pay you will also need to send in form SSP1 as well as a medical certificate. You can get this form from your employer.
Both the initial work-focused interview and the follow-up interviews are mandatory. If you fail to either attend or participate in a work-focused interview, your ESA may be paid at a reduced rate or ‘sanctioned’. Sanctions can only be applied to the additional payments of ESA, not the basic allowance. Hence sanctions can only be applied when the assessment phase of the benefit is over.
For the first 4 weeks the sanction will consist of a 50% reduction to the additional payment within your ESA. Thereafter the additional payment will be removed completely. The sanction will last for as long as you do not comply with the requirements that are demanded of you. For instance, if you refuse to attend a work-focused interview, the sanction will apply until you do attend one.
If you are a student you can claim contributory ESA if you have paid enough national insurance (NI) contributions, or satisfy the rules for claimants under 20/25. You will still have to satisfy the limited capability for work test.
If you are aged 16, 17 or 18 you will usually be excluded from claiming contributory ESA if you are still at school or in full-time education of 21 hours or more a week. Lunch breaks, breaks between lessons, free periods, and periods of private (unsupervised) study or homework do not count. From age 19 there are no rules that limit the hours and type of study you can do.
When adding up the number of hours that you study each week, you should ignore 'any instruction or tuition which is not suitable for persons of the same age who do not have a disability'.
You can only get ESA on grounds of low income (income-related ESA) if you are getting disability living allowance (DLA).
If you are on DLA you are also treated as having limited capability for work but you will still be assessed under the limited capability for work-related activity test, which decides whether you are in the support group or the work-related activity group.
If you are in the work-related activity group you will also have to attend a work-focused health-related assessment as well as work-focused interviews.
If you are a part-time student you can claim contributory ESA if you have paid enough national insurance (NI) contributions, or satisfy the rules for claimants under 20. You can also claim income-related ESA if you are on a low income. You do not have to be receiving DLA.
If you are already receiving incapacity benefit (IB) or income support (IS) paid on the grounds of incapacity when ESA is introduced you will continue to receive those benefits, rather than ESA, for the time being.
For the moment, if you are claiming incapacity benefit (IB) or income support (IS) on grounds of disability, you still have to satisfy the old personal capability assessment test rather than the new ESA test. The Government has announced its intention to transfer those on IB/IS to ESA and to apply the ESA test at a future date. So far this date has not been determined.
For basic information on ESA see Factsheet F32 - employment and support allowance medical tests.
For more detailed information on ESA see the following:
You can also obtain copies of our factsheets and publications by contacting Disability Alliance on 020 7247 8776 (voice and minicom) or by fax on 020 7247 8765.
www.disabilityalliance.org - 29 September 2009
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