Employment and Support Allowance (ESA) is a benefit paid if your ability to work is limited by ill health or disability. It replaced both Incapacity Benefit (IB) and Income Support (IS) paid on the grounds of incapacity.
Contributory ESA is linked to your National Insurance Contribution record. It replaces Incapacity Benefit, which was also a National Insurance benefit. To be entitled to Contributory ESA, you must have paid National Insurance contributions over a number of years, from before the age of 20 (or 25 if you have been in education or training), it may not be necessary for you to satisfy these contributory conditions. A time limit of one year now applies to certain Contributory ESA claimants.
Income-related ESA is the means-tested element of ESA. It replaces Income Support paid on the grounds of incapacity. It provides for your basic living expenses (and those of your partner).
What are the rules for Employment and Support Allowance?
The following rules apply to all ESA claims:
- Be at least 16 years or over.
- Be under pensionable age.
- Undergo a 13 week assessment phase.
- And satisfy one of the following:
- A contributory test or be under 20 (or 25 in some cases).
- You pass the low income test for income-related ESA.
Residence and Presence Tests for ESA
Income Related ESA – you must be present in the UK, be habitually resident and have the right to reside.
Contributory ESA – you must be present in the UK
How to apply for Employment and Support Allowance
You will be expected to provide medical certificates (fit notes) to make your claim. If you don't already have one, contact your GP. The next step is to call the National Contact Centre on 0800 055 6688 to start your claim. If you are unable to use a telephone you can make a claim via a representative or by completing a printed form available from your local Jobcentre (ESA1). Claim forms can also be downloaded here.
What happens after the initial application?
When someone applies for Employment and Support Allowance they will enter a 13 week assessment phase. This applies to all new ESA claimants with the exception of those who are terminally ill. The assessment period usually takes place over a 13 week period but can be longer. During this assessment period claimants undergo a work capability assessment and a work focused interview.
The Work Capability Assessment
The Employment and Support Allowance work capability assessment (WCA) will determine whether you are eligible for Employment and Support Allowance and the amount you will receive. The assessment will be carried out by a health care professional working on behalf of the Department for Work and Pensions. It is intended to:
- find out whether you have a 'limited capability for work'
- find out whether you have a 'limited capability for work-related activity'
There are two parts to the Work Capability Assessment:
Limited Capability for Work Test
The test for limited capability for work has some similarities to the incapacity benefit personal capability assessment. Points are scored on your ability to carry out a range of physical or mental health activities as appropriate. You score points according to your inability to carry out these tasks. If you score 15 points you are deemed to have limited capability for work and can remain on ESA. If you fail this part of the test you will be moved onto jobseeker's allowance instead.
Limited Capability for Work-Related Activity Test
This is the test to establish whether a claimant's capability for work related activity is limited by their physical or mental condition and if so whether the limitation means that it is not reasonable to require them to undertake such an activity. The test has a list of 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. This means that you will be entitled to the additional support component when you go into the main phase of ESA at week 14 and will not be obliged to participate in work related activity.
As such, it may be viewed as an assessment of what a claimant may be able to do in terms of employment now or in the foreseeable future. The information collected at this assessment is put into a 'capability report' which is used in the work-focused interview.
Some people may not have to attend the full Work Capability Assessment, this will include individuals with a terminal illness and those that can be identified as having limited capability for work or limited capability for work related activity without the need for them to take part in the full assessment. Clients who are terminally will be fast-tracked into the support group of Employment and Support Allowance so that they can receive all entitlements as quickly as possible. They will not be required to participate in a work focused health related assessment or any other work related activity.
Repeat Claims for ESA
Claimants who have been found not to have limited capability for work (sometimes known as being fit for work) following a Work Capability Assessment (WCA), will not be paid the ESA assessment rate for a repeat claim unless they have developed a new condition or an existing condition has significantly worsened. Where someone makes a repeat claim for ESA and there is no change in their health condition, the DWP decision maker will be able to use evidence from their previous WCA when considering whether to disallow the claim immediately, or to refer them for another WCA. Claimants will not receive ESA payments for the assessment phase in these ciscumstances. This does not prevent someone from making another claim to ESA. It also does not prevent someone whose condition has significantly worsened or who has developed a new condition, from being entitled to ESA during the assessment phase.
Those who are found not to have limited capability for work should claim Jobseeker's Allowance or Universal Credit, as appropriate.
Between now and 2017, Universal Credit will eventually replace:
- Child Tax Credit
- Housing Benefit
- Income Related ESA
- Income Related JSA
- Working Tax Credit
- Income Support
- Parts of the Social Fund
For more detailed information about this benefit click on the link Universal Credit, this link takes you to the Disability Rights UK Factsheet.
Whilst all the information given in this document was correct at the time of going to press, DIAL Doncaster cannot be held responsible for any subsequent changes.