Overview of Employment and Support Allowance

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

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

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).

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'

From 28 January 2013, a range of changes have been in force in relation to the limited capability for work and limited capability for work related activity tests, including when deciding who is to be treated as having either a limited capability for work or a limited capability for work-related activity.  In general, the new rules apply to those making a claim or whose determination is made on or after 28 January.   

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.

Universal credit (UC) is a new benefit which will replace the following benefits, for anyone under state pension credit age, nationwide in Great Britain from October 2013:

• child tax credit
• housing benefit
• income related employment and support allowance
• income based jobseekers allowance
• income support
• parts of the social fund
• working tax credit

Between October 2013 and 2017 income related employment and support allowance will be abolished and will be paid as part of universal credit. If you are already getting income related employment and support allowance you will be moved, at some point, over to universal credit.

DIAL Disclaimer
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.