Disability benefit reviews and reassessments are suspended. This temporary measure is to ensure that benefits continue during the coronavirus (COVID-19) outbreak.
To find out more, visit the GOV.UK website.
To be eligible for contributory ESA you need to have paid enough in National Insurance contributions. If you have, you will receive a flat-rate benefit.
Payment of contributory ESA is limited to 12 months, unless you are placed in the ‘support group’ (see 'The assessment phase and the Work Capability Assessment').
Contributory ESA is now called ‘New style’ ESA for new claims.
Income-related ESA is a means-tested benefit. This means your needs (and those of your partner, if you have one) are compared with the existing money you have, such as your income and savings.
Whether you get income-related ESA and how much you're paid, is worked out from this.
Income-related ESA has now been replaced by Universal Credit. It's no longer possible to make a new claim for means-tested ESA, unless you're entitled to the Severe Disability Premium.
If you're already getting income-related ESA, you will at some point be moved over to Universal Credit.
Income-related ESA can be paid on its own (if you're not entitled to contributory ESA), or as a top-up to contributory ESA if you are. Unlike contributory ESA, income-related ESA is not time-limited.
There are common rules that apply to both types of ESA. You must:
- not be working (some limited work is permitted - see section on 'What work is permitted work with ESA?')
- be aged 16 or over
- be under State Pension age. You can calculate your state pension age online.
- live in Great Britain
- not be entitled to Income Support, Jobseeker’s Allowance or Statutory Sick Pay
- have a limited capability for work. This is tested under the Work Capability Assessment.
To claim contributory ESA you need to complete a NSESAF1 claim form, which you can get from the Universal Credit Helpline, download or collect one from your local Jobcentre.
You can also claim online.
You'll be expected to provide a medical certificate from your doctor (commonly known as a 'fit note' or 'sick note') until you have undergone the Work Capability Assessment.
If you have a job but don’t get Statutory Sick Pay, you'll need to send in form SSP1 as well as a medical certificate. You can get this form from your employer.
An ‘assessment phase’ normally applies to all new ESA claimants. During the assessment phase, you should undergo the ‘Work Capability Assessment’.
The assessment phase should last for 13 weeks, although it can be extended if there's a delay in carrying out the assessment (delays are common).
During the assessment phase, you'll be paid just a basic allowance of ESA.
The Work Capability Assessment has 2 aims:
- To assess whether you have a limited capability for work. If you do, you're considered eligible for ESA.
- To assess whether you have a limited capability for work-related activity. This is used to decide whether you're placed in the 'support group' or the 'work-related activity' group.
The Work Capability Assessment is also important for Universal Credit, the new benefit that’s currently being phased in to replace several existing means-tested benefits, including the income-related part of ESA.
The Work Capability Assessment works out whether you're entitled to the ‘limited capability for work-related activity’ amount of Universal Credit and what work-related requirements you must meet to keep receiving the benefit in full.
When will the assessment take place?
The first Work Capability Assessment should take place during the 13-week assessment phase.
If it's decided that you're entitled to ESA, you may be asked to take part in further Work Capability Assessments in the future. This is to make sure you're still entitled to ESA and find out whether you should remain in the same group.
The first part of the Work Capability Assessment finds out if you have a 'limited capability for work'. It looks at your physical, mental and cognitive health.
A points system is used to see how well you can carry out a range of activities, such as moving around, standing and sitting, reaching, communicating, manual dexterity (using your hands), behaving appropriately, socialising and keeping safe.
In some situations, you don't need to meet the 15 points requirement to pass the test. There's a long list of circumstances which mean you're exempt, which includes being terminally ill, receiving cancer treatments (chemotherapy or radiotherapy), having an infectious disease, being in hospital, pregnant, a serious risk to health, or receiving dialysis. In these kinds of circumstances you can be automatically treated as having a limited capability for work.
For more details contact the Parkinson's UK helpline on 0808 800 0303 or email [email protected]
If you don’t qualify, you'll need to claim benefits as a jobseeker instead, or challenge the decision. If you're unsuccessful with your first claim and make a second claim, you'll have to show either a new disablement (disability or condition) or that the original condition(s) has significantly worsened before the new claim can proceed.
The second part of the assessment looks at whether you have a 'limited capability for work-related activity'. This decides whether you'll be placed in the ‘support group’ or the ‘work-related activity group’.
This assessment also has a list of descriptors. If at least 1 of them applies to you, you’ll be placed in the support group.
The support group
If you’re put in the support group, it means the Department for Work and Pensions has decided that you’re unable to work and that it doesn’t expect you to do anything to improve your chances of finding work. You'll get a higher rate of ESA, and if you're awarded contributory ESA, it can be paid indefinitely (which means it's paid for as long as you continue to meet the conditions for it).
Under both 'New style' ESA and Universal Credit, you'll be placed in the support group if there's a ‘substantial risk’ to your mental or physical health if you're found not to have a limited capability for work-related activity. For more details, call the Parkinson's UK helpline on 0808 800 0303 or email [email protected]
If you're in the support group, you won’t have to take part in work-related activities, but you can do voluntary work if you want to.
The support group is also known as the ‘limited capability for work-related activity group’ for both ESA and Universal Credit.
The work-related activity group
If you're put in the work-related activity group, it means the Department for Work and Pensions has decided that your disability or health condition does limit your ability to work at the moment, but there are things you can do to improve this.
You'll have to meet strict work-related conditions in order to continue receiving ESA (or Universal Credit) in full. This involves attending a series of work-focused interviews. At these interviews, a work coach will talk with you about your work prospects, the steps you're willing to take to move into work and the support available to you. Your benefit can be reduced (or 'sanctioned') if you do not meet the work-related conditions.
If you're placed in the work-related activity group and are getting contributory ESA too, your contributory ESA will be limited to 12 months.
The work-related activity group is known as the ‘limited capability for work group’ for both ESA and Universal Credit.
A Department for Work and Pensions decision-maker looks at the information you've provided with your claim for ESA or Universal Credit to see if there's evidence that you have a limited capability for work or for work-related activity.
You'll be asked to complete a 'capability for work questionnaire' unless you are terminally ill.
Completing the capability for work questionnaire
The questionnaire asks about your ability to complete different tasks under a number of activity headings. The questions relate to the activities in the limited capability for work assessment.
The activities, and the points that you can get for each one, are listed in our Supplementary guidance on the Work Capability Assessment (PDF, 95KB).
Things to note when completing the questionnaire:
- The questionnaire asks whether you can do certain tasks without problems. You can answer ‘yes’, ‘no’ or ‘it varies’. The last answer is helpful if your condition changes, as is likely to be the case with Parkinson’s. You might find it useful to keep a diary of your day-to-day problems to help answer this correctly.
- Each of your answers should take into account tiredness, pain, discomfort and whether you can repeat the activity. If you're not able to complete a task repeatedly, or without pain or discomfort, then you should be treated as being unable to do it.
- Remember that non-physical problems are just as important to the assessment as physical problems. So do include information about non-physical difficulties such as depression, memory problems or hallucinations.
- Use the box provided in each section to give extra information about the problems you have with each task. For example, if a task causes discomfort, pain or tiredness, you should say so. If your condition varies, give an idea of how many days you would be able to do the task and how many you would not.
- You must be able to do each task safely, to an acceptable standard, as often as you need to, and in a reasonable time. Make a note wherever this is not the case. Think about whether you could do the task in a workplace setting. Include information about any injuries or accidents that have happened when you’ve tried to do a task. Explain how much rest or medication you need after doing a particular task.
- If a task would be a risk to your health, enough to put off any reasonable person from doing it, then you should be treated as being unable to do it.
- If your doctor, physiotherapist or another health professional has told you to avoid an activity, make sure you write this in the box.
- A detailed statement can be attached to the questionnaire, setting out how Parkinson's (and any other health issues) affects you. This could be in the form of a diary, clarifying what your difficulties are on a good day, a bad day and an average day. Comment generally, as well as in relation to an actual work situation. Make several copies of the statement (one of which you could give to the healthcare professional at the face-to-face assessment).
- If you have to appeal against a benefit decision, the questionnaire will make up part of the evidence put before the tribunal. It's important that you do not miss anything out and that you give as much information as you can.
- You should attach copies of any medical evidence to the questionnaire if possible.
Parkinson’s affects people differently, and some people with Parkinson’s may also have other illnesses or disabilities. So, depending on the individual, any of the activities in the questionnaire might be relevant. Because of this, it's important you read the whole questionnaire carefully.
For more detailed guidance, including explanations of each of the activity headings and example responses, please see our Supplementary guidance on the Work Capability Assessment (PDF, 95KB).
The face-to-face assessment
Once you've completed your capability for work questionnaire, you may be asked to attend a face-to-face assessment carried out by a healthcare professional working for Maximus, the organisation delivering the assessment on behalf of the Department for Work and Pensions.
Maximus may also be called the 'Health Assessment Advisory Service' or the 'Centre for Health and Disability Assessments'.
If you have to go to a face-to-face assessment, the following tips might be useful:
- If you have problems getting to the venue, it's important to explain this and ask for an alternative, such as a home visit. Set out any risk to your health if you were to attempt to go to their venue and get a letter from a healthcare professional to back this up.
- At the assessment, explain your physical abilities as well as you can. You shouldn't assume the healthcare professional assessing you knows you can only do a task with discomfort, or that your ability to do it changes because of your condition. Tell them about any pain or discomfort caused by the task and how you'd feel if you had to keep repeating it.
- Focus on the problems you have, rather than on how you manage them.
- The healthcare professional assessing you shouldn't base their opinion on your condition on the day, but rather the effects of your condition over time. So if you're having a good day when you have your assessment, you will need to tell them this and explain how your condition affects you most of the time, and how you are at your worst.
- When they ask about your mental or other non-physical difficulties, the healthcare professional assessing you should find out how your condition affects your day-to-day abilities. When you explain this, tell them how you are most of the time. If your condition changes over time, or from day to day, tell them how often it changes and for how long.
- You might find it helpful to take someone with you, such as a friend or relative, to fill in the gaps of what you tell the healthcare professional.
- If you've made a written statement or diary about your condition, give the healthcare professional a copy.
Asking for a reconsideration
If you're refused ESA (or are placed in the wrong Universal Credit group) after the Work Capability Assessment and you disagree with the decision, you can ask the Department for Work and Pensions for a 'mandatory reconsideration' of the decision.
You can also request a mandatory reconsideration if you're put into the work-related activity group and you think you should be in the support group (and so would not have contributory ESA limited to 12 months).
You must ask for the mandatory reconsideration within 1 month of the date on the decision letter.
You can ask for a mandatory reconsideration by phone, but it's best to put your request in writing and keep a copy of your letter. You can use a CRMR1 mandatory reconsideration form, but you're not obliged to do so. In any letter you send, include your National Insurance number, the date of the disputed decision and why you believe it is incorrect.
To challenge a decision about Universal Credit you need to add an entry to your online journal asking for a mandatory reconsideration.
Appealing the decision
If your reconsideration request is unsuccessful, you can appeal to an independent tribunal.
You should ask for the appeal within 1 month of the date on the decision letter, but if you have a good reason for being late, you have a maximum of 13 months to request the appeal. You should contact the Parkinson's UK helpline on 0808 800 0303 or [email protected]
You'll be sent 2 copies of the mandatory reconsideration notice. This is the Department for Work and Pensions decision. To appeal, use form SSCS1 if you live in England, Wales or Scotland or form NOA1(SS) in Northern Ireland.
When you complete the appeal form, you should list all of the descriptors you think apply to you (see our Supplementary guidance on the Work Capability Assessment [PDF, 95KB]).
The form will also ask if you want to attend an appeal hearing. You stand a much better chance of winning your case if you do.
Appeal papers will then be sent to you. These will contain the report from the face-to-face assessment that was used in making the decision. This will show you where you need to dispute it or where misunderstandings have occurred.
Try to get medical evidence to back up your case. For example, you could get a letter from your Parkinson's nurse confirming which descriptors they think apply to you.
Send a copy of this evidence to the tribunal before your appeal hearing.
You might want to contact an advice centre, such as Citizens Advice, to see if they can give you some guidance and perhaps represent you at the tribunal.
For more information on rights and benefits call our free, confidential helpline on 0808 800 0303.
What if my condition gets worse before the appeal?
A tribunal can only look at how your condition was at the time of the decision you’re appealing.
If your condition has got significantly worse since then, you could consider making a new claim for ESA or requesting a new Universal Credit assessment, but this is a complex area and it is best to get advice first.
For the first 13 weeks of your claim (the 'assessment phase'), you're paid the basic allowance. This amount depends on your age.
- Aged under 25 years - £58.90 per week
- Aged 25 years and over - £74.35 per week
During the assessment phase, you should undergo the Work Capability Assessment. If you're found to have a limited capability for work at this assessment, then from the 14th week of your claim you enter the 'main phase' of the claim.
Once in the main phase, the standard rate of the basic allowance will apply, no matter what your age is. If you're placed in the support group, you'll also get a ‘support component’.
- Basic allowance - £74.35 per week
- Support component - £39.20 per week
If you have an occupational or personal pension that pays more than £85 a week, then for any amount over this limit, your contributory ESA payment will be reduced by half this amount.
The general rule is that if you do any work you are not entitled to ESA. You are, however, allowed to do ‘Permitted Work’.
The rules allow you to:
- work for under 16 hours a week and earn up to £140.00 a week, or
- earn up to £140.00 a week if you're doing ‘Supported Permitted Work’
'Supported Permitted Work' is work supervised by an employee of a public or voluntary body whose job it is to arrange job opportunities for disabled people.
It can also be work carried out as part of a treatment programme under medical supervision while you're a patient in hospital or a regular outpatient.
Earnings from Permitted Work will not affect your ESA.
You must inform the Department for Work and Pensions that you're due to start Permitted Work (you can call the helpline on 0800 169 0310).
If you live in Northern Ireland, contact the Employment and Support Allowance Centre on 0800 587 1377.
If you already get income-related ESA, you can get full Housing Benefit (as long as you meet the other rules for this benefit).
If you only get contributory ESA, you'll need to claim Universal Credit to get help with housing costs.
Income-related ESA can also provide access to Sure Start Maternity Grants, Funeral Payments and Winter Fuel Payments.
If you have a mortgage, income-related ESA can provide access to Support for Mortgage Interest Loans, which provide help through repayable loans towards the costs of the interest on your mortgage.
If you get income-related ESA, you qualify for help with NHS charges, such as prescriptions, vouchers for glasses and hospital travel fares.
If you only get contributory ESA, you can apply for help with NHS charges under the Low Income Scheme, but this will be means-tested.
The rules for Disability Living Allowance and Personal Independence Payments are different from ESA, so they are not affected by a claim for ESA.
The benefit cap
A ‘benefit cap’ limits the total amount of out-of-work and children’s benefits that you can receive. The cap varies according to your circumstances, and whether or not you live in Greater London.
- In Greater London, the cap is £296.35 a week for single people and £442.31 a week for single parents and couples (with or without children).
- Outside Greater London, the cap is £257.69 a week for single people and £384.62 a week for single parents and couples (with or without children).
You'll be exempt from the cap if you (or anyone in your household) are getting ESA with the support component.
If your contributory Employment and Support Allowance (ESA) is terminated at the end of the 12-month payment period, you have a number of options. This does not apply to means-tested ESA as there is no time limit on this.
In all of the following situations, you'll need to show that you still have a limited capability for work. In this case, you'll need to complete a 'capability for work' questionnaire and take part in the Work Capability Assessment where necessary.
- Reclaim ESA. At the end of the first 12 months, you can reclaim ESA after a further 12 weeks if you can use a different tax year for your new second claim. So if the first claim used your national insurance contributions in the tax years 2015/16 and 2016/17 and the second uses your national insurance contributions in the tax years 2016/17 and 2017/18 (because of the date of the new claim), you can claim ESA for another 365 days.
- Claim National Insurance credits. If you can’t get income-related ESA, you can still be given National Insurance credits, as long as your circumstances do not change. National Insurance credits can help you satisfy the conditions for State Pension.
- If your condition gets worse in the future. If you can’t get income-related ESA, you might be able to claim contributory ESA again in the future if your condition gets worse – as long as the Department for Work and Pensions considers that you have continuously had a limited capability for work since your contributory ESA stopped.
To make sure this happens, you should ask the Department for Work and Pensions to continue to assess you as having limited capability for work once your contributory ESA ends. Then, if your condition does get worse, you can make a new claim for ESA.
You'll probably be referred for a Work Capability Assessment. If it's accepted at this assessment that you have a limited capability for work-related activity (and so can be moved into the support group), you can be awarded contributory ESA again. It will then last as long as you stay in the support group.
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Last updated July 2020. We review all our information within 3 years. If you'd like to find out more about how we put our information together, including references and the sources of evidence we use, please contact us at [email protected]