Employment and Support Allowance
You may be eligible for Employment and Support Allowance (ESA) if your ability to work is limited because of ill health or disability.
ESA has 2 parts – contributory ESA and income-related ESA. Income-related ESA is currently being phased out and replaced by Universal Credit.
What is contributory ESA?
To be eligible for contributory Employment and Support Allowance (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', below).
What is income-related ESA?
Income-related Employment and Support Allowance (ESA) is a means-tested benefit. This means your needs and those of your partner are compared with the money you have, such as your income and savings. Whether you get income-related ESA and how much you are paid is worked out from this.
Income-related ESA is being phased out and replaced by Universal Credit. The government aims for this to be complete by the end of 2018, after which time no new claims for income-related ESA can be made.
During 2018, as the phasing out continues, there will be a gradually reducing number of postcodes where Universal Credit is yet to be introduced and you can still claim income-related ESA. Visit universalcreditinfo.net to find out which benefit you can claim in your area.
If you are 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 are 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.
Do I qualify for ESA?
There are common rules that apply to both types of Employment and Support Allowance (ESA). You must:
- not be working (although some limited work is permitted - see section on permitted work, below, for more details)
- be aged 16 or over
- be under State Pension age. Currently, State Pension age is 65 for men. For women, it depends on your date of birth. 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 (read on for more details).
How do I claim ESA?
How you claim ESA depends on whether Universal Credit has been introduced into your postcode area yet. You can check this by visiting universalcreditinfo.net
If Universal Credit has not yet been introduced in your area, and you live in England, Scotland and Wales, you should start your claim for ESA by ringing the Jobcentre Plus claim line on 0800 055 6688 (textphone 0800 023 4888). There is also a Welsh language line on 0800 012 1888.
If you live in Northern Ireland, call the ESA Centre on 0800 085 6318 (textphone 0800 328 3419).
A call handler will go through your claim with you over the phone. Once they have finished, they will send you a customer statement so you can check the details are correct. You may be called back for extra information if you do not have it to hand.
If you are unable to use a telephone, you can request or download a paper claim form.
If Universal Credit has been introduced in your area, then how you claim ESA will depend on whether you plan to claim contributory ESA only or contributory ESA and Universal Credit together.
- To claim Universal Credit alongside your contributory ESA, you must claim Universal Credit online.
- To claim contributory ESA without Universal Credit you must ring 0800 328 5644 (textphone 0800 328 1344) and ask for form ESA1(UC). This can only be emailed, not posted. When your form is completed, phone the helpline again to ask for an appointment at your local Jobcentre Plus office to take in the form and start your claim.
You will 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 are working but don’t get Statutory Sick Pay, you will need to send in form SSP1 as well as a medical certificate. You can get this form from your employer.
The assessment phase and the Work Capability Assessment
An ‘assessment phase’ normally applies to all new Employment and Support Allowance (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 is a delay in carrying out the assessment. Such delays are common.
During the assessment phase, you will be paid just a basic allowance of ESA (whether you get contributory ESA or income-related ESA).
The Work Capability Assessment has 2 aims:
- To assess whether you have a limited capability for work. If you do, you can stay on ESA.
- To assess whether you have a limited capability for work-related activity. This is used to decide whether you are placed in the 'support group' or the 'work-related activity group' (read on for more details).
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 determines whether you are 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 assessment phase.
If it is decided that you are entitled to ESA, you may be asked to take part in further Work Capability Assessments in the future. This will be to find out whether you are still entitled to ESA and whether you should remain in the same group.
limited capability for work
The first part of the Work Capability Assessment finds out if you have a 'limited capability for work'.
It looks at both your physical and your 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.
Each activity is divided into different ‘descriptors’ which explain related tasks of varying degrees of difficulty. You score points if you are not able to perform a task safely, to an acceptable standard, as often as you need to and in a reasonable time.
Read our Supplementary guidance on the Work Capability Assessment (PDF, 95KB) for a list of the descriptors and the scores that apply to them.
At the end of the assessment, scores from each activity are added together. If you score 15 points or more, you qualify as having a limited capability for work and can stay on ESA.
limited capability for work-related activity
The second part of the assessment looks at whether you have a limited capability for work-related activity. This determines whether you are place in the ‘support group’ or the ‘work-related activity group’.
This assessment also has a list of descriptors. If at least one of them applies to you, you’ll be placed in the support group.
See our Supplementary guidance on the Work Capability Assessment (PDF, 95KB) for a list of the descriptors.
The support group
If you are put in the support group, this means the Department for Work and Pensions has decided that you are unable to work and that it doesn’t expect you to do anything to improve your chances of finding work.
You will get a higher rate of ESA, and if you are awarded contributory ESA, it can be paid indefinitely (as long as you continue to meet the conditions for it).
You won’t have to take part in work-related activities, but you can volunteer to do so if you want.
The support group in ESA is also known as the ‘limited capability for work-related activity group’ in Universal Credit.
The work-related activity group
If you are 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 right now, but that there are things you can do to improve this.
You will 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 are 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 are placed in the work-related activity group and are getting contributory ESA, the award will be limited to 12 months.
The work-related activity group in ESA also known as the ‘limited capability for work group’ in Universal Credit.
How will I be assessed for ESA?
A Department for Work and Pensions decision-maker looks at the information you have provided with your claim for Employment and Support Allowance (ESA) or Universal Credit to see if there is evidence that you have a limited capability for work or for work-related activity.
You will be asked to complete a ‘capability for work questionnaire’.
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. In order to answer this question correctly, you may find it useful to keep a diary of your day-to-day problems.
- Each of your answers should take into account tiredness, pain and discomfort. If you are not able to complete a task without pain or discomfort, then you should be treated as being unable to do it.
- Remember that non-physical problems are just as relevant 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 fatigue, 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. Consider 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 – explained further down the page).
- If you have to appeal against a benefit decision, the questionnaire will make up part of the evidence put before the tribunal. Therefore, it is 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. Therefore, it is 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 are due to attend a face-to-face assessment, the following tips might be useful:
- If you might have problems getting to the venue, it’s important to explain this and ask for an alternative, if possible, such as a home visit. Set out any risk to your health in attempting to go to their venue and provide a letter from a healthcare professional to confirm this.
- 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 are 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 have produced a written statement or diary about your condition, give the healthcare professional a copy.
How do I challenge an ESA decision?
Asking for a reconsideration
If you are refused Employment and Support Allowance (or are placed in the wrong Universal Credit group) following 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 are put into the work-related activity group and you think you should be in the support group (and therefore 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 is 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 will 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 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.
How much is Contributory ESA?
For the first 13 weeks of your claim (the ‘assessment phase’), you are paid the basic allowance. This amount depends on your age.
- Aged under 25 years - £57.90 per week
- Aged 25 years and over - £73.10 per week
During the assessment phase, you should undergo the Work Capability Assessment. If you are 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, regardless of your age. If you are placed in the support group, you will also get a ‘support component’.
- Basic allowance - £73.10 per week
- Support component - £37.65 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.
What work is permitted with ESA?
The general rule is that if you do any work you are not entitled to Employment and Support Allowance (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 £125.50 a week, or
- earn up to £125.50 a week if you are 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 are 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 are 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 085 6318.
Will ESA affect my other benefits?
If you get income-related Employment and Support Allowance (ESA), you can get full Housing Benefit (as long as you meet the other rules for this benefit and live in a part of the UK where Housing Benefit has not yet been replaced by Universal Credit). If you only get contributory ESA, you will need to satisfy a means test to be able to get Housing Benefit.
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 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 will be exempt from the cap if you (or anyone in your household) are getting ESA with the support component.
What can I do if ESA is limited to 12 months?
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.
In all of the following situations, you will need to show that you still have a limited capability for work. In this case, you will need to complete a 'capability for work' questionnaire and take part in the Work Capability Assessment where necessary.
- Claim income-related ESA. If you live in an area of the UK where income-related ESA has not yet been replaced by Universal Credit, you may be entitled to income-related ESA instead of contributory ESA. The Department for Work and Pensions should contact you before the benefit ends to ask if you wish to be considered for income-related ESA. If you do not hear from them, you should contact them directly on 0800 055 6688 (textphone 0800 023 4888), or on 0800 085 6318 in Northern Ireland.
- 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 may 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 will probably be referred for a Work Capability Assessment. If it is 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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