ESA has 2 parts – contributory/new-style ESA and income-related ESA. Income-related ESA is currently being phased out and replaced by Universal Credit (see below for details of how this will affect your claim).
Contributory ESA is now called 'new-style' ESA for new claims.
To be eligible for contributory/new-style ESA, you need to have paid enough in National Insurance contributions. If you have paid enough, you'll receive a flat-rate benefit.
Payment of contributory/new-style ESA is limited to 12 months, unless you're placed in the 'support group' (see 'The assessment phase and the Work Capability Assessment' section below).
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 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Income-related ESA has now been replaced by Universal Credit.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.
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.
Do I qualify for ESA?
There are common rules that apply to both types of ESA. You must:
- not be working (some limited work is permitted – see 'What work is permitted with ESA?' below)
- be aged 16 or over
- be under State Pension age
- 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
How do I claim ESA?
You can claim contributory/new-style ESA by phone or claim online.
To claim Universal Credit alongside your contributory ESA, you must 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've undergone the Work Capability Assessment (see below for more information).
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' (see below)
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 if any work-related requirements you must meet to keep receiving the benefit in full.
When will the assessment take place?
Your first Work Capability Assessment for both ESA and Universal Credit should take place during the 13-week assessment phase. If it's decided that you're entitled, 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 or Universal Credit and to 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 required to pass the test. There's a long list of circumstances which mean you’re exempt from the test, including being terminally ill, receiving cancer treatments (chemotherapy or radiotherapy), having an infectious disease, being in hospital, being pregnant, having a serious risk to your 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. You can also read through Appendix 3 in our ESA information booklet (PDF, 484KB) for a list of the 'limited capability for work' descriptors.
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 your original condition(s) has significantly worsened before the new claim can proceed.
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 situation.
You'll have to meet strict work-related conditions 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 don't meet the work-related conditions.
If you're placed in the work-related activity group and are getting contributory ESA, your ESA payment 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.
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 classed as having 'limited capability for work-related activity'.
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.
See Appendix 2 in our ESA information booklet (PDF, 484KB) for the list of descriptors.
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 or Universal Credit, and if you're awarded contributory/new-style 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 not found to have a limited capability for work-related activity.
For more details on this, call the Parkinson's UK helpline on 0808 800 0303.
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.
To assess you for ESA, 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' (called ESA50 or UC50 for Universal Credit) unless you're terminally ill.
Completing the capability for work questionnaire
This questionnaire asks about your ability to complete different tasks. The questions relate to the activities in the limited capability for work assessment.
We also have advice in the appendices of our ESA information booklet (PDF, 484KB)
Things to note when filling out 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, which is highly likely to be the case with Parkinson's. You might find it useful to keep a diary over a few days of your day-to-day problems, to help answer this correctly.
- Each of your answers should take into account tiredness, pain and 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 whenever 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 put this on the form.
- A detailed statement can be attached to the questionnaire, setting out how Parkinson's (and any other health issues) affects you. This could be a diary, making clear what your difficulties are on a good day, a bad day and an average day. Comment generally, as well as specifically about actual work situations. Make several copies of the statement (1 of which you could give to the healthcare professional at the 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 don't 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 the condition may also have other illnesses or disabilities.
So, depending on the individual, any of the activities in the questionnaire might be important. Because of this it's crucial that you read the whole questionnaire carefully.
For more detailed guidance, including explanations of each of the activity headings and example responses, please see Appendix 3 in our ESA information booklet (PDF, 484KB)
Once you've sent in your capability for work questionnaire, you may be asked to attend an assessment carried out by a healthcare professional working for Maximus, the organisation delivering the assessment on behalf of the Department for Work and Pensions.
At the moment most assessments are being completed on the phone or via video.
Maximus may also be called the 'Health Assessment Advisory Service' or the 'Centre for Health and Disability Assessments'.
If you have an assessment, the following tips might be useful:
- If you think you'll have problems getting to the venue for a face-to-face assessment, it's important to explain this and ask for an alternative arrangement, such as a home visit or phone assessment. Set out any risk to your health if you were to attempt to go to their venue. It may be necessary to get a letter from a healthcare professional to back this up.
- During the assessment, explain your physical abilities as well as you can. You shouldn't assume the 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 the task causes 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 of your condition on the day they meet you, but the effects of your condition over time. So if you're having a good day when you have your assessment, you'll 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 day-to-day or over the course of a day, tell them how often it changes and for how long.
- You might find it helpful to have 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, give the healthcare professional a copy.
Asking for a reconsideration
If you're refused ESA or Universal Credit ('limited capability for work' or 'limited capability for work-related activities') after the assessment, and you disagree with the decision, you can ask the Department for Work and Pensions for a 'mandatory reconsideration' of the decision, or for ESA you can go straight to an appeal. This appeal option only applies for new claims, it is not available if you have previously claimed ESA.
You can also request a mandatory reconsideration or appeal if you're put into the work-related activity group and you think you should be in the support group (and therefore would not have new-style/contributory ESA limited to 12 months).
You must ask for the mandatory reconsideration or appeal 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 (on your letter from the Department for Work and Pensions) and why you believe it's incorrect.
To challenge a decision about Universal Credit, you need to add an entry to your online journal asking for a mandatory reconsideration. For Universal Credit you can't go straight to appeal.
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 our helpline for more information.
When you're told of the mandatory reconsideration decision you'll be sent 2 copies of the mandatory reconsideration notice. This is the Department for Work and Pensions' decision.
When you complete the appeal form, list all the descriptors you think apply to you.
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 identify 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 advice and perhaps represent you at the tribunal.
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.
For the first 13 weeks of your claim (the 'assessment phase'), you're paid the basic allowance. This amount depends on your age.
- Assessment phase, aged under 25 years: £67.20 per week
- Assessment phase, aged 25 years and over: £84.80 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 will enter the 'main phase'.
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'.
- Main phase, basic allowance: £84.80
- Main phase, support component: £44.70
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 that amount.
The general rule is that, if you do any work, you're not entitled to ESA. You are, however, allowed to do 'Permitted Work' (for ESA only).
The rules allow you to:
- Work for under 16 hours a week and earn up to £167 a week, or
- Earn up to £167 a week if you're doing 'Supported Permitted Work'
'Supported Permitted Work' is work that's 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 your 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. Please note no new Housing Benefit claims can now be made unless you live in certain types of accommodation
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 Payment are different from ESA, so they are not affected by an ESA claim.
Payment of the means-tested version of ESA will trigger an additional £900 to help with the cost of living in 2023/24.
The first payment of £301 was paid in April/May 2023, the second of £300 is expected to be paid in the autumn and the last one of £299 will be paid in spring 2024.
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 £326.29 a week for single people and £486.98 a week for single parents and couples (with or without children).
- Outside Greater London, the cap is £283.71 a week for single people and £423.46 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 ESA is terminated after the 12-month payment period, you have several options. There are no time limits on means-tested ESA.
In all the following situations, you'll need to show that you still have a limited capability for work. You'll probably need to complete a new 'capability for work' questionnaire and take part in a new Work Capability Assessment where necessary.
1. 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 2018/19 and 2019/20 and the second uses your national insurance contributions in the tax years 2019/20 and 2020/21 (because of the date of the new claim), you can claim ESA for another 365 days.
2. Claim National Insurance credits
If you can't be paid income-related ESA, you can still be given National Insurance credits as long as your circumstances don't change. National Insurance credits can help you satisfy the conditions for State Pension.
3. 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/new-style ESA stopped being paid.
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 new-style ESA.
You'll probably be referred for a Work Capability Assessment. If it's accepted at this assessment that you have 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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