What is Employment and Support Allowance (ESA)?

What is Employment and Support Allowance (ESA)?

ESA can provide financial support if you’re unable to work because you’re ill or disabled. It can also help with personalised help to allow you to work if you’re able to - this might include things like setting job goals and improving your skills.

There are two types of ESA and you can be eligible for both or either of them at the same time:

Contribution-based ESA (also called ‘new style’ if you're in a Universal Credit area) is linked to your National Insurance contribution record. You must have paid contributions over a certain number of years to get this benefit. Contributory ESA often only lasts 12 months.

Income-related ESA is means tested – it depends on your income and savings. Income-related ESA provides for your basic living expenses (and those of your partner, if you have one). It’s not time-limited. Income-related ESA can help with getting other benefits

Should I apply for ESA or Universal Credit?

Universal Credit is a means-tested benefit that will eventually replace most means-tested benefits, including income-related ESA. The rules for Universal Credit are slightly different to ESA – for example, you can claim Universal Credit if you have limited capacity to work but are working.

Universal Credit is being introduced in stages. Whether you can claim income-related ESA or Universal Credit depends on your circumstances and where you live.

Am I eligible for ESA?

You can apply if:

you’re under State Pension age (see GOV.UK )

you have an illness or disability that makes it difficult or impossible to work (this is assessed with a work capability assessment

you’re not receiving Statutory Sick Pay or Maternity Pay and you haven’t returned to work

you’re not receiving Jobseeker’s Allowance, Income Support or Pension Credit. You must not normally be in work. However, some exceptions apply

How much could I get?

You’ll normally get the assessment rate for the first 13 weeks:

up to £57.90 a week if you’re aged under 25

up to £73.10 a week if you’re aged 25 or over.

After the assessment period, if you’re entitled to ESA, you’ll be placed in one of two groups and will receive:

up to £73.10 a week if you’re in the work-related activity group

up to £110.75 a week if you’re in the support group.

Which group you’re in depends on whether you’re expected to work in the future (see below – What happens if I’m eligible). If you have a terminal illness, you will automatically be placed in the support group.

If you’re in the support group and on income-related ESA, you may be able to get an enhanced disability premium at £16.40 a week or severe disability premium at £64.30 a week.

When you claim, the government department will check these factors and see what you’re eligible for.

How do they assess if I'm eligible because of my health condition?

You'll have a work capability assessment to decide:

whether your ability to work is limited - if it's not, you won't get ESA, and

whether you're expected to work in the future - this determines how much you'll get and how you'll be monitored

You are normally sent a self-assessment questionnaire to fill in: the capability for work questionnaire. The questionnaire looks at a number of activities related to your day-to-day life, and your ability to do these things.

What happens if I'm eligible for ESA?

If the government department decides that you shouldn’t be expected to work in the future, you’ll be placed in the support group. This means that will not be expected to meet work-related conditions, such as attending interviews. And you’ll get more money than people who are expected to return to work in the future.

If you have a terminal illness, you will automatically be placed in the support group. You can also be automatically placed in the support group if you are receiving treatment for cancer (or are likely to receive it within six months) with chemotherapy or radiotherapy, or you’re recovering from that treatment.

If the government department decides that you should be expected to work in the future, you’ll be put in the work-related activity group. This means that you’ll have regular interviews .

What can I do if my claim is rejected?

If you disagree with a decision related to your ESA claim, you must first ask the government department to reconsider it. You usually need to do this within one month from the date on their decision letter. It’ll be the Department for Work and Pensions (DWP) in England, Wales and Scotland, or the Department for Communities (DfC) in Northern Ireland. You can do this over the phone, but you should confirm your request in writing and keep a copy of the letter.

If the government department has refused your ESA claim, you won’t be able to get the benefit while they reconsider their decision. However, you can claim Jobseeker’s Allowance (JSA) in the meantime. If your reconsideration request is refused, you can then consider appealing.

Can I work while I’m getting ESA?

If you’re claiming ESA, the general rule is if you do any work, you’re treated as capable of work for that week. However, you’re allowed to do permitted work, without it affecting your ESA if you're in the work-related activity group. This is work of less than 16 hours a week. You can earn up to £120. You must inform the government department that you are due to start permitted work; call 0345 608 8545

WCA limited capability for work assessment

Work capability assessment

The first part of the work capability assessment finds out if you have a ‘limited capability for work’.

For employment and support allowance, if you are found to have a limited capability for work, you can stay on the benefit. For universal credit, the same assessment is used to find out if restrictions can be applied to the work-related responsibilities you must meet to keep getting the benefit in full.

A points system is used to see how well you can carry out a range of activities, both physical and ‘mental, cognitive and intellectual’.

Each activity is divided into different ‘descriptors’, which explain related tasks of varying degrees of difficulty. These have scores, ranging from 0 to 15 points. You score points when you are not able to perform a task described safely, to an acceptable standard, as often as you need to and in a reasonable time. You add together the highest score from each activity that applies to you.

For a list of the descriptors and the points that you get from each, see here

If you score 15 points, you qualify as having a limited capability for work. If not, you will need to claim jobseeker’s allowance instead (or, in the case of universal credit, you will have to meet all the work-related responsibilities), unless you challenge the decision.

You will be automatically treated as having a limited capability for workin some circumstances

Work-related activity group

If it is decided at the work capability assessment that you do not have a limited capability for work-related activity, you will be put in the work-related activity group of claimants. You will get a lower rate of employment and support allowance (ESA) than if put in the support group. You will have to meet strict work-related conditions to continue getting the benefit in full. This will involve attending a series of work-focused interviews and possibly taking part in ‘work-related activity’. You cannot be required, as part of work-related activity, to apply for a job, do work or undergo medical treatment.

If you are getting contributory ESA, the award of this will be limited to 12 months, although you may be able to claim income-related ESA once the award has come to an end.

Universal credit

The work capability assessment is also important for the new benefit, universal credit. It finds out what work-related responsibilities (or ‘requirements’) you must meet to keep getting the benefit in full. If you are found to have a ‘limited capability for work’ in the assessment, your work-related responsibilities will be limited. If you are found to have a ‘limited capability for work-related activity’ in the assessment, none of the work-related requirements will apply to you, and you will also be entitled to the work capability amount

Challenging work capability assessment decisions

Employment and support allowance

You cannot appeal straight away. You must first ask the Department for Work and Pensions to reconsider the decision, which you can do within one month of the date on the decision letter. This is called a ‘mandatory reconsideration’.

If your reconsideration request is unsuccessful, you can then appeal to an independent tribunal.

Mandatory reconsiderations

If it is decided that you do not have a limited capability for work and none of the exceptional circumstances apply, you will not be entitled to employment and support allowance (ESA). If you are claiming universal credit, you will be expected to search for work and be available for work. In either case, you can ask the Department for Work and Pensions for a ‘mandatory reconsideration’ of the decision.

You can also ask for such a reconsideration if you are put in the work-related activity group and you think you should be in the support group (which would mean any contributory ESA would not be limited to 12 months).

You must ask for the mandatory reconsideration within one calendar month of the date on the decision letter. You can ask for a reconsideration by phone, but it is best to put your request in writing. You can use a CRMR1 mandatory reconsideration request form, but are not obliged to do so. Include in the letter your National Insurance number, the date of the disputed decision and why you believe the decision is incorrect. Keep a copy of the letter.

How is the work capability assessment applied?

Work capability assessment

A Department for Work and Pensions (DWP) decision maker looks at the information you have provided with your claim for employment and support allowance or universal credit to see, without having to make further enquiries, if there is evidence that you have a limited capability for work and for work-related activity. If the decision maker considers they do not have such evidence, they will send you a capability for work questionnaire for you to complete.

Once the decision maker has received your completed questionnaire, they may decide that there is clear evidence that you have a limited capability for work (and possibly work-related activity). If not, you will be sent an appointment to attend a face-to-face assessment carried out by a healthcare professional working for the Health Assessment Advisory Service. This is operated by Maximus, the organisation delivering the assessment on behalf of the DWP.

Even if the DWP decision maker decides that you do not pass the limited capability for work assessment, they can still treat you as having passed it if one of the exceptional circumstances applies.

Audio Recording of WCA assessments

The FAQ states that:

You do not have a legal right to have your face-to-face assessment recorded but all requests will be accommodated where possible.

You should always request audio recording in advance.

You must sign a consent form.

If recording equipment is not available you may have to wait longer than normal for their face-to-face assessment. Although this may slow down the benefit process it will not effect your entitlement to benefit.

You can request to have a home based assessment recorded.

You may be allowed to use your own recording equipment providing you give DWP/Atos notice and it meets DWP/Atos Healthcare requirements. This includes providing two copies of the recording in such a way to ensure that the recording has not been tampered with and is a reliable and accurate record of the assessment.

Approved recording media are standard CD and audio tapes only. Video recording of assessments is not permitted.

If you are caught making a secret recording your assessment will be terminated.

Any recording made will not form part of your benefit claim records. Copy recordings will not be returned to the DWP with case papers or be considered as part of the initial decision making process. Recordings will be stored securely by Atos Healthcare for a period of 14 months after which time they will be destroyed.

You can ask a Tribunal to consider a recording as additional evidence during an appeal. The acceptance of the recording as evidence is at the discretion of the Tribunal.

There are no plans to offer audio recording to PIP claimants. The Department intends to look closely at the Employment and Support Allowance experience and is evaluating the impact of audio recording, before taking any decisions on whether to include it as part of the PIP process in the longer-term.

Information about audio recording is available on the Atos Healthcare website for claimants who wish to have their face-to-face assessment recorded. DWP and Atos Healthcare will also amend written communications with claimants to provide more information about the recording facility and how to request a recorded assessment.

https://www.gov.uk/employment-support-allowance ESA JOURNEY