Employment and Support Allowance (ESA)

Transcription

1 Employment and Support Allowance (ESA) This factsheet aims to provide information about the out of work benefit called Employment and Support Allowance (ESA). It will explain who the benefit is aimed at, how the Department for Work and Pensions (DWP) are reassessing people receiving the old style sickness benefits for ESA, the different types of ESA, how you will be assessed, how to challenge a decision you do not agree with and how you may claim the benefit on behalf of someone else. ESA is paid to people who have limited capability for work To start a claim for ESA you need a note from your GP to confirm that you are not fit for work. You are then asked to take part in a Work Capability Assessment (WCA) so the Department for Work and Pensions (DWP) can decide whether you are eligible for ESA. If you are eligible for ESA you will be placed into either the Work Related Activity Group or the Support Group If you are in the Work Related Activity Group you have to attend meetings with a personal adviser to discuss and prepare for an eventual return to work If you are placed in the Support Group you don t have to prepare for a return to work but you can if you want to. If the DWP decide that you don t qualify for ESA then you will be expected to claim Jobseeker s Allowance (JSA) If you disagree with any of the decisions the DWP make you have the right to ask them to look at the decision again or lodge an official appeal. This factsheet covers - 1. What is Employment & Support Allowance? 1

2 2. How does ESA work? 3. How can I claim ESA? 4. What will happen if I don t attend an interview or assessment? 5. Can I appeal if I think a decision is wrong? 6. What if I have a relative who refuses to claim benefit 7. Phasing in ESA 1. What is Employment & Support Allowance (ESA)? ESA is a welfare benefit that is paid to people who are not well enough to work. In October 2008, ESA replaced the benefits paid to people over 16 and under pension age if being ill or disabled makes it difficult for them to work. The main benefits replaced were - Income Support (IS) on the grounds of disability Incapacity Benefit (IB) Severe Disablement Allowance (SDA) In October 2010 the DWP started reassessing people on these benefits for ESA using a test called the Work Capability Assessment. The DWP believe everyone will have been assessed using the new test by March You can find more information in our Work Capability Assessment factsheet, which you can download for free from or call and ask for a copy to be sent to you. The previous test to assess long term incapacity for work was called the Personal Capability Assessment (PCA) which some people with mental health problems were exempt from. If you were exempt from the PCA it does not mean you will be exempt from the Work Capability Assessment (WCA) and you will be reassessed using the new criteria. If you are due to reach the qualifying age for the State Retirement Pension between now and 2014 you will remain on your current benefit and move straight onto the State Pension. i You may also become eligible for Pension Credit, contact the Pension Credit helpline on How does ESA work? There are two different types of ESA. Some people will get contribution based ESA (CB-ESA) because they made enough National Insurance contributions while they were at work to qualify for it (similar to Incapacity Benefit). 2

3 Others will get Income-related ESA (IR-ESA) provided they have little or no income and little if any capital (similar to Income Support) Everybody making a new claim for ESA (unless terminally ill) will go into the assessment phase for the first 13 weeks. During this period, the Department for Work and Pensions (DWP) will assess your physical & mental health and your prospects of working or training for work. While this happens, single people will be paid the basic ESA allowance which will be the same as Jobseeker s Allowance. This is for people 25 or over and for couples. These figures are correct for the period April 2013 until March At the end of the 13 weeks (it could take longer) the DWP will make a decision about your eligibility for ESA. There could be three possibilities - Some people will be found fit for work and could claim JSA. Some will remain on ESA and will move into the work related activity group. Some will remain on ESA and move into the support group. Both groups who remain on ESA will get an additional amount for the work related activity group and for the support group. People in the support group who get Income-related ESA will also receive the Enhanced Disability premium an extra It will be possible for people on Income-related ESA to be paid extra money called premiums currently paid to people on IS who qualify for them (e.g. because they receive a certain level of Disability Living Allowance, live alone and nobody is claiming Carer s Allowance for supporting them). This will be in addition to the basic ESA allowance and the additional amount paid for support or work related activity. 1 year cap on contribution based ESA for those in the Work Related Activity Group If you are placed in the WRAG and are receiving ESA based on your National Insurance contributions, from April 2012 you will only get CB-ESA for 12 months. After this time, if you would also qualify for ESA because you have a low household income you can continue to receive it. If, however, you live with a partner who works and your household income is over the earning s threshold or you have savings/capital over the allowed limits, you may no longer qualify for this benefit. 3. How can I claim ESA? People usually start by phoning a Jobcentre Plus contact centre. The adviser there will go through the application form over the telephone with you. If this is difficult for you, you can ask for a paper claim form. It is possible for someone to make the phone call on your behalf. You can call (8am-6pm Monday to Friday). A text phone service is available if you have a speech or hearing impairment on

4 You can also download a paper copy of the form from this website - You will have to provide a medical note from your GP which shows that you are not fit for work. Since April 2010 doctors now provide a fit note rather than a sick note. What happens next? You will be sent an ESA50 questionnaire which asks more questions about how your condition affects your ability to work. You may also be asked to attend a medical with a healthcare professional from Atos Healthcare. Atos are contracted by the DWP to conduct their disability assessments. Please see our Work Capability Assessment factsheet for more detailed information on how to fill in the questionnaire and what to expect at the medical. It also explains the criteria the DWP use to decide whether you are eligible for ESA. Once you have gone through the Work Capability Assessment process, the DWP will make a decision about whether they think you qualify for ESA. They could either decide that you are - fit to work not well enough to work right now but could be with support. If they make this decision you will be placed in the Work Related Activity Group (WRAG) not well enough to work. If they make this decision you will be placed in the Support Group. If you are placed in the WRAG you will have to attend 6 Work Focussed Interviews. These are not the same as job interviews. They are meetings with a personal adviser to discuss the barriers you face getting back to work and how they could be overcome. They could put you forward for training courses to increase your skills or help with CV writing. The Work Programme The Work Programme is a scheme that aims to help people into work. The Jobcentre Plus puts people who claim Jobseekers Allowance (JSA) and Employment and Support Allowance (ESA) onto the Work Programme. Some people must take part in the work programme to get their full benefit payment. If you are in the Work Related Activity Group, and your ESA is due to be reviewed in the next 12 months, you must take part in the Work Programme when asked to. If you refuse you may lose some of your benefit. 4

5 If you are in the Support Group of ESA you do not have to take part in the Work Programme. However, you can choose to at any point if you think it will be helpful. There are a number of different organisations that run the Work Programme. These organisations are called providers. You will have regular meetings with the provider where you will discuss what will help you get into work. You could ask for support with: finding information about different jobs and industries application writing & interview techniques managing a mental illness in the work place The provider should think about your individual needs and have a good knowledge of the work and training opportunities in your area. 4. What will happen if I don t attend an interview or assessment? The first work-focused interview and the follow-up interviews are compulsory. If you don t attend a work-focused interview, your ESA may be reduced. This is called a reduction. New rules mean the DWP can stop paying you all of the basic amount of ESA if you don t attend without a valid reason. If there was good cause for not being able to attend the interview, because you were unwell for example, you have to let the DWP know within 5 days after being notified of your failure to take part in the interview. 5. Can I appeal if I think a decision is wrong? Yes. If you disagree with any decision the DWP have made about your entitlement to ESA you have the right to appeal. You generally have 1 month from the date of the decision to officially appeal against it. Any appeal goes to an independent Tribunal to look again at the facts. You can find more information in our Revisions and Appeals factsheet, which you can download for free from or call and ask for a copy to be sent to you. 6. What if I have a relative who refuses to claim benefit? Some people with mental health problems can t or don t want to claim benefits even though they may be entitled to them. It s usually possible for a relative or friend to become an appointee and make a claim on behalf 5

6 of the person whose mental health difficulties are affecting their judgement. You should speak to your local Jobcentre Plus. Don t be put off if the Jobcentre Plus officer doesn t seem to know much about appointeeship and get advice if they are unhelpful. You can find more information in our Options for Dealing with Someone Else s Financial Affairs factsheet, which you can download for free from or call and ask for a copy to be sent to you. 7. Phasing in ESA If you are currently receiving IB, IS or SDA you may be entitled to less ESA under the new system than what you get at the moment. For example people now on IB who have partners or children (or both) are paid additional allowances for them but this does not happen with ESA. So when you move to the new benefit, you will get an extra payment called transitional benefit which will bring your ESA up to the same level as your current payment. You should not be financially worse off because of the change to ESA. The disability premium is not paid with ESA but some other premiums, such as the Severe Disability Premium, are available to people on Incomerelated ESA if you qualify for them. People in the Support group on Income-related ESA will also qualify for the Enhanced Disability Premium. Different rates apply to couples. People who own their own home might receive help with mortgage costs in certain circumstances. You can find the ESA regulations by visiting the government website at You can also get more information on ESA on the DirectGov website - OtherSupport/Illorinjured/DG_ Regulation 5(a) The Employment and Support Allowance (Transitional Provisions, Housing Benefit, Council Tax Benefit) (Existing Awards) (No 2) Regulations 2010 London: TSO

7 Rethink Mental Illness 2013 Last updated March 2013 Next update March 2014 Version 9 This factsheet is available in large print. Last updated 01/10/2010