People with a disability or ill health and their carers

Transcription

1 People with a disability or ill health and their carers Incapacity Benefit, Income Support and Severe Disablement Allowance... 3 Statutory Sick Pay... 4 Who is entitled to Statutory Sick Pay?... 4 Employment and Support Allowance... 6 Claiming Employment and Support Allowance... 6 Claiming Employment and Support Allowance: assessment phase... 7 Work Capability Assessment... 8 Limited Capability for Work Related Activity... 9 Employment and Support Allowance: support group If you are found fit for work Employment and Support Allowance: work-related activity group Employment and Support Allowance, and National Insurance contributions Working while on Employment and Support Allowance Going into work or training while on Employment and Support Allowance Studying while receiving Employment and Support Allowance Switching from Jobseeker s Allowance to Employment and Support Allowance during illness Employment and Support Allowance amounts Personal Independence Payment Who is entitled to Personal Independence Payment? Daily living component of Personal Independence Payment Mobility component of Personal Independence Payment Disability Living Allowance Who is entitled to Disability Living Allowance? Three rates of the care component of Disability Living Allowance Two rates of mobility component Children on Disability Living Allowance Hospitals and care homes, and Disability Living Allowance How to claim Disability Living Allowance Further points about Disability Living Allowance... Error! Bookmark not defined. Attendance Allowance Chapter 4, Page 1

2 Carer s Allowance Who is entitled to Carer s Allowance? How to claim Carer s Allowance Further points about Carer s Allowance Benefits for a work-related accident or disease Who is entitled to benefits for a work-related accident or disease? How to claim benefits for a work-related accident or disease Further points about benefits for a work-related accident or disease Return to Work Credit Jobcentre Plus services to help disabled people into work Disability Employment Advisers Work Choice Who is eligible for Work Choice? How long does Work Choice last? Stages of Work Choice Referral or introduction to Work Choice Module one of Work Choice: work-entry support Module two of Work Choice: in-work support Module three of Work Choice: longer-term in-work support Returning to Work Choice Conditions of participation in Work Choice Residential Training The Work Programme Access to Work Who is eligible for Access to Work? How to apply for Access to Work Access to Work grants Supported employment provision If your illness or disability means that you are unable to work, you should be able to get one or more benefits. The benefit you receive will normally depend on whether you are employed, have paid National Insurance contributions, or fulfil certain other conditions. You could be getting: Statutory Sick Pay Chapter 4, Page 2

3 Employment and Support Allowance (ESA) Incapacity Benefit. (This is only if you already claim Incapacity Benefit. It is not possible to make a new claim). You can also continue to claim Jobseeker s Allowance for up to two weeks while ill. See chapter 2 for details. If you are an employee when you become ill your employer will pay you Statutory Sick Pay. If you are self-employed or not in work when you become ill, you should claim ESA. You may also be able to receive means-tested benefits (such as Council Tax Benefit and Housing Benefit) either on top of another benefit or as an alternative source of income. If you care for someone with ill health or a disability, you may be entitled to Carer s Allowance. The following benefits may be paid whether or not you are in paid work: Personal Independence Payment or Disability Living Allowance or Attendance Allowance and benefits for work-related accidents and diseases. Incapacity Benefit, Income Support and Severe Disablement Allowance Before 27 October 2008, people who were unable to work because of physical or mental health problems or disabilities received Incapacity Benefit or Income Support. (It is possible to make new claims for Income Support but not on the grounds of disabilities or health problems). Severe Disablement Allowance was also paid to some people who were not able to work but new claims stopped in April If you currently get any of these benefits, they will carry on for as long as you are ill, unless you leave the benefit for 12 or more weeks or unless you are Chapter 4, Page 3

4 transferred onto either ESA or Jobseekers Allowance (JSA) by the Department for Work and Pensions. This is being done on a rolling basis between April 2011 and March Statutory Sick Pay 1 Statutory Sick Pay is the legal minimum amount that is paid by employers to their staff, for a maximum of 28 weeks. It is not a means-tested benefit, but it counts as income for means-tested benefits. Statutory Sick Pay is not paid for the first three days of your absence from work (unless you have been getting Statutory Sick Pay within the last eight weeks). Some employers have occupational sick pay schemes, and these may be more generous and last for more than 28 weeks. Employers with employees off sick for long periods may reclaim their spending on Statutory Sick Pay from Her Majesty s Revenue and Customs. 2 If you are on Statutory Sick Pay, you may be able to claim Income Support but you must move to ESA when your Statutory Sick Pay expires. Who is entitled to Statutory Sick Pay? You can receive Statutory Sick Pay if: your average gross earnings are more than the lower earnings limit for National Insurance ( 102 per week) you are incapable of work you have been incapable of work for at least four days (unless you have been ill within the last eight weeks) you are within a period of entitlement you have notified your employer of your sickness. Statutory Sick Pay is only paid for days you would normally work ( qualifying days ). 3 There are special rules for when normal working patterns change, and you may need to seek advice if this applies to you. Who is an employee? The term employee 4 includes people who are employed by an employment agency, certain office-holders and people on temporary contracts, as well as Chapter 4, Page 4

5 people on permanent contracts. You do not need to have a written contract of employment to count as an employee. Generally, whoever deducts National Insurance for you is considered to be your employer. Some employers try to avoid taking responsibility for employee rights by classing their workers as self-employed or sub-contractors. You may be able to challenge their classification, and you should seek advice on employment law in such cases. 5 There are no rules about how long you must have been employed for, or the number of hours you must work in order to qualify for Statutory Sick Pay so long as you earn more than 102 per week, and it is possible to get Statutory Sick Pay from more than one employer (for example, if you have two part-time jobs). You can also be unfit for one type of employment but fit for another type, and so receive Statutory Sick Pay from one job and earnings from the other job. Notification of sickness You should notify your employer of your sickness as soon as possible. Your method of notification needs to be approved by your employer. For the first seven days of sickness, you should personally vouch for your sickness. After that, you should submit a medical certificate (a Med 3, or a Med 5 if you are proving a past sickness). People other than a doctor can give medical evidence for Statutory Sick Pay and ESA. A community nurse, a physiotherapist or a social worker can give proof of sickness, if it is reasonable in the circumstances (for example, if you don t have a GP). 6 Extra proof from other professionals can also help in borderline or unusual situations. Period of entitlement An employer who lays off an employee to avoid paying Statutory Sick Pay is still liable to pay Statutory Sick Pay during the period of entitlement, or until the contract of employment is due to end. 7 This may also count as unfair dismissal or discrimination or both, and you should seek employment law advice. If your employer fails to pay Statutory Sick Pay, it is also worth telling Her Majesty s Revenue and Customs, who can enforce payment. If your employer refuses to pay Statutory Sick Pay, you can ask Her Majesty s Revenue and Customs to make a decision 8 which then binds the employer, and which you can also appeal against if you feel it is wrong. Chapter 4, Page 5

6 What happens when my claim to Statutory Sick Pay ends? Just before you reach the maximum 28 weeks of Statutory Sick Pay, your employer must send you a notice (called SSP1) telling you that you have had the maximum amount of Statutory Sick Pay. 9 You should complete the Statutory Sick Pay1 notice and send it with a medical certificate to Jobcentre Plus. Jobcentre Plus will use the notice as a claim for ESA. Your employer must also send a SSP1 notice if you are not entitled to Statutory Sick Pay from the start, so that you can use the notice to claim ESA instead. If your employer fails to keep adequate records or fails to notify you correctly about your Statutory Sick Pay, Her Majesty s Revenue and Customs can make them pay a penalty of up to 300, plus a daily penalty, or up to 3,000 in more serious cases. 10 Statutory Sick Pay is more than the basic rate of ESA so, if you haven t claimed income-related ESA as a top-up already, it may be worth considering now. People on work-based training Trainees who are employed will normally qualify for Statutory Sick Pay. Trainees who are not employees will usually qualify for ESA instead. Employment and Support Allowance Employment and Support Allowance provides financial help to people who are unable to work because of illness or disability. It also provides personalised support to those whose health limits their ability to work, but are not wholly unable to work. Claiming Employment and Support Allowance To claim ESA, you will have to meet certain basic conditions: You must: be aged 16 or older and below state pension age. have limited capability for work. not be getting JSA, Statutory Sick Pay, or Income Support (for example, as a carer). ESA can be paid either as a non-means tested benefit based on your National Insurance contributions (or because you meet special rules for people aged Chapter 4, Page 6

7 under 25) or as an income related benefit this may be paid on its own or to top up National Insurance contribution-based ESA if your income and capital is low enough. If you qualify for the National Insurance contribution-based ESA, because of your National Insurance record, then it doesn t matter whether you have a partner or not, what they earn, or what savings you have. However, an occupational pension of over 85 per week can affect the amount of contribution-based ESA you get. If you are not in the support group, you can only claim contributionbased ESA for one year. Income-related ESA may be affected by other income or savings you have as well as any partner s earnings, income and savings. If you have partner and they work for 24 or more hours a week, you can t get income-related ESA at all. Your will only be entitled to National Insurance credits. Any earnings from work of less than 24 hours, or if your partner gets other benefits themselves such as JSA, will also affect how much ESA you get. You are allowed to work up to 16 hours a week while claiming ESA (but there are other conditions see page 15). However you cannot do any governmentfunded training (unless you are aged under 21 and also meet certain conditions). Claiming Employment and Support Allowance: assessment phase The first weeks of your claim for ESA are called the assessment phase, and during this phase you are paid the basic rate of ESA (which is the same amount as JSA). To get your payments, you must show that you have limited capability for work. During the assessment phase you show this through medical certificates (Med 3 or Med 5) which you get from your GP or hospital doctor. During the assessment phase, you will have a Work Capability Assessment. First, the Department for Work and Pensions will usually ask you to fill out a Limited Capability for Work Self Assessment form ESA50. Your answers and any other evidence you can supply may show that you have limited capability for work but if there is doubt you will have a medical examination with a healthcare professional. It is very important to fill in the ESA50 form carefully, and preferably with independent help. You must send the form back to Jobcentre Plus within four weeks, and you should make a copy of the form to take to a medical examination if you are asked to have one. If you miss the medical Chapter 4, Page 7

8 examination, you have five days to contact Jobcentre Plus and explain why. If you do not contact Jobcentre Plus, or you do not have a good reason for missing the assessment, your benefit may be cut. If you know you won t be able to attend the examination, you should let Jobcentre Plus know in advance. The second part of the Work Capability Assessment is a Limited Capability for Work Related Activity test. This will determine whether you qualify for the support component or the work-related activity component of ESA if you have been found to have a limited capability for work. The assessment phase ends when the Work Capability Assessment is complete. If the assessment has not been completed within 13 weeks (for example, because of Department for Work and Pensions delay or non-attendance by you), then your assessment phase may continue beyond 13 weeks but any extra ESA that you are due will be backdated to that 13 week point. The Limited Capability for Work Related Activity assessment includes a prognosis of when you could become fit for work. This determines who will be referred to the Work Programme on a mandatory basis. Work Capability Assessment The Work Capability Assessment uses a points system to decide whether or not you have limited capability for work. To count as having limited capability for work, you must score at least 15 points on the assessment. The following people are automatically treated as having limited capability for work, and will not have a Work Capability Assessment: hospital inpatients people suffering from a progressive disease where death within six months can reasonably be expected people being treated by intravenous, intraperitoneal or intrathecal chemotherapy (there are other forms of delivering chemotherapy that do not qualify) or will receive this treatment within six months or you are recovering from such treatment people refraining from work because they carry, or have been in contact with, an infectious disease Chapter 4, Page 8

9 those attending a residential programme of treatment for drug or alcohol addiction pregnant women, where there is a serious risk to the health of the mother or the child if the woman does not refrain from work women who are pregnant or have recently given birth but are not entitled to maternity allowance or statutory maternity pay, from six weeks before the baby is due to two weeks after the birth. If you are assessed as not having limited capability for work, you can still be treated as having limited capability for work if there is medical evidence that: you are suffering from a severe life threatening disease, and there is medical evidence that the disease is uncontrollable, or uncontrolled, by a recognised therapeutic procedure (in the case of a disease that is uncontrolled, there must be a reasonable cause for the disease to be uncontrolled by a recognised therapeutic procedure) you suffer from a specific disease, bodily or mental disablement, and there is a substantial risk to anyone s mental or physical health if you are found not to have limited capability for work. The last category is a very important safeguard, as it takes into account the range of work you can do, along with things such as getting ready for work, travel to and from work, and the broad results of being found as not having limited capability for work. Substantial risk means that there is a risk of serious harm, even though it may be unlikely to happen. Limited Capability for Work Related Activity As part of the Work Capability Assessment, the Jobcentre Plus decision maker will decide your ESA entitlement by considering whether you have limited capability for work and, if so, whether you also have Limited Capability for Work Related Activity (See Appendix 1). This will decide whether you get the support component of ESA, or the work-related activity component. The Limited Capability for Work Related Activity test will apply unless you are terminally ill or you have other proof that you can t do work-related activity (for example, you are on the kind of chemotherapy, or you have the kind of pregnancy described in the previous section). The Limited Capability for Work Related Activity test has Chapter 4, Page 9

10 46 descriptors, and if you satisfy at least one, you will qualify for the support component of ESA. Employment and Support Allowance: support group If, following the Limited Capability for Work Related Activity text, you are put in the support group, you will get the highest rate of ESA (including the support component) and you will not have to participate in work-related activity. If you want to take part in work related activity, you can do so on a voluntary basis. You will be in what is commonly called the support group. If you are in this group, you can still look for work, and you can volunteer for work-related activity, but you will be under no pressure from Jobcentre Plus to move into employment while your health stays the same. It is important to get placed in the support group if it applies to you, because it will protect your right to continue getting contributory ESA in the future. If you have qualified for ESA but following the Limited Capability for Work Related Activity test you are not put into the support group, then you will get ESA at a lower rate than those in the support group (but the work-related activity component will be added to your basic rate of ESA), and you have to participate in work-related activity. You will be in what is commonly called the work-related activity group. Support group and the Work Programme If you are a member of the ESA support group you will not be required to take part in the Work Programme. However, you can volunteer to take part at any point after you have had your Work Capability Assessment. Once Jobcentre Plus has referred you, your ongoing participation in the programme is entirely voluntary. If you are found fit for work Many more people with health problems are being found fit to work under the Work Capability Assessment compared with the old medical assessment used for Incapacity Benefit. If you do not score 15 points and you also cannot be treated as having limited capability for work under another category, you will be refused ESA and you must then either return to work, make a claim for JSA or appeal against the Chapter 4, Page 10

11 decision about limited capability for work. If you appeal, you will continue to be paid ESA at the assessment phase rate until the appeal has been decided. A very large number of appeals against decisions that people are fit for work are successful. Jobcentre Plus cannot refuse your JSA claim on the grounds that you are not fit for work if you decide to claim JSA. The decision maker at the Department for Work and Pensions who has looked at your ESA claim and decided you are fit for work has to take account of the medical and other evidence that you provide, and not base his or her decision solely or mainly on the medical report from their own health professional. You should be prepared to appeal if you think the evidence you have submitted has been overlooked or discounted. Employment and Support Allowance: work-related activity group If you are awarded ESA but you are not put in the support group, then you will go into the work-related activity group instead. You will get ESA at a slightly lower rate than those in the support group. You may also have to participate in work-related activity, including work focused interviews. If you are a full-time carer in the work related activity group, you will not be required to participate in work-related activity. You must attend a new joiner s work focused interview. If your prognosis is that you will be fit for work in three or six months, you will be referred immediately to the Work Programme. If you have a longer prognosis will be required to attend periodic work focused interviews, the format and timing of which will be flexible. You may have to undertake work related activity at your adviser s discretion. If your Work Capability Assessment suggests you will be fit for work within three or six months, you will be referred to the Work Programme. If you are asked, you must attend and participate in the work focused interviews, which means that you must give details of your qualifications, education, plans for work, and so on, and also agree to an action plan. The action plan lists the jobsearch and training activities you are willing to do, and anything else that is relevant to finding or staying in work. This could include drawing up a CV, taking steps to improve your health, doing some voluntary work or training, and looking for suitable jobs. (You have no right to appeal a decision not to defer a work Chapter 4, Page 11

12 focused interview, though you could use the Department for Work and Pensions s complaints procedure and take judicial review or ombudsman action). If you fail to attend or participate in a work focused interview or to draw up an action plan (for those who have to take part in work-related activity), and you do not tell the Department for Work and Pensions within five working days that you had good cause for not attending or participating, then your ESA will be sanctioned. This means that the work-related activity component you get for being in that group is reduced by 50 per cent for four weeks and then by 100 per cent until you either attend and participate in work focused interviews or qualify for the support component. As soon as you either attend and participate in work focused interviews, or qualify for the support component, the sanction will be lifted but not backdated. The basic rate of ESA (which is the same as JSA) cannot be sanctioned. If the personal adviser identifies barriers to work which you have and it is also reasonable in view of all your circumstances, you can be required to take part in work-related activity and this will be included in your written action plan. You cannot be required to apply for a job or undergo medical treatment and the compulsory work-related activity does not apply to lone parents with a child aged under five or people who get Carer s Allowance or who qualify for the carer premium in their income-related ESA. If you do not show good cause for not undertaking work-related activity within five working days, your ESA can be sanctioned. When deciding whether or not you have good cause for not attending or participating in a work focused interview, the Department for Work and Pensions decision maker will take a number of things into account. You can have good cause if you: did not understand the need to take part in the work focused interview because of learning, language or literacy difficulties, or because you were given misleading information by government staff had transport difficulties, and no reasonable alternative was available were attending an interview with an employer were following up employment opportunities as a self-employed earner Chapter 4, Page 12

13 were attending a medical or dental appointment, and it was unreasonable in the circumstances to change the appointment were accompanying someone for whom you have caring responsibilities to a medical or dental appointment, and it was unreasonable for that person to change their appointment had an accident, sudden illness or relapse of a physical or mental condition, or your dependant or someone you care for had an accident, sudden illness or relapse of a physical or mental condition were attending the funeral of a relative or close friend on the day of your work focused interview have a physical or mental condition which made it impossible to attend at the time and place fixed for the interview, or the established customs and practices of your religion stopped you attending on that day or at that time. The Department for Work and Pensions will also take into account anything else that it deems appropriate. The Department for Work and Pensions should contact you before the work focused interview to remind you to attend, offering alternative times, dates and venues for the work focused interview, if you can give good reason for not being able to attend the appointment. Where appropriate, the interview can be conducted in your home or other suitable location. If you do not attend the appointment and are considered to be vulnerable because of a mental health condition, learning disability or conditions affecting communication or cognition, for example, you have had a stroke or have an autistic spectrum disorder, then the Department for Work and Pensions may attempt to visit you in your home. Work-related activity group and the Work Programme If you are a new ESA customer in the work related activity group, your participation in the Work Programme is mandatory from the point at which your prognosis says you will be fit for work within six months (unless you are referred to Work Choice, claiming contribution-based ESA, or you are a lone parent with children aged under five or a carer). Six months before you are expected to be Chapter 4, Page 13

14 fit for work, Jobcentre Plus will refer you to the programme. You can volunteer to take part in the Work Programme before an adviser refers you or if you are one of the one of the ESA work related activity groups whose participation is not mandatory, listed above. Once you have been referred to the programme in this way (voluntarily), your participation in programme activities will be compulsory. If you are a member of the ESA work related activity group but are a lone parent with a child aged under five or a carer you do not have to participate in the Work Programme. You can volunteer to take part at any point after you have undertaken your Work Capability Assessment. Once you have been referred, your ongoing participation in the programme is entirely voluntary. However, your participation may become compulsory once your child is aged over five or your caring ends. If you are an Incapacity Benefit claimant who has been reassessed via the Work Capability Assessment, moved over to the ESA work related activity group and deemed fit to start work in the next three months, these measures will also apply to you. Repeat Work Capability Assessments Work Capability Assessments will be repeated for those found to have limited capability for work. The minimum interval is three months, though repeats can be further apart depending on the Department for Work and Pensions decision maker. Employment and Support Allowance, and National Insurance contributions You must have paid enough National Insurance contributions in order to qualify for ESA through the contributions route. That normally means having worked and paid National Insurance during the past couple of years. Those who are not in the support group can only claim contribution-based ESA for one year. If you are aged between 16 and 20 (or under 25 if in education or training at least three months immediately before turning 20) and already receive contribution-based ESA without paying National Insurance contributions, known as ESA Youth, you will only be eligible for contribution-based ESA for one year. No new awards of ESA Youth are made. Chapter 4, Page 14

15 Working while on Employment and Support Allowance You can do a limited amount of work while you get ESA. The same rules about work apply to both contributory ESA and income-related ESA. You are allowed to do: work for which the earnings in any week are less than 20 work for which the earnings in any week are less than 95 and which is: part of a treatment programme under medical supervision done while you are a hospital inpatient or outpatient or supervised by someone from a public, local authority or voluntary body involved in providing work for people who have a disability work for fewer than 16 hours per week (on average), where your earnings in any week are less than 95, and where you do not do this work for more than 52 weeks (if you have done this kind of work before while you were on ESA, and you want to do the work again, you must either wait 52 weeks from the last period of work, or stop claiming ESA for at least 12 weeks) work for fewer than 16 hours per week (on average), where your earnings in any week are less than 95, if you are in the ESA support group work while self-employed under an approved training programme voluntary or unpaid work where it is reasonable to work without pay (you can be paid out-of-pocket expenses) work on an unpaid work placement approved in advance by Department for Work and Pensions domestic tasks carried out for a relative or in your own home work in an emergency to protect people, property or livestock. Chapter 4, Page 15

16 If you do any other work (paid or unpaid), or if you exceed the earnings limit or the working hours limit in any week, you will be disqualified from ESA for that week because you will not count as having limited capability for work. The higher earnings limit (currently 95 per week) normally increases each October in line with the national minimum wage. Going into work or training while on Employment and Support Allowance If you work for 16 or more hours per week (including breaks at work), or if you join government-funded training, you cannot get ESA but you may qualify for inwork benefits such as Working Tax Credit (WTC) or Housing Benefit (HB). You can return to your ESA if you leave the benefit but reclaim it within 12 benefit weeks. Studying while receiving Employment and Support Allowance You can study part-time while receiving income-related ESA. You can study fulltime if you receive Disability Living Allowance, Personal Independence Payment or contributory ESA. If you are receiving ESA and are in the work-related activity group, fees for non-advanced further education should be reduced or waived by the educational institution. Other colleges have discretion to waive fees. If you do not receive Disability Living Allowance or Personal Independence Payment, you should seek advice before you start your course. Switching from Jobseeker s Allowance to Employment and Support Allowance during illness If you are claiming JSA and you are sick for more than two weeks, or if you expect your sickness to last for more than two weeks, you will have to make a claim for ESA instead. You should notify Jobcentre Plus as soon as you are sick because you can continue to claim JSA for up to two weeks, despite being unfit for work. If you are unable to visit Jobcentre Plus to sign on because of your sickness, you should tell them by phone straight away so that your payments aren t disrupted. Chapter 4, Page 16

17 Jobcentre Plus should then send you a form so that you can notify them about your sickness. You must complete and return this form to safeguard your benefit. You can receive JSA while sick for up to two fortnights out of every 12 months that you claim the benefit. If you fail to sign on at Jobcentre Plus on the right day, you have five working days to sign a written declaration stating that you had good cause for not signing-on on your normal day. Good cause might include a few days of sickness. Your JSA claim should not be stopped because you could not sign on because of sickness (but payment of your benefit will be delayed). Employment and Support Allowance amounts Contributory ESA and income-related ESA are paid at the same basic rate. During the assessment phase, ESA is paid at the same age-related rates as Income Support and income-based JSA. Like Income Support, income-related ESA can be increased to include premiums (for example, if you are a carer) and housing costs for owner-occupiers. There is no disability premium in income-related ESA but there are severe disability and enhanced disability premiums. If you receive contributory ESA (or the noncontributory version payable to certain young people), check whether you also qualify for an income-related ESA top up. Income is assessed for income-related ESA in the same way it is assessed for Income Support. See Chapter 5 for information on how Income Support is assessed. There is no special rate for couples who are claiming the work-related activity component or the support component. If both members of a couple qualify for ESA, double amounts of the components are paid. Personal Independence Payment Personal Independence Payment is a new benefit that helps with some of the extra costs caused by long-term ill-health or a disability. What you get is not based on your condition but how your condition affects you. You will need an assessment to work out the level of help you get. Chapter 4, Page 17

18 Personal Independence Payment has replaced Disability Living Allowance for new claims by people between 16 to 64 years old. Current Disability Living Allowance claimants will start to be re-assessed from October 2013 but only if there is a change in circumstance or an existing award ends. This means most existing claimants will not be reassessed until 2015, after the Department for Work and Pensions has considered the findings of the first independent review in Claimants can also see if they will be affected by the changes using the government s online 'Personal Independence Payment checker': Your award will be regularly reassessed to make sure you are getting the right support. Personal Independence Payment is usually paid every four weeks. It is tax free and can be paid whether you are in or out of work. Personal Independence Payment is made up of two parts, the daily living and mobility components. Whether you get one or both of these depends on how your condition affects you. Who is entitled to Personal Independence Payment? To qualify for Personal Independence Payment, you must have a long-term health condition or disability and have difficulties with activities related to: daily living and mobility. You must have had these difficulties for three months and expect them to last for at least nine months. Terminal illness You may also qualify if you are terminally ill (i.e. not expected to live more than six months). You can get Personal Independence Payment whether you are in work or not. Children under 16 and adults aged 65 or over The government does not plan to replace Disability Living Allowance for children under 16 and for people who were aged 65 or over on 8 April 2013 who are already receiving the allowance. Chapter 4, Page 18

19 Daily living component of Personal Independence Payment You may get the daily living component of Personal Independence Payment if you need help with things like: preparing or eating food washing and bathing dressing and undressing reading using the toilet communicating managing your medicines or treatments making decisions about money. Mobility component of Personal Independence Payment You may get the mobility component of Personal Independence Payment if you need help with going out or moving around. Disability Living Allowance Personal Independence Payment has replaced Disability Living Allowance for new claims. If you currently claim Disability Living Allowance, you will be re-assessed from October 2013, if there is a change in your circumstance or your existing award ends. Most existing claimants will not be reassessed until 2015, after the Department for Work and Pensions has considered the findings of the first independent review in You can also see if you will be affected by the changes using the online Personal Independence Payment checker : Chapter 4, Page 19

20 You can claim Disability Living Allowance if you have a physical or mental disability (including mental illness, a learning disability or behavioural problems), whether you are in or out of work. It is paid to people who need help looking after themselves, or who need someone on hand in case of danger, and/or to people who find it difficult to walk or get around. It can be paid to children or adults, but you must claim the benefit before you turn 65 years old. Disability Living Allowance is not means-tested, is tax-free and is paid on top of other social security benefits. It has two components: one for care, and the other for mobility. There are three care component rates and two mobility component rates. Taking on a job or voluntary work while you get Disability Living Allowance does not give the Department for Work and Pensions legal grounds to review your Disability Living Allowance claim. 11 In practice, however, the Department for Work and Pensions will often look into your entitlement if you take on any work or increase your hours. This is because the Department for Work and Pensions assumes that you may be starting work because your disabilities have reduced. Disability Living Allowance can help you to claim higher amounts of benefits such as Working Tax Credit, Housing Benefit, income-related ESA and Income Support, and can help with the extra cost involved in staying in work. Who is entitled to Disability Living Allowance? Personal Independence Payment has replaced Disability Living Allowance for new claims. If you currently claim Disability Living Allowance, you will be re-assessed from October 2013, if there is a change in your circumstance or your existing award ends. Most existing claimants will not be reassessed until If you are aged between 16 and 65, and starting a new claim, you will no longer be entitled to start a new claim for Disability Living Allowance, and will claim Personal Independence Payment instead. Use the PIP checker to find out: if and when PIP affects your DLA and when you can claim PIP: If you are an adult, to qualify for Disability Living Allowance you must have been aged 16 to 64 on 8 April 2013 and have made your claim before 10 June 2013, as well as needing help looking after yourself and or having walking difficulties. Chapter 4, Page 20

21 If you already get the care and/or mobility component, you will still be paid after the age of 65, as long as you continue to meet the rules for receiving the benefit. Three rates of the care component of Disability Living Allowance 12 Low rate To receive the low rate, you must: need help with your bodily functions (that is anything someone normally does without help, for example washing, dressing, eating, thinking, seeing or moving around) for a significant portion in the day or be unable to prepare a cooked main meal from ingredients you have on hand (if you are aged 16 or over). Middle rate To receive the middle rate, during the day you must: need frequent help with personal care such as washing, dressing, getting in or out of bed, using the toilet, feeding constant supervision to avoid substantial danger to yourself or other people. This might apply if you need someone to keep an eye on you or motivate you or help you take your medication, or you are at risk of neglecting or hurting yourself or others in some way. Or during the night you must: need frequent or prolonged attention in connection with your bodily functions or need someone to be awake for a prolonged period or at frequent intervals to watch over you. Chapter 4, Page 21

22 High rate To receive the high rate, you must satisfy both the night and the day rules for the middle rate. Two rates of mobility component 13 Low rate To receive the low rate, you must need guidance or supervision from another person most of the time when you walk in unfamiliar places. You do not need to be physically disabled to qualify for the low rate, and people with visual impairments or chronic anxiety problems can often qualify. High rate To receive the high rate, you must be physically disabled and one of the following must apply to you: you are unable to walk or your ability to walk outdoors is so limited that: you have pain or severe discomfort when walking you can only walk a short distance you can only walk at a slow speed walking takes a long time you can only walk in an unusual manner so that you are virtually unable to walk or the effort of walking outdoors could affect your health or cause it to worsen. You can also get the higher rate if: you are both blind and deaf you have a severe visual impairment Chapter 4, Page 22

23 you are severely mentally impaired with severe behavioural problems and you also qualify for the high-rate care component of Disability Living Allowance or you have had both legs amputated. It is important to remember that it is the help you need, not the help you get, that decides whether you get Disability Living Allowance or not, so don t be put off if you live alone or currently don t get all the help that you need. If you are assessed as eligible for the high rate, you may be eligible for mobility assistance from the Motability car or scooter scheme. Children on Disability Living Allowance To claim Disability Living Allowance, as well as meeting the usual rules of entitlement, children aged under 16 must show that they have substantially more needs than other children in normal health. Quality and quantity of care are important. Children under 16 cannot use the cooking test to claim the low-rate care component. Children will continue to be eligible for Disability Living Allowance and will not claim Personal Independence Allowance. Hospitals and care homes, and Disability Living Allowance If you live in certain types of publicly funded accommodation (for example, local authority-funded care or a NHS hospital), it may affect your Disability Living Allowance. Speak to a social worker if this applies to you and get specialist advice. How to claim Disability Living Allowance If you are aged between 16 and 65, and starting a new claim in Merseyside, North West England, Cumbria, Cheshire and parts of North East England, you will no longer be entitled to start a new claim for Disability Living Allowance, and will claim Personal Independence Payment instead. Use the PIP checker to find out: if and when PIP affects your DLA and when you can claim PIP: Chapter 4, Page 23

24 Attendance Allowance Attendance Allowance is for people who make their first claim after age 65. This is not covered in this handbook. Carer s Allowance Carer s Allowance is a benefit for carers. It is not means-tested, but your pay can affect your entitlement because there is a maximum amount you can earn while claiming Carer s Allowance (currently 100 per week). Carer s Allowance can increase your entitlement to means-tested benefits because extra amounts for carers are included when calculating these benefits. Who is entitled to Carer s Allowance? To claim Carer s Allowance, you must: spend at least 35 hours per week looking after someone who claims either Attendance Allowance, the middle or high-rate care component of Disability Living Allowance or Personal Independence Payment daily living allowance, and not be in full-time education (usually based on how the college describes the course but this can be varied in some cases, provided it is less than 21 hours a week). 14 If you are working part time while receiving Carer s Allowance, you can offset certain costs against your earnings when calculating whether or not your earnings are less than the 100 earnings limit. You can offset the following from your gross earnings: Income Tax and National Insurance Half of any contributions to a personal or occupational pension scheme The cost of paying a carer (who is not a close relative) to look after children or the person you care for while you are at work (up to half of your net earnings can be offset by these care expenses). 15 Chapter 4, Page 24

25 How to claim Carer s Allowance You make a claim for Carer s Allowance online at the Department for Work and Pensions website ( or you can download form DS700 from the government s website and send it by post: Further points about Carer s Allowance Keep these things in mind when you are making a claim for Carer s Allowance: You can t receive Carer s Allowance if you also receive another non-meanstested benefit that pays the same or more than your Carer s Allowance (for example, contributory ESA, Incapacity Benefit, contributory JSA or retirement pension). However, you should still make a claim so that you have underlying entitlement to Carer s Allowance, because then you will qualify for higher amounts of means-tested benefits. People who receive Carer s Allowance are also credited with National Insurance contributions. If you claim Carer s Allowance, you will not have a work focused interview unless you choose to have one or also receive Income Support. Carer s Allowance is given to a carer who looks after a named individual. This means that a couple can have two carers who each receive Carer s Allowance. If a carer receives Carer s Allowance, it may affect the means-tested benefits that are paid to the person they care for. Seek advice to check this before making a claim. Your Carer s Allowance will be affected if the person you care for goes into hospital or publicly funded care and their Attendance Allowance, Disability Living Allowance or Personal Independence Payment stops. Benefits for a work-related accident or disease There are a number of benefits for people who have ill health or disability because of their employment. These are: Chapter 4, Page 25

26 Industrial Injuries Disablement Benefit Reduced Earnings Allowance Retirement Allowance (replaces Reduced Earnings Allowance after you retire) Constant Attendance Allowance. These benefits are often called industrial injury benefits, and they are paid to people who have a disability or health problem because of an accident at work or a prescribed industrial disease. These benefits are non-taxable, non-contributory, and they can be paid whether or not you are working and regardless of your income or capital. They do not affect any tax credits you may get. Because of this, these benefits can help you go back into paid work, maybe for reduced hours or on lower pay than before you had the accident or disease. You do not have to prove that your employer was negligent, and you can receive these benefits whether or not your employer has paid you compensation. Who is entitled to benefits for a work-related accident or disease? To claim a benefit for a work-related accident or disease, you must: be an employed earner (self-employed people do not count) have had an accident caused by and during your work, or have a prescribed industrial disease that has caused a loss of faculty assessed as a disability of at least 14 per cent (one per cent for Reduced Earnings Allowance) and have had the accident or caught the disease at least 90 days before your claim, and still have a disability or ill health. 16 For Reduced Earnings Allowance, your accident or disease must have happened before 10 October 1990, and you must be unable to follow your regular occupation or do work of an equal standard. There is often a grey area in industrial injury claims between whether a person has had an injury or not (for example, is it the result of one accident or a series of accidents, or is it simple wear and tear?) and also whether the person is at Chapter 4, Page 26

27 work or not (e.g. while travelling to work or during a break). Seek specialist advice from a trade union or advice agency if you think you have been injured at work. How to claim benefits for a work-related accident or disease You can get claim forms from a Jobcentre Plus office or by calling If you find it hard to speak or hear clearly a textphone is available on Lines are open from 8.00 am to 6.00 pm, Monday to Friday. For Industrial Industries Disablement Allowance you can also print the form from the Directgov website ( You do not need to claim Retirement Allowance. If you were entitled to Reduced Earnings Allowance while in regular employment once you reach statutory retirement age and you stop regular employment, your entitlement to Reduced Earnings Allowance will be replaced by entitlement to Retirement Allowance, provided that Reduced Earnings Allowance was payable at over 2.00 a week. You will be sent a letter to complete before reaching statutory retirement age. There will be a part of this you have to complete and return before a decision can be made. The letter will ask for details of your employment. Further points about benefits for a work-related accident or disease Keep these things in mind when you claim for a work-related accident or disease: These benefits are not means-tested (though Reduced Earnings Allowance depends on your earnings) but they do count as income for means-tested benefits. They are ignored as income for tax credits, so they are particularly helpful if you are in work or have a drop in earnings after an accident. These benefits are not affected if you receive compensation for an injury, but the amount of compensation you receive from legal action can be affected if you are paid benefits. You will not be asked to have a work focused interview if you make a claim. Chapter 4, Page 27