Employment Support Allowance

Employment Support Allowance

Employment Support Allowance This factsheet is part of our Benefits range. It is written for people who are deaf. We use the term people who are deaf to refer to people who are deaf, deafened or hard of hearing. Read this factsheet to find out: What is Employment Support Allowance (ESA)? What are the rules for ESA? What is the assessment phase? How much will I get? What about those who are already receiving Incapacity Benefit (IB) or Income Support (IS)? What about better off considerations? What work can I do? Can I appeal against a decision? Where can I get further information? If you would like this factsheet on audio tape, in Braille or in large print, please contact our helpline (see front page). State pension age for women to rise The state pension age is the age at which you can claim your state retirement pension. Men can claim their retirement pension at 65. From 6 April 2010 until 2020, the government will gradually raise the state pension age for women from 60 to 65. If you are a woman born: Before 6 April 1950, your state pension age will remain at 60. Between 6 April 1950 and 5 April 1955, your state pension age will vary from 60 years and one month to 64 years and 11 months the later your date of birth, the higher your state pension age will be. From 6 April 1955 onwards, your state pension age will be 65. Other benefits and entitlements that were previously available to women and men at 60 (such as the Winter Fuel Allowance, Pension Credit and free prescriptions) will change so that they are available to both men and women at a woman s state pension age. What is Employment Support Allowance (ESA)? ESA is a benefit paid if your ability to work is limited by ill health or disability. From 27 October 2008, it replaced Incapacity Benefit (IB) and Income Support (IS) paid on the grounds of incapacity. ESA has been designed to help you achieve your full potential if you have a health condition or are disabled, and to help you gain independence from benefits. It does so by focusing on your abilities Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 2

on what you can do rather than on what you can t. It is run by Jobcentre Plus, as part of the Department for Work and Pensions (DWP). What are the rules for ESA? If you are claiming ESA, you must be aged over 16 years old and under pensionable age (currently 60 for women and 65 for men). You must have a limited capability for work and satisfy either a national insurance contributory test or a low income test. For more about eligibility for ESA, go to the Directgov website (see page 11). There are two types of ESA: contributory ESA, which you claim as an individual and is based on your national insurance contribution record, and income-related ESA, which is means-tested. If you live with a partner you have to claim income-related ESA as a couple and your partner s income and savings will be taken into account. What is the assessment phase? When you initially claim ESA, you will need to supply a medical certificate from a doctor. The first 13 weeks of your claim is called the assessment phase. During this time you will undergo a work capability assessment and a work-focused interview. You will receive the single rate of the basic personal allowance if you are claiming contributory ESA. If you are claiming income-based ESA, you will receive either the single or couple rate of ESA personal allowance, plus any premiums you might be entitled to. At the end of the assessment phase, the DWP will decide whether you will be put into the support group or the work-related activity group. You will receive extra benefit based on the group you are in. The assessment phase applies to all new ESA claimants, unless you are terminally ill. Work capability assessment (WCA) The WCA is carried out by a healthcare professional working on behalf of the DWP. You will normally have to attend a medical examination centre. If you require communication support, let the DWP know as soon as you can. The WCA is intended to: Find out whether you have a limited capability for work. Find out whether you have a limited capability for work-related activity. Assess the sort of support you may need to return to work by carrying out a work-focused health-related assessment. The test for limited capability for work has many similarities to the old personal capability assessment for IB. Points are scored according to your ability to carry out a range of physical or mental-health activities. If you score 15 points, you are deemed to have limited capability for work and can stay on ESA. If you fail this part of the test, you will not receive ESA. But you may be able to claim Jobseeker s Allowance (JSA) instead. Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 3

The limited capability for work-related activity test is used to decide whether you are placed in the support group of claimants or the work-related activity group. The test has a list of 46 descriptors relating to both physical and mental functions (but not hearing). If at least one of them fits you, you will be placed in the support group of claimants. The Limited Capability for Work assessment The Limited Capability for Work assessment (LCWA) is an assessment of your ability to perform a range of physical and mental activities. You score points if you cannot do a particular activity, or you have difficulties with the activity. You must score at least 15 points in total to be treated as incapable of work. First, you will be sent a questionnaire to complete, which asks you about each activity. You will probably also be asked to attend a medical examination with a doctor employed on behalf of the DWP. The activities most relevant to people who are deaf is hearing and speech. Functional category: Hearing (with hearing aids or other aids, if normally worn) Points Cannot hear at all. 15 Cannot hear well enough to be able to hear someone talking in a loud voice in a quiet room sufficiently clearly to distinguish the words being spoken. 15 Cannot hear someone talking in a normal voice in a quiet room, sufficiently clearly to distinguish the words being spoken. 9 Cannot hear someone talking in a loud voice on a busy street, sufficiently clearly to distinguish the words being spoken 6 none of the above apply 0 When your hearing is being assessed, your ability to lipread or get clues from someone s gestures should not be taken into account. Ask yourself can you understand what someone is saying when your back is turned to them? If you use hearing aids, you should explain the problems you have understanding speech when there is background noise. You should explain whether you need to ask people to repeat themselves over and over again before you can understand them, as this means you are effectively unable to hear speech. If you have been advised to use hearing aids but have stopped using them, explain why. For example, your hearing aids may have distorted sound or been uncomfortable. Guidance given to DWP doctors advises that a client who has been inconvenienced by a hearing aid and has abandoned it should be assessed without aids. Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 4

Functional category Points Speech Cannot speak at all. 15 Speech cannot be understood by strangers. 15 Strangers have great difficulty understanding speech. 9 Strangers have some difficulty understanding speech. 6 None of the above apply. 0 You should be assessed purely on your clarity of speech, not using clues and gestures that help people to understand you. Ask yourself if someone has their back turned to you, will they understand what you are saying? Only the highest score from each activity will count. If you score at least 15 points in total from one or more activity, then you will be assessed as incapable of work. Example total score If you cannot understand someone talking in a loud voice on a busy street (scoring six points under hearing ) and strangers have great difficulty understanding your speech (scoring nine points under speech ) you will score 15 points in total and be entitled to ESA. Tinnitus If you get anxiety and depression as a result of tinnitus, you may be able to score points on the mental activities section of the LCWA. You should consider if your tinnitus affects: Your concentration. Your ability to carry out tasks. Your ability to cope with social situations. Your sleep (for example, you experience problems when sleeping and this interferes with your daytime activities). Ménière s disease If you have Ménière s disease, you may experience attacks of vertigo (dizziness) with tinnitus, nausea and hearing loss. You may find it hard to walk or stand during such attacks. You should describe how often the attacks happen, how long they last, and what happens during them. Under the LCWA, as well as scoring points for hearing and speech problems, you may also score points for your ability to do other activities such as walking, standing and sitting, or bending. You may also be asked if you have fits or seizures. The doctor should consider the effects of Ménière s disease over a period of time, not just on a certain day. Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 5

The support group The most severely disabled people will be put in the support group. If you are placed in this group, you will not have to undertake work-related activities (although you can volunteer to do so if you want) and you will receive a higher rate of benefit. If your only disability is hearing loss, you will not be put in the support group. The work-related activity group If it is decided that you do not have a limited capability for work-related activity, you will be placed in the work-related activity group. You will have to follow strict work-related conditions to continue receiving ESA in full. These conditions include attending a further series of five work-focused interviews, which will normally take place each month. Your personal adviser will draw up an action plan, which will outline the activities that you could do to help you move into work. The work-focused health-related assessment (WFHRA) collects information about your functional capacity to carry out tasks. The WFHRA focuses on the things you can do unlike the limited capability for work assessment, which focuses on the things you can t. It also collects information about any health interventions that could improve your functional capacity and therefore support a move back into work. Health interventions could include the use of appropriate aids and adaptations. The information collected in the WFHRA is put into a capability report, which is used in your work-focused interviews. The initial work-focused interview Unless you are terminally ill, you are expected to attend an initial work-focused interview during the assessment phase. This interview will normally take place around the eighth week of your ESA claim. At this interview, a Jobcentre Plus personal adviser will discuss your work prospects, the steps that you are willing to take to move into work and the support available to you. As a guide, the personal adviser will be using the capability report that was produced in the WFHRA. If you are likely to be starting a job or returning to work, the interview might not be necessary. The personal adviser can also defer an interview if, because of your condition, it would be inappropriate at that particular time. If you require communication support, please ensure that you let your personal adviser or Jobcentre Plus know in advance. Contributory ESA The contributory test You will need to have paid enough National Insurance contributions in one of the last three tax years to satisfy this test. Contributory ESA is paid at a flat rate, and in general is not affected by your savings or other income, or your partner s savings or income. However, if you have an occupational pension of over 85 per Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 6

week, your ESA will be reduced by 50% of the amount by which your pension exceeds 85 (for example, if your pension is 105 per week, your ESA will be reduced by 10). Contributory ESA has no age-related additions or additions for dependents (such as a wife, husband, civil partner or child), no premiums and no allowances for housing costs. To get any of these extra amounts with your ESA, you ll also need to satisfy the low income test. If you re responsible for looking after a child, you should claim Child Tax Credit. Under age 20 If your limited capability for work began before you were 20 years old, and you claim ESA before that age (or 25 if you have been in education or training), you will be entitled to contributory ESA without having to satisfy the contribution conditions. Income-related ESA You can claim income-related ESA if you do not have enough national insurance contributions to get contributory ESA or if your contributory ESA is not enough for you to live on (if you or your partner are over 60 you can claim pension credit rather than income-based ESA). There are some extra rules for income-based ESA: You must have no more than 16,000 savings (if you have a partner, their savings will be added to yours). If you have savings over 6,000, they will be assumed to provide you with a weekly income of 1 per week for every 250 over 6,000. Your partner must either be unemployed or working for fewer than 24 hours a week. Your income must be less than your applicable amount (see below). Income-related ESA is calculated by working out your applicable amount. This includes the personal allowance (paid at the single or couple rate), the work-related or support component, plus any other any premiums you might be entitled to. Premiums are paid if any special circumstances apply to you or your partner, such as whether you get any disability benefits or if you are a carer. If you have a mortgage, or you pay service charges for your property, your applicable may also include a weekly amount to cover these housing costs. If your income is less than your applicable amount, you will be entitled to income-related ESA. If you receive income-related ESA, you will be passported (automatically entitled) to maximum housing and council tax benefit. How much will I get? The weekly rates of ESA from April 2010 are: Basic personal allowance Single or lone parent 64.30 Single under 25 (during assessment phase) 50.95 Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 7

Lone parent under 18 (during assessment phase) 50.95 Couple (income-related ESA only) 100.95 Work-related activity component (paid after assessment period) 25.50 Support component (paid after assessment period) 30.85 Examples of contributory ESA Premiums Sharon is aged 30 and has just been made redundant. She qualifies for contributory ESA. When she first claims ESA she will receive 64.30. After the assessment period, she is placed in the work-related group and will receive contributory ESA of 89.80 per week ( 64.30 + 25.50). Surinder is aged 18 and has limited capability for work. When he first claims ESA he will receive a reduced personal allowance of 50.95 as he is under 25. After the assessment period, he is placed in the work-related group. He will receive contributory ESA (based on the youth provisions) of 89.50 per week ( 64.30 + 25.50). These are extra amounts available in income-related ESA only. Enhanced disability single 13.40 couple 19.30 This is paid where either the ESA claimant is placed in the support group, or if either the claimant or partner receives higher-rate DLA care component. Severe disability one qualifies 52.85 couple both qualify 105.70 This is paid when: The claimant is receiving DLA middle or higher-rate care component. No one is being paid Carer s Allowance for looking after the claimant. The claimant lives alone or, if the claimant has a partner, they both receive DLA middle or higher-rate care (and no-one receives Carer s Allowance for looking after them). Carer for each person who qualifies 29.50 This is paid where the claimant or their partner is entitled to Carer s Allowance Examples of income-related ESA Sumit is aged 35 and receives DLA lower-rate care component. When he first claims ESA he will be entitled to 64.30. After 13 weeks he is placed in the work-related group and will receive ESA of 89.80 per week ( 64.30 + 25.50). Susan is aged 27 and receives DLA middle-rate care component. She lives by herself and noone claims Carer s Allowance for looking after her. When she first claims ESA, she will be Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 8

entitled to 64.30 plus the severe disability premium of 52.85, which makes 117.15. After 13 weeks, she is placed in the work-related group and is entitled to an extra 25.50 to make a total of 142.65. Simon is aged 40 and his partner is aged 35. When he first claims ESA, he will receive the couple rate 100.95. After 13 weeks, he is placed in the support group. He will receive the support component of 30.85, plus the enhanced disability premium (couple rate) of 19.30, making a total of 151.20. Sanctions Both the initial work-focused interview and the follow-up interview are mandatory (you must go). If you fail either to attend or to participate in a work-focused interview, your ESA may be sanctioned that is, paid at a reduced rate. Sanctions can only be applied to the additional components of ESA, not the basic personal allowance. So sanctions can only be applied when the assessment phase of the benefit is over. For the first four weeks, the sanction will be a 50% reduction of the additional component within your ESA. After four weeks, the additional component will be removed completely. The sanction will last for as long as you don t comply with the requirements that are demanded of you. For example, if you refuse to attend a work-focused interview, the sanction will apply until you do attend one. What about those who are already getting Incapacity Benefit (IB) or Income Support (IS)? If you were already receiving IB or IS paid on the grounds of incapacity when ESA was introduced on 27 October 2008, you will continue to receive those benefits. The rules and conditions that apply to IB or IS will continue to apply. So, for example, if you are called to a medical examination, your incapacity will be tested under the old IB personal capability assessment rather than the new ESA work capability assessment. However, from April 2010 some people may be required to take the work capability assessment test. Although the majority of IB and IS claimants should not be worse off under ESA, some groups of claimants may be. If you are in this position, once you have been moved onto ESA you should receive transitional protection. This will bring your ESA up to the same level as your previous rate of IB or IS. What about better off considerations? If you receive Disability Living Allowance (DLA) because of your deafness, there are some circumstances where you may be better off claiming income-based JSA rather than ESA. Or, if you have a partner, you may be better off claiming IS rather than ESA. This is because income-based JSA and IS include an extra amount called a disability premium, which is not available with ESA. Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 9

Comparison of ESA and JSA If you are a single person over 25 in the work-related group, your ESA will be 64.30 for 13 weeks, going up after that to 89.80. For a single person over 25, income-based JSA with the disability premium (paid if you get any rate of DLA) is 91.80 from the start of the claim. If you have a partner, your income-related ESA would be 100.95, going up to 126.45 after 13 weeks. If you claimed income-based JSA with the disability premium (paid if either of you gets any rate of DLA), you would receive 140.10 per week from the start of your claim. To claim ESA, you have to pass a series of tests (see page 3). If you are placed in the workfocused group, you will have to attend work-focused interviews and agree an action plan. To claim JSA, you have to sign on every two weeks and be accepted as available for and actively seeking work. You will draw up a jobseeker s agreement at the start of your claim. You can restrict your availability for work to what would be reasonable given your disability. After you have been claiming JSA for two years, you may have to take part in a work programme such as the flexible new deal, and any housing costs you receive with your income-based JSA may be reduced. If you live with a partner who is entitled to IB or SDA, or who is a carer, you may be better off if your partner claims IS rather than you claiming income-related ESA. If you or your partner are aged 60 or over, you may be better off claiming Pension Credit. If you think any of these circumstances apply to you, seek advice. What work can I do? Generally, you cannot work while you are receiving ESA. However, there are some sorts of work you can do and still get ESA. Voluntary work Voluntary work is unpaid work, usually done for a charitable organisation. You can do any amount of voluntary work while you get benefits. Permitted work There are three types of permitted work. You can do one of the following at any one time: Work and earn up to 20 a week. This is called the permitted work lower limit. You can carry on doing this work for as long as you like. Work for up to 16 hours a week and earn up to 92 a week. This is called the permitted work higher limit. You are only allowed to do this work for up to 52 weeks (one year). Carry out supported permitted work. This is work supervised by someone who is working for a local or public authority, or voluntary organisation. You can earn up to 92 a week. Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 10

Permitted work does not affect the amount of ESA you receive, and if you receive income-related ESA, your Housing Benefit and Council Tax Benefit will not be affected if you do permitted work (as you are passported on to Housing Benefit and Council Tax Benefit). However, if you receive only contributory ESA, your Housing Benefit and Council Tax Benefit may be reduced because of your earnings from permitted work. There are other types of work you can do, such as being a panel member of an Appeal Tribunal, or a local authority councillor. There are also Approved Work schemes such as a Work Trial arranged by the Jobcentre Plus Office. Can I appeal against a decision? Yes. If you are found capable of work following a medical examination, you can appeal against the decision. The DWP should write to inform you of their decision and should also tell you how to challenge the decision. You normally have only one month from the date of decision to make an appeal, although an appeal can be made up to 52 weeks (one year) late in exceptional circumstances. You should seek independent advice from Citizens Advice, a law centre or other advice agency if you want to appeal against a decision. Where can I get further information? Benefit Enquiry Line (BEL) Free advice line run by the DWP. 2nd Floor, Red Rose House, Lancaster Road, Preston PR1 1HB Telephone 0800 882 200 Textphone 0800 243 355 bel-customer-services@dwp.gsi.gov.uk Social Security Agency for Northern Ireland Telephone 0800 220 674 Textphone 0800 243 787 www.dsdni.gov.uk/ssa Citizens Advice Your local Citizens Advice will give free advice. See your phonebook for your nearest bureau or do an online search at: www.citizensadvice.org.uk (England and Wales) www.cas.org.uk (Scotland) www.citizensadvice.co.uk (Northern Ireland) Directgov Information about benefits and allowances. You can also find contact details for your local Jobcentre Plus office. www.direct.gov.uk/disabledpeople Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 11

Disability Alliance Provide a range of information about benefits Universal House, 88-94 Wentworth Street, London E1 7SA Tel/textphone 020 7247 8776 Fax 020 7247 8765 office@disabilityalliance.org www.disabilityalliance.org Law centres Provide free advice and representation you can find details of your local law centre from the Law Centres Federation. Law Centres Federation, 22 Tudor Street, London EC4Y 0AY Telephone 020 7842 0720 Fax 020 7842 0721 info@lawcentres.org.uk www.lawcentres.org.uk Further information from Action on Hearing Loss Our helpline offers a wide range of information on many aspects of hearing loss. You can contact us for further copies of this factsheet and our full range of factsheets and leaflets see the cover page for contact details. Action on Hearing Loss Information, April 2010 The Royal National Institute for Deaf People. Registered Office: 19-23 Featherstone Street, London EC1Y 8SL. A company limited by guarantee registered in England and Wales No. 454169, Registered Charity Numbers 207720 (England and Wales) and SC038926 (Scotland). Employment Support Allowance (ESA), Action on Hearing Loss Information, April 2010 12