Employment and Support Allowance is for people of working age who cannot work because of illness or disability and are not entitled to Statutory Sick Pay, or whose Statutory Sick Pay has run out. Entitlement usually depends upon your National Insurance record (except for some young adults), and may be subject to a medical assessment. Note: this leaflet gives a brief summary of Employment and Support Allowance (ESA) and is for guidance only. It does not cover all situations, nor is it a full statement of the law. Sources of further, more detailed information are given at the end.
What is Employment and Support Allowance?
Employment and Support Allowance (ESA) was introduced on 27 October 2008 and has replaced Incapacity Benefit (and Income Support paid because of an illness or disability) but for new claimants only. If you already receive Incapacity Benefit, you will continue to receive it.
Most people claiming ESA will be expected to take steps to prepare for work. However, if you have an illness or disability that severely affects your ability to work, you will get increased financial support and will not be expected to prepare for a return to work.
How does Employment and Support Allowance work?
There are two phases to ESA:
- The assessment phase rate which is paid for the first 13 weeks of your claim while a decision is made on your capability for work through the Work Capability Assessment (see below).
- The main phase which starts from week 14 of your claim, if the Work Capability Assessment shows that your illness or disability does limit your ability to work.
As a result of the assessment you will be put in either:
- The Work Related Activity Group. You will be expected to take part in work focused interviews with your personal adviser. In return, you will receive a work-related activity component in addition to your basic rate. If you refuse to go to the work focused interviews, or to take part fully in the work focused interviews, it may affect your entitlement to ESA.
- The Support Group. You will be placed in this group because your illness or disability has a severe effect on your ability to work. You will not be expected to take part in any work and do not have to go to interviews. However, you can ask to talk to a personal adviser if you want to. You will receive a support component in addition to your basic rate.
Who can get Employment and Support Allowance?
You may be able to claim ESA if you are over 16 and under the state pension age, and any of the following apply to you:
- Your Statutory Sick Pay (SSP) has ended, or you cannot get it, or
- You are self-employed or unemployed, or
- You have been getting Statutory Maternity Pay (SMP) and have not gone back to work for your employer because you have an illness or disability which affects your ability to work.
You must also either:
- Have had an illness or disability which affects your ability to work for at least four days in a row (including weekends and public holidays), or
- Be unable to work for two or more days out of seven consecutive days, or
- Be getting special medical treatment.
If you are aged between 16 and 20 (or under 25 if you were in education or training at least three months immediately before turning 20), you must:
- Have been too ill to work because of an illness or disability for at least 28 weeks.
- Have been too ill to work before you turned 20 (or 25 if you were in education or training at least three months immediately before turning 20).
There are two types of ESA:
- You may be entitled to claim contribution-based ESA if you have paid enough National Insurance Contributions, or
- You may be entitled to claim income-based ESA if you do not have enough money coming in, or you have not paid enough National Insurance Contributions, and you satisfy the entitlement conditions.
How much is Employment and Support Allowance?
ESA is paid in two phases:
- The assessment phase rate which is paid for the first 13 weeks of your claim while a decision is made on your capability for work through the Work Capability Assessment:
- A single person aged under 25 can receive up to £53.45 a week.
- A single person aged 25 and over can receive up to £67.50 a week.
- The main phase which starts from week 14 of your claim, if the Work Capability Assessment shows that your illness or disability does limit your ability to work:
- A single person in the Work Related Activity Group can receive up to £94.25 a week.
- A single person in the Support Group can receive up to £99.85 a week.
The above rates are for April 2011, but they usually go up each April. In most cases you will not get any money for the first three days of your claim. These are called 'waiting days'.
Note: your individual circumstances may affect the amount you receive. For example:
- If you get income-related ESA you may be able to get more money if you have adult dependants.
- If you receive a pension you may get less ESA.
- Income tax may be taken from contribution-based ESA.
What happens at the Assessments?
Work Capability Assessment
The Work Capability Assessment is to assess how your illness or disability affects your capability for work or work-related activity.
Most people are also asked to attend a medical assessment which generally takes place at a medical centre near where you live. You should be able to change the appointment time if it is not convenient, but it is very important that you do attend and fully participate in your medical assessment as your benefit may be affected if you don't.
You can ask for the following at the assessment:
- To have a friend, relative or support worker with you.
- To have an interpreter if you need one.
- To be assessed by an approved healthcare professional of the same gender as yourself.
The medical assessment consists of up to three parts. You will need to take identification with you to the medical assessment, plus any pills or medication you are currently taking and any simple aids and appliances that you use, such as glasses or hearing aids.
The medical assessment will involve an interview to assess how your illness or disability affects you and your ability to work. You may need to have a physical examination. Allow up to 1½ hours for the whole medical assessment.
First of all there will be an interview to build up a brief history covering. For example, what you did in your old job, details of medical treatment, your domestic situation, how your illness or disability affects daily tasks, etc.
If you are claiming ESA because of a mental health problem or a physical illness or disability that could affect your mental health, you may be asked some questions about your social behaviour.
The physical examination happens after the interview and will only go ahead if you feel comfortable. You will not be asked to do anything that causes you discomfort.
Finally, there may be a work focused health-related assessment when you will be asked about how you feel your illness or disability is stopping you working, and what help you need to start work. If this assessment takes place, a report is sent to your personal adviser, and a copy to you.
After the medical assessment a report (ESA85) is completed and sent to the Department for Work and Pensions and to your personal adviser. You can ask for a copy of the report to be posted to you from the Department for Work and Pensions.
Can you work while getting Employment and Support Allowance?
You may be able to do what is called 'Permitted Work' but there are rules on. For example, how many hours you can do, how much money you can earn. You should check with your personal adviser whether the work you want to do is with the rules for 'Permitted Work'.
How do you claim Employment and Support Allowance?
- By telephone or textphone. Lines are open Monday to Friday, from 8.00 am to 6.00 pm. Contact centre numbers:
- Telephone 0800 055 6688
- Textphone 0800 023 4888
- By going to the Direct.gov website (details below) to download a claim form.
How is Employment and Support Allowance paid?
ESA is usually paid into a bank, building society, Post Office or National Savings account.
Further information, help and advice
Directgov brings together the widest range of public service information and services online.
Produced by the Central Office of Information, Directgov provides information from across UK government departments on topics ranging from travel safety and parental leave, to special educational needs, local NHS services, and benefits. The site also brings together an increasing number of online government services - including being able to download and/or complete certain benefit claim forms online.
Citizens Advice Bureau
Provides independent advice on many issues including benefits. Listed in the phone book under 'Citizens Advice Bureaux'. Also, see their excellent website: www.citizensadvice.org.uk
Further reading & references
- Employment and Support Allowance, Directgov
|Original Author: Dr Tim Kenny||Current Version: Hilary Cole|
|Last Checked: 28/09/2011||Document ID: 12693 Version: 4||© EMIS|
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.