Employment and Support Allowance
Employment and Support Allowance (ESA) is a UK Government state benefit introduced on 27 October 2008. The benefit replaced Incapacity Benefit (IB), Income Support (IS) paid because of an illness or disability and Severe Disablement Allowance (SDA). Initially it only replaced new claims and the migration of existing claims did not begin until Spring 2011. The migration process is expected to be finished by March 2014.[1]
ESA can be either contributory or income-related. If claimants satisfy National Insurance conditions they can claim contributory ESA for up to one year (if they get the work-related activity component) or indefinitely (if they get the support component).[2] Income-related ESA is subject to a means test and certain other conditions. If they meet both sets of conditions, they can get contributory ESA topped up with income-related ESA.
The main change from Incapacity Benefit is that the old Personal Capability Assessment (PCA) has been replaced with a Work Capability Assessment (WCA), which the government claim will give a better view of the claimant's ability to undertake some form of work.
The Department for Work and Pensions contracted Atos Healthcare, a healthcare company part of the global Atos Origin company to undertake medical assessments. There are a number of medical conditions for which a medical assessment is not required and others where the medical advisor has to ask the patient's GP or consultants for information.
Eligibility
An individual can claim ESA if they:-
- have limited capability for work. This is determined by the limited capability for work assessment, which is one of the three assessments that makes up the work capability assessment; and
- are at least 16 years old; and
- have not yet reached state pension age (61 years and nine months for a woman, 65 for a man);[3] and
- are in Great Britain or Northern Ireland (although in some cases, entitlement can continue during a temporary absence); and
- are not receiving Income Support. If her/his partner is receiving Income Support, this too stops the claimant from being entitled to income-related ESA; and
- are not receiving Jobseeker's Allowance (JSA). If her/his partner is receiving income-based JSA, this too stops the claimant from being entitled to income-related ESA; and
- are not entitled to statutory sick pay
ESA Initial Information Assessment
The ESA information provided by the claimant together with other information such as a covering letter should be assessed by a qualified healthcare professional to decide whether a face to face medical assessment is necessary. The Contract between the DWP and Maximus lists those medical conditions for which a face to face assessment is not required and for those where a medical advisor with specialist knowledge of the pathology and treatment of the medical condition is mandatory or advisory.
Work Capability Assessment (face-to-face)
Once a person has claimed ESA, they will receive it initially for up to thirteen weeks, as long as they provide medical evidence of their sickness or disability. This thirteen-week period is known as the assessment phase. During this time, a work capability assessment (WCA) will be carried out to determine whether the claimant is sufficiently sick or disabled to qualify for ESA.
The WCA is usually made up of two separate assessments.[4] The assessments are:-
- the limited capability for work assessment. This assesses a claimant's ability to perform a range of specified activities that determine fitness for work. Both physical factors and mental health problems are included. The assessment determines whether or not the claimant remains entitled to ESA after the assessment or has to claim another benefit such as Jobseeker's Allowance.
- the limited capability for work-related activity assessment. This is usually carried out at the same time as the limited capability for work assessment. It determines the benefit rate subsequently received by the claimant. It also determines whether the claimant needs to undertake specified work-related activity in order to continue to qualify for ESA.
The limited capability for work assessment
The limited capability for work assessment determines entitlement to ESA. It measures a person’s ability to perform certain activities relating to physical function, and to mental, cognitive and intellectual function. In order to be entitled to ESA, a person will need to score 15 points in total. Within each function, a claimant can score 15, 9, 6 or 0 points. They can score these because of physical functions, mental functions or a mixture of the two.
The limited capability for work-related activity assessment
The limited capability for work-related activity assessment is the second assessment within the WCA. It is used to decide what rate of ESA will be paid after the first 13 weeks and whether the claimant will be required to undertake any work-related activity as a condition of entitlement. If a claimant satisfies the limited capability for work-related activity assessment, they will be entitled to the support component of ESA after 13 weeks and will not have to undertake work-related activity or have work-focused interviews. If they do not, they will receive the work-related activity component of ESA and have to undertake work-related activities and have work-focused interviews.
The work-focused health-related assessment
Between 2008 and 2010 a work-focused health-related assessment was also included. This helped to identify work a claimant who received the work-related activity component could do, despite their condition, and identified ways of improving their capacity for work. The assessment was abolished from 19 July 2010 as a result of the planned introduction of the Work Programme.[5]
The allowances
The basic weekly allowances (as of 9 April 2015) are given below (although these are different for claimants who are under 25):
| (weeks 1-13 only, no component payable) | (payable from week 14) | |
| Basic allowance | £73.10 | £73.10 |
| Work-related activity component * | ——— | £29.05 |
| Support component * | ——— | £36.20 |
(* only one component is payable, depending on the result of the WCA process)
Income-related ESA is not time-limited. Similarly contributory ESA for claimants receiving the support component is not time-limited. However, contributory ESA for claimants receiving the work-related activity component is limited to a maximum of 365 days.[4]
Controversy
Many organisations, including the Citizens Advice Bureau, have shown concern about the way the work capability assessments are carried out.
The Citizens Advice website states: "Employment and support allowance (ESA) was introduced in October 2008 to replace the existing incapacity benefit (IB) for new claimants. It aims to give more help to those who might, with support, be able to work. Citizens Advice has been monitoring the impact of the new benefit, and this is our second report since its introduction. Limited capability, published in November 2009, covered the administration of the benefit, and this report looks at the assessment process. Bureaux advisers have expressed grave concern at the number of people unexpectedly being found fit for work. This report therefore examines three key aspects of the ESA assessment process: who is being selected for the work capability assessment (WCA); its design and content; and how it is carried out in practice."
References
- ↑ Martin Williams (October 2011). "Unnoticed? The flaw in ESA conversion decisions". Child Poverty Action Group. Retrieved 27 February 2014.
- ↑ "Welfare Reform Act 2012 and disabled people". DWP. Retrieved 2012-05-17.
- ↑ Dan Hyde (7 January 2014). "State pension age rises: When will you retire?". The Telegraph. Retrieved 27 February 2014.
- ↑ 4.0 4.1 "Employment and Support Allowance". Citizens Advice Bureau. Retrieved 27 February 2014.
- ↑ "Disability Alliance UK". Retrieved 2010-07-12.
External links
- DWP Atos ESA a personal experience of applying for and receiving ESA following emergency admittance to hospital and MRI scans which confirmed a primary brain tumour. Extracts from the contract, the correspondence in full and lists of medical conditions not requiring a face-to-face assessment are included.
- Guardian Special Report - State Benefits
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