What is Employment Support Allowance?

Posted: | By Sunrise Medical
What is Employment Support Allowance?

If you are disabled or chronically ill and unable to work you may be wondering where you can find support. Thankfully, there are a number of benefits available that can give you the help you need. One option is Employment Support Allowance (ESA) offered by the Department for Work and Pensions (DWP) in the UK. But what is ESA and how does it work?

What is ESA?

Employment Support Allowance is there to help people who are struggling to work due to illness or disability. It is separate from any statutory sick pay you may receive through your employer. It is similar in some ways to Job Seekers Allowance in that it supports people who are out of work, but it is specifically designed to recognise the difficulties people with disabilities face.

There are two types of ESA: Contribution Based and Income Related ESA.

Contribution Based ESA is for those who have paid sufficient National Insurance or National Insurance Credits. It is therefore usually available for those who have had some form of employment previously.

If you live in an area with Full Universal Credit, you may have access to “New Style” ESA which is similar to Contribution Based. Any savings you have or the savings and income of your partner will not affect how much you receive. You may qualify to receive ESA on its own or as well as your Universal Credit.

Income Related ESA is for those who do not qualify for Contribution Based. The amount of money you receive depends on your circumstances including any income or savings of your partner should you have one.

With ESA you may be awarded up to £110.75 per week depending on your circumstances. See the “What happens next?” section below for more information.

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Who can get ESA?

ESA is for those people who are employed, self-employed or unemployed due to their illness or disability. Students who receive Disability Living Allowance or Personal Independence Payments may also be eligible.

You are eligible if your illness or disability affects your ability to work and earn and you are not receiving Statutory Sick Pay or Maternity Pay. You are not eligible if you are currently in receipt of Job Seekers Allowance but there is support available if you need to change your claim to ESA.

The DWP will assess your eligibility for ESA through forms and in-person assessments. You will be asked to fill out a questionnaire called the Capability for Work Assessment. In this, you must detail your condition and how it impacts your ability to work. They may then call you for a “health and work conversation” which aims to see if there are any changes which can be made in the workplace to help you to continue to work. They may also ask you to attend a Work Capability Assessment which is a face-to-face assessment with a trained member of staff to look further at your limitations and difficulties. They may ask questions similar to those on the form, as well as carrying out a basic physical assessment, for example range of movement.  You can take somebody along to the assessment for support, or even request the assessment take part in your own home.

Based on these methods, the DWP will decide if you are eligible for ESA and what group of ESA you should be put in to. In cases of Income Related ESA, your finances, including any income or savings of your partner (if applicable) will also be taken in to consideration.

How do I apply?

In the first instance, you would contact the DWP with your details. Be aware that there is a different phone number if you live in a Universal Credit area and would be claiming the “New-style” ESA.

For Income Related and Contribution Based ESA call:

Telephone: 0800 055 6688
Textphone: 0800 023 4888
Welsh language telephone: 0800 012 1888
Monday to Friday: 8am to 6pm

For New-Style ESA call:

Telephone: 0345 600 4272
Textphone: 0345 600 0743
Monday to Friday: 8am to 6pm

Your personal details will be taken and you will be sent an ESA1 form to complete, sign and return. Alternative formats are available such as Braille, large print and some non-English languages.

You will need to send evidence with your form including council tax bills, a medical certificate from your GP, proof of address, details of current or previous employers and bank statements. These help to support your claim and help the DWP to make a decision.

What happens next?

As described in “Who can get ESA?” above, they may call you for one or more face-to-face assessments. These help to provide further details to support your claim. You may need to wait several weeks before they call you for an assessment.

During this period, you may have access to the “assessment rate” of ESA for up to 13 weeks. This is £57.90 a week if you are under 25 and £73.10 a week if you are over 25.

After your assessment you will receive a letter telling you if your claim was successful or not.

If it was successful, your payments will begin from the date on your letter including any back payments you are owed. Your letter will also state which group you have been put in to.

There are two groups for people receiving ESA:

Work Related Activity Group (WRAG)

This group is for people who are thought to be capable of some work given the right support or if they are expected to recover some or all of their ability. People in WRAG receive up to £73.10 a week.

While you are in this group, you are expected to attend meetings with a support worker at your local job centre or other similar facility. At these meetings you may be provided with opportunities for therapy, pain management, and training. These opportunities are there to help you manage your condition better as well as helping you find work that is suitable for your abilities.

The Support Group

This group is for those people who are unlikely to experience any improvement in their condition and whose disabilities entirely prevent them from working.

If you are in the Support group, you may be paid up to £109.65 per week and have access to additional payments such as the disability or severe disability premium.

If you are in this group you may be called for future Work Capability Assessments, for example every two years, in order to assess if there are any changes in your condition which may impact your eligibility. However, with the support of your doctor these Assessments can be limited and do not need to be a source of stress.

What if my claim is unsuccessful?

If your claim is unsuccessful or you disagree with the group they have put you in, you need to ask for a “mandatory reconsideration”. You have one month from the date of your decision to ask for your mandatory reconsideration and unless you are able to show that you have a good reason for it i.e. being in hospital, they may not accept a late request. If this is successful, they will adjust your rate and group as appropriate.

If your mandatory reconsideration is unsuccessful then you need to make a formal appeal. Don’t worry if you get to this stage. It is very common that people who are unhappy with the initial decision decide to make a formal appeal, even after the mandatory reconsideration.

Your mandatory reconsideration letter will include details of how to appeal, and you must make your appeal within one month of your reconsideration decision, unless you have special circumstances. You will need to fill out the form SSC1 and send it to the HM Courts and Tribunal Service (HMCTS). Details of where to send your form to will be included in your reconsideration letter.

In your appeal, you should include any additional supporting evidence you have, as well as a copy of your reconsideration letter. This can include things like letters or statements from doctors and specialists, letters from your employers and occupational health therapists and supporting statements from people who know you. The form asks you if you want an oral hearing – this is an opportunity to present your case in person to the people making the decision.

The appeal and tribunal are carried out by the HMCTS and are independent of the DWP. It is recommended that you request the opportunity for oral hearing, as this increases the chance of success.

Waiting for a tribunal can take a long time in some cases, though the exact wait will vary depending on region. It can take 13 months after your initial application to get a tribunal and final decision. However, if your appeal is upheld (that is, you are awarded ESA or the amendments you requested) then you will begin receiving your new payments immediately and will be awarded back pay from the date of your decision.

There is cause to be hopeful if you decide to make an appeal: 68% of appeals for ESA are overturned, that means a person’s claim is upheld and they will begin receiving the new amount.

Who can help?

Applying for ESA and any subsequent reconsiderations or appeals can be daunting, especially with chronic illness or disability. However, you are permitted to have people help you at every stage of the way.

You can get a family member to help you fill out the first forms; as long as you are able to sign the form and confirm that everything contained within is true and accurate. In case a person’s disability means he cannot fill out his own forms at all, somebody (usually a relative or carer) can be appointed by the DWP as able to apply on their behalf.

There are also a number of charities and organisations who offer help and advice on application, mandatory reconsideration and appeals.

Local council Adult Social Services – your local council may have assistance available to help you with your claim and appeal. They are often very well versed in the process and can help you gather supporting evidence. They may be able to accompany you to the tribunal as well.

Citizens Advice BureauCAB have many volunteers who will help you with your forms. You can make appointments to see them in person for help filling out your initial claim forms and any appeal forms. There may be a long wait to get an appointment, so it is worth contacting them as soon as you think you may need help, so that you can complete any reconsiderations or appeals within the allotted time. CAB also has an extensive website with detailed explanations of how the processes work, what evidence you may need as well as the phone numbers and addresses of relevant agencies.

Benefits and workBenefits and Work are an independent organisation with detailed guides and information on a number of benefits including ESA. The site includes real stories from people who have claimed ESA. The website and guides are free to use but there is the option to become a subscribed member and access further information.

ESA Support – A site dedicated to helping people with ESA. It has a number of files, information and advice on applying for and appealing ESA.

Disability Rights– this is an organisation offering a wide variety of help and support to people living with disability. They have a large number of fact sheets and other resources relating to ESA. They also have telephone help lines available if you find speaking to somebody easier.

Employment Support Allowance can seem complicated and difficult to apply for but don’t worry, there are people who can help and ESA can help you. The application process is designed to make sure that you are getting the help you need and, it’s important to remember that the most recent statistics[1] show that 2.4million people are receiving ESA.

It’s worth taking a look at ESA and seeing what help is there for you.

[1] [https://www.gov.uk/government/statistics/dwp-statistical-summaries-2017]

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