Employment & Support Allowance: Making a new claim

What is Employment and Support Allowance (ESA)?

Moving from Incapacity benefit to Employment and Support Allowance.

There will be transitional protection for anyone who moves from incapacity benefits to ESA. This means that if your current entitlement is more than you would receive under ESA, the amount of ESA will be increased to make it the same as what you currently receive.

How to Claim

The quickest way to apply for Employment and Support Allowance is by phone. You can also download the ESA1 form, fill in, print and send or take it to your local Jobcentre Plus office.

Contact centre numbers – Monday to Friday, 8am to 6pm
Tel: 0800 055 6688
Text: 0800 023 4888

You’ll need the following when you make a claim:

• National Insurance number
• medical certificate
• GP’s address and phone number
• home and mobile telephone numbers
• mortgage or landlord details
• council tax bill
• employer’s address and telephone number and dates of employment or last day worked
• bank account details
• details of any other money you are getting, eg benefits or sick pay

How much will I get?

You won’t get any money for the first seven days of your claim. These are called ‘waiting days’.

After this, most people get a basic rate of ESA for the first 13 weeks. This is called the ‘assessment phase’. During this time, the Department for Work and Pensions will decide whether you qualify to keep getting the allowance. They may be able to decide this based on your illness or disability, or they may need you to fill in a questionnaire or go to a ‘work capability assessment’.

After 13 weeks, if you have completed a work capability assessment and still qualify for ESA, you will move to the ‘main phase’ and get a higher amount. This assessment will also determine whether you are placed in the Work Related Activity Group (WRAG) or the Support Group.

You can get:

• First 13 weeks Under 25 – £57.90
• First 13 weeks 25 or over – £73.10
• From 14 weeks Work Related Activity Group – Up to £73.10
• From 14 weeks Support Group – Up to £111.65

From April 2017 new ESA claimants who are placed in the Work-Related Activity Group will receive the same rate of benefit as those claiming Jobseeker’s Allowance (this is the same as ESA assessment rate) alongside additional support to help them take steps back to work.

If you are on contribution based ESA you will only get an allowance for yourself. If you are on income-related ESA you also may get allowances for your partner, if you have one, as well as additional premiums (pensioner, severe disability, carer and enhanced disability premiums).

The Benefit Cap

The benefit cap puts a limit on the total amount of benefit that most people aged 16 to 64 can get. The level of the cap will be:

• £384.62 a week for couples (with or without children living with them)
• £384.62 a week for single parents whose children live with them
• £257.69 a week for single adults who don’t have children, or whose children don’t live with them.

The cap won’t affect you if you’re in the Support Group.

Questionnaire

You will normally be sent a Limited Capability for Work Questionnaire (the ‘ESA50’) to complete. This form has a number of questions with tick-boxes and a space to provide more detailed information about the difficulties you face. When completing each section, let them know if your ability to perform the activity varies.

Make it clear if you cannot perform an activity repeatedly, safely or reliably or if it would take you a long time to complete it. Let them know about any pain, tiredness or discomfort you would feel completing the activity.

It is advisable to include any supporting medical evidence you may have.The time limit for completing and returning the ESA50 is four weeks.

You need to score at least 15 points in order to qualify for the work related activity group (WRAG).

Activities and descriptors: Physical Functions

PART 1: Physical Functions

Activity 1. Mobilising

• Cannot unaided by another person either: (i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or  (ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion. Score 15
• Cannot, unaided by another person, mount or descend two steps even with the support of a handrail. Score 9
• Cannot, unaided by another person, either: (i) mobilise more than 100 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or  (ii) repeatedly mobilise 100 metres within a reasonable timescale because of significant discomfort or exhaustion.  Score 9
• Cannot, unaided by another person, either: (i) mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or (ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion. Score 6
• None of the above apply. Score 0

Activity 2. Standing and sitting

• Cannot move between one seated position and another seated position which are located next to one another without receiving physical assistance from another person. Score 15
• Cannot, for the majority of the time, remain at a work station, either: (i) standing unassisted by another person (even if free to move around); or (ii) sitting (even in an adjustable chair) or (iii) a combination of (i) and (ii) for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion.  Score 9
• Cannot, for the majority of the time, remain at a work station for more than an hour without experiencing significant discomfort or exhaustion. Score 6
• None of the above apply Score 0

Activity 3. Reaching

• Cannot raise either arm as if to put something in the top pocket of a coat or jacket. Score 15
• Cannot raise either arm to top of head as if to put on a hat. Score 9
• Cannot raise either arm above head height as if to reach for something. Score 6
• None of the above apply. Score 0

Activity 4. Picking up and moving or transferring by the use of the upper body and arms

• Cannot pick up and move a 0.5 litre carton full of liquid. Score 15
• Cannot pick up and move a one litre carton full of liquid. Score 9
• Cannot transfer a light but bulky object such as an empty cardboard box. Score 6
• None of the above apply. Score 0

Activity 5. Manual dexterity

• Cannot press a button with either hand or cannot turn the pages of a book with either hand. Score 15
• Cannot pick up a £1 coin or equivalent with either hand. Score 15
• Cannot use a pen or pencil to make a meaningful mark. Score 9
• Cannot single-handedly use a suitable keyboard or mouse. Score 9
• None of the above apply. Score 0

Activity 6. Making self understood

• Cannot convey a simple message, such as the presence of a hazard. Score 15
• Has significant difficulty conveying a simple message to strangers. Score 15
• Has some difficulty conveying a simple message to strangers. Score 6
• None of the above apply. Score 0

Activity 7. Understanding communication

• Cannot understand a simple message, such as the location of a fire escape, due to sensory impairment. Score 15
• Significant difficulty understanding a simple message from a stranger due to sensory impairment. Score 15
• Has some difficulty understanding a simple message from a stranger due to sensory impairment. Score 6
• None of the above applies. Score 0

Activity 8. Navigation and maintaining safety

• Unable to navigate around familiar surroundings, without being accompanied by another person, due to sensory impairment. Score 15
• Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment. Score 15
• Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment. Score 9
• None of the above apply. Score 0

Activity 9. Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting), despite the wearing or use of any aids or adaptations which are  normally, or could reasonably be, worn or used.

• At least once a month experiences: (i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or (ii) substantial leakage of the contents of a collecting device, sufficient to require cleaning and a change in clothing.  Score 15
• The majority of time is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly. Score 6
• Neither of the above applies. Score 0

Activity 10. Consciousness during waking moments

• At least once a week, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. Score 15
• At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. Score 6
• None of the above apply. Score 0.

Activities and descriptors: Mental, cognitive and intellectual functions

PART 2: Mental, cognitive and intellectual functions

Activity 11. Learning tasks.

• Cannot learn how to complete a simple task, such as setting an alarm clock. Score 15
• Cannot learn anything beyond a simple task, such as setting an alarm clock. Score 9
• Cannot learn anything beyond a moderately complex task, such as the steps involved in operating a washing machine to clean clothes. Score 6
• None of the above apply. Score 0

Activity 12. Awareness of everyday hazards

• Reduced awareness of everyday hazards leads to a significant risk of: (i) injury to self or others; or (ii) damage to property or possessions such that the claimant requires supervision for the majority of the time to maintain safety. Score 15
• Reduced awareness of everyday hazards leads to a significant risk of (i) injury to self or others; or (ii) damage to property or possessions  such that the claimant frequently requires supervision to maintain safety.  Score 9
• Reduced awareness of everyday hazards leads to a significant risk of: (i) injury to self or others; or (ii) damage to property or possessions such that the claimant occasionally requires supervision to maintain safety. Score 6
• None of the above apply. Score 0

Activity 13. Initiating and completing personal action

• Cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions. Score 15
• Cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions for the majority of the time. Score 9
• Frequently cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions. Score 6
• None of the above apply. Score 0

Activity 14. Coping with change

• Cannot cope with any change to the extent that day-to-day life cannot be managed. Score 15
• Cannot cope with minor planned change to the extent that overall day-to-day life is made significantly more difficult. Score 9
• Cannot cope with minor unplanned change, to the extent that overall, day-to-day life is made significantly more difficult. Score 6
• None of the above apply. Score 0

Activity 15. Getting about

• Cannot get to any place outside of the claimant’s home with which the claimant is familiar. Score 15
• Is unable to get to a specified place with which the claimant is familiar, without being accompanied by another person. Score 9
• Is unable to get to a specified place with which the claimant is unfamiliar without being accompanied by another person. Score 6
• None of the above apply. Score 0

Activity 16. Coping with social engagement due to cognitive impairment or mental disorder

• Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the claimant. Score 15
• Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the claimant. Score 9
• Engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to difficulty relating to others or significant distress experienced by the claimant. Score 6
• None of the above apply. Score 0

Activity 17. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder

• Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace. Score 15
• Frequently has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace. Score 15
• Occasionally has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace. Score 9
• None of the above apply. Score 0.

Exceptional circumstances

Even if the DWP decision maker decides that you do not pass the limited capability for work test by scoring 15 points or more, they can still treat you as having passed it if one of the following ‘exceptional circumstances’ applies:

• You are suffering from a severe life threatening disease, in relation to which there is medical evidence that the disease is uncontrollable or uncontrolled by a recognised therapeutic procedure; and in the case of a disease that is uncontrolled, there is a reasonable cause for it not to be controlled by a recognised therapeutic procedure.
• You suffer from some specific disease or bodily or mental disablement and consequently there would be a substantial risk to the mental or physical health of any person if you were found not to have a limited capability for work. This risk should be linked to work you could realistically do according to your education or skills. This circumstance will not apply to you if the risk could be significantly reduced by making reasonable adjustments to your workplace or by you taking medication as prescribed.

Activities & Descriptors for Work Related Activity Test

The limited capability for work-related activity test (Support Group)

If one or more of the following descriptors applies to you, you will be assessed as having a limited capability for work-related activity.  This will place you in the support group of claimants.

Activity 1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid is normally, or could reasonably be, worn or used.

• Cannot either: mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or (b) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

Activity 2. Transferring from one seated position to another.

• Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person.

Activity 3. Reaching.

• Cannot raise either arm as if to put something in the top pocket of a coat or jacket.

Activity 4. Picking up and moving or transferring by the use of the upper body and arms (excluding standing, sitting, bending or kneeling and all other activities specified in this appendix).

• Cannot pick up and move a 0.5 litre carton full of liquid.

Activity 5. Manual dexterity.

• Cannot press a button (such as a telephone keypad) with either hand or cannot turn the pages of a book with either hand.

Activity 6. Making self understood

• Cannot convey a simple message, such as the presence of a hazard.

Activity 7. Understanding communication by

• (i) verbal means (such as hearing or lip reading) alone (ii) non-verbal means (such as reading 16-point print or Braille) alone, or (iii) a combination of (i) and (ii) using any aid that is normally, or could reasonably be, used, unaided by another person.  Cannot understand a simple message, such as the location of a fire escape, due to sensory impairment.

Activity 8. Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or voiding of the bladder, other than enuresis, despite the wearing or use of any aids or adaptations which are normally, or could reasonably be, worn or used.

• At least once a week experiences:
  (a) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or (b) substantial leakage of the contents of a collecting device, sufficient to require the individual to clean themselves and change clothing.

Activity 9. Learning tasks

• Cannot learn how to complete a simple task, such as setting an alarm clock, due to cognitive impairment or mental disorder.

Activity 10. Awareness of hazard

• Reduced awareness of everyday hazards, due to cognitive impairment or mental disorder, leads to a significant risk of: (a) injury to self or others; or (b) damage to property or possessions such that the claimant requires supervision for the majority of the time to maintain safety.

Activity 11. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks)

• Cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions.

Activity 12. Coping with change

• Cannot cope with any change, due to cognitive impairment or mental disorder, to the extent that day-to-day life cannot be managed.

Activity 13. Coping with social engagement, due to cognitive impairment or mental disorder

• Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the claimant.

Activity 14. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder

• Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.

Activity 15. Conveying food or drink to the mouth.

• Cannot convey food or drink to the claimant’s own mouth without receiving physical assistance from someone else;
• Cannot convey food or drink to the claimant’s own mouth without repeatedly stopping or experiencing breathlessness or severe discomfort;
• Cannot convey food or drink to the claimant’s own mouth without receiving regular prompting given by someone else in the claimant’s physical presence; or (d) Owing to a severe disorder of mood or behaviour, fails to convey food or drink to the claimant’s own mouth without receiving: (i) physical assistance from someone else; or (ii) regular prompting given by someone else in the claimant’s presence.

Activity 16. Chewing or swallowing food or drink.

• Cannot chew or swallow food or drink;
• Cannot chew or swallow food or drink without repeatedly stopping, experiencing breathlessness or severe discomfort;
•  Cannot chew or swallow food or drink without repeatedly receiving regular prompting given by someone else in the claimant’s presence; or (d) Owing to a severe disorder of mood or behaviour, fails to: (i) chew or swallow food or drink; or (ii) chew or swallow food or drink without regular prompting given by someone else in the claimant’s presence.

Work Related Activity Test-Exceptional circumstances

You can be automatically treated as having a limited capability for work-related activity (support group) if you are:

1. suffering from a progressive disease and consequently your death can reasonably be expected within six months.

2. receiving treatment by way of chemotherapy or radiotherapy (or are likely to receive such treatment within six months), or you are recovering from that treatment and the DWP is satisfied that you have a limited capability for work-related activity.

3. suffering from some specific disease or bodily or mental disablement and consequently there would be a substantial risk to the mental or physical health of any person if you were found not to have a limited capability for work-related activity.

4. pregnant and there would be a serious risk to the health of you or your child if you did not refrain from work-related activity.

Assessment

If a decision cannot be made using the information in your ESA50 questionnaire you will be given appointment to attend a face-to-face assessment carried out by a DWP approved healthcare professional.

If you are unable to attend the Assessment Centre it may be possible to arrange a home visit, this will usually need a letter from your GP explaining that you are unable to travel on health grounds.

The healthcare professional should have read a copy of the ESA50 form that you completed. At the face-to-face assessment they will be trying to identify whether or not your account in the ESA50 corresponds with their findings. They will ask you a series of questions, relating to both your physical and mental, cognitive or intellectual capabilities. Once they have finished this, they may then give you a brief physical examination.

Decision

Where can I get further help

If you need assistance with your ESA application, need further benefit advice or if you are unhappy with the outcome of the DWP’s decision it may be helpful to contact an organisation such as a local citizens advice bureau or a local disability advice / welfare rights service. It is worth noting that these organisations can be very busy and if you need assistance you should contact them as soon as possible.

Useful contacts

Disability Information Scotland

Call our helpline on 0300 323 961. Search our Scottish Disability Directory online for details of local disability information services and welfare rights services.

Government Information and Service

Jobcentre Plus: Telephone:
Tel: 0800 055 6688
Text: 0845 6055 255
or search for your local Jobcentre Plus website