Employment and Support Allowance

Employment and Support Allowance (ESA) is a UK Government State Benefit which replaced new claims for Incapacity Benefit (IB) and Income Support (IS) on the basis of incapacity for work for most claimants from 27 October 2008. Initially, claimants already receiving Incapacity Benefit continued to receive it as long as they remained eligible. However, the government has now announced that claimants in receipt of IB, Income Support paid because of an illness or disability or Severe Disablement Allowance (SDA) will be migrated to ESA between Spring 2011 and 2014.

ESA can be either contributory or income-related. If they satisfy national insurance conditions they can claim contributory ESA. 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 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 has 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 (60 years and three months for a woman, 65 for a man); 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 Atos Healthcare 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 13 weeks, as long as they provide medical evidence of their sickness or disability. This 13-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 made up of three separate assessments, although not all ESA claimants will have all three assessments. The assessments are:-

• the limited capability for work assessment. This determines whether or not a person remains entitled to ESA after the assessment or has to claim another benefit, for example, jobseeker’s allowance
• the limited capability for work-related activity assessment. This determines whether a person gets the support component or the work-related activity component of ESA.
• a work-focused health-related assessment. This helps identify work a claimant who receives the work-related activity component can do, despite their condition and identifies ways of improving their capacity for work.

Note: The work-focused health-related assessment is to be suspended for two years from 19 July 2010 as a result of the planned introduction of the new Work Program.

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, whereas 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 allowances

The basic weekly allowances (as of 2011) 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	£67.50	£67.50
Work-related activity component *	———	£26.75
Support component *	———	£32.35

(* only one component is payable, depending on the result of the WCA process)

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."

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