Employment and Support Allowance (ESA) is a benefit for people aged between 16 and the state pension age, who cannot work due to sickness or disability, and who are not getting Statutory Sick Pay. It replaces Incapacity Benefit and, for some people, Income Support. You apply for ESA through the Department for Work and Pensions (DWP).
Types of ESA
There are two types of ESA:
- contributory ESA is available for people who have paid enough national insurance contributions; and
- income-related ESA for people who have a low income and capital (such as savings).
More about ESA from Citizens Advice (opens new window).
People who receive ESA will either be in the 'support group' (where individuals will not have to take part in any work-related activities) or the 'limited capability for work' group (where individuals will have to do some work-related activities).
Applying for ESA
When you apply for ESA you have to show that you are not able to work due to sickness or a disability. You will need to complete an application form and include any relevant medical certificates or information to support your claim. You will also usually need to have a work capability assessment.
Work capability assessments are made up of two tests:
- a limited capability for work assessment (this includes a face-to-face medical assessment with a healthcare professional to see if you are able to work); and
- a limited capability for work-related activity assessment (usually done at the same time as the limited capability for work assessment, this is to see what level of benefit you might need, and what you need to help you get back into work).
Part of the work capability assessment is comparing you to ESA 'descriptors'. These descriptors look at any 'physical' and 'mental' problems that you have due to sickness or disability. You must score 15 on these descriptors to be eligible for ESA.
If you are found to be eligible for ESA, you will then be assessed to see if you fall into the 'support group' or the 'limited capability for work group'. Again, this is assessed using a different set of 'descriptors'.
After these two stages, you may have a 'work focused health assessment' to see what problems you might have in the workplace. This will usually only be done if you are likely to be in the 'limited capability for work group'.
If you are placed in the 'limited capability for work group' you may then have a work focused interview, to produce an action plan for what you can do to get back into work.
Whether you are eligible for ESA, and what level of ESA you will receive, will then be decided.
More information about applying for ESA and the descriptors (opens new window) from the Disability Law Service.
Appealing against a decision about ESA
If you have applied for ESA and have been turned down, or you do not agree about the decision that has been made about your capability to work, you can appeal this decision. There are three levels of appeal. The time frame for appealing means that you only have a short amount of time to appeal and so you will need to get your appeal in quickly. Details about this will usually be included in the letter you receive about the result of your ESA application and assessment (your decision letter).
First level of appeal: reconsideration
You can write to the DWP and ask for the decision about your capability to work to be reconsidered. You need to do this within one month of getting your decision letter. This means that the DWP will look again at your application and the results from your assessments. If you have any other information, such as a letter of support from your doctor, you can include this with your letter. You can also ask the DWP to consider particular parts of your application that you feel are particularly relevant.
It is a good idea to keep a copy of your letter, and to send it by recorded delivery (so that you can show that you have appealed within the specified one month timescale for a reconsideration).
Reconsideration can take up to 11 weeks, and you will usually get a letter from the DWP saying that they are reconsidering your application.
More about reconsideration ESA appeals (opens new window) from the Disability Law Service.
Second level of appeal: first tier tribunal
If you want to appeal against your ESA decision by 'first tier tribunal', rather than asking for a reconsideration, you need to write to the DWP within one month of your decision letter. You will then be sent a 'GL24' appeal form. When you return this appeal form, you will be sent further information about this appeal. To be able to appeal through this route, you will need to look again at the 'descriptors' section and see whether and how they apply to you, and be able to provide evidence to support this.
First tier tribunal appeals mean that you will have a tribunal hearing, The tribunal will include a doctor and a judge (a solicitor or barrister). You may receive a decision on the day of the tribunal, or they may write to you with the decision.
More about first tier tribunal ESA appeals (opens new window) from the Disability Law Service.
Watch a video (opens new window) on YouTube about attending a first tier tribunal.
Third level of appeal: the upper tribunal
This level of appeal only applies if it is thought that the first tier tribunal made an 'error in law' when considering your appeal. For example, an 'error in law' might be that the tribunal had no evidence to support their decision. At this stage you will not be able to ask for additional information to be considered.
More about upper tribunal ESA appeals (opens new window) from the Disability Law Service.
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