esa - making a claim
Employment and Support Allowance (ESA) is a UK benefit for people of working age, who cannot work or who have 'limited capability for work' due to sickness or disability, and who are not getting Statutory Sick Pay.
Who can claim ESA?
You may be able to claim Employment and Support Allowance (ESA) if you are between 16 years old and state pension age, and your epilepsy or other medical condition or disability affects your ability to work. This may apply to some people with epilepsy. You can apply for ESA if you work but do not get Statutory Sick Pay, if you are self-employed or unemployed, or a student on Disability Living Allowance or Personal Independence Payment. ESA replaces Incapacity Benefit and Income Support, so people on these benefits will be contacted about ESA.
Types of ESA
According to the Department for Work and Pensions (DWP), ESA aims to give you financial support if you're unable to work, and personalised help so that you can work if you're able to. There are two types of ESA:
- contributory ESA for people who have paid enough national insurance contributions; and
- income-related ESA for people who have a low income and low (or no) savings.
A person may be awarded either contributory ESA, or income-related ESA, or both depending on their situation.
People who receive ESA will be placed either in the 'work-related activity' group (where you have to do some work-related activities) or in the 'support group' (where you do not have to do any work-related activities). If you are in the work-related activity group, and get contribution-based ESA, these payments will last for one year only.
Applying for ESA
The quickest way to apply for ESA is by phone:
- telephone: 0800 055 6688 or Welsh language telephone: 0800 012 1888; or
- textphone: 0800 023 4888 (these numbers are free from a UK landline; mobile charges vary).
Or you can fill in an ESA1 claim form online at www.gov.uk and print it out to take it to your local Job Centre.
You will be asked for information such as your national insurance number, your doctor’s name and address, and your bank account details. You also need to send in a medical certificate (also called a ‘doctor’s note’ or ‘fit note’).
Visit www.gov.uk/employment-support-allowance for more information.
The assessment phase
Once you have claimed by phone or by filling in an ESA1 form, you will enter the ‘assessment phase’ of ESA while a decision is being made about your claim. This is for 13 weeks (or more as this process is currently delayed in some areas), and during this time you will receive a ‘basic allowance’ which is currently:
- up to £57.35 a week if you’re aged under 25; or
- up to £72.40 a week if you’re aged 25 or over.
To continue receiving this allowance during the assessment phase, you will be asked to provide further ‘fit notes’ from your doctor. To check that the DWP has received your fit note, you can put your mobile phone number on the top right corner of your note. The DWP will text you to say it has been received, and aim to do this within seven days.
The work capability assessment
During the assessment phase you will be asked to go through a ‘work capability assessment’ to decide two things:
- Firstly, whether you have ‘limited capability for work’ and are eligible for ESA. If it is decided you can work, you will be turned down for ESA, but can claim Job Seeker’s Allowance instead.
- Secondly, whether you can do ‘work-related activities’ such as attending courses or applying for jobs, which will place you into the ‘work-related activity group’. If it is decided that you cannot do these things, you will be placed into the ‘support group’, which means you receive ESA without needing to do ‘work-related activity’.
Limited capability for work questionnaire
As part of the ‘work capability assessment’, most people will be asked to complete a second form called the ‘Limited capability for work questionnaire’ (the ESA50 form). This form is long and asks a lot of questions about how your condition affects your ability to do everyday tasks. To give the assessors a full picture, you need to answer each question fully (do not just tick the Yes/No boxes), giving clear and specific details about your ability to do each task, how often you are unable to do a task (if this varies) and why, and any help that you need to do tasks.
You need to return your completed form within four weeks.
See our guide completing benefit forms for more information.
Face-to-face medical assessment
In some cases, a decision about ESA is made on the basis of the information received on the forms. However, most people will also be asked to attend a face-to-face medical assessment with a healthcare professional (an ‘assessor’). You will be told when and where to attend the medical assessment, and you can claim back your travel expenses for getting there. You can take someone with you, such as a friend, family member, social worker or other professional who is involved in your care. It is important that you attend the medical, otherwise you may lose your claim for ESA.
At the medical, the assessor will compare what you wrote on your ESA50 questionnaire with what you can do, and what you tell them, on the day. They will ask you questions about your physical and mental abilities and your understanding of your abilities. They may also give you a physical examination.
What happens next
The assessor will send their report to a DWP decision-maker, who will then decide whether you can claim ESA and whether you will be in the ‘work-related activity group’ or the ‘support group’. If you are placed in the ‘work-related activity group’, you may then be asked to have a ‘work-focused interview’ with a Jobcentre Plus personal adviser, to produce an action plan for what you can do to get a job. If you do not attend the work-focused interviews or other work-related activities, your ESA basic allowance may be cut.
What if my claim is unsuccessful?
If you are not awarded ESA, the DWP will contact you to tell you this. If you want the DWP to look at this again (particularly if your situation has changed) you can challenge their decision, by asking for a ‘mandatory reconsideration’ within one month of the date of the decision.
The DWP will look again at your situation and send you a second decision, called a ‘mandatory reconsideration notice’. This could say that the first decision still stands, or that you have been placed into a different group and are to receive a different level of ESA benefit. The notice will say whether you can appeal against this second decision.
If you want to appeal, you need to do this within one month of the date on the mandatory reconsideration decision letter that you have received. If you intend to appeal, it is recommended that you ask for expert advice from an organisation offering independent benefits advice, such as the Citizens Advice Bureau (CAB) or DIAL UK.
See our guide benefit decisions and appeals for more information.