FACTSHEET No. 27

Employment & Support Allowance: An Overview

This factsheet is a basic introduction to Employment and Support Allowance (ESA).

1. What is employment and support allowance?

You can get employment and support allowance (ESA) if your ability to work is limited by ill health or disability. ESA replaced both incapacity benefit (IB) and income support (IS) paid on the grounds of incapacity for new claims from 27 October 2008.

2. What are the rules for ESA?

If you are claiming ESA you must:

• be at least 16 years old
• be under pensionable age (ESA stops when you reach retirement age)
• undergo a 13 week assessment phase
• satisfy at least one of the following:

1. pass a contributory test or be under age 20 (or 25 in certain cases)
2. pass a low income test

3. The assessment phase?

When you make a claim for ESA you have to have an initial assessment. This assessment usually takes place over 13 weeks, but can be longer. During the assessment phase you will undergo a work capability assessment and a work focused interview.

4. The work capability assessment

The ESA work capability assessment (WCA) is carried out by a health care professional working on behalf of the Department for Work and Pensions. It is intended to:

• find out whether you have a ‘limited capability for work’.
• find out whether you have a ‘limited capability for work-related activity’.

4.1 The limited capability for work test

The limited capability for work test decides whether or not you remain on ESA. If you do not pass the test, because you are not considered to have a limited capability for work, you would need to consider appealing this decision or claiming jobseeker’s allowance instead.

If you appeal you can continue to receive the basic allowance of ESA until a decision is made on your appeal by a tribunal.

For this test you are assessed on your ability to carry out 17 listed physical or 'mental, cognitive and intellectual' activities. Points are awarded on the basis of your limitations with respect to each activity. These points are totalled up and if the total reaches the threshold of 15, you are deemed to have limited capability for work and thus stay on ESA.

Within each type of activity there is a list of descriptors with associated scores ranging from 0 to 15. The descriptors describe related tasks of varying degrees of difficulty. You score when you are not able to perform the activity described. Though more than one descriptor may apply to you, you can only pick up one score from each type of activity; in each case whichever scores the highest.

If you score 15 in any one activity, you automatically pass the test. If your score is less than 15, it can be added to the scores you pick up from any of the other types of activity (in both the physical and the mental parts of the test). If your total score reaches 15, you pass the test.

The physical activities

The physical functions in the limited capability for work test are grouped into 10 different types of activity. These are:

1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used.
2. Standing and sitting.
3. Reaching.
4. Picking up and moving or transferring by the use of the upper body and arms.
5. Manual dexterity.
6. Making self understood through speaking, writing, typing, or other means normally used, unaided by another person.
7. Understanding communication by both verbal means (such as hearing or lip reading) and non-verbal means (such as reading 16 point print) using any aid it is reasonable to expect them to use, unaided by another person.
8. Navigation and maintaining safety, using a guide dog or other aid if normally used.
9. Absence or loss of control leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting) despite the presence of any aids or adaptations normally used.
10. Consciousness during waking moments.

The assessment takes into account your abilities when using any aid or appliance you would normally use.

The mental,cognitive and intellectual activities

These functions in the limited capability for work test are grouped into sets of activities under the following 7 headings:

1. Learning tasks.
2. Awareness of everyday hazards (such as boiling water or sharp objects).
3. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks).
4. Coping with change.
5. Getting about.
6. Coping with social engagement due to cognitive impairment or mental disorder.
7. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder.

4.2 Treated as having limited capability for work

You will be automatically treated as having a limited capability for work in the following circumstances:

• You are terminally ill.  This is defined as a progressive disease and death in consequence of that disease can reasonably be expected within six months.
• You are receiving treatment by way of intravenous, intraperitoneal or intrathecal chemotherapy (or are likely to receive such treatment within 6 months), or you are recovering from that treatment and Jobcentre Plus is satisfied that you should be treated as having a limited capability for work.
• You have been requested or given notice, under specific legislation, to refrain from work because you are a carrier of, or have been in contact with, an infectious disease. You are pregnant and there would be a serious risk to the health of you or your child if you did not refrain from work.
• You are pregnant or have recently given birth, are entitled to maternity allowance and are within the maternity allowance payment period.
• You are pregnant or have recently given birth but are not entitled to maternity allowance or statutory maternity pay from six weeks before the baby is due to two weeks after the birth.
• You are a hospital inpatient and you are receiving medical or other treatment as an inpatient in a hospital or similar institution or recovering from such treatment and Jobcentre Plus is satisfied that you should be treated as having a limited capability for work. This can include where the you are attending a residential programme of rehabilitation for the treatment of drug or alcohol addiction.
• You are receiving treatment or recovering from treatment by way of haemodialysis, plasmapharesis, radiotherapy or total parenteral nutrition. You will only be treated as having limited capability for work from the first week that you have 2 days of treatment or 2 days of recovery or 1 day of treatment and one day of recovery (these days do not have to be consecutive).
• You have problems conveying food or drink to the mouth.
• You have problems chewing or swallowing food or drink.

4.3 Limited capability for work-related activity

The second test within the WCA considers whether you have a ‘limited capability for work-related activity’. Though the wording may seem similar to that of the first test, the second test has a very different function. It is used to determine whether you are placed in the support group of claimants or the work-related activity group.

Which of these groups you are placed in will determine both the level of ESA that you will receive and the responsibilities you will need to meet in order to retain the benefit. The test has a list of activities and descriptors, relating to both physical and mental, cognitive or intellectual functions. If you satisfy at least one of them you will be placed in the support group of claimants.

The descriptors are grouped together under the following 16 activity headings:

1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used.
2. Transferring from one seated position to another.
3. Reaching.
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 Schedule).
5. Manual dexterity.
6. Making self understood through speaking, writing, typing, or other means normally used.
7. Understanding communication by hearing, lip reading, reading 16 point print or using any aid if reasonably used.
8. Absence or loss of control over extensive evacuation of the bowel and/or voiding of the bladder, other than enuresis (bed-wetting), despite the presence of any aids or adaptations normally used.
9. Learning tasks.
10. Awareness of hazard.
11. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks).
12. Coping with change.
13. Coping with social engagement, due to cognitive impairment or mental disorder.
14. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder.
15. Conveying food or drink to the mouth.
16. Chewing or swallowing food or drink.

The assessment takes into account your abilities when using any aid or appliance you would normally use.

4.4 Treated as having a limited capacity for work related activity

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

• suffering from a progressive disease and consequently your death can reasonably be expected within six months.
• receiving treatment by way of intravenous, intraperitoneal or intrathecal chemotherapy (or are likely to receive such treatment within 6 months), or you are recovering from that treatment and Jobcentre Plus is satisfied that you have a limited capability for work-related activity.
• 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.
• 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.
  

4.5 How the work capability assessment is applied

In order to apply the tests for limited capability for work and limited capability for work-related activity a decision maker will first look at the information that you have provided in your initial claim for ESA to see if you pass these tests without the need for further enquiries.

If the decision maker considers that there is not enough information to make a decision you will normally be sent an ESA50 questionnaire to complete. This form has a number of questions about the activities listed above. Each activity has a section with tick-boxes and space to provide more detailed information about each activity.

Once the decision maker has received your completed ESA50 they may decide that there is clear evidence that you have limited capability for work (and possibly work-related activity). If not, you will be sent an appointment to attend a face to face assessment carried out by an approved disability analyst.

The disability analyst will have read a copy of the ESA50 form that you have completed and at the face to face assessment they will be trying to identify whether or not your account, in that form, of your functional limitations corresponds with their findings.

They will ask you a series of questions, relating to both your physical and mental, cognitive or intellectual capabilities, guided by what you have put down on the ESA50. Once they have finished this, they will then give you a physical examination.

The decisions on whether or not you have limited capability for work and limited capability for work-related activity will not, however, be taken by the disability analyst. He or she will complete an ESA85 medical report form which will be sent to a decision maker, who will make these two decisions.

The report form also has recommendations as to when you should be retested for limited capability for work and limited capability for work-related activity.

4.6 Exceptional circumstances

Even if the decision maker decides that you do not pass the limited capability for work test they can still treat you as having passed it if the health care professional has obtained evidence that one of the following exceptional circumstances apply:

1. 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.
2. 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 limited capability for work.   This risk should be linked to work you could realistically do according to your education or skills. 

5. The work-focused interview

You are expected to attend an initial ‘work-focused interview’, unless you are terminally ill. This will normally take place during the 8th week of your ESA claim. At this interview a ‘personal adviser’ will discuss your work prospects, the steps that you are willing to take to move into work and the support available to you.

The interview can be waived if you are likely to be starting a job or returning to work. The personal adviser can also defer an interview if, because of your condition, it would be inappropriate at that particular time.

Whether you have to attend further interviews will depend on whether you are placed in the work related activity or support groups (see 8 and 9).

Some people are not required to take part in these interviews such as those in the support group, those who have reached the qualifying age for pension credit and those under 18 (who will have a learning focused interview with Connexions).

6. The contributory test

You will need to have paid enough National Insurance contributions in specific tax years to satisfy this test. If you do pass the test you will receive a flat-rate benefit payment for yourself.

Contributory ESA has no age-related additions or additions for dependents (such as your wife, husband, civil partner or child) premiums or allowances for housing costs. In order to get additions for your partner, additional premiums or housing costs you will need to also satisfy the low income test (see 7).
 
If you need extra money to look after a child, you should claim child tax credit.
If you have limited capability for work and claim ESA before the age of 20 (or 25 if you have been in education or training) you do not have to satisfy the contribution conditions.

The amount of contributory ESA you get will be reduced if you have an occupational pension of over £85 per week. There are some exceptions to this rule. For more information see our Disability Rights Handbook.

From April 2012 a time limit of 1 year will apply to certain Contributory ESA claimants.  See Section 13.1 of this factsheet for more details.

7. The low income test - income related ESA

This is a test similar to income support. In brief, your needs (and those of your partner if you have one) are compared with your resources, such as your income and savings, and the income-related allowance worked out from this comparison.

You cannot get income-related ESA if your capital or savings (or you and your partner's capital or savings) is above an upper savings limit of £16,000.

Your benefit will also be affected if your capital or savings (or you and your partner's capital or savings) is above a lower savings limit of £6,000. If you are permanently in a care home this lower limit is £10,000.

If you need extra money to look after a child, you should claim child tax credit.

8. The support group

If it is decided that you have a limited capability for work-related activity, you will be placed in the support group of claimants. If you are placed in this group, you will not have to undertake work-related activities (though you can volunteer to do so if you want).

9. The work-related activity group

If it is decided that you do not have a limited capability for work-related activity, you will be placed in the work-related activity group of claimants. You will have to adhere to strict work-related conditions in order to continue receiving the benefit in full. This may involve attending further work-focused interviews in addition to the initial work-focused interview.

These interviews will normally take place each month and at them the personal adviser will try to help you back into work. As with the initial work-focused interview, the adviser will be using the capability report as a guide. The adviser will draw up an ‘action plan’, which will outline the activities that you could undertake to help you move into work.

9.1 Sanctions

Both the initial work-focused interview and the follow-up interviews are mandatory. If you fail to either attend or participate in a work-focused interview, your ESA may be paid at a reduced rate or ‘sanctioned’. Sanctions can only be applied to the additional payments of ESA, not the basic allowance. Hence sanctions can only be applied when the assessment phase of the benefit is over.

You can appeal using form GL24.  There is a one month appeal deadline from the decision date. 

10. If you are on incapacity benefit

At some point between now and March 2014, if you are on incapacity benefit, you will be reassessed under the Work Capability Assessment instead of the personal capability assessment. The Work Capability Assessment is the test for employment and support allowance (ESA).

If you are found to have a limited capability for work in this assessment, you will be moved (migrated) onto employment and support allowance.

11. If you are a student

If you are a full time student claiming contributory ESA you will have to satisfy the limited capability for work test. If you are claiming income-related ESA you will be treated as having limited capability for work if you are getting disability living allowance (DLA).

Whether or not you automatically satisfy the limited capability for work test you will still be assessed under the limited capability for work-related activity test, which decides whether you are in the support group or the work-related activity group.

If you are a part-time student you will have to satisfy the limited capability for work test and be assessed under the limited capability for work-related activity test.

12. How much is ESA?

Employment and Support Allowance - rates

The amount you get paid depends on your circumstances. There are several things that will be taken into consideration. It also depends on what effect your disability has on your ability to do any work.

Weekly rate during the assessment phase

The assessment phase rate is paid for the first 13 weeks of your claim while a decision is made on your capability for work through the Work Capability Assessment.

Weekly rate during the main phase

The main phase starts from week 14 of your claim, if the Work Capability Assessment shows that your illness or disability does limit your ability to work.

In most cases you will not get any money for the first three days of your claim. These are called 'waiting days'.

Depending on your circumstances you may be able to get more money if you get income-related Employment and Support Allowance. 

You can only get extra money for your husband, wife or civil partner if you get income-related Employment and Support Allowance.

Pension income rules

If you receive contribution-based Employment and Support Allowance and have a gross pension income of more than £85 a week, the amount of benefit payable will be reduced by half of the excess.

The excess is the difference between £85 and the actual pension income. For example, for a pension income of £100, the excess is £15. The amount of Employment and Support Allowance payable is reduced by half of that, which is £7.50.

If you receive income-related Employment and Support Allowance, any pension income you have will be taken into account, regardless of the amount.

Income Tax

Income Tax will not be taken from income-related Employment and Support Allowance.

There are some other cases where no Income Tax will be taken, for example if you are getting an occupational pension.

Contribution-based Employment Support Allowance is taxable. Tax may be paid on it from the start of an award.

You will get a letter that tells you how much tax you will have to pay, if any. The amount of tax depends on your tax code.

• Tax codes (general money, tax and benefits section)

How it is paid

Employment and Support Allowance is usually paid into your bank, building society, Post Office or National Savings account - any account that accepts Direct Payment.

What to do if your circumstances change

It is important to contact the Jobcentre Plus office dealing with your claim if your circumstances change. You can do this by telephone - their number will be on letters they have sent to you. For example if:

• you do any work, including voluntary work
• you start training and get a training allowance
• you change your address
• you have been in hospital for 52 weeks and part of your benefit is paid for someone else
• you go abroad

12.1 The assessment phase

During the assessment phase you are paid a ‘basic allowance’. This is set at a similar level to that of jobseeker’s allowance. If you are aged under 25 you will receive a reduced rate of this basic allowance. Once you have completed the assessment period the reduction for under 25s does not apply.

If you are on contribution related 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). There is no disability premium with ESA.

12.2 After the assessment phase

After the assessment phase you can receive one of two additional payments depending on whether you are placed in the work-related activity group or the support group.

If you are placed in the work-related activity group you will receive a work related activity component of £26.75 included in your payment.

If you are placed in the support group you will receive a support component of £32.35. included in your payment. If you are terminally ill this component will be paid to you during the assessment phase.
 
If you are aged under 25 you will no longer be paid a reduced rate of the basic allowance.

Everyone in the support group, who is on income-related ESA, gets the enhanced disability premium. You may also be able to get additional premiums and housing costs.

12.3 Premiums

You can get extra amounts in the form of premiums if you satisfy certain conditions.

You can get any or all of the following premiums if you satisfy the rules for them:

carer premium 
enhanced disability premium
pensioner premium
severe disability premium

Carer premium

You or you partner must be entitled to carer's allowance, even if you are not actually paid it because you receive another benefit. This premium is payable for each person who qualifies.

Enhanced disability premium

You or your partner must satisfy one of the following:

• be in the support group
• be under the qualifying age for pension credit and receiving the high rate care component of disability living allowance

If you have a partner you will be paid a higher couple rate of this premium. 

Pensioner premium

This is paid if you or your partner have reached the qualifying age for pension credit. If you have a partner you will be paid a higher couple rate of this premium.

Severe disability premium

You or your partner must satisfy all of the following:

• be receiving the care component of disability living allowance (middle or higher rate) or attendance allowance
• live alone (there are exceptions to this rule - For more information see our Disability Rights Handbook.)
• no one else must be getting carer's allowance for looking after you 

There is a couple rate if both of you qualify.

12.4 Capital

You cannot get income-related ESA  if your capital or savings (or you and your partner's capital or savings) is above £16,000. Your benefit will be affected if your capital or savings (or you and your partner's capital or savings) is above £6,000 (£10,000 if you live permanently in a care home).

12.5 Tariff income

If your capital is between the lower and upper limits, a ‘tariff income’ is assumed. One pound a week for every £250 (or part of £250) above the lower limit is included as your income.

For example, if you have capital of between £6,250.01 and £6,500, £2 a week is included as your income. Each time capital gets into the next block of £250 (even by as little as one penny) an additional £1 is included as income.

13. How to claim employment and support allowance

You should phone the national contact centre:

Telephone: 0800 0 55 66 88
Textphone: 0800 0 23 48 88 (i)
Welsh language: 0800 0 12 18 88

Lines are open from 8:00 am - 6:00 pm, Monday to Friday. Charges may apply to calls from mobile phones, but the contact centre will call the customer back if requested.

You can also get a claim form (ESA1) from your local Department for Work and Pensions office or Jobcentre Plus office or download it from the DirectGov website at http://tinyurl.com/6fs4537.

You can also make an online claim at www.dwp.gov.uk/eservice/.

You will also be expected to provide medical certificates from your doctor, known as fit notes, until you have passed the limited capability for work test. If you are claiming contributory ESA because you are under 20/25 these fit notes must also cover the 196 day period).
 
If you are working but do not get statutory sick pay you will also need to send in form SSP1 as well as a fit note. You can get this form from your employer.

13.1 Time limiting of ESA claims

There is currently no time limit for claiming either contribution or income based ESA. Even with contribution based ESA, you do not run out of NI contributions after a certain period of time and you will continue to receive ESA as long as you can still show you have a limited capability for work.

However, from April 2012,  a time limit of just one year is to apply to all contribution based ESA claims  for those in the work related activity group (WRAG).  As of April 2012, those who have already received contribution based ESA for a year or more will have their entitlement ceased immediately.  The 13 week assessment phase will form part of the calculation of the 1 year period.  

14. Students

14.1 Full time students

If you are a student you can claim contributory ESA if you have paid enough national insurance (NI) contributions, or satisfy the rules for claimants under 20/25. You will still have to satisfy the limited capability for work test.

If you are aged 16, 17 or 18 you will usually be excluded from claiming contributory ESA if you are still at school or in full-time education of 21 hours or more a week. Lunch breaks, breaks between lessons, free periods, and periods of private (unsupervised) study or homework do not count. From age 19 there are no rules that limit the hours and type of study you can do.

When adding up the number of hours that you study each week, you should ignore 'any instruction or tuition which is not suitable for persons of the same age who do not have a disability'.

You can only get ESA on grounds of low income (income-related ESA) if you are getting disability living allowance (DLA).

If you are on DLA you are also treated as having limited capability for work but you will still be assessed under the limited capability for work-related activity test, which decides whether you are in the support group or the work-related activity group.

14.2 Part-time students

If you are a part-time student you can claim contributory ESA if you have paid enough national insurance (NI) contributions, or satisfy the rules for claimants under 20/25. You can also claim income-related ESA if you are on a low income. You do not have to be receiving DLA.

Whether your course is full or part-time usually depends on how it is classed by the institution. However, if you are on a course of government-funded further education in England or Wales it is full-time if it involves more than 16 guided learning hours a week. In Scotland, it is still full-time if structured learning packages make up the hours to over 16 a week, up to a maximum of 21 hours a week.

15. What about those who are already getting IB or IS?

If you are receiving incapacity benefit (IB) or income support (IS) paid on the grounds of incapacity you will continue to receive those benefits, rather than ESA, for the time being.

At some point between now and March 2014 you will be reassessed under the Work Capability Assessment instead of the personal capability assessment. The Work Capability Assessment is the test for employment and support allowance (ESA).

If you are found to have a limited capability for work in this assessment, you will be moved (migrated) onto employment and support allowance.

Those getting incapacity benefit who are moved onto contributory ESA , and who are in the work-related activity group, will have their benefit time limited to 12 months from the point of conversion. This applies whether reassessment takes place before or after April 2012. 

16. Where can I get more help or information?

You can get information about employment and support allowance from CARA or any of your local advice centre, such as a citizen's advice bureau. You can get more information about this from Factsheet F16 - finding a local advice centre.

You can also obtain copies of our factsheets and publications by contacting CARA on Tel: +44 (0) 844 478 0015 - Mob: +44 (0) 795 695 2645 - Fax: +44 (0) 872 115 8436 - Email: info@cara-online.org

Updated 8 April 2011