Employment and Support Allowance (ESA) is the benefit for people who cannot work or have a limited ability to work because of a disability or health condition. The basic rules for ESA are that:

• you must be aged between 16 and state pension age
• you must have a ‘limited capability for work’ (see below for how this is decided)
• you must meet certain rules about being a resident in the UK and about your immigration status
• the general rule is that you cannot work and get ESA, but certain types of ‘permitted work’ are allowed
• you must not be getting Statutory Sick Pay (but you can claim ESA once the Statutory Sick Pay ends)
• you must meet at least one of the following three conditions:

1. at the start of your ESA claim, you had paid enough national insurance contributions to qualify
2.  your income and savings are low enough to qualify
3. you have been transferred off Incapacity Benefit or Severe Disablement Allowance and onto ESA, or you have qualified under the ESA in Youth rules before April 2012.

It is possible to get ESA while you are in full-time education, if you meet certain rules.

ESA is administered and paid by Jobcentre Plus which is part of the Department of Work and Pensions (DWP).

There are two types of ESA:

• contribution-based ESA (following the introduction of Universal Credit, this is now called New Style ESA)
• income-related ESA.

It is possible to qualify for just one type or a combination of both types of ESA. You do not have to choose which type to claim, there is a single claims process and the DWP should assess and decide which type you qualify for.

New Style ESA is claimed through the Universal Credit Helpline on 0800 328 5644.

If you have a Severe Disability Premium on your means-tested benefits, you may still be able to claim the old-style ESA. To make a claim, call 0800 169 0350 (or 0800 085 6318 in Northern Ireland).

ESA claimants are assessed and placed in either the ‘work-related activity group’ or the ‘support group’, there is more information about this below.

The old ‘sickness’ benefits

Incapacity Benefit, Severe Disablement Allowance and Income Support

ESA was introduced in 2008 and replaced Incapacity Benefit (including Incapacity Benefit in Youth), Severe Disablement Allowance and Income Support paid on the basis of incapacity. People who currently receive these old benefits are being reassessed and moved off those benefits.

The two types of ESA

Contribution-based ESA/New Style ESA and income-related ESA

You may qualify for just one type, or a combination of both types of ESA. People can move from getting one type of ESA to the other.

Contribution-based ESA/New Style ESA can be paid to people who have paid enough national insurance contributions to qualify. It is not means-tested, so your income and savings are not assessed. Contribution-based ESA/NSESA is only paid for one year if you are placed in the work-related activity group.

Income-related ESA is paid to people whose income and savings are low enough to qualify. Only the claimant’s income and savings, and those of a partner who lives with the claimant, are assessed. For example, if you live with your parents, or with a friend, their money is not considered. But if you live with a partner, their income and savings are considered. Income-related ESA is not time limited.

If your savings add up to £16,000 or more, you cannot get any income-related ESA. If your savings are below £6,000, they are ignored. If your savings are between £6,000 and £16,000, you may still be able to get income-related ESA, but the weekly amount you are paid will be reduced.

If your contribution-based ESA/NSESA stops after a year because you are in the work-related activity group (explained below), you may need to make a claim for Universal Credit.

For more information please see ESA and the work capacity assessment.

Claiming ESA

Most new claims for income-related ESA have now been replaced by Universal Credit (see information below).

To make a claim for New Style ESA, call the Universal Credit Helpline on 0800 328 5644. If a person lacks capacity to manage the claim themselves, someone else can claim for them as their ‘appointee’.

The ESA office will ask you to send in certain evidence to support your claim. This will include a medical certificate (commonly known as a Fit note) from your doctor.

Once you have made the claim and sent in the requested evidence, the ESA should be paid at a basic rate during the first 13 weeks. This is called the ‘assessment phase’. During this time, you must keep sending in fit notes if your original one runs out.

During the assessment phase, you will be assessed under the ‘work capability assessment’. More details about this below.

At the end of the assessment phase (which should last 13 weeks), the work capability assessment will have been carried out and there are three possible outcomes.

1. It is decided that you do not meet the ESA criteria and the ESA payments are stopped.
2. It is decided that you do meet the criteria and you are placed in the work-related activity group.
3. It is decided that you do meet the criteria and you are placed in the support group.

The work capability assessment

The assessment for ESA is called the 'work capability assessment'. It is a points-based assessment that looks at your ability to carry out various activities. If yours is a new claim for ESA, you are assessed during the initial 13-week assessment phase. If you are being transferred from Incapacity Benefit or one of the other old sickness benefits, you will be assessed under the work capability assessment before you are transferred off the old benefit.

Information is collected about you including the ESA50 form you fill in, the medical assessment and anything else you send in. Sometimes they will write to a professional you told them about in the form such as your doctor or social worker, but often they do not contact anyone.

Once they have collected this information, the DWP must decide the answer to two questions:

1. Do you have limited capability for work?
   This is the basic criteria for ESA. If they decide you don’t have limited capability for work, you cannot get ESA. There is no assessment of whether you could do a job, instead it is a points-based assessment. There is a list of statements and each statement is worth a certain number of points. If you score 15 points in total, you are said to have ‘limited capability for work’.
2. Do you have limited capability for work-related activity?
   This is the additional criteria for the support group. If they decide that you do have limited capability for work and so can get ESA, they must then go on to consider whether you also have limited capability for work-related activity. Membership of the support group has various advantages. In the support group, you cannot be required do any work-related activity, you get a higher amount of benefit, and you are exempt from the time limit of contribution-based ESA/NSESA.

How the work capability assessment is carried out

Parts of the work capability assessment are carried out by a company called Maximus, who also use the name ‘Centre for Health and Disability Assessments’. Maximus currently have the DWP contract to provide what the DWP calls ‘medical services’. This includes arranging and carrying out medical assessments. Maximus does not make the final decision about entitlement.

Stage 1: The form – The ESA50 questionnaire

The first stage of the work capability assessment is the ESA50 form which should be posted to you. The form asks lots of detailed questions about what you can and cannot do. If possible, get help with this form. It is also a good idea to have a look through the points-based criteria first so you have an understanding of what sort of information is relevant. If you have any letters, reports or other information about yourself and your condition, send copies with the form. Keep a copy of the form. You should be given four weeks to complete the ESA50.

Stage 2: Your completed ESA50 form is assessed by the Centre for Health and Disability Assessments and they decide if you need to attend a medical assessment

Most, but not all, people are then asked to attend the medical assessment. If you know that you will not be able to attend it, explain why in your ESA50 form and if possible send with it a letter from a professional confirming that you are not able to attend.

Stage 3: The medical assessment

The medical assessment is called a ‘face to face assessment’, but ‘medical assessment’ is the legal term. You will attend an assessment centre and be seen by a Maximus employee who will ask you questions about your day-to-day life. The assessor may be a doctor, a nurse or physiotherapist. The medical will not involve any physical examination unless you have told them that you also have a physical condition or disability. You can take someone with you to the medical assessment to help you to communicate and explain your difficulties. The assessor will write a report about you. This report is called the ESA85 and is sent to the DWP.

Stage 4: The decision

The official decision is always made by the DWP and must always be issued in a letter. There are three possible outcomes.

It is decided that you do not meet the ESA criteria and the benefit is stopped (because you do not have limited capability for work).

It is decided that you do meet the criteria and you are placed in the work-related activity group (because you do have limited capability for work, but do not have limited capability for work-related activity).

It is decided that you do meet the criteria and you are placed in the support group (because you have both limited capability for work and limited capability for work-related activity).

If you are refused ESA or are placed in the work-related activity group and think that you should have been placed in the support group, you should consider challenging the decision. For information about how to challenge the decision, please see our information on appeals and reconsiderations . You carry on getting ESA paid at a basic rate once you have requested an appeal and are waiting for the appeal to be heard, and many appeals are successful.
 

Getting ESA while in education

It is possible to get income-related ESA whilst you are in full-time education if you are also getting Disability Living Allowance or Personal Independence Payment.
 

Reassessment

ESA claimants are regularly reassessed using the work capability assessment, often once a year, unless they are in the support group and:

• have a severe, lifelong disability, illness or health condition
• are unlikely to ever be able to move into work.

More about who will and won't be reassessed.

Universal Credit

Income-related ESA (but not contribution-based ESA/NSESA) is being replaced by Universal Credit.

Universal Credit has started to replace income-related ESA for new claims and people who have a change of circumstances.

Everyone getting income-related ESA will eventually be moved on to Universal Credit. This is called ‘managed migration’ and is planned to take place between November 2020 and 2024.

Claimants do not need to do anything until they get a letter inviting them to claim UC.

More information

• The Government’s website has information on Employment and Support Allowance
• Citizen’s Advice has lots of information about Employment and Support Allowance, including tips on filling out the form and preparing for an assessment
• Disability Rights has lots of information about benefits including Employment and Support Allowance.