Employment and Support Allowance or ESA is a benefit that was introduced in 2011 as a way to streamline and organise a series of benefits.
These were paid to people who were unable to work due to illness or disability but who weren’t getting Statutory Sick Pay (SSP). But what is the process for claiming ESA?
For the claim form
To start with there is an online claim form you have to fill in to make a claim for ESA. You can also ring the ESA helping number to make the claim over the phone with someone. But there is information you need to have before doing this. This information includes:
- National insurance number
- Medical certificate with information about why you are unfit to work
- Details of your doctor and the surgery’s address
- Contact information for yourself such as address and phone numbers
- Details about your living situation such as rent or mortgage information
- A copy of your most recent council tax bill
- Details of a current employer or dates of the last employment
- Bank account information
- Any other documents that support your claim and details of other types of payments or benefits you might have received or still be receiving
The application process
Once you have submitted an application then you will start to receive ESA at a reduced rate while the full application process is completed. This reduced rate remains in place until you have gone through the process called the Work Capability Assessment (WCA). The idea of this is to be certain that people receiving ESA cannot work and has been somewhat controversial but remains the system used.
The WCA involves a three-stage process – a medical questionnaire, the ESA 50 form, a face to face assessment and a decision made by a qualified advisor at the DWP based on the recommendations from the assessor. Not everyone will be required have a face to face assessment but if you are asked and you don’t attend, you will be classed as available for work and moved straight off ESA.
The assessment involves 17 different activities that you might be required to do a job including physical issues connected with your condition or disability as well as mental, cognitive and intellectual tests. This might mean that you are asked to move around and use steps, reaching and moving things, understanding verbal communications and navigating safely around a space.
You might also be asked to undertake learning tasks, awareness of hazards or dangers and starting and finishing tasks. Assessment can include coping with social engagement and behaving appropriately.
Outcomes of the process
There are three possible outcomes to the application process. The first is that you are found fit for work and would need to start looking for a job. You won’t continue to receive ESA but might qualify for other benefits depending on your situation such as Jobseeker’s Allowance.
If you are found not fit for work, then there are two further outcomes depending on your situation:
- You are found fit to take part in work-related activity – this means being in the ‘Work Related Activity Groups’ and taking part in some activities that will allow you to be able to work at some point in the future
- You are found not fit to take part in work and are placed in the ‘Support Group’
- How much ESA will I get?
Appealing the process
If you are unhappy with the decision or some part of the process, you may need to check by calling the ESA helpline who to speak to regarding the problems. You can ask for ‘mandatory reconsideration’ which involves the DWP formally reconsidering their decision which can be done by calling them or by writing to them.
If you still aren’t happy with the decision they have made, you can appeal against it. The appeal is done through form SSCS1 within one month of the date of the letter telling you the outcome of the mandatory reconsideration. This form isn’t sent to DW but instead to HM Courts and Tribunal Service. You may want to get the Citizen’s Advice Bureau or similar service to help you fill out this form. It will then be considered, and you will be notified of the outcome in writing.