Why Does ESA require customers to attend a medical assessment?

This system is actually much the same as what was in place under the previous Incapacity Benefit system.

The Work Capability Assessment or WCA is a professional assessment of the eligibility of someone for ESA based on what they can do, as opposed to what they can’t do.  The criteria for Incapacity Benefit included a personal capability assessment but focused primarily on what someone couldn’t do. Created back in 1995, it has proved outdated in relation to the changes of the modern workplace as well as the development in medical therapy and understanding of conditions that are common.

The WCA is a more robust and accurate assessment that helps to identify people with health conditions that mean it is unreasonable to expect them to work.  They can then get the support they need.

The key change to the system is where it identifies people who can take part in work related activity and the support and interventions that are needed to help them to get back into employment.  It also helps to understand the limitations of their condition and looks as if it would be unreasonable to ask them to undertake work-related activity in the foreseeable future.

Does everyone have to go through a WCA?

Most new customers to ESA need to go through an assessment.  Sometimes a decision may be made with documentary evidence for those with the most severe conditions and disabilities who are placed in the Support group.

Why does GP provide medical certificates and reports?

Under the terms of the General Practitioner contract, they are required to supply paperwork that helps ESA to decide about a customer.

What happens if you don’t attend?

If someone doesn’t attend a medical assessment, ESA will write and ask for an explanation.  This is then passed to a Decision Maker who will decide if they have a good cause for not attending or not.  If they decide a good reason has not been provided, the ESA benefit can be stopped.

Are the assessments carried out by experts in the condition?

The assessments are carried out by professionals who have the training to understand the effect that a condition has on a person and their abilities.  They don’t need to have specific knowledge of the exact nature of the condition but in the analysis of their abilities.

Why is there no disability premium under ESA?

ESA works differently from the old benefits and this means that there is no a concept of a disability premium.  However, the benefit does understand the needs of people with disabilities and instead looks at these in a different way.  Other benefits don’t include a work related activity or support component. Those who come under the work related activity category are there because they can do some form of activity and will benefit from it.

Does this system make it harder to get the benefit?

The aim of ESA is not to make it harder to get the right benefit but ensuring that the assessment is still relevant today, considering changes in workplace condition, health conditions and general medical knowledge.  It contains a fairer and more accurate assessment of a person’s abilities with their condition and to identify those who can carry out some form of work.

The WCA is a comprehensive assessment of mental, cognitive and intellectual functions with a scoring system being removed to make sure there is no perceived bias against those with mental health conditions versus physical health conditions.

Why have descriptions been changed?

Descriptions have been changed in line with many of the activities carried out by employees.  When descriptions were no longer relevant, new ones were brought it. They also reflect a new view of mental health assessment, taking into account things such as learning disabilities.

Work has been done with medical experts to ensure that descriptions and scoring are more accurate and ensures that if it is unreasonable to expect people to work, the assessment clearly shows this.

Are people with mental health issues penalised as they can’t provide information requested?

ESA advisers understand that people with some mental health conditions may struggle to provide information required.  All efforts are made to help them with this and they would not be sanctioned for not providing information until a carer or health care professional has been contacted and all efforts made to help them understand.