ESA is a benefit for people whose ability to work is limited by disability or poor health.
To be eligible for ESA, you must be:
at least 16 and under state pension age
have an illness or condition that prevents or impairs your ability to work
You must not receive:
Statutory Sick Pay (SSP)
Statutory Maternity Pay (SMP)
or Jobseeker's Allowance (JSA)
Types of ESA
'New Style' ESA is linked to your National Insurance contributions over the past 2 to 3 tax years and is not means-tested. Your or your partner’s income and savings will generally not affect the amount you are paid. Income from pensions, health insurance and Financial Assistance Schemes may reduce what you will get.
Contributory ESA is linked to your National Insurance contributions and is not means-tested. Your (or your partner’s) income and savings will generally not affect how much contribution-based ESA you’re paid. Income from pensions, health insurance and Financial Assistance Schemes may reduce what you will get.
Most new claims are for 'New Style' ESA. You can only claim the old-style contribution-based ESA if you receive a Severe Disability Premium on another benefit or you were entitled to this in the month before you make the claim.
Income-related ESA is means-tested (your other income and savings are taken into account). Universal Credit has replaced this for most new claims. You can only apply for this type of ESA if you are entitled to a Severe Disability Premium. If you receive a Severe Disability Premium, you cannot claim Universal Credit.
Warning Benefits sanctions
Your benefits can be sanctioned if you do not do things in your claimant commitment from 1 July 2020.
The Government has not said how this will affect face-to-face assessments, re-assessments or appeals.
Talk to your work coach if you cannot meet your claimant commitment because you or someone you live with is vulnerable to coronavirus.
Work Capability Assessment
The Work Capability Assessment, carried out by Approved Healthcare Professionals (AHP) on behalf of the Department for Work and Pensions (DWP), tests your eligibility.
The assessment has 2 parts: to find out if you have a limited capability for work and then work-related activity.
This normally takes place within the first 13 weeks of your ESA claim. You will receive the basic rate of ESA during this time.
Limited capability for work
The first test is the Limited Capability for Work assessment. This considers 17 activities and descriptors: 10 physical and 7 mental, cognitive and intellectual.
Most claimants, except those with the most severe impairment, will have to complete an ESA50 form (GOV.UK).
You will have a face-to-face assessment with an approved healthcare professional who will advise the DWP if you're entitled. You're given 0, 6, 9 or 15 points for each activity.
If you're given 15 points or more, you're thought to have limited capability for work and are entitled to ESA. You'll then have a second test to see if you have a limited capability for work-related activity.
If you're given 14 points or less, you're thought not to have limited capability for work and are not entitled to ESA. You may request a mandatory reconsideration of this decision. You will not be entitled to ESA while this decision is being reconsidered.
The second test looks at whether you should be placed in the support group or the work-related activity group.
The test has a list of activities and descriptions relating to physical and mental, cognitive or intellectual functions. If you satisfy any of these, you're thought to have limited capability for work-related activity and will be placed in the support group.
‘New Style’ ESA and contribution-based ESA can only be paid for 12 months if you’re in the work-related activity group. But you may also be entitled to Universal Credit or Income-related ESA. There’s no time limit if you’re in the support group or if you’re getting income-related ESA. This may carry on beyond 12 months, provided you still meet the qualifying criteria.