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Employment and Support Allowance (ESA) is a UK Government State Benefit which replaced new claims for Incapacity Benefit (IB) and Income Support (IS) on the basis of incapacity for work for most claimants from 27 October 2008. Originally, claimants already receiving Incapacity Benefit, Income Support paid because of an illness or disability or Severe Disablement Allowance (SDA) continued to receive those benefits as long as they remained eligible. However, the government announced in 2010 that these claimants would all be migrated to ESA between Spring 2011 and 2014.
ESA can be either contributory or income-related. If claimants satisfy national insurance conditions they can claim contributory ESA for up to one year (if they get the work-related activity component) or indefinitely (if they get the support component). . Income-related ESA is subject to a means test and certain other conditions. If they meet both sets of conditions, they can get contributory ESA topped up with income-related ESA.
The main change from Incapacity Benefit is that the old Personal Capability Assessment (PCA) has been replaced with a Work Capability Assessment (WCA), which the government claim will give a better view of the claimant's ability to undertake some form of work. The Department for Work and Pensions has contracted Atos Healthcare, a healthcare company part of the global Atos Origin company to undertake medical assessments. There are a number of medical conditions for which a medical assessment is not required and others where the medical advisor has to ask the patient's GP or consultants for information.
An individual can claim ESA if they:-
The ESA information provided by the claimant together with other information such as a covering letter should be assessed by a qualified healthcare professional to decide whether a face to face medical assessment is necessary. The Contract between the DWP and Atos Healthcare lists those medical conditions for which a face to face assessment is not required and for those where a medical advisor with specialist knowledge of the pathology and treatment of the medical condition is mandatory or advisory.
Once a person has claimed ESA, they will receive it initially for up to 13 weeks, as long as they provide medical evidence of their sickness or disability. This 13-week period is known as the assessment phase. During this time, a work capability assessment (WCA) will be carried out to determine whether the claimant is sufficiently sick or disabled to qualify for ESA.
The WCA is made up of three separate assessments, although not all ESA claimants will have all three assessments. The assessments are:-
The limited capability for work assessment determines entitlement to ESA. It measures a person’s ability to perform certain activities relating to physical function, and to mental, cognitive and intellectual function. In order to be entitled to ESA, a person will need to score 15 points in total. Within each function, a claimant can score 15, 9, 6 or 0 points. They can score these because of physical functions, mental functions or a mixture of the two.
The limited capability for work-related activity assessment is the second assessment within the WCA. It is used to decide what rate of ESA will be paid after the first 13 weeks and whether the claimant will be required to undertake any work-related activity as a condition of entitlement. If a claimant satisfies the limited capability for work-related activity assessment, they will be entitled to the support component of ESA after 13 weeks and will not have to undertake work-related activity or have work-focused interviews, whereas if they do not, they will receive the work-related activity component of ESA and have to undertake work-related activities and have work-focused interviews.
The basic weekly allowances (as of 2011) are given below (although these are different for claimants who are under 25):
|(weeks 1-13 only, no|
|(payable from week 14)|
|Work-related activity component *||———||£26.75|
|Support component *||———||£32.35|
(* only one component is payable, depending on the result of the WCA process)
Many organisations, including the Citizens Advice Bureau, have shown concern about the way the work capability assessments are carried out.
The Citizens Advice website states: "Employment and support allowance (ESA) was introduced in October 2008 to replace the existing incapacity benefit (IB) for new claimants. It aims to give more help to those who might, with support, be able to work. Citizens Advice has been monitoring the impact of the new benefit, and this is our second report since its introduction. Limited capability, published in November 2009, covered the administration of the benefit, and this report looks at the assessment process. Bureaux advisers have expressed grave concern at the number of people unexpectedly being found fit for work. This report therefore examines three key aspects of the ESA assessment process: who is being selected for the work capability assessment (WCA); its design and content; and how it is carried out in practice."