What is ESA?

ESA is Employment & Support Allowance. It was introduced in 2008 as a replacement for:

• Incapacity Benefit
• Invalidity and Sickness Benefit
• Income Support claimed on grounds of sickness

It has been rolled out slowly, gradually reassessing those who have been claiming those benefits name above. If you are claiming one of those, you will be reassessed at some point, so it would be wise to be prepared.

Employment & Support Allowance is intended for people who are unable to work due to sickness or ill health. There are different types of ESA. It can be quite daunting trying to understand which to apply for.

 

ESA - Contributions Based

• In order to claim Contributions Based ESA you need to have had an employer pay your National Insurance (Class 1 contributions) for the whole of the previous year. 
• If you were in full time employment before becoming ill, this is the type of ESA you should apply for.
• If you are in the WRAG (Work Related Activity Group - see below), on Contributions Based ESA, you will only receive it for a year. You can then apply for Income Related ESA (see below).
• If you are in the Support Group (see below), on Contributions Based ESA, you are not time limited to the year.

ESA - Income Related

• Income Related ESA is means tested. If you haven't been employed (do not have Class 1 contributions) this is the one you need to apply for.
• The means testing takes into account your income, your savings, and any income and savings of a partner if you live with one.
• It does not take into account your out goings.
• Income Related ESA is not limited to a year.

 

WRAG (Work Related Activity Group)

There are a lot of misunderstandings over what the Work Related Activity Group is.

• The Work Related Activity Group is for those who are expected to be able to return to work within a given time period.
• If you are placed in the WRAG you will be expected to seek and partake in 'activity' that progresses your situation to being able to work again in the future.
• This activity may be voluntary work, but it may also be attending therapy or specialist appointments - it depends upon how open and understanding the Job Centre Plus employee you work with, is.
• It is imperative that the 'activity' you undertake does not cause your health to decline. You can use letters from your GP to guide them in how much they push you.
• One of the useful bits of being in the WRAG is that having regular appointments with a DWP employee means there is a regular record if your health is declining.

It is NOT:

• A group. You do not sit in a circle with other people as if you were in group therapy.
• The Work Program.
• Forced unpaid labour.

The Support Group

The Support Group is for people considered too ill to be likely to return to work in the near future.

Rates

The rates paid to those on ESA have changed since it was introduced, but I believe they have been frozen for the next few years.

• £56.80pw is the introductory rate for under 25s.
• £71.70pw is the introductory rate for over 25s.
• £100.15 is the rate for the WRAG.
• £106.50 is the rate for the Support Group.

Officially the introductory rate is only for 13 weeks. In reality the assessment process often takes a lot longer. When you are eventually placed in WRAG or the Support Group you should get payment at the appropriate rate, back-dated to the 13th week.

If you do not have appropriate National Insurance Contributions, and your household income is too high to place you on Income Related ESA, you will receive no payments - £0.00pw - but they will still pay your National Insurance Credits. (Credits and Contributions are not the same thing).

 

The Process Outlined

If you are employed, and become severely ill:

• you can self certify yourself as ill for one week.
• a doctor can then sign you off work for as long as they consider you need to be off work.
• you send the the sick note (called a 'fit note' since 2010) you are given by the doctor to the DWP in order to receive Statutory Sick Pay from the government. (Statutory Sick Pay is £86.70).
• you can claim Statutory Sick Pay for 28 weeks 
• the DWP may ask you to complete the ESA1 when you send in your first sick note. You don't have to (until 28 weeks); basic rate ESA is less than Statutory Sick Pay.

You do not have to leave work because of sickness. Some employers will create an agreement with you whereby your position is held open for you should you be able to return to work in the future. You will no longer receive payment from your work place, but will receive ESA payments from the government, whilst still holding a contract with your work place. You are in a more secure position if you can make this arrangement with your employment, than if you resign.

If you have been severely ill for a few years, but haven't claimed ESA yet:

• you can also submit sick notes from your GP to the DWP for 28 weeks, as described above,
• or you can telephone the DWP and fill in an ESA1 form over the phone.

Once you have completed the ESA1:

• You will be sent the ESA50 form to complete.
• When you receive the ESA50 you will be given a three or four week time limit in which it must be returned. It is advisable to be prepared for this form before you receive it, and have evidence lined up to send with it.
• Once your form and evidence has been returned, it will be briefly assessed as to whether you require a Work Capability Assessment (the WCA - otherwise known as "the medical").
• Most people are invited to the WCA, but some are placed either in the WRAG or the Support Group on the strength of their form and evidence.
• If you are invited to the WCA and do not attend, your application for ESA will be declined.
• In the WCA you will be assessed by a doctor, a physiotherapist or a nurse. They will make a recommendation as to what they believe the decision on your case should be.
• A Decision Maker will then look at your form, the evidence you submitted with it, and the data collected in your WCA, and make a decision over which group you should be placed in, if you should receive ESA at all.
• You will receive a document from them informing you of the decision. You should then start to receive the higher rate of pay, and any back pay that has accumulated.
• If you disagree with the decision you can either request a Reconsideration or go straight to Appeal.
• If you request a reconsideration another Decision Maker will look at all your evidence again.You can write to them explaining why you disagree with the decision, but you do not have to.
• If you ask to go to Appeal, another Decision Maker will look at your case (Reconsideration) anyway.
• If the decision is not over turned at this point, you will eventually go before a tribunal panel to plead your case.