General information on Employment and Support Allowance (ESA)
What is ESA about?
Employment and Support Allowance (ESA) is about focusing on what a person can do, rather than what they can’t. Under Incapacity Benefit, statistics showed that after two years on the benefit someone was more likely to die or retire than to find a job again. ESA aims to ensure that no-one is written off and that everyone who is able to work is given assistance to help them back into employment.
It is a new way of helping people with an illness or disability move into work, rather than stay on benefits. ESA offers personalised support and financial help for customers who are not able to work. Central to ESA is the medical assessment which examines what customers can do, rather than what they can’t.
The Work Focused Interview (WFI) is an important part of the return to work process for customers claiming ESA. A WFI is arranged with an Employment Service Adviser during which they will discuss the customer's barriers to returning to work and agree a package of support to help them progress and/or move into work.
It is fairer, giving more financial support to most customers sooner, paying the work-related activity or support component after 13 weeks, rather than higher rates after 28 or 52 weeks under previous incapacity benefits.
Is Employment and Support Allowance forcing people into work?
Asking people to take part in some form of work-related activity is not the same as forcing them into work. What ESA offers is more help and support which can transform lives. Those with the most severe conditions will receive more financial help through the Support component and will be able to volunteer for any appropriate support on offer if they wish.
What is the target group for Employment and Support Allowance?
Employment and Support Allowance is aimed at people whose capability for work is limited by a physical or mental condition and the limitation is such that it is not reasonable to require them to work.
What about people with the most severe conditions?
People who are assessed as having the severest disabilities or health conditions will go into the ‘support group’ and be exempt from the Work Focused Interviews.
Support Group customers are people who are so severely ill or disabled it is unreasonable to require them to engage in work-related activity as a condition for receiving ESA. Support Group customers will have periodical medical assessment reviews (every three years at a maximum). Medical conditions can improve with treatment, or they may decline. Depending on the WCA outcome, customers who are placed in the Support Group may be removed from that group and placed in the Work-Related Activity Group, and vice versa.
Employment and Support Allowance focuses additional resources on the most severely disabled. Many of the poorest and most severely disabled customers can be nearly £17 a week better off under Employment and Support Allowance than they would have been on incapacity benefits.
The Work-Related Activity component can be sanctioned if people don’t comply – what are the safe guards?
The benefit can be sanctioned for not attending or participating fully in a work focused interview.
There are of course appropriate safeguards in place to ensure that the system is fair, for example, ensuring those with mental health conditions are visited before any sanction may be imposed.
What work-related conditionality have customers to undertake? Is there a compulsion to attend job interviews?
Customers not in the support group may be required to take part in work focused interviews. Although the Welfare Reform Act (Northern Ireland) 2007 includes provision for additional work-related activity, it has not been introduced at this stage and further regulations would be required. However, there is no intention that work-related conditionality would include any compulsion to apply for or attend job interviews.
If the Government is offering a more attractive system of support, do we need conditionality / sanctions? Won't people want to volunteer?Experience from existing programmes shows the importance of engaging people, and the difference this makes in their aspirations to return to work.
Based on the experience of Pathways to Work it is not envisaged that sanctions will be widely used. The aim is to encourage people to avail of the help being offered, however it is necessary to have a sanction available for use if needed.
Does the potential additional stress of work-focused interviews not act as a disincentive for vulnerable people to offer themselves for work?
Customers with all conditions are dealt with sensitively. Additionally there is a system of safeguards particularly geared to customers with mental health problems. It is believed that engagement with the community and some form of work-related activity is good for most customers.
What is the effect of imposing work focused interviews on vulnerable people, especially those with mental health conditions?
Such cases are approached with sensitivity, applying the full range of safeguards, such as home visits, encouraging a support worker to be present and ensuring that there is pre-interview contact with the customer when Employment Service Advisers can explain their purpose. There will of course be cases where mandatory intervention is clearly inappropriate. Those with the most severe mental health conditions will already be in the support group and not required to attend WFIs. Employment Service Advisers have the ability to defer interviews where a customer is clearly not able to attend or to effectively take part. This is particularly useful in cases where, for example, there is a fluctuating condition.
In what circumstances are work focused interviews waived or deferred?
Employment Service Advisers are able to waive an interview when a customer is very close to returning to employment, for example, where an imminent start date for work has been agreed and an interview would be of no assistance to the customer.
Deferrals are used to cover a wide range of circumstances and for varying periods of time. Where there is a short term problem affecting attendance on a particular day, the interview would be re-arranged in the days following the original date. Where problems are longer term, such as a period in hospital, deferral could last months.
Is there sufficient suitably trained support for people with learning disabilities?
Employment Service Advisers receive specialist training to give them the skills, knowledge, techniques and confidence to deal with people with a disability or illness including people with learning disabilities. Also, the condition management programmes are delivered by qualified health professionals.
This is all a waste of time, given the state of the economy and very high levels of unemployment?
Unemployment has certainly risen during the past year but employers are still recruiting and the Employment Service is available to assist employers to fill vacancies.
One consequence of the recessions of the 1980s and early 1990s was that people were effectively written off on inactive benefits with no support to get back to work when the job market strengthened. We need to avoid those mistakes and the long-term social and economic costs that resulted.
To support this goal, Employment and Support Allowance has replaced incapacity benefits and return to work support is available through Employment Service Advisers. This has improved the personalised support available to disabled people or people with a health condition who are on benefits and on their own journey back to work.
The Disablement Advisory Service has a range of programmes and services providing opportunities that encompass work placements, training, employment, and retention in work, for people with disabilities.
Work Capability Assessment and medical evidence
Why does Employment and Support Allowance (ESA) require customers to attend a medical assessment?
This is not new, similar arrangements were in place for Incapacity Benefit.
But why is it needed at all and why the change?
The Work Capability Assessment (WCA) provides a professional assessment of an individual’s eligibility for ESA based on what they can do rather than what they cannot do.
While the criteria used for Incapacity Benefit, the personal capability assessment, provided a robust evaluation, it focused on what a person is incapable of doing. Developed in 1995, it has become out-dated in relation to the modern workplace, developments in medical therapy and the conditions prevalent in society today.
The WCA is therefore a more robust and accurate assessment, and provides a better means to correctly identify people with health conditions which make it unreasonable to expect them to work and therefore give them the support they require.
The key change is that it identifies those people who are capable of taking part in work-related activity and the support and interventions required to help them get back to work;
It also identifies people who are so limited by their illness or disability that it would be unreasonable to require them to undertake any form of work-related activity in the foreseeable future.
Does everyone who applies have to attend a medical assessment?
Most new customers are required to attend an assessment.
Whenever possible, however, a decision will be made using documentary evidence for those with the most severe illnesses and disabilities who are likely to be in the Support Group.
Why are General Practitioners required to provide medical certificates and reports for patients?
Under the terms of the current General Practitioner contract, they are required to provide these documents and to do so in a timely manner.
What happens if a customer doesn’t go for their assessment?
If a customer fails to attend an appointment for a medical assessment, we will write to them and ask for their reasons for not attending. Their reply is considered by a Decision Maker, who may decide that the customer has shown good cause for not attending and refer the case for a new appointment; if the Decision Maker takes the view that good cause has not been shown, ESA will be disallowed and benefit stopped.
Why aren’t the assessments for people with mental health conditions carried out by health care professionals who are experts in the condition?
All health care professionals carrying out assessments are specially trained in assessing the effects a condition has on a person’s functional ability. They do not need expert knowledge of the condition to do this competently; their expertise lies in disability analysis.
Why is there no disability premium in Employment and Support Allowance when it remains in other benefits?
Employment and Support Allowance is not structured in the same way as the old incapacity benefits of incapacity benefit and income support. There is not the concept of a disability premium in the new allowance, but it is not that the new allowance ignores the needs of people with disabilities; rather it takes account of these needs in a different way. Other benefits do not include work-related activity or support components. We believe that those capable of some form of work-related activity will benefit from, and have a responsibility to engage in undertaking work focused interviews and this concept is reflected in the benefit structure.
Is the new work capability assessment just making it more difficult for people to get benefit?
The work capability assessment descriptors are not about tightening the gateway to benefit. They are about ensuring the assessment remains relevant to today’s environment, which has seen changes in the prevalence of disabling conditions, advances in medical interventions available, and changes in the tasks and activities employers expect their workforce to be able to carry out. The new descriptors are about creating a fairer and more accurate assessment of a person’s entitlement to benefit, that will correctly identify those people who have limited capability for work because of a physical or mental condition.
The WCA is designed to provide a comprehensive assessment of an individual’s mental, cognitive and intellectual functions, by using more descriptors addressing a wider range of functions. The scoring system has also been changed in order to remove the perceived bias in the WCA against people with mental health problems as opposed to limitation of physical function.
Why have many of the current descriptors been changed?
The activities that employers expect of their workforce have changed. Those descriptors not relevant to customers' ability to work have been dropped and, where gaps have been identified, new descriptors have been added. In relation to mental health the new approach of the assessment takes better account of the needs of people with conditions like learning disabilities.
Work was undertaken with medical experts in re-focusing descriptors and scores to identify more accurately the overall functional limitation at which it is unreasonable to expect a person to engage in work.
People with a mental health problem may not be able to comply with the need to provide information. Will they be penalised?
It is recognised that people with a mental health condition may have difficulty in complying. Before applying sanctions, every effort will be made to contact customers and make sure they understand what is required of them. A person with mental health problems would not be sanctioned without first contacting them or their carer or health care professional, to ensure they understand what is required of them.
Making claim/contact by phone
Why should people bother to phone to make their claim?
Claiming by telephone is by far the most effective method of ensuring customers obtain the benefit most appropriate to them and that it is paid promptly.
The customer is assisted by a member of staff throughout the process who can help determine if ESA is the most appropriate benefit for the customer, provide advice if required and sign-post the customer to any secondary benefits they may be entitled to.
The staff member will also inform the customer of any evidence they must provide before their claim can be processed (providing clarification if required).
The customer is also given the opportunity to make a claim for both contribution and income related parts and there has been a significant number who have claimed both parts since ESA was introduced.
How long does it take to make a claim over the phone?
From the convenience of their own home a customer can make a claim for ESA over the phone in about 20 minutes. This is considerably more convenient and quicker than completing a paper form.
Why should changes in circumstances be made by phone?
Reporting changes of circumstances by phone benefits the customer as some changes can be recorded immediately. This saves time and the costs associated with sending documents to the Centre.
Who pays for these calls?
There is no charge for customers who use a BT telephone line to contact the 0800 line to make a new claim. Calls to the 0845 enquiry line may also be free to BT customers depending on their Calling Plan.
Customers ringing from a non BT landline or mobile may be charged by their network provider for the connection onto the BT number. However, in these circumstances, customers can request a call-back at the outset of the call.
What opportunities are in place for customers who have difficulty in making a claim to ESA by telephone?
A small percentage of customers may be unable to use the new telephony service and in these cases they can ask that a claim form be issued. Vulnerable customers who contact the ESA Centre are directed to their local Jobs & Benefits office for assistance in completing an ESA claim form.
What arrangements are there in place to ensure that customers do not lose benefit because they have difficulty getting through?
The law protects customers in these circumstances. A claim may be accepted covering a period up to three months before the date on which a customer notifies the Department of their intention to claim the benefit, as long as they can provide medical evidence to support the claim.
Why does ESA Centre not call customers back
If a customer requests a call back the details will be recorded on a priority case list, which is used to manage return calls to customers. Once on this list a call will be made as soon as a manager is available.
What arrangements are there in place to ensure vulnerable people can access information on ESA?
Information about ESA is available from the ESA Centre and can be obtained by calling the freephone number.
Like other benefits information is also available in all Jobs & Benefits offices / Social Security Offices and on the Department’s website.
Information leaflets on ESA are provided in Braille and audio for the visually impaired and a text phone service is available for customers with hearing difficulties who wish to contact the ESA Centre.
Arrangements are also in place to provide interpreting services for customers with limited understanding of English.
Why is there a delay between making a claim and getting payment?
A substantial number of customers are under the false impression that once they make their claim (either by telephone or a clerical claim form) that their payment will be automatically issued. However, payment cannot be issued until certain evidence has been provided by the customer - (for example, medical evidence, bank statements, P45/P60s, pension details).
Customers are reminded about their responsibility to provide outstanding evidence at several points during the claim-take process- during the initial telephony claim-take, in their customer statement and, if the information is still outstanding 14 days after the claim has been received, a reminder letter is issued to the customer. The responsibility to provide outstanding evidence lies with the customer. The claim is made defective unless the Department is provided with all the information required to determine the claim.
What protection is there for customers who are in financial distress?
An interim payment of ESA can be considered pending determination of entitlement.
Customers can apply for a crisis loan from the Social Fund.
Why does the Department close an ESA claim if a customer cannot be contacted by telephone?
If a customer is asked to provide further evidence in support of a claim they have one month to provide this. If the evidence is not received within one month at least two further requests for the information will be made. If evidence is not provided within the stipulated one month period consideration will be given to closing the claim. A claim will only be closed if there is insufficient evidence available to make a decision on entitlement to benefit. The same rules apply to customers claiming Income Support.