Claiming ESA - Everything You Need To Know
Avrielle
Member Posts: 182
I hope this information will be of use and help inform you on how to claim for Employment and Support Allowance. There is no fool-proof way to be sure that you will recieve the benefit you are entitled to, but hopefully this guide will help you to increase your chances of recieving ESA and a lower chance of having to go through an appeal. This post will give most of the ins and outs of Employment and Support Allowance.
First of all, Employment and Support Allowance is the benefit that replaced Incapacity Benefit a couple of years ago. As from January 2011, no new claims to Incapacity Benefit are accepted. Instead, a claim to ESA is to be made instead.
The Initial Claim
To claim ESA, you must be unable to work. There are some certain exceptions, but during the time that you are claiming for Employment and Support Allowance, you must not be in current paid work. (Unless you are Self-employed.)
Even though you are not currently in work, you must be unable to work 2 days or more in a week. This means that you cannot work due to pain, mobility problems, mental health problems, treatment or side-effects of treatment.
You must not be recieving Statutory Sick Pay, or your Sick Pay has ended.
You must also be under State Pension Age.
Go to your Job Centre and ask to make a claim for ESA. You may have to make a phone call for a new claim and/or fill in an application form. This is an initial claim to decide if you are entitled to make a full claim for ESA, regarding your income, your working status, where you live and who you live with, and other questions that will determine if you are eligiable for ESA.
You will be asked if you wish to make a claim for income-based ESA or Contribution-based ESA. Generally Income-based is the option to choose. This is based on how much you currently earn and have in savings and that you do not have enough money to live on. They will also take in to account money coming in to your household, from a partner, for example. The will also take in to account some expendatures. They will ask you a lot of questions about your finances when you are on the phone making the claim.
Contribution-based is available if you have paid enough National Insurance contributions, through work, etc. But there is often a time limit. Generally, you are only entitled to Conrtibution-based ESA for 365 days - unless you are on the Support Componant (I will come to that later.)
After you have made your initial claim, you may be required to attend an appointment at your local Job Centre to complete the claim, unless you have filled out the initial form yourself, rather than over the phone. This is a simple appointment that basically has you sign and agree that the information you have given is correct and it still applies to you.
The ESA Claim Form
If your Initail Claim is successful, you will then be asked to fill in a second form that asks for more detailed information about your health and how it affects you. This form will be sent to a decision maker who will decide if you are entitled to ESA or not.
The form works on a point system. Each answer you give to each of the questions in the form will be translated by the decision maker in points. Each answer in the form has their own point worth, the lowest score is 0 points and the highest for each question is 3 points. For instance; One question may be Do you have sight problems? This is followed by multiple choice answers. Being able to see fine with no problems will give you 0 points, having lost sight in one eye, but fine in the other may give you 1 point, and being blind in both eyes may give you 3 points.
You must have a total score of 15 points or more to be able to recieve ESA.
Additional information may be required from your doctor or other healthcare proffessionals who are involved with your treatment/illness. To speed up the process, I recommended that you provide as much information about your illness and how it affects you as you can. Particularly think about how it affects your daily living. If you struggle to get up stairs, add information on how long it takes you, what equiptment or help you need to be able to do it (i.e a banister must be needed, do you use one or both hands to hold on to it?) do you need to stop and rest before reaching the top of a flight of stairs? Have you ever fallen while attempting to climb from stairs from severe pain, fatigue or lack of balance?
Think on these sorts of questions with regard to each question in the application form. Think also on day-to-day struggles you have. Do you struggle to stand and wash the dishes or cook a regular evening meal or housework? Do you have someone who helps you in day-to-day things? For instance, I have someone who helps me by taking me shopping once a fortnight and helps me to pick items off shelves etc. I also have someone who helps me by doing some shopping through the week for small items like milk and bread, when I am unable to get to the shop myslef because of pain or fatigue.
Also add in what hobbies or interests you have that you can no longer do or find difficult due to your illness/disability.
You may also add any photocopies of letters from healthcare proffessionals in with the form that you feel may aid your claim. You may also add letters for forth-coming appointments, so there is evidence that you are seeing the medical proffessionals you say you are. You can explain to your GP or other healthcare proffessionals that you are making a claim for ESA and ask them to write a letter for you to help aid your case. Some doctors may ask for a small fee for writing a letter, but most will be happy to write a letter confirming that you see them for your condition(s) and that they do affect your ability to work.
You can also add a letter from a carer (paid or unpaid) or a friend to give their opinion on your illness or disability and how they help you or how it affects you. However, unless it is from a paid carer from Social Services, this will not be considered as 'evidence' in the same way a letter from a doctor would be.
Another thing that I feel is vital to add in your claim with your additional information is how your illness/disability/treatment affects your ability to work. After all, that is the prime reason for the claim. These days, the DWP look at what you *can* do, not what you cannot. Take your most recent paid job as an example, or use examples of a general office/admin job if you have not been in paid work, or if you feel your previous paid work is not a good example. Explain how your illness or disability/treatment/side-effects of treatment would affect you if you were in work now. For instance, if you struggle with mobility and pain, how would sitting or standing or walking through a shift affect you. if you suffer from fatigue from pain or medication side-effects, then how would this affect you in work, for instance, working on a computer or continuing through a 4 hour shift. There are many more examples. But think about your own illness, disability, mental health, treatment, side-effects, pain, fatigue, and so on in regards to how it affects you and you ability to complete tasks.
I will also make a small note on Mental Health. Even if you have not been diagnosed with mental health problems, such as depression, you may suffer from low mood, irritability, lack of motivation or other non-physical symptoms that can be an effect from your physical problems. An example, if you are suffering pain every day and struggle to walk and do things, then your mood may be very low beause you are unable to do the things you normally do, you may feel very low because you are unable to socialise like you once did. You may also feel irritable because things you do cause pain and you may be frustrated because you cannot do the things you once did. You may suffer from lack of motivation and stay in bed or not do things that need doing, because your pain and difficulties have had a knock on affect on your mood, and in turn causing symptoms of depression. It is important that you add this to your information as it may also aid your claim. I must also add that if you do feel these symptoms, or other symptoms of depression, then please see your GP. Chronic pain or illness can easily cause a knock-on effect of depression and it can be treated.
After the Claim
If your claim has been succesful, you will be placed on the 'Assesment Phase' of ESA. You will likely be asked to attend a compulsory medical examination by the DWP for a face-to-face consultation with a doctor employed by the DWP to ask about how your health affects your day-to-day living. Sometimes, the medical examination appointment can be a long time away, meaning you may have to wait for some time before you have your examination. However, in most circumstances, you will recieve the initial rate of ESA payment during this time. This is called the Assesment Phase.
The Assesment Phase lasts for 13 weeks, while a decision is being made on your medical assesment and your circumstances and what type of ESA you are entitled to.
The information from the medical examination, which is called the Work Capability Assesment, will be forwarded to a decision maker to decide if you have Limited Capability for Work. You may be placed on the Work-Related Componant of ESA or the Support Componant of ESA, based on the decision on how your health affects you and your ability to work. Which ever rate you are entitled to, the rate payment will begin from week 14 of your initial claim. If you have recieved your Work Capability Assesment and a desicion before the 14th week, then you will usually start recieving the new rate at the start of week 14 of your claim. If you recieved the decision afterwards, then your new rate will be calculated and back-dated so you will recieve a payment of your new rate in a lump sum from the date starting on the first day of week 14 of your claim, followed by regular payments of your new rate.
The Work-Related Componant
The Work-Related Componant of ESA means that you are able to do some form of work, or are expected to be able to do some form of work in the near future. There are some forms of 'permitted work' that you will be able to do while on the Work-Related Componant of ESA. You may be required to attend meetings with an advisor at your local Job Centre called Work Focused Interviews and they will focus on how best to move forward and help you to get back in to work again.
The Support Componant
The Support Componant means that your health has a severe impact on your ability to do any form of work, and are not expected to return to work in the near future. You will not be expected to attend meetings with a Job Advisor at the Job Centre, but you can still ask to see an advisor if you wish. You may also do some forms of unpaid work which is allowed under 'permitted work'. Ask at your local Job Centre if you wish more information on this.
Disallowed
The other possible outcome from the decision maker on either your claim form or your Work Capability Assesment is that they decide you are capable for work and you are not entitled to Employment and Support Allowance. In such cases, you will not recieve payment of Employment and Support Allowance and your claim will end. However, you may request a reconsideration form the decision maker. This where you ask in writing for the desicion maker to reconsider his decision. Sometimes the decision will be turned around and your claim will become active again and you will recieve your entitlement to ESA. If this does not succeed you can ask for an appeal. During the duration of the appeal, you will normally have the Assesment Phase rate of ESA re-enstated and recieve payment during the time from when your appeal request has been considered until the Tribunal hearing has been heard and a decision has been made on the appeal.
I shall continue with more detailed information on the Appeals Service and how to appeal in another post. It is often a lengthy process and can be rather daunting to the person appealing.
I really hope this information will be of benefit to people here. Join me next time for Appealing an ESA Decision - Everything You Need to Know. I will write it out another time in the near future.
Good luck with your claim. xx
First of all, Employment and Support Allowance is the benefit that replaced Incapacity Benefit a couple of years ago. As from January 2011, no new claims to Incapacity Benefit are accepted. Instead, a claim to ESA is to be made instead.
The Initial Claim
To claim ESA, you must be unable to work. There are some certain exceptions, but during the time that you are claiming for Employment and Support Allowance, you must not be in current paid work. (Unless you are Self-employed.)
Even though you are not currently in work, you must be unable to work 2 days or more in a week. This means that you cannot work due to pain, mobility problems, mental health problems, treatment or side-effects of treatment.
You must not be recieving Statutory Sick Pay, or your Sick Pay has ended.
You must also be under State Pension Age.
Go to your Job Centre and ask to make a claim for ESA. You may have to make a phone call for a new claim and/or fill in an application form. This is an initial claim to decide if you are entitled to make a full claim for ESA, regarding your income, your working status, where you live and who you live with, and other questions that will determine if you are eligiable for ESA.
You will be asked if you wish to make a claim for income-based ESA or Contribution-based ESA. Generally Income-based is the option to choose. This is based on how much you currently earn and have in savings and that you do not have enough money to live on. They will also take in to account money coming in to your household, from a partner, for example. The will also take in to account some expendatures. They will ask you a lot of questions about your finances when you are on the phone making the claim.
Contribution-based is available if you have paid enough National Insurance contributions, through work, etc. But there is often a time limit. Generally, you are only entitled to Conrtibution-based ESA for 365 days - unless you are on the Support Componant (I will come to that later.)
After you have made your initial claim, you may be required to attend an appointment at your local Job Centre to complete the claim, unless you have filled out the initial form yourself, rather than over the phone. This is a simple appointment that basically has you sign and agree that the information you have given is correct and it still applies to you.
The ESA Claim Form
If your Initail Claim is successful, you will then be asked to fill in a second form that asks for more detailed information about your health and how it affects you. This form will be sent to a decision maker who will decide if you are entitled to ESA or not.
The form works on a point system. Each answer you give to each of the questions in the form will be translated by the decision maker in points. Each answer in the form has their own point worth, the lowest score is 0 points and the highest for each question is 3 points. For instance; One question may be Do you have sight problems? This is followed by multiple choice answers. Being able to see fine with no problems will give you 0 points, having lost sight in one eye, but fine in the other may give you 1 point, and being blind in both eyes may give you 3 points.
You must have a total score of 15 points or more to be able to recieve ESA.
Additional information may be required from your doctor or other healthcare proffessionals who are involved with your treatment/illness. To speed up the process, I recommended that you provide as much information about your illness and how it affects you as you can. Particularly think about how it affects your daily living. If you struggle to get up stairs, add information on how long it takes you, what equiptment or help you need to be able to do it (i.e a banister must be needed, do you use one or both hands to hold on to it?) do you need to stop and rest before reaching the top of a flight of stairs? Have you ever fallen while attempting to climb from stairs from severe pain, fatigue or lack of balance?
Think on these sorts of questions with regard to each question in the application form. Think also on day-to-day struggles you have. Do you struggle to stand and wash the dishes or cook a regular evening meal or housework? Do you have someone who helps you in day-to-day things? For instance, I have someone who helps me by taking me shopping once a fortnight and helps me to pick items off shelves etc. I also have someone who helps me by doing some shopping through the week for small items like milk and bread, when I am unable to get to the shop myslef because of pain or fatigue.
Also add in what hobbies or interests you have that you can no longer do or find difficult due to your illness/disability.
You may also add any photocopies of letters from healthcare proffessionals in with the form that you feel may aid your claim. You may also add letters for forth-coming appointments, so there is evidence that you are seeing the medical proffessionals you say you are. You can explain to your GP or other healthcare proffessionals that you are making a claim for ESA and ask them to write a letter for you to help aid your case. Some doctors may ask for a small fee for writing a letter, but most will be happy to write a letter confirming that you see them for your condition(s) and that they do affect your ability to work.
You can also add a letter from a carer (paid or unpaid) or a friend to give their opinion on your illness or disability and how they help you or how it affects you. However, unless it is from a paid carer from Social Services, this will not be considered as 'evidence' in the same way a letter from a doctor would be.
Another thing that I feel is vital to add in your claim with your additional information is how your illness/disability/treatment affects your ability to work. After all, that is the prime reason for the claim. These days, the DWP look at what you *can* do, not what you cannot. Take your most recent paid job as an example, or use examples of a general office/admin job if you have not been in paid work, or if you feel your previous paid work is not a good example. Explain how your illness or disability/treatment/side-effects of treatment would affect you if you were in work now. For instance, if you struggle with mobility and pain, how would sitting or standing or walking through a shift affect you. if you suffer from fatigue from pain or medication side-effects, then how would this affect you in work, for instance, working on a computer or continuing through a 4 hour shift. There are many more examples. But think about your own illness, disability, mental health, treatment, side-effects, pain, fatigue, and so on in regards to how it affects you and you ability to complete tasks.
I will also make a small note on Mental Health. Even if you have not been diagnosed with mental health problems, such as depression, you may suffer from low mood, irritability, lack of motivation or other non-physical symptoms that can be an effect from your physical problems. An example, if you are suffering pain every day and struggle to walk and do things, then your mood may be very low beause you are unable to do the things you normally do, you may feel very low because you are unable to socialise like you once did. You may also feel irritable because things you do cause pain and you may be frustrated because you cannot do the things you once did. You may suffer from lack of motivation and stay in bed or not do things that need doing, because your pain and difficulties have had a knock on affect on your mood, and in turn causing symptoms of depression. It is important that you add this to your information as it may also aid your claim. I must also add that if you do feel these symptoms, or other symptoms of depression, then please see your GP. Chronic pain or illness can easily cause a knock-on effect of depression and it can be treated.
After the Claim
If your claim has been succesful, you will be placed on the 'Assesment Phase' of ESA. You will likely be asked to attend a compulsory medical examination by the DWP for a face-to-face consultation with a doctor employed by the DWP to ask about how your health affects your day-to-day living. Sometimes, the medical examination appointment can be a long time away, meaning you may have to wait for some time before you have your examination. However, in most circumstances, you will recieve the initial rate of ESA payment during this time. This is called the Assesment Phase.
The Assesment Phase lasts for 13 weeks, while a decision is being made on your medical assesment and your circumstances and what type of ESA you are entitled to.
The information from the medical examination, which is called the Work Capability Assesment, will be forwarded to a decision maker to decide if you have Limited Capability for Work. You may be placed on the Work-Related Componant of ESA or the Support Componant of ESA, based on the decision on how your health affects you and your ability to work. Which ever rate you are entitled to, the rate payment will begin from week 14 of your initial claim. If you have recieved your Work Capability Assesment and a desicion before the 14th week, then you will usually start recieving the new rate at the start of week 14 of your claim. If you recieved the decision afterwards, then your new rate will be calculated and back-dated so you will recieve a payment of your new rate in a lump sum from the date starting on the first day of week 14 of your claim, followed by regular payments of your new rate.
The Work-Related Componant
The Work-Related Componant of ESA means that you are able to do some form of work, or are expected to be able to do some form of work in the near future. There are some forms of 'permitted work' that you will be able to do while on the Work-Related Componant of ESA. You may be required to attend meetings with an advisor at your local Job Centre called Work Focused Interviews and they will focus on how best to move forward and help you to get back in to work again.
The Support Componant
The Support Componant means that your health has a severe impact on your ability to do any form of work, and are not expected to return to work in the near future. You will not be expected to attend meetings with a Job Advisor at the Job Centre, but you can still ask to see an advisor if you wish. You may also do some forms of unpaid work which is allowed under 'permitted work'. Ask at your local Job Centre if you wish more information on this.
Disallowed
The other possible outcome from the decision maker on either your claim form or your Work Capability Assesment is that they decide you are capable for work and you are not entitled to Employment and Support Allowance. In such cases, you will not recieve payment of Employment and Support Allowance and your claim will end. However, you may request a reconsideration form the decision maker. This where you ask in writing for the desicion maker to reconsider his decision. Sometimes the decision will be turned around and your claim will become active again and you will recieve your entitlement to ESA. If this does not succeed you can ask for an appeal. During the duration of the appeal, you will normally have the Assesment Phase rate of ESA re-enstated and recieve payment during the time from when your appeal request has been considered until the Tribunal hearing has been heard and a decision has been made on the appeal.
I shall continue with more detailed information on the Appeals Service and how to appeal in another post. It is often a lengthy process and can be rather daunting to the person appealing.
I really hope this information will be of benefit to people here. Join me next time for Appealing an ESA Decision - Everything You Need to Know. I will write it out another time in the near future.
Good luck with your claim. xx
Life is just a ride. Up and down, round and around, thrills and chills, very brightly coloured and very loud. But don't ever be afraid, because it is just a ride.
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Comments
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Apologies. I fear I have made a mistake. :shock:
I think it is once your Initial Claim has been processed and you are accepted and elegible, then you will begin recieving payment of the 'Assesment Phase' rate. This lasts for 13 weeks, and in that time you will recieve the form that asks for more detailed information on your health and how it affects you to be sent off and to be followed by the Work Capability Assesment.
Hope I haven't confused anyone. xxxLife is just a ride. Up and down, round and around, thrills and chills, very brightly coloured and very loud. But don't ever be afraid, because it is just a ride.0 -
I would also suggest that people applying for ESA get help from the CAB or a welfare rights adviser. As they have a better understanding of the ESA50 medical questionnaire and the pitfalls that the form entails.
stephen.
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Thanks.
Yes. The CAB is very helpful with these things and they can help you make a claim. However, with the budget cuts, the CAB charity is not being at all well-funded. This has meant the closure of a number of CAB's up and down the country and the number that are left are struggling, looking at closure or requesting funding from elsewhere to keep going. Main reason why I left it out.
But if you do have a local CAB, then yes, do ask them for help if you do not feel confident, because they really can help. xxLife is just a ride. Up and down, round and around, thrills and chills, very brightly coloured and very loud. But don't ever be afraid, because it is just a ride.0 -
You can also try DIAL if you are stuck.
Those forms are a minefield :roll:
Love
Toni xx0 -
thankyou this is so helpful I had a letter today saying I was now in work based group I can't walk for goodness sake0
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Hello Everyone, your posts have been very helpful, however I still need a little more help
I Have applied for ESA and they sent me a letter saying that they can pay me £56.25 a week from the 31st Oct 2012. Well I checked my account today as it had been 2 weeks since the 31st but nothing was in there... So does anyone know when or if we get paid before we have sent off the questionnaire (I cant do that until the 20th because I Need a full Medical report from my doctor). Should I receive anything yet or do I need to send off the Questionnaire first?
Thanks Guys
x 0 -
Hello
Sorry, BumbleB, I'm afraid I can't help with advice but I'm sure someone else will.
Just stating this as one example: I've been getting ESA since my six-month SSP ran out. I've had an ATOS work capability assessment and should get the result any time now. The ESA goes into my bank account every two weeks and I'm potentially eligible for 365 days, depending on my capability to work, of course. When I phoned up to make the initial claim, I wasn't given an option of which "type" of ESA I could apply for - I was told it was the Contribution type early on in the conversation.
Shula0 -
Hi All. Just seen this post,wish i had seen it before.Avrielle you are a star very helpful read.I was put in the support group without attending a medical at the end of last year.Dont want anyone to be fooled though i have now received the forms yet again to fill in.Why on eearth do they put people through this stress when the illnesses are not going to change.Any advice any of you can give about filling them in again would be most welcome.It makes you wonder if they are trying to catch people out and dont beleive them.
Regards Oldies0 -
Thank you for adding this, it's very helpful and will use it as a help to check back on when we fill the forms in today.0
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Pleas photo copy,even if you get put in the support group we all have to go through it again and again,looks like mine is yearly.I have quite a few illnesses one of which is never going to be any different,as is the RA if anything they go worse.If doctors read these forms when we send them in surley they know all this.Such a waste of money and also GP's time when they have to do the forms to.Makes me so angry0
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Hi
I've got a date beginning of sept for tribunal as dumb Atos said I'm fit for work I had just retired from work due to ill health only claimed ESA for four months but they want their money back! Considering I've worked for 30 years never claimed anything in my life and retired at 49 surely I'm entitled to claim not like the ones that can work but won't as they get more on benefits
Annoys me greatly as the benefit cheats have spoilt it for the genuine claimants
I digress any advice for my tribunal
Best wishes
Maria0
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