To find out more information about health assessments, contact Health Assured free on: 0800 030 5182.
Employment and Support Allowance (ESA), is a benefit that offers financial support to employees. It provides an allowance to individuals unable to work because of an illness or disability.
The Department of Work and Pensions (DWP) uses an ESA work capability assessment to assess an employee’s claim for ESA. It focuses on how the condition may affect an employee on a day-to-day basis.
Qualifying for ESA
The first question this article aims to answer is, How do you qualify for ESA?’
Applicants may be eligible for ESA if they are:
- Under state pension age.
- Not getting Statutory Sick Pay (SSP) or Statutory Maternity Pay (SMP).
- Not getting Jobseekers Allowance (JSA).
There are two types of ESA
- Contribution based: Provides financial support if claimants have paid sufficient National Insurance (NI) contributions.
- Income-related: Applicants on a low income can get this either on its own or in addition to contribution based ESA.
ESA support group criteria
Depending on the outcome of this assessment, claimants go into one of two ESA groups which affects how much they’ll continue to receive.
Staff members are either in:
ESA medical assessment questions
Claimants are also asked questions relating to their mental and physical health. They use these descriptors to determine the level to which their disability or illness affects their ability to work.
Some ESA assessment of mental health questions include:
- Do you know what you are here for?
- What are your medical conditions?
- How long have you had these conditions?
- How do these conditions affect you?
- Is there an upstairs or downstairs bathroom?
- How often do you shop?
- Do you do shopping on your own?
- Do you drive?
- Is the car automatic or manual?
- How long can you drive for?
- Do you have any hobbies or interests?
Some activities relating to the physical health assessment include:
- Mobilising and navigation.
- Picking up and moving.
- Manual dexterity.
ESA medical assessment home visit
In cases where a claimant’s illness or disability makes it difficult or impossible to travel to the allocated assessment centre, they can put in a request for a home assessment.
When necessary, the Health Assessment Advisory Service will ask individuals to provide information from a medical professional supporting their request for a home visit.
How to claim ESA for depression and anxiety?
A majority of ESA claims are for stress, anxiety and depression. Once the applicant collects a medical certificate (fit note) for their medical specialist, they can then make an ESA claim with the DWP.
It’s worth noting there might be overlapping issues if the applicant collects other benefits like SSP or SSM.
ESA medical assessment points system
If an applicant scores 15 points in any individual activities (or a total of 15 points for a combination of the physical or mental activities) they’ve met the criterion for limited capability for work.
It’s at this stage the decision maker will consider if it places the claimant in a support or limited capability for work-related activity group.
If a claimant scores below 15 points, they aren't classes as having limited capability to work and so not entitled to ESA.
How long does it take to get ESA?
For first-time ESA applicants, after completing the initial claim form (ESA1), the DWP can send some money straight away. They only do this if they believe it’s likely the claimant will be eligible for ESA. When sending in the claim form, the claimant must provide a ‘fit note’ from their GP which confirms they’re not fit to work.
It can take several months for the DWP to make a decision. Generally, applicants that haven’t heard anything regarding their claim can contact the DWP after eight weeks of sending off the ESA50 questionnaire.
They should receive the first ESA payment into their bank account within three weeks.
After the assessment, a professional healthcare assessor will pass on recommendations to someone at the DWP. They’ll then use this information to decide if you get ESA or not. From the ESA50 form to finish, the whole process can take as much as a year to receive a final decision.
If the DWP eventually decides a claimant isn’t eligible for ESA, claimants won’t have to pay the money already received back. They’re also able to backdate claims for up to three months.
Read our article: Health and Disability Assessments Services
To find out more information about health assessments, contact Health Assured free on: 0800 030 5182
