MGA leaflet ESA issue 1
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First Floor, Southgate Business Centre
Normanton Road,
Derby DE23 6UQ
Tel: 01332 290219, Fax: 01332 293641,
Web Site: www.mga-charity. org Email: mg@mga-charity.org
EMPLOYMENT SUPPORT ALLOWANCE
What is Employment Support Allowance?
Employment Support Allowance (ESA) is a new benefit which replaced Incapacity Benefit and Income Support
paid on the grounds of ill health or disability. ESA was introduced on 27th October 2008 and initially only those
making fresh claims on or after that date will receive ESA.
From April 2009 all those under 25 years of age and on Incapacity Benefit will be re-assessed for the new
benefit, and all other claimants will be re-assessed from April 2010 - by April 2013 there will be only one
benefit for those who have limited capability for work. There are no exempt conditions as there were with
Incapacity Benefit.
How to Claim
To start the process of making a claim for ESA, most claimants will make a telephone call to Jobcentre Plus
with no initial claim forms to complete. Keep a note of the date and the person you spoke to.
For those unable to make a telephone claim, they can make it face to face at a Jobcentre through an interpreter
or representative using a printed claim form. This may apply to Myasthenics with speech difficulties.
Medical certificates from a GP will need to be sent to Jobcentre Plus at the start of any claim. We suggest that
you also include copies of any relevant reports from speech therapists, GP, consultant etc. together with a copy
of your medication list. Copies of the relevant MGA information publications may also be useful.
ESA is paid fortnightly in arrears following on from your 13 weeks of SSP. There are rules applying to
applications regarding the number of national insurance contributions etc. and details can be given of these if
required.
It is expected that only 10% of claimants will continue on benefit without having to seek work or re-train.
The Work Capability Assessment (WCA)
This process is more complex than the current test applied to find out if someone is capable of work. The test
comprises three parts:
1. Assess if the claimant has 'limited capability for work'
2. Find out whether the claimant has a 'limited capability for work-related activity'
3. Carry out a 'work focused health-related assessment.'
The first test
This establishes whether the claimant meets the criteria for ESA and is similar to the test currently carried out
for Incapacity Benefit.
Points are scored according to the claimant's inability to carry out certain tasks. If the score is 15 or more, then
the person is treated as having 'limited capability for work' and is entitled to receive ESA. If the score is less
than 15, then the claimant will be moved to Jobseekers Allowance. (A list of the points is available)
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The Second Test
Having established that the claimant has limited capability for work and is eligible for ESA, a second test
assesses whether the claimant is placed in the support group or the work-related activity group. The test will
take place by week 8 of their claim, with payment being made from week 14.
If the person is placed in the support group it means that they do not have to undertake further work-related
activities unless they want to. They are entitled to receive a support component of £29* per week and no
conditions or sanctions are imposed. (* In addition to £60.50 basic allowance)
Terminally ill patients will be fast tracked and will not be required to take part in any further work-related
activities.
*Payments will vary slightly according to NI contributions, single or couple status.
The Third Test
The work-related activity group will receive the basic allowance but any additional amount will be
conditional on meeting strict work-related conditions. A person placed in the Work related activity group
will also have to take part in a third test - the work-focused health-related assessment. This part of the test
looks at a person's functional capacity to carry out certain tasks. These three tests form the Work Capability
Assessment and determine eligibility and entitlement to ESA.
Initial Work-Focused Interview
Most claimants will have to attend the initial work focused interview unless they are terminally ill. It is possible
to have this interview deferred if it is considered inappropriate at this point either because of your condition, or
for example, if you are in hospital.
The interview will usually take place during the 8th week of the claim. A personal advisor using the information
gathered in the Capability Assessment, will discuss work prospects with the claimant, look at support available
to help them move back into work, and what steps the person is prepared to take at this stage.
Follow-up Interviews
During the follow-up interviews an Action Plan will be agreed between the claimant and the personal advisor
and discussions might include:
• Job goals
• Skills, strengths and abilities
• Factors preventing them from looking for and securing work, or limiting the work they could do - and
then helping them to overcome these.
• Ideas for re-training.
A Schedule of the questions asked may be found below (Page4).
The Assessment
A decision maker will look at the information the claimant gave when making the initial claim for ESA -
usually by telephone, so do make sure you describe problems very specifically; also any medical evidence
provided. E.g. copies of all reports and medication lists.
If the assessors cannot decide whether a claim can be made, they may ask for a medical examination at this
stage.
It will be possible to appeal against any decision. NB as this is a new benefit there, is no Case Law to back up
appeals as there is with Incapacity benefit.
The main impact on Myasthenics will be that many will not reach the required 15 points to go onto ESA and
will have to claim Jobseekers Allowance and therefore attend training and job interviews.
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HELP AND INFORMATION
Assistance
It is strongly recommended that Myasthenics seeking to make a claim should seek the advice of their Local
Citizens Advice Bureau, or similar organisation.
Useful Websites
Department for Work and Pensions (DWP) - DWP.gov.uk/esa
Disability Alliance (DA) - www.disabilityalliance.org
Other sources of information
There are a number of clear leaflets provided by the Department for Work and Pensions, working together
with the Disability Alliance.
The DA Handbook, ESA supplement, is on the DWP site and will be a 'bible' for those applying and their
family/ advisors.
The Department of Work and Pensions guide to ESA may be found on the internet at
http://www.dwp.gov.uk/esa/index. asp.
By following the links you can access a series of fact sheets setting out the requirements for ESA.
Schedule 2 is reproduced from the DWP website
ACKNOWLEDGEMENTS
This leaflet has been based on the experience and research carried out by Mrs. Rita Goldthorp - MGA Regional
Organiser for SW England and S Wales.
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The Employment and Support Regulations
2008
SCHEDULE 2
ASSESSMENT OF WHETHER A CLAIMANT HAS LIMITED CAPABILITY
FOR WORK
PART 1
Physical disabilities Regulation 19(2) and (3)
(1)
Activity
(2)
Descriptors
(3)
Points
1. Walking with a walking stick or
other aid if such aid is normally used.
1 (a) Cannot walk at all.
15
(b)
Cannot walk more than 50 metres on level
ground without repeatedly stopping or severe
discomfort.
15
(c)
Cannot walk up or down two steps even with
the support of a handrail.
15
(d)
Cannot walk more than 100 metres on level
ground without stopping or severe discomfort.
9
(e)
Cannot walk more than 200 metres on level
ground without stopping or severe discomfort.
6
(f) None of the above apply.
0
2. Standing and sitting.
2 (a)
Cannot stand for more than 10 minutes,
unassisted by another person, even if free to
move around, before needing to sit down.
15
(b)
Cannot sit in a chair with a high back and no
arms for more than 10 minutes before needing
to move from the chair because the degree of
discomfort experienced makes it impossible to
continue sitting.
15
(c)
Cannot rise to standing from sitting in an
upright chair without physical assistance from
another person.
15
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(1)
Activity
(2)
Descriptors
(3)
Points
(d)
Cannot move between one seated position and
another seated position located next to one
another without receiving physical assistance
from another person.
15
(e)
Cannot stand for more than 30 minutes, even
if free to move around, before needing to sit
down.
6
(f)
Cannot sit in a chair with a high back and no
arms for more than 30 minutes without
needing to move from the chair because the
degree of discomfort experienced makes it
impossible to continue sitting.
6
(g) None of the above apply.
0
3. Bending or kneeling.
3 (a)
Cannot bend to touch knees and straighten up
again.
15
(b)
Cannot bend, kneel or squat, as if to pick a
light object, such as a piece of paper, situated
15cm from the floor on a low shelf, and to
move it and straighten up again without the
help of another person.
9
(c)
Cannot bend, kneel or squat, as if to pick a
light object off the floor and straighten up
again without the help of another person.
6
(d) None of the above apply.
0
4. Reaching.
4 (a)
Cannot raise either arm as if to put something
in the top pocket of a coat or jacket.
15
(b)
Cannot put either arm behind back as if to put
on a coat or jacket.
15
(c)
Cannot raise either arm to top of head as if to
put on a hat.
9
(d)
Cannot raise either arm above head height as
if to reach for something.
6
(e) None of the above apply.
0
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(1)
Activity
(2)
Descriptors
(3)
Points
5. Picking up and moving or
transferring by the use of the upper
body and arms (excluding all other
activities specified in Part 1 of this
Schedule).
5 (a)
Cannot pick up and move a 0.5 litre carton full
of liquid with either hand.
15
(b)
Cannot pick up and move a one litre carton
full of liquid with either hand.
9
(c)
Cannot pick up and move a light but bulky
object such as an empty cardboard box,
requiring the use of both hands together.
6
(d) None of the above apply.
0
6. Manual dexterity.
6 (a)
Cannot turn a "star-headed" sink tap with
either hand.
15
(b)
Cannot pick up a £1 coin or equivalent with
either hand.
15
(c)
Cannot turn the pages of a book with either
hand.
15
(d) Cannot physically use a pen or pencil.
9
(e)
Cannot physically use a conventional
keyboard or mouse.
9
(f)
Cannot do up/undo small buttons, such as shirt
or blouse buttons.
9
(g)
Cannot turn a "star-headed" sink tap with one
hand but can with the other.
6
(h)
Cannot pick up a £1 coin or equivalent with
one hand but can with the other.
6
(i)
Cannot pour from an open 0.5 litre carton full
of liquid.
6
(j) None of the above apply.
0
7. Speech.
7 (a) Cannot speak at all.
15
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(1)
Activity
(2)
Descriptors
(3)
Points
(b) Speech cannot be understood by strangers. 15
(c)
Strangers have great difficulty understanding
speech.
9
(d)
Strangers have some difficulty understanding
speech.
6
(e) None of the above apply.
0
8. Hearing with a hearing aid or other
aid if normally worn.
8 (a) Cannot hear at all.
15
(b)
Cannot hear well enough to be able to hear
someone talking in a loud voice in a quiet
room, sufficiently clearly to distinguish the
words being spoken.
15
(c)
Cannot hear someone talking in a normal
voice in a quiet room, sufficiently clearly to
distinguish the words being spoken.
9
(d)
Cannot hear someone talking in a loud voice
in a busy street, sufficiently clearly to
distinguish the words being spoken.
6
(e) None of the above apply.
0
9. Vision including visual acuity and
visual fields, in normal daylight or
bright electric light, with glasses or
other aid to vision if such aid is
normally worn.
9 (a) Cannot see at all.
15
(b)
Cannot see well enough to read 16 point print
at a distance of greater than 20cm.
15
(c) Has 50% or greater reduction of visual fields. 15
(d)
Cannot see well enough to recognise a friend
at a distance of a least 5 metres.
9
(e)
Has 25% or more but less than 50% reduction
of visual fields.
6
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(1)
Activity
(2)
Descriptors
(3)
Points
(f)
Cannot see well enough to recognise a friend
at a distance of at least 15 metres.
6
(g) None of the above apply.
0
10 (a)
Continence other than
enuresis (bed wetting) where
the claimant does not have an
artificial stoma or urinary
collecting device.
10 (a) (i)
Has no voluntary control over the
evacuation of the bowel.
15
10 (a) (ii)
Has no voluntary control over the
voiding of the bladder.
15
10 (a) (iii)
At least once a month loses control of
bowels so that the claimant cannot
control the full evacuation of the
bowel.
15
10 (a) (iv)
At least once a week, loses control of
bladder so that the claimant cannot
control the full voiding of the bladder.
15
10 (a) (v)
Occasionally loses control of bowels so
that the claimant cannot control the full
evacuation of the bowel.
9
10 (a) (vi)
At least once a month loses control of
bladder so that the claimant cannot
control the full voiding of the bladder.
6
10 (a) (vii)
Risks losing control of bowels or
bladder so that the claimant cannot
control the full evacuation of the bowel
or the full voiding of the bladder if not
able to reach a toilet quickly.
6
10 (a) (viii) None of the above apply.
0
10 (b)
Continence where the
claimant uses a urinary
collecting device, worn for
the majority of the time
including an indwelling
urethral or suprapubic
10 (b) (i)
Is unable to affix, remove or empty the
catheter bag or other collecting device
without receiving physical assistance
from another person.
15
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(1)
Activity
(2)
Descriptors
(3)
Points
catheter.
10 (b) (ii)
Is unable to affix, remove or empty the
catheter bag or other collecting device
without causing leakage of contents.
15
10 (b) (iii)
Has no voluntary control over the
evacuation of the bowel.
15
10 (b) (iv)
At least once a month, loses control of
bowels so that the claimant cannot
control the full evacuation of the
bowel.
15
10 (b) (v)
Occasionally loses control of bowels so
that the claimant cannot control the full
evacuation of the bowel.
9
10 (b) (vi)
Risks losing control of bowels so that
the claimant cannot control the full
evacuation of the bowel if not able to
reach a toilet quickly.
6
10 (b) (vii) None of the above apply.
0
10 (c)
Continence other than
enuresis (bed wetting) where
the claimant has an artificial
stoma.
10 (c) (i)
Is unable to affix, remove or empty
stoma appliance without receiving
physical assistance from another
person.
15
10 (c) (ii)
Is unable to affix remove or empty
stoma appliance without causing
leakage of contents.
15
10 (c) (iii)
Where the claimant's artificial stoma
relates solely to the evacuation of the
bowel, at least once a week, loses
control of bladder so that the claimant
cannot control the full voiding of the
bladder.
15
10 (c) (iv)
Where the claimant's artificial stoma
relates solely to the evacuation of the
bowel, at last once a month, loses
control of bladder so that the claimant
9
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(1)
Activity
(2)
Descriptors
(3)
Points
cannot control the full voiding of the
bladder.
10 (c) (v)
Where the claimant's artificial stoma
relates solely to the evacuation of the
bowel, risks losing control of the
bladder so that the claimant cannot
control the full voiding of the bladder if
not able to reach a toilet quickly.
6
10 (c) (vi) None of the above apply.
0
11. Remaining conscious during
waking moments.
11 (a)
At least once a week, has an involuntary
episode of lost or altered consciousness,
resulting in significantly disrupted awareness
or concentration.
15
(b)
At least once a month, has an involuntary
episode of lost or altered consciousness,
resulting in significantly disrupted awareness
or concentration.
9
(c)
At least twice in the six months immediately
preceding the assessment, has had an
involuntary episode of lost or altered
consciousness, resulting in significantly
disrupted awareness or concentration.
6
(d) None of the above apply.
0
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SCHEDULE 2
ASSESSMENT OF WHETHER A CLAIMANT HAS LIMITED CAPABILITY
FOR WORK
PART 2
Mental, cognitive and intellectual function assessment
(1)
Activity
(2)
Descriptors
(3)
Points
12. Learning or
comprehension in the
completion of tasks.
12 (a)
Cannot learn or understand how to successfully complete a simple
task, such as setting an alarm clock, at all.
15
(b)
Needs to witness a demonstration, given more than once on the same
occasion, of how to carry out a simple task before the claimant is able
to learn or understand how to complete the task successfully, but
would be unable to successfully complete the task the following day
without receiving a further demonstration of how to complete it.
15
(c)
Needs to witness a demonstration of how to carry out a simple task,
before the claimant is able to learn or understand how to complete the
task successfully, but would be unable to successfully complete the
task the following day without receiving a verbal prompt from
another person.
9
(d)
Needs to witness a demonstration of how to carry out a moderately
complex task, such as the steps involved in operating a washing
machine to correctly clean clothes, before the claimant is able to learn
or understand how to complete the task successfully, but would be
unable to successfully complete the task the following day without
receiving a verbal prompt from another person.
9
(e)
Needs verbal instructions as to how to carry out a simple task before
the claimant is able to learn or understand how to complete the task
successfully, but would be unable, within a period of less than one
week, to successfully complete the task the following day without
receiving a verbal prompt from another person.
6
(f) None of the above apply.
0
13. Awareness of
hazard.
13 (a)
Reduced awareness of the risks of everyday hazards (such as boiling
water or sharp objects) would lead to daily instances of or to near-
avoidance of:
15
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(1)
Activity
(2)
Descriptors
(3)
Points
(i) injury to self or others; or
(ii) significant damage to property or possessions,
to such an extent that overall day to day life cannot successfully be
managed.
(b)
Reduced awareness of the risks of everyday hazards would lead for
the majority of the time to instances of or to near-avoidance of
9
(i) injury to self or others; or
(ii) significant damage to property or possessions,
to such an extent that overall day to day life cannot successfully be
managed without supervision from another person.
(c)
Reduced awareness of the risks of everyday hazards has led or would
lead to frequent instances of or to near-avoidance of:
6
(i) injury to self or others; or
(ii) significant damage to property or possessions,
but not to such an extent that overall day to day life cannot be
managed when such incidents occur.
(d) None of the above apply.
0
14. Memory and
concentration.
14 (a)
On a daily basis, forgets or loses concentration to such an extent that
overall day to day life cannot be successfully managed without
receiving verbal prompting, given by someone else in the claimant's
presence.
15
(b)
For the majority of the time, forgets or loses concentration to such an
extent that overall day to day life cannot be successfully managed
without receiving verbal prompting, given by someone else in the
claimant's presence.
9
(c)
Frequently forgets or loses concentration to such an extent that overall
day to day life can only be successfully managed with pre-planning,
such as making a daily written list of all tasks forming part of daily
life that are to be completed.
6
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(1)
Activity
(2)
Descriptors
(3)
Points
(d) None of the above apply.
0
15. Execution of
tasks.
15 (a) Is unable to successfully complete any everyday task.
15
(b)
Takes more than twice the length of time it would take a person
without any form of mental disablement, to successfully complete an
everyday task with which the claimant is familiar.
15
(c)
Takes more than one and a half times but no more than twice the
length of time it would take a person without any form of mental
disablement to successfully complete an everyday task with which the
claimant is familiar.
9
(d)
Takes one and a half times the length of time it would take a person
without any form of mental disablement to successfully complete an
everyday task with which the claimant is familiar.
6
(e) None of the above apply.
0
16. Initiating and
sustaining personal
action. **
16 (a)
Cannot, due to cognitive impairment or a severe disorder of mood or
behaviour, initiate or sustain any personal action (which means
planning, organisation, problem solving, prioritising or switching
tasks).
15
(b)
Cannot, due to cognitive impairment or a severe disorder of mood or
behaviour, initiate or sustain personal action without requiring daily
verbal prompting given by another person in the claimant's presence
for the majority of the time.
15
(c)
Cannot, due to cognitive impairment or a severe disorder of mood or
behaviour, initiate or sustain personal action without requiring verbal
prompting given by another person in the claimant's presence for the
majority of the time.
9
(d)
Cannot, due to cognitive impairment or a severe disorder of mood or
behaviour, initiate or sustain personal action without requiring
frequent verbal prompting given by another person in the claimant's
presence.
6
(e) None of the above apply.
0
17. Coping with
17 (a)
Cannot cope with very minor, expected changes in routine, to the
15
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(1)
Activity
(2)
Descriptors
(3)
Points
change.
extent that overall day to day life cannot be managed.
(b)
Cannot cope with expected changes in routine (such as a pre-arranged
permanent change to the routine time scheduled for a lunch break), to
the extent that overall day to day life is made significantly more
difficult.
9
(c)
Cannot cope with minor, unforeseen changes in routine (such as an
unexpected change of the timing of an appointment on the day it is
due to occur), to the extent that overall, day to day life is made
significantly more difficult.
6
(d) None of the above apply.
0
18. Getting about. 18 (a)
Cannot get to any specified place with which the claimant is, or
would be, familiar.
15
(b)
Is unable to get to a specified place with which the claimant is
familiar, without being accompanied by another person on each
occasion.
15
(c)
For the majority of the time is unable to get to a specified place with
which the claimant is familiar without being accompanied by another
person.
9
(d)
Is frequently unable to get to a specified place with which the
claimant is familiar without being accompanied by another person.
6
(e) None of the above apply.
0
19. Coping with social
situations.
19 (a)
Normal activities, for example, visiting new places or engaging in
social contact, are precluded because of overwhelming fear or
anxiety.
15
(b)
Normal activities, for example, visiting new places or engaging in
social contact, are precluded for the majority of the time due to
overwhelming fear or anxiety.
9
(c)
Normal activities, for example, visiting new places or engaging in
social contact, are frequently precluded, due to overwhelming fear or
anxiety.
6
(d) None of the above apply.
0
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(1)
Activity
(2)
Descriptors
(3)
Points
20. Propriety of
behaviour with other
people.
20 (a)
Has unpredictable outbursts of aggressive, disinhibited, or bizarre
behaviour, being either:
15
(i) sufficient to cause disruption to others on a daily basis; or
(ii)
of such severity that although occurring less frequently than on
a daily basis, no reasonable person would be expected to
tolerate them.
(b)
Has a completely disproportionate reaction to minor events or to
criticism to the extent that the claimant has an extreme violent
outburst leading to threatening behaviour or actual physical violence.
15
(c)
Has unpredictable outbursts of aggressive, disinhibited or bizarre
behaviour, sufficient in severity and frequency to cause disruption for
the majority of the time.
9
(d)
Has a strongly disproportionate reaction to minor events or to
criticism, to the extent that the claimant cannot manage overall day to
day life when such events or criticism occur.
9
(e)
Has unpredictable outbursts of aggressive, disinhibited or bizarre
behaviour, sufficient to cause frequent disruption.
6
(f)
Frequently demonstrates a moderately disproportionate reaction to
minor events or to criticism but not to such an extent that the claimant
cannot manage overall day to day life when such events or criticism
occur.
6
(g) None of the above apply.
0
21. Dealing with other
people.
21 (a) Is unaware of impact of own behaviour to the extent that:
15
(i)
has difficulty relating to others even for brief periods, such as a
few hours; or
(ii) causes distress to others on a daily basis.
(b)
The claimant misinterprets verbal or non-verbal communication to the
extent of causing himself or herself significant distress on a daily
basis.
15
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(1)
Activity
(2)
Descriptors
(3)
Points
(c) Is unaware of impact of own behaviour to the extent that:
9
(i)
has difficulty relating to others for longer periods, such as a day
or two; or
(ii) causes distress to others for the majority of the time.
(d)
The claimant misinterprets verbal or non-verbal communication to the
extent of causing himself or herself significant distress to himself for
the majority of the time.
9
(e) Is unaware of impact of own behaviour to the extent that:
6
(i)
has difficulty relating to others for prolonged periods, such as a
week; or
(ii) frequently causes distress to others.
(f)
The claimant misinterprets verbal or non-verbal communication to the
extent of causing himself or herself significant distress on a frequent
basis.
6
(g) None of the above apply.
0