Eligibilty for ESA
You may be able to claim ESA if any of the following apply:
- your Statutory Sick Pay has ended or you cannot get it
- you are employed, self-employed, unemployed or a student on Disability Living Allowance or Personal Independence Payment
- you have been getting Statutory Maternity Pay (SMP) and have not gone back to work for your employer because you have an illness or disability which affects your ability to work
- you are under State Pension age
- you are not getting Jobseeker’s Allowance
You must also either:
- have had an illness or disability which affects your ability to work
- be unable to work for two or more days out of seven consecutive days
- be getting special medical treatment
There are three types of ESA:
- new style
'New style' ESA
If you are claiming or have made a claim to Universal Credit you may be entitled to ESA, known as ‘new style’ ESA.
'New style' ESA works in the same way as contribution-based ESA. Your partner’s income and savings won’t affect how much new style ESA you’re paid.
You can get new style ESA on its own or at the same time as Universal Credit. If you get both at the same time, your new style ESA payment will be deducted from your Universal Credit payment – you aren’t guaranteed to get any extra money
You may be entitled to this if you have paid enough National Insurance contributions.
You may be entitled to income-related ESA if you do not have enough money coming in or you have not paid enough National Insurance contributions, and you satisfy the entitlement conditions.
This means that you have savings of less than £16,000 and if you have a partner or civil partner, they work for less than 24 hours a week on average.
If you have a terminal illness
If your doctor doesn’t think you’ll live for more than six months, there are special rules to make sure you get the most money you can. If this applies to you, please contact the ESA Centre.
If you've been living or working abroad
This can affect your ESA claim. You may be able to claim if you've either:
- paid enough UK National Insurance Contributions in the past (and the equivalent in certain other countries)
- worked abroad for an employer based in the UK and paid National Insurance contributions for the first 52 weeks of that employment
Moving between Northern Ireland and Great Britain
If you move you must tell the ESA Centre of the change of address on arrival in your new location.
ESA claim process
For new ESA claims, there are of two phases:
- the assessment phase
- the main phase
The assessment phase
This lasts for the first 13 weeks of your claim while a decision is made on your capability for work through a Work Capability Assessment. During this phase, ESA is paid at a basic rate.
The main phase
This phase starts from week 14 of your claim. Your Work Capability Assessment will decide which of the following two groups you are placed in during the main phase of your claim:
- Work Related Activity Group
- Support Group
More information on the Work Capability Assessment is provided further down the page.
Work Related Activity Group
In this group, you will be expected to take part in work-focused interviews with your Employment Service Adviser. You will get support to help you prepare for suitable work.
It may affect your entitlement to ESA if you refuse to go to, or fully take part in, the work-focused interviews.
If your claim was made before 3 April 2017, you will be paid a ‘work-related activity component’ in addition to your basic rate.
If your claim was made on or after 3 April 2017 and does not link to a previous ESA claim, you will not be paid a ‘work-related activity component’.
In this group, because your illness or disability severely affects your ability to work, you will not be expected to take part in any work. You can do so on a voluntary basis if you want to.
You do not have to go to work-focused interviews either but you can ask to talk to an Employment Service Adviser if you want to.
You will be paid a ‘support component’ in addition to the basic rate.
Moving onto ESA from Incapacity Benefit
You'll be told whether you're in the Support Group or Work-Related Activity Group and your benefit will be transferred automatically and there will be no break in the payments you receive.
If the amount of Incapacity Benefit you get is more than the amount of ESA, you’ll get a top-up payment. The amount of benefit you get won't rise until the amount of ESA catches up with the amount of the top-up payment.
If the amount of Incapacity Benefit you get is lower than the amount of ESA, you will get more money. Your money will increase as soon as you move to ESA.
How to claim
You can claim ESA by telephone, textphone or by downloading a claim form.
Claim by telephone or textphone
You can phone or textphone the ESA Centre and an adviser will talk through the application with you and fill in the form on your behalf.
Textphones are for people who find it hard to speak or hear clearly. They can only receive calls made from other textphones.
If you do not have a textphone but need to use one, try your local library or an advice centre like Advice NI.
Complete an application form
You can download the application form from the link below. There are also guidance notes to read before filling in the claim form.
You will need to print this form and post it to the ESA Centre.
In most cases, you won’t be eligible for ESA again if you were found capable of doing some work after your Work Capability Assessment. The main exceptions are when:
- your current condition has got a lot worse
- you’re claiming for a new condition
The amount you get paid depends on your circumstances and on what effect your disability has on your ability to work. In most cases you will not get any money for the first seven days of your claim. These are called 'waiting days'.
|a single person aged under 25||up to £57.90|
|a single person aged 25 and over||up to £73.10|
|Group||Person||Date of claim||Weekly rate|
|Work related activity group||Single person||Before 3 April 2017||Up to £102.15|
|Work related activity group||Single person||On or after 3 April 2017||Up to £73.10|
|Support group||Single person||N/A||Up to £111.65|
Income related ESA
For income-related ESA:
- your household income, pension and any savings of £6,000 or more are taken into account
- depending on your circumstances you may be able to get more money if you get income-related ESA
- you can only get extra money for your husband, wife or civil partner if you get income-related ESA
Pension income rules
If you receive contribution-based ESA and have a gross pension income of more than £85 a week, the amount of benefit payable will be reduced by half of the excess.
The excess is the difference between £85 and the actual pension income. For example, for a pension income of £100, the excess is £15. The amount of ESA payable is reduced by half of that, which is £7.50.
If you receive income-related ESA, any pension income you have will be taken into account, regardless of the amount.
Income-related ESA is not taxable.
Contribution-based ESA is taxable so you may have to pay tax. How much tax you have to pay, if any, depends on whether you receive any other income, for example, an occupational pension.
Depending on your circumstances, you may get a new tax code.
How ESA is paid
All benefits, pensions and allowances are paid into an account. This is the safest, most convenient and efficient method of payment.
You may be able to do some types of work while claiming ESA but within certain limits. This is called 'permitted work'. Information on permitted work and how to apply is available at the following link:
Work Capability Assessment
When you claim ESA, you will take part in a Work Capability Assessment. This assesses how your illness or disability affects your ability to work.
If you’re claiming both Universal Credit and new style ESA, you’ll only go to one Work Capability Assessment.
Capability for work questionnaire (for all claims)
You will complete a capability for work questionnaire (ESA50) about how your condition affects your ability to complete everyday tasks.
Your own doctor may be asked to provide a medical report.
If more information is needed before a decision on your claim is made, you will be asked to go to a face-to-face medical assessment.
If you have a mental health condition, this may include questions about your condition could affect:
- your mood
- the way you behave
- the way you relate to the world around you
- how you cope with things from day to day
Medical assessment (for some claims)
If you have been asked to take part in a medical assessment, it is very important you do so as your benefit may be affected if you don't.
You will be given notice of your appointment and the option to change it.
It will usually take place at a medical centre near your home. If you're unfit to travel or live more than a 90 minute journey from the nearest centre, the healthcare professional may visit you at home.
For the appointment, you can:
- have a friend, relative or support worker with you
- ask for an interpreter if you need one
- ask to be assessed by a healthcare professional of the same gender as yourself
You need to let the medical centre know ahead of time if you want an interpreter or healthcare professional of the same gender. They will try to find one for you, although this may not always be possible.
Before the medical assessment
To prepare for the assessment, you should think about:
- what everyday tasks you have difficulty with or are unable to do
- if you can do more on some days than others, what a typical day is like for you
- how your illness or disability affects your ability to work
- what support you think you need to improve your ability to work
What to bring to the assessment
You should bring your passport as identification.
If you do not have a passport, you must bring three of the following documents:
- birth certificate
- full driving licence
- life assurance policy
- recent bank statements
You should also bring pills or medication you're taking and any simple aids or appliances you use, such as glasses or hearing aids.
At the assessment
The medical assessment is to assess how your illness or disability affects you and your ability to work. It is not to diagnose or discuss treatment.
It involves an interview and sometimes a physical examination. You should allow around 50 minutes for the assessment.
This will normally cover:
- what you did in your old job (if you had one), and when and why you left
- a brief medical history, including details of treatment, medication and any hospital stays
- your domestic situation - who you live with and what type of house you live in
- how your illness or disability affects how you are able to carry out everyday tasks
- an outline of a typical day for you
If you're claiming ESA because of a mental health problem or a physical illness or disability that could affect your mental health, you may be asked about:
- understanding and focus
- adapting to change
- social interaction
The physical examination
If a physical examination is needed, the healthcare professional will first explain what is involved and check you're happy it goes ahead.
You will not be asked to carry out any action that causes you discomfort.
The medical assessment report
After the assessment, the healthcare professional will complete an ESA85 report. You can request a copy from the ESA Centre.
If you are unhappy with the medical assessment, you can complain to Medical Support Services. The complaints procedure is explained in the letter you received about your medical assessment.
You can also complain to the approved healthcare professional at the time of the assessment. If they cannot resolve the problem, they will give you information on the formal complaints procedure.
From 29 September 2017, your condition(s) will be assessed against new criteria as part of the Work Capability Assessment (WCA) to identify if any reassessment is required. Those with the most severe lifelong disabilities, illness, or health conditions may not require any future reassessment.
You will be informed if you will no longer be routinely assessed.
Receiving a decision on your ESA claim
The ESA centre will review your capability for work questionnaire, medical assessment and other information provided, and make a decision on your claim.
You will receive a letter stating the decision. If you are entitled to ESA, it will tell you if you are being placed in the Work Related Activity Group or Support Group.
All medical information about your claim is confidential and will not be released to anyone outside the Department for Communities (DfC) without your consent.
Should the healthcare professional want to send information about your medical assessment to your doctor, Medical Support Services (who organise medical examinations on behalf of the DfC), will write to you requesting your consent.
When claiming ESA you may receive text messages (SMS) from the Department for Communities (DfC). They will always be clearly marked as DfC and will never ask you to give, or click a link to give, personal information or financial details by message or email.
If you’re concerned or unsure about any text messages (SMS) you receive from about ESA you should contact the ESA Centre directly. If you suspect you have received a fraudulent message as a scam, please contact the ESA Centre immediately.
- Further information is available at: scamwiseni
If your circumstances change
It's important to contact the ESA Centre if your circumstances change. For example if:
- you do any work, including voluntary work
- you start training and get a training allowance
- you change your address
- you have been in hospital for 52 weeks and part of your benefit is paid for someone else
- your condition(s) has got worse
- you go abroad
How to appeal
If you are refused ESA or if you have questions about your payment, you can ask that the decision is looked at again. If you're still unhappy with the outcome, you can appeal.
Help with housing costs
If you receive ESA and have a mortgage, remortgage or home loan, you may be able to get a loan to help towards the interest payments.