Universal Credit if you have a health condition or disability

This video explains what help is available if you have a health condition or disability which stops you from working or limits the amount of work you can do, or if you are nearing the end of life.

If you are ill or have a disability, you must tell Universal Credit as soon as you make your claim or as soon as the illness or disability occurs. This will help Universal Credit to provide you with the help and support you need.

If your illness or disability limits the work you can do, or stops you from working, you may be able to get an extra monthly amount as well as your monthly standard allowance.

You will still need to agree a claimant commitment so it is important to report an illness or disability to allow your work coach to consider the effect it may have on your claimant commitment. For example, if your illness or disability stops you from working your work coach may be able to adjust or pause your claimant commitment until you are fit for work.

If you need help with your claim, you can contact Universal Credit through your Universal Credit online account, speak with your work coach in your local Jobs and Benefits office or phone the Universal Credit Service Centre.

You may also be eligible for Claim New Style Employment and Support Allowance | nidirect

Medical evidence

If you have a health condition or disability which limits your capability for work, when you make your claim or while you are claiming you need to immediately complete a self-certification for up to the first seven days.  

This is a declaration you complete to say you have a health condition or disability which limits your capability for work.

You can report the self–certification using your online account, over the phone or at your local Jobs and Benefits office.

From the eighth day that you are unfit for work, after the period of self-certification expires, you must provide acceptable medical evidence. This will normally be a Statement of Fitness for Work (SoFFW). This is called a fit note, sick note, medical certificate or doctor’s note and it may be an electronic or handwritten copy. If you are still unfit for work when your fit note ends you will need to provide another one.

It can be provided by any doctor or authorised registered Health Care Professionals (HCPs) which are Nurses, Occupational Therapists, Pharmacists and Physiotherapists.

Acceptable medical evidence includes a:

• statement of Fitness for Work
• doctor's letter
• special rules for end of life form - SR1
• hospital inpatient form - Med10
• psychiatric hospital admission form
• hospital discharge letter
• private medical certificates
• other evidence

Medical evidence is not required if you have moved from ESA to Universal Credit, and ESA advised that you no longer need to supply fit notes.

For further information on when you need to send medical evidence for a health condition or disability, speak to your work coach.

For further information see Financial support for people with disabilities.

Work Capability Assessment

A Work Capability Assessment is carried out to identify the extent that your health condition or disability affects your capability to work, or to carry out work-related activity such as training and searching for work.

It is important that you provide medical evidence to decide whether you need to have a Work Capability Assessment.

If you need a Work Capability Assessment

You will be told if you need a Work Capability Assessment.  The assessment can be in person, by video call or on the phone.

Your Work Capability Assessment will check what you can and can’t do on a day-to-day basis.  You can also tell Universal Credit if your condition changes over time, and how it changes.  The Work Capability Assessment will help you and your work coach to discuss and agree the things you have to do to get Universal Credit.

If you move from Employment and Support Allowance (ESA) to Universal Credit and have already had a Work Capability Assessment, this will last until a new Work Capability Assessment decision is made following a review.

If you receive a Work Capability Allowance assessment invitation from ESA and one from Universal Credit in a short space of time, contact Universal Credit on your journal or by telephone.

Your Work Capability Assessment will decide if:

You are fit for work

If your Work Capability Assessment finds you fit for work you will need to agree to look for work that is suitable for your health condition. 

If your health condition or disability has worsened, or you have a new medical condition, you should supply medical evidence and request that you are referred for another Work Capability Assessment.

You have limited capability for work

If you have limited capability for work, you can earn a certain amount before your Universal Credit payment is reduced. This is called a Work Allowance. You will keep 45p from every £1 you earn over your Work Allowance until your earnings are too high to get Universal Credit.

You need to prepare to work in the future.  Your work coach will discuss your situation and help you prepare for work.

You have limited capability for work and work related activity

You do not need to look for work or prepare for work.  You can work if you feel able to do so.  You may get extra money as well as your standard allowance.

Your Universal Credit payments will not include an extra monthly amount unless the Work Capability Assessment decision confirms you are eligible for this.

Work Capability Reassessments

You will get a letter if you need another reassessment in the future.

If you might have 12 months or less to live

If you have a progressive disease or health condition and due to that condition you are not expected to live more than 12 months, you may get benefits at a higher rate, get extra money or get payments quicker than usual.  

If a medical professional has said you might have 12 months or less to live you must tell Universal Credit as soon as you make your claim or as soon as the illness occurs. This will help Universal Credit to make sure you receive the help and support you need to make or maintain your claim. You can report it when you are making a claim for Universal Credit or at any point during your claim. 

You can report if you are nearing the end of life during your claim using your online journal, by phone or at an appointment in your local Jobs and Benefits office.

You will need to ask your medical professional to complete an SR1 form.  They will have copies of the form. This could be your:

• GP
• hospital or hospice doctors
• registered nurses (for example, Macmillan nurses or specialist nurses)

The SR1 form confirms your diagnosis along with your current and proposed treatment plan, and it should be sent by you or your medical professional to the Department for Communities (DfC) at the following address:  

Freepost, UNIVERSAL CREDIT NORTHERN IRELAND

The Freepost address should be printed on a single address line and no additional address details should be included.

Envelopes addressed in any other way may not be delivered.

You can also take the SR1 form to your nearest Jobs and Benefits office.

If you are found to be eligible for the Special Rules for End of Life, you will be treated as having Limited Capability for Work and Work related Activity (LCWRA), and will be eligible for an additional amount of money from the first day of the assessment period in which you reported it.

If it is decided that you have LCWRA, you will not be expected to look for work. You will not need to provide a fit note or have to go to a Work Capability Assessment.

If you are nearing the end of life, you will no longer need to agree a claimant commitment or be required to go to or be in contact with your Jobs and Benefits Office.

Further information is available about claiming benefits if you are nearing the end of life.

Universal Credit if you get a Severe Disability Premium 

If you get one of the benefits being replaced by Universal Credit and also receive Severe Disability Premium, you may move onto Universal Credit if you have a change in your circumstances. 

You can find out more information on Universal Credit if you get the severe disability premium.

You will be eligible for transitional payments to make sure you don’t lose money when you move. This is known as Transitional Protection.

For more information on Transitional Protection, contact your work coach through your online journal or call the Universal Credit Service Centre.

Universal Credit and Personal Independence Payment

You can claim Universal Credit and Personal Independence Payment (PIP) at the same time.

Help with the cost of some health services and travel

If you are claiming Universal Credit you may be entitled to get help with Health Service dental treatment, eyesight tests, vouchers towards the cost of glasses or contact lens or help with the costs of travel for treatment on referral by a doctor or dentist. 

You will not get this help automatically. You will need to complete a Help with Health Costs (HC1) form and post it or take it to your local Jobs and Benefits office. 

You will not get help with these costs until after you send the form and get confirmation that you are eligible.

If your application is successful, you will be issued a certificate which will entitle you to either:

• full remission of health costs for a 12 month period (HC2 certificate)
• partial remission of health costs for a 12 month period (HC3 certificate)

These certificates are valid for 12 months.  You will need to complete a new HC1 form before your certificate expires.

You can also get an HC1 form by going to your local Jobs and Benefits office or by calling the helpline on Freephone 0800 012 1331.

You can watch a video or find more information on Help with Health Costs