Universal Credit if you have a health condition or disability

If you have a health condition or disability

As part of your claim for this benefit, or a review of an existing claim, you may need to go to a face-to-face health assessment. Read how to safely go to a face-to-face health assessment. You will not need to do this if you have a terminal illness

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 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 have to go to a Work Capability Assessment to find out if you:

• are fit for work
• have limited capability for work (meaning that you cannot work now, but you can prepare for work sometime in the future)
• have limited capability for work and work related activity (meaning that you are unable to work and do not have to look for or prepare for work)

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 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.

If your Work Capability Assessment finds you fit for work and you stay ill or have a disability which continues to limit the work you can do, you should continue to supply medical evidence and request that you are referred for another Work Capability Assessment.

If you are already claiming Universal Credit and your health condition changes, you can stay on Universal Credit but you must report your new circumstances and supply medical evidence.

Medical evidence

If you have a health condition or disability which limits your capability for work, when you make you 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 hand written copy.

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
• terminally ill form - DS1500 (or the new SR1 form)
• 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.

Universal Credit if you have a terminal illness

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 you have a terminal illness 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 a terminal illness when you are making a claim for Universal Credit or at any point during your claim. 

You can report a terminal illness 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 a DS1500 or 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 DS1500 or SR1 form confirms your diagnosis along with your current and proposed treatment plan, and it should be sent to the Department for Communities (DfC) at the following address:  

Freepost,
Universal Credit NI 

or to the nearest Jobs and Benefit office by you or by your medical professional. 

If you are found to be eligible for the Special Rules for Terminal Illnesses, 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 terminally ill, you will no longer need to agree a Claimant Commitment or be required to go to or be in contact with your Job and Benefit Centre.

Further information is available about claiming benefits if you have a terminal illness

Universal Credit if you get a Severe Disability Premium 

From February 2021 if you are receiving Severe Disability Premium and you have a change in your circumstances, you may move onto Universal Credit.

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

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 free dental treatment, free eye sight 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. 

People claiming Universal Credit need to make a separate application for help with health service or travel costs using a Help with Health Costs (HC1) form