EMPLOYMENT SUPPORT ALLOWANCE

1
EMPLOYMENT SUPPORT ALLOWANCE
2
Employment Support Allowance
This will replace Incapacity Benefit and Income
Support paid on the grounds of incapacity.
Between 2010 and 2014 all existing incapacity
benefits claimants will be required to take the
work capability assessment.
3
ESA will be paid to people in Great Britain who
satisfy the following

• have a limited capability for work have a
  physical or mental condition, which means that it
  is not reasonable to require them to work.

• are at least 16 years old and who have not
  reached pensionable age

• pass either a national insurance contribution
  test (similar to that for incapacity benefit) or
  have income below the statutory threshold

4
How much is ESA?

• The amount of ESA will be determined by whether
  someone is entitled to a contributory or
  income-related allowance or both, and whether
  they are entitled to the work-related activity or
  support component.

• The Government has stated that young people under
  age 25 will receive the same basic allowance to
  for the main phase of ESA as everyone else.

• However this does not seem to apply for the 12
  weeks prior to the medical assessment (where the
  rates will be similar rate to that for
  jobseeker's allowance).

5
IS (all claimants, although some claimants may
also receive the enhanced disability premium)
60.50 per week personal allowance25.85
disability premium86.35 per week total
Non Contributory ESA (work-related activity
group, estimated 90 of claimants)
60.50 per week basic rate24.00 work-related
activity component84.50 per week total (a
reduction of 1.85 per week)
6
Non Contributory ESA (support group, estimated
10 of claimants)
60.50 per week basic rate29.00 support
component12.60 enhanced disability premium
102.10 per week total (increase of 15.75 p/w,
in cases where Enhanced Disability Premium (EDP)
wasnt previously payable, or increase of 3.15
p/w where EDP was payable)
7
Contributory Employment Support Allowance
People entitled to the Support Component to ESA
will not automatically be entitled to the
Enhanced Disability Premium and will be required
to claim it.
8
Statutory Sick Pay claimants
SSP Claimants will Receive 28 weeks of 75.40
- then 13 weeks on assessment of 60.50 and then
84.50
9
End of age adult dependant additions
Age additions (up to 16.50 in 2006/7)

• extra amounts on long term IB for under 45s and
  under 35s to reflect loss of lifetime earnings
  through long term incapacity

Adult dependant additions (up to 50.50)

• extra amounts for another adult who is not
  earning/on another income replacement benefit
  and who either
• looks after your child (any adult partner,
  friend etc) supporting caring and childcare
  or
• is your spouse aged over 60, if no dependent
  children.

10
ESA and young people

• Less money at start
• Current IB (Youth) starts at 59.20
• Basic allowance during first 13 weeks paid at
  JSA under 25s rate (currently 45.50). Will be
  at full rate (currently 57.45) after 13 weeks

• Less money long term
• Long term IB with age addition is 95.00
• Without age addition current IB is 78.50

11
The new PCA test

• No exemptions

• Some exceptional circumstances remain

• No Own Occupation Test all claimants go
  straight to PCA

• A new and tougher test of incapacity

• These will be more frequent .

• A further test (for most severely ill/disabled)
  for Support Component

12
No exemptions from the PCA

• No exemptions for specific groups (e.g. higher
  DLA Care, severe mental health or learning
  disability, quadriplegic, blind etc)

• But deemed incapacity after DWP medical
  assessment in exceptional circumstances
  continues (e.g. terminal illness).

• So all claimants will need to go through process
• starting with a new ESA version of IB50,
• followed by medical assessment (either scrutiny
  of papers or medical examination).

• Medical assessment decides whether or not you
• score the 15 or more points for PCA - have
  limited capability for work
• You qualify for the Support Component have
  limited capability for work-related activity
• Any exceptional circumstances apply
  regardless of other two assessments

13
Exceptional circumstances

• People will be treated as both passing the PCA
  and being entitled to Support Component, if they
  are

• reasonably expected to die in next six months due
  to progressive disease or

• receiving chemotherapy or

• WOULD BE SUBSTANTIAL RISK - MENTALLY OR
  PHYSICALLY TO ANY PERSON IF NOT TREATED AS
  HAVING PASSED or

• if pregnant, serious risk to mother or child

14
Qualification for Support Component

• Medical decision does the claimant have
  limited capability for work-related activity ?

• The decision is appealable

• any one of a number of severe disability
  descriptors must apply

They must apply for most of the time, or on
most occasions an activity is attempted
15
Support Component

• Some Support Component descriptors are identical
  to some (new) PCA ones

• Others are very similar but use a slightly
  different test

• Others introduce completely new concepts e.g.
  feeding oneself

• Complex and lengthy list!

16
Initial Assessment Period
Anyone claiming ESA will be assessed during a 13
week period, or longer if necessary, not only to
determine whether they have a limited capability
for work but also whether or not he or she is
capable of engaging in work-related activity.
Those who cannot engage in work-related activity
will receive a 'support component'.
17
Mental, Cognitive and Intellectual Function

• New test virtually unrecognisable

• Mental health claimants will have to score 15
  points

• No rounding up and combining option but the
  claimant can score from both the physical and
  mental health tests

18
Old Mental Health Descriptors

• Completion of tasks

• Daily living

• Coping with pressure

• Interaction with other people

19
The New Descriptors
1. learning tasks
2. understanding instructions
3. memory and concentration
4. getting about/"forward planning"
5. coping with change
6. execution of tasks
7. initiating and sustaining tasks
8. inappropriate behaviour with other people
9. dealing with other people
10. coping with social situations
11. awareness of hazard.
20
Work Related Activity Component
Those who can engage in work-related activity
will receive a 'work-related activity component'
and will normally be required to do three things
as part of the conditionality for receiving
this component.
21
Work Related Activity Component

• They will have a work-focused health-related
  assessment aimed at providing additional
  information about the claimant's functional
  capacity.

22
Work Related Activity Component
2. Attend 5 work-focused interviews to discuss
what steps they can take to move towards work. A
claimant may be asked to assist in drawing up an
action plan of work related activity they intend
to undertake - but they would not be obliged to
do what the action plan says.
23
Work Related Activity Component
3. Undertake activities that increase the
likelihood of getting a job. This may include
activities such as work trials, training, or
attending a programme designed to help them
manage their condition.
24
Qualification for Work-related activity Component

• Score of 15 in PCA

• Participate in Work Focused Interviews

• Government to look at conditionality of
  participation in work related activity
  potentially extending requirements and
  overlapping with JSA

25
Physical Disability

• Broadly same categories as now but some combined
  standing, sitting and rising from sitting now
  all one descriptor

• Some other descriptors have had points reduced

• Some minor but negligible tinkering since
  evaluation

• The lower scoring problems (i.e. old 3
  pointers have disappeared

• Bad news for claimants with physical problems
  in pilots, one quarter of existing claimants
  failed new PCA

26
The Main Changes to the physical descriptors
A number of descriptors have been combined and
their number drastically reduced.
Whereas the old PCA had 7 different levels for
EACH function, the new test has only combination
of 4 levels for the combined descriptor of
walking and using stairs and introduces new
descriptors.
27
ESA RECAP
SEVERE DISABILITY PREMIUM and / or ENHANCED
DISABILITY PREMIUM As per current IS/JSA
rules, based on appropriate DLA entitlement
Plus within income-based ESA
SUPPORT COMPONENT for the most severely
disabled Not conditional on work focused
activity Can choose to opt in Paid at higher
rate than Work Related Activity Component
WORK RELATED ACTIVITY COMPONENT for most
claimants Must participate in c. 6 WFIs and draw
up an action plan. Sanctions back to basic
benefit .
Plus from week 13. These replace Disability
Premium
OR
For first 13 weeks Assessment Phase
BASIC ALLOWANCE Work focused interview at 8
weeks IB50 and PCA within first 12 weeks Benefit
paid at JSA levels
28
Sanctions
Benefit can by be reduced (sanctioned) if a
claimant on the work related activity component
fails to undertake such assessments, interviews
or activity as required without good cause.
The Support Group Those identified as not able
to take part in any work- related activity (the
most severely disabled group) will not be
expected to take part in work-focused activities
unless they want to, but will not face any
sanctions.
29
Sanction and Appeal Rights

• Questionnaire not received (without an acceptable
  good cause).

• Benefit withdrawn customer has right of appeal.

• Claimant does not attend WCA Assessment
  (without an acceptable good cause)

 
 

• Benefit withdrawn customer has
  right of appeal.

Benefit withdrawn customer has right of
appeal
Claimant does not have limited capability
for work

• Sanction of ESA 50 of personal allowance rate
  implemented. Claimant has right of appeal against
  sanction.

• Claimant fails to attend Work Focused Interview
  (without an acceptable good cause).

30
Good Cause
If you are unable to attend or take part in a
work focused interview you will need to show good
cause to avoid a penalty.
A decision maker will look at the circumstances
such as where there could be a misunderstanding
due to learning, language or literacy
difficulties, attending medical or dental
appointments or related to a physical or mental
condition which made it impossible for attendance.
31
Safeguards before a sanction is imposed
The purpose of the sanctions regime is not to
punish people but rather to provide incentives
for claimants to undertake activity that we
believe will be beneficial to them. Safeguards
are particularly important for claimants with
mental health conditions for whom a home visit
will be arranged if a sanction is to be imposed.
32
Safeguard procedures are in place to ensure that
a rigorous process is adhered to before a
sanction is imposed to ensure that no one has
their benefit reduced inappropriately and to give
each individual the chance to comply with the
requirements.
33
Introduction of ESA to lead to 26,500 more
appeals each year
Government publishes impact assessment
The introduction of employment and support
allowance in October 2008 will be likely to lead
to an extra 26,500 appeals each year, the
government has said.
34
In an impact assessment published alongside
the Employment and Support Allowance Regulations
2008, the government advises that it expects
there to be an increase in the number of appeals
and appeal hearings as a result of the new
benefit's tighter 'gateway' and the introduction
of appealable decisions which do not currently
exist under incapacity benefits.
35
Amongst the government's own estimates are that

• 60,000 more people a year will fail the work
  capability assessment than are currently failing
  the personal capability assessment

• around a third of those who fail the work
  capability assessment will appeal and around 70
  of these will reach an appeal hearing

• appeals challenging decisions relating to whether
  the claimant should be placed in the new support
  group

36
Amongst the government's own estimates are that

• 6,000 fewer claimants will be placed in the
  support group, compared to those who are
  currently exempt form the personal capability
  assessment

• appeals against sanctions will number 1,500 each
  year.

As a result, the government anticipates that each
year an extra 26,500 appeals will be lodged, with
21,000 reaching a tribunal hearing.
37
the cost of these extra appeals could amount to
9 million/year, the government advises, with 4
million covering Jobcentre Plus costs in
processing the appeals and 5 million in respect
of Ministry of Justice costs, for example in
relation to provision for hearings by the
Tribunals Service and provision of legal aid by
the Legal Services Commission
38
(No Transcript)
39
Claimants ESA Journey
40
Claimants ESA Journey
41
Claimants ESA Journey
42
Claimants ESA Journey
43
ESA Customer Journey
44
Claimants ESA Journey