Employment and Support Allowance Mark Maddison

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Employment and Support Allowance Mark Maddison

• 5th June 2008

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Why are we introducing the Employment and Support
Allowance?

• The Employment and Support Allowance plays a
  pivotal role in delivering the Governments
  vision of a modern active welfare state, as a
  replacement for incapacity benefits.
• Focus on helping individuals realise their full
  potential and a better life through the world of
  work.
• The Employment and Support Allowance will provide
  a gateway to work, assessing peoples capability
  to work and not just their entitlement to
  benefit whilst ensuring that people who are
  unable to work receive the support they need.

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What is the Employment and Support Allowance?

• The Employment and Support Allowance will be
  introduced from October 2008 and will bring a
  more active system of support for people who have
  a health condition or disability.
• The Employment and Support Allowance regime will
  be delivered through our existing Jobcentre Plus
  network of Contact Centres, Benefit Delivery
  Centres and Jobcentre Plus offices.
• It will bring together Incapacity Benefit and
  Income Support into a single benefit for those
  people with health problems or disabilities,
  combined with a work focused support regime for
  those who can benefit from work, and condition
  management support.
• Pathways to Work will underpin the new Employment
  and Support Allowance, by providing work focused
  interviews and work related activity.

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What is Pathways to Work?

• Pathways to Work provides an enhanced package of
  extra support and
• opportunities for new and repeat incapacity
  benefits customers with health
• problems and disabilities that
• Is provided in the early weeks of their claim to
  benefit
• Delivers support that will help them to return to
  work, or move closer to it now or at some point
  in the future
• Targets support on an individual basis to help
  address health-related, personal and external
  barriers to work it is not a one size fits
  all.

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What has Pathways to Work achieved so far?

• Almost 32,000 recorded job entries for Incapacity
  Benefit (IB) customers.
• A significant increase in the number of customers
  leaving IB in the first 6 months of their claim
  compared to non-Pathways Districts.
• Research shows that after 10.5 months, 32 of new
  IB customers in Pathways districts were in
  employment compared to an expectation of only
  22.5 without Pathways.
• 25,380 people have been awarded the Return to
  Work Credit.
• 15 of Pathways customers attending a Work
  Focused Interview join New Deal for Disabled
  People compared to 4 of IB customers elsewhere.
• 14,520 people were referred to the Condition
  Management Programme.
• ( National Figures for period Oct 2003 March
  2006)

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Employment and Support Allowance will

• Provide a gateway to work assessing peoples
  capability for work and not just their
  entitlement to benefit, while ensuring that
  people who are unable to work receive support.
• Quickly and sensitively identify those eligible
  for enhanced support.
• Provide an improved customer experience by making
  it easier and simpler to apply for benefits, with
  quick and sensitive handling to confirm
  eligibility, rights and responsibilities.

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The Employment and Support Allowance Process
Extra premiums where appropriate
First contact by customer
Assessment Phase where a Work Capability
Assessment will be undertaken
Allowance set at JSA level
13 weeks
Main Phase
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The Work Capability Assessment will

• Include updated mental and physical health
  assessments, including the interaction between
  physical and mental health.
• Incorporate a Work Focused Health Related
  Assessment to look at what the customer can do,
  not just what they cannot do, and identify any
  health barriers to work.

The health assessment report will be sent to the
customer and their Personal Adviser and will be
used to support the Work Focused Interviews
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What does the Employment and Support Allowance
mean for customers?

• We will offer customers the choice on how to
  claim the Employment and Support Allowance. For
  most, a single telephone call, with no forms to
  complete will be all that is needed to start the
  process.
• We will of course see customers who satisfy the
  relevant criteria at a Jobcentre if they wish to
  have a face to face interview.
• We will ask customers to attend a Work Focused
  Interview at the Jobcentre around 9 weeks after
  they have claimed.
• A Personal Adviser will discuss with the customer
  their entitlement, their aspirations for work,
  the steps they might take to help them take up a
  job and the support that is available to them.
• Most customers in the work-related activity group
  will have a further series of five interviews
  with a Personal Adviser from Jobcentre Plus or
  one of our contracted partners focused on helping
  them back to work.
• The customer will be provided with an action
  plan, which will reflect the discussion at each
  interview, including the steps a customer could
  take to help them take up a job or prepare to
  return to work.

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What about existing customers?

• Existing customers on incapacity benefits will
  continue to receive Incapacity Benefit after
  October 2008 and will have their benefit levels
  protected.
• Anyone on incapacity benefits will be able to
  volunteer for appropriate support through
  Pathways to Work (fully rolled out nationally by
  April 2008).
• At some point in the future existing incapacity
  benefits customers will move to the Employment
  and Support Allowance, as resources allow.

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The new claims process starts in the ESA Contact
Centre but links to the WCA examination and
Work-Focused Interview
New Claims Process
Weeks from initial claim
1.5 weeks
2.5 weeks
9 weeks
0 weeks

• Customer Contact
• Identify customer, reason for contact and claim
  type.
• Data gather.
• Issue evidence request, Customer Statement.

• Initial WFI
• Subsequent
• WFIs

WFI
Decision Making, Payment and Notification.
Evidence Handling and Verification
WFHRA

• Work Capability Assessment
• Medical Services activities.
• Capability Assessment.

Handle Limited Capability for Work Outcome
LCW Report
Weeks from initial claim
13 weeks
From 4 weeks
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ESA Customer Journey
DAY
BENEFIT ENTITLEMENT This shows the steps taken to establish the customers benefit entitlement.
WORK CAPABILITY ASSESSMENT This shows the steps taken to determine the customers Limited capability for work.
WORK-FOCUSED SUPPORT Jobcentre services, including Pathways provider services, are available to the customer from Day 1.
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ESA Customer Journey
DAY 1
BENEFIT ENTITLEMENT Customer rings 0800 number to make a claim for benefit. The customer selects the new claim option for sick/disabled people. Jobcentre Plus receives the call, confirms identity and takes the claim. Asks the customers if they wish to claim under Special Rules'. Call recording means there is no requirement for a customer signature.
WORK CAPABILITY ASSESSMENT
WORK-FOCUSED SUPPORT Jobcentre services, including Pathways provider services, are available to the customer from Day 1.
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ESA Customer Journey
DAY 2 - 3 DAY 5 DAY 8 / 9
BENEFIT ENTITLEMENT The Customer receives a printed Customer Statement for checking, and gathers any further evidence required. The Customer continues to gather required evidence. Jobcentre Plus receives medical services report for Special Rules customers and makes a decision on Limited Capability for Work and group. The Customer sends required evidence to the Benefit Delivery Centre in envelope provided. Evidence received in Benefit Delivery Centre. Medical Certificate received and consideration for early entry to WCA process by Jobcentre Plus.
WORK CAPABILITY ASSESSMENT If the Customer is claiming under Special Rules their GP or HCP may be contacted for further evidence.
WORK-FOCUSED SUPPORT Jobcentre services, including Pathways provider services, are available to the Customer.
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ESA Customer Journey
DAY 11 DAY 30 DAY 33
BENEFIT ENTITLEMENT The Customers claim to ESA processed. The Customer receives payment on the due pay day. The Local Authority is also advised of the customers ESA entitlement. If customer has not returned the required evidence claim may be considered as defective.
WORK CAPABILITY ASSESSMENT The customer receives a questionnaire from Medical Services (If early referral made on receipt of Med Cert) This needs to be completed and returned as soon as possible, but within 6 weeks from date of issue. All remaining customers will receive a questionnaire from Medical Services. This needs to be completed and returned as soon as possible, but within 6 weeks from date of issue.
WORK-FOCUSED SUPPORT Jobcentre services, including Pathways provider services, are available to the customer.
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ESA Customer Journey
DAY 34 DAY 36 DAY 37
BENEFIT ENTITLEMENT Customers allocated to the Support Group from the information on the questionnaire receive their decision.
WORK CAPABILITY ASSESSMENT The customer completes and returns the questionnaire in the envelope provided. Other customers receive an appointment for their Work Capability and Work Focused Health Related Assessments.
WORK-FOCUSED SUPPORT Jobcentre services, including Pathways provider services, are available to the customer.
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ESA Customer Journey
DAY 43 DAY 45 DAY 47
BENEFIT ENTITLEMENT The customer receives their benefit payment decision.
WORK CAPABILITY ASSESSMENT The customer attends a joint appointment for a Work Capability and a Work Focused Health Related Assessment. The customer receives an outcome letter for the Work Capability Assessment and a copy of the Work Focused Health Related Assessment report.
WORK-FOCUSED SUPPORT Jobcentre services, including Pathways provider services, are available to the customer. The customer receives a phone call from the Jobcentre inviting them to attend a Work Focused Interview with a Personal Adviser. Then customer receives a letter from the Jobcentre confirming their Work Focused Interview appointment.
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ESA Customer Journey
DAY 55 DAY 57 DAY 92 ?
BENEFIT ENTITLEMENT The customer enters the main phase of Employment and Support Allowance and is paid at either the Support Group or the Work Related rate.
WORK CAPABILITY ASSESSMENT
WORK-FOCUSED SUPPORT The customer receives a phone call reminder from the Jobcentre to attend Work Focused Interview. The customer attends and participates in a Work Focused Interview with a Personal Adviser at the Jobcentre. Customers in the Work Related Group start to receive Pathways support to return to work. Customers in the Support Group can access these services on a voluntary basis.
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Customers Rights and Responsibilities

• Ensure personal details are accurate at first
  contact and correctly answer three security
  questions to confirm own identity.
• Agree the next steps and responsibilities as
  described by the Contact Centre in the wrap-up
  to the telephone call.
• Ensure Customer Statement is correct, notifying
  changes to the Benefit Delivery Centre.
• Provide appropriate evidence to support their
  claim to benefit within one calendar month.
• Return form ESA50 to Medical Services within
  agreed time limit.
• Attend Work Capability Assessment where
  appropriate.
• Attend and participate in 1st and subsequent Work
  Focused Interviews where appropriate.
• Ensure all further changes of circumstances are
  notified to the Benefit Delivery Centre/
  Jobcentre or Provider as they occur.

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Sanction and Appeal Rights
Behaviour Sanction
Questionnaire not received (without an acceptable good cause). Benefit withdrawn customer has right of appeal.
Customer does not attend LCW Assessment (without an acceptable good cause) Benefit withdrawn customer has right of appeal.
Customer does not have limited capability for work. Benefit withdrawn customer has right of appeal.
Customer fails to attend Work Focused Interview (without an acceptable good cause). Sanction of ESA 50 of personal allowance rate implemented. Customer has right of appeal against sanction.
Customer fails to attend Work Focused Health Related Assessment (without an acceptable good cause). Sanction of ESA 50 of personal allowance rate implemented. Customer has right of appeal against sanction.
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What information can you expect in the future?

• More detail on the
• Employment and Support Allowance Regulations
  (including rates of benefit).
• The Appeal process.
• Work Capability Assessment (WCA) detailed
  process.
• Work Focused Health Related Assessment (WFHRA)
  detailed process.
• Planned communications with customers / key
  stakeholders.