Employment Support Allowance

Slater and Gordon Lawyers are one of the country's leading claimant personal injury law firms, recovering millions of pounds worth of compensation for accident victims every year. We are experts in securing the maximum amount of spinal cord injury compensation and getting rehabilitation support as quickly as possible. Slater and Gordon Lawyers understand the sudden change in lifestyle caused by an injury to the spinal cord and the immediate strain this places on finances. That is why with Slater and Gordon Lawyers on your side, a No Win, No Fee (Conditional Fee) agreement can enable you to get the support and financial compensation you need to live with a spinal cord injury, not only in the short term, but also to provide for your future needs. Every spinal cord injury claim is different and the amount of compensation paid will vary from case to case. We will however give you an accurate indication at the earliest stage as to how much compensation you could expect to receive, to help you plan for your future. Slater and Gordon Lawyers have a specialist team dedicated to pursuing compensation claims on behalf of those who sustain spinal cord injury in all types of accident, be it a road traffic collision, an accident in the workplace or whilst on holiday or travelling in a foreign country. Our expert solicitors provide total support for our clients, particularly at times when they may feel at their most vulnerable. We approach each case with understanding and sensitivity. Where possible, we will seek to secure an interim payment of compensation to relieve financial pressures and cover immediate expenses. We can also provide advice on long-term financial planning and rehabilitation. Contact Slater and Gordon Lawyers for a free consultation. We will be happy to help you. Freephone 0808 175 8105 or visit our website at www.slaterandgordon.co.uk Slater and Gordon Lawyers are proud to be a Diamond Corporate Sponsor of the Spinal Injuries Association and a wider supporter of their services. By supporting the SIA, we understand the need to raise money which will go towards funding SIA’s key services such as their Advice Line, website and peer support in the spinal injury centres, hospitals and wider community.

WHAT IS SIA? SIA is the national organisation for people with spinal cord injuries and their families. If you, a relative or friend is paraplegic or tetraplegic, or you are interested in our work, why not join us? Membership is free of charge and all new UK members will receive a year’s free subscription to SIA’s bi-monthly magazine Forward. An annual subscription to Forward is £20.00. We also circulate a bi-monthly email newsletter, ‘e-clips’ to all who subscribe while our popular interactive website offers Chat Rooms and a Message Board as well as hundreds of pages of useful information. We produce a wide range of publications (available to purchase) which deal with all aspects of living with spinal cord injury, e.g. books on bowel and bladder management, sexuality, publications for health care professionals, as well as sports opportunities. We also have an extensive series of Factsheets on a wide range of topics, and, for those pursuing a compensation claim; we publish a Directory of Personal Injury Solicitors. Our Advice Line is accessible by e-mail, fax, post and telephone and provides accurate and up-to-date information on subjects including welfare advice, specialist equipment, legal rights etc as well as health related topics. We run an employment service, Workwise, for those wishing to return to employment or take up retraining or volunteering. Our Health and Ageing projects both work to improve the quality of life of spinal cord injured people and can be accessed via the Advice Line. Externally, our Peer Support Service, staffed by spinal cord injured people, operates at the Spinal Injuries Centres in England, Wales and Northern Ireland. SIA also actively campaigns on vital issues affecting the everyday lives of disabled people, set out in our manifesto ‘Campaigning for Change’. We are represented on major voluntary and statutory bodies and our own Governing Board is composed of spinal cord injured people. We have our own state-of-the-art premises, SIA House, which combines the twin principles of inclusive design and accessibility and from here we run the only specialist spinal cord injury Library in the country. To find out more, or join us, please write to us at: Spinal Injuries Association, SIA House, 2 Trueman Place, Oldbrook, Milton Keynes MK6 2HH or contact us on: Tel: Fax Website: E-mail:

0845 678 6633 (General Office – 9-5) 0800 980 0501 (Freephone Advice Line (9.30-1pm & 2pm– 4.30pm) 0845 070 69211 www.spinal.co.uk [email protected]

Employment and Support Allowance Introduction The Government has announced that the following benefits Incapacity Benefit (IB), Income Support (IS) and Severe Disablement Allowance (SDA) are being phased out and will be replaced by Employment and Support Allowance (ESA). Between October 2010 and March 2014 existing claimants of the benefits above, will be reassessed to see if they are eligible for Employment and Support Allowance. The Government wants to move people who are able to work, off the benefit system, into a more positive assessment around ability to work (rather than inability to work) and into mainstream employment, through work programmes. For those who have a limited capability for work, they can apply for ESA. What is Employment and Support Allowance (ESA)? ESA is a benefit for people of working age, who have a Limited Capability for Work due to a health condition or a disability. ESA has 2 elements, Contributory ESA and Income-related ESA. For new claimants, If you have paid enough National Insurance contributions, you are entitled to Contributory ESA, which is non means-tested and is taxable. If you do not qualify for Contributory ESA or it doesn’t meet your needs, you may qualify for Income-related ESA, which is means-tested and is not taxable. If you are in receipt of one or more of the following benefits Incapacity Benefit (IB), Income Support (IS) or Severe Disablement Allowance (SDA), you will receive a letter from Jobcentre Plus advising that you will be migrated on to either Contributory or Income Based Employment and Support Allowance. Generally, if you receive Incapacity Benefit or Severe Disablement Allowance, you will be migrated onto Contributory ESA but those in receipt of Income Support, will be migrated onto Income Based ESA. The aim of this Factsheet is to give you up to date information on how these changes will affect you and where you can find additional information. What are the rules for ESA? If you are claiming ESA you must:    

be at least 16 years old be under pensionable age (ESA stops when you reach retirement age) undergo a 13 week assessment phase satisfy at least one of the following:

1. (a) pass a contributory test for contributory ESA or (b) be under age 20 (or 25 in certain cases) - This does not apply to new claims - see 8 and 14(2) below. 2. pass a low income test for income-related ESA Residence and Presence Tests for ESA To claim income-related ESA you must   

be present in the UK be habitually resident and have the right to reside

To claim contributory ESA you must 

be present in the UK

Contributory Employment and Support Allowance To qualify for Contributory ESA, you have to have paid enough national insurance contributions. However, this criteria doesn't apply if the DWP converts your Incapacity Benefit or Severe Disablement Allowance into contributory ESA. It is possible to receive both Contributory ESA and Income-related ESA depending on your circumstances. In some circumstances, if you get contributory ESA and have been placed in the work-related activity group, you can claim for up to 365 days only. If your contributory ESA stops due to this time limit, you may be able to get:   

income-related ESA, depending on your circumstances other means-tested benefits, such as housing benefit or council tax reduction scheme, or an increase in these benefits if you are already claiming them national insurance credits if you continue to have limited capability for work. It is important to carry on getting national insurance credits if you can, because they may help you to qualify for other benefits such as state pension, or to get an increase in benefits such as housing benefit, or to re-qualify for ESA if your condition deteriorates. You would still need to complete a limited capability for work questionnaire form (ESA50).

Income-related Employment and Support Allowance If you do not qualify for Contributory ESA or it doesn’t meet your needs, you may be entitled to income-related ESA. To get income-related ESA, your income will be compared with the amount that the government thinks is enough for you to live on. If your income is less than this amount, you will get the difference between your income and the amount the government thinks is enough for you to live on,

depending on your circumstances. If your income is equal to or more than this amount, you won't get income-related ESA. You are not entitled to income-related ESA if you have savings of £16,000 or more. Your benefit will also be affected if your capital or savings (or you and your partner’s capital or savings) is above a lower savings limit of £6,000. If you have a mortgage and qualify for income-related ESA, you may get help with some of your housing costs, for example, the interest due on the mortgage loan. If you pay rent, you should check if you can get Housing Benefit. If you get incomerelated ESA, you will get the maximum amount of Housing Benefit allowed for your circumstances. How to make your first claim for ESA? Please call Tel: 0800 055 6688. For Welsh language Tel: 0800 012 1888 or, you can visit the following website and download the Application Form (ESA1):www.gov.uk/employment-support-allowance/how-to-claim For new applicants, once the Jobcentre has received the completed ESA1 application form, they will send you a Limited Capability for Work Questionnaire form (ESA50) to complete and return, along with any relevant medical evidence you would like to send them. The ESA50 form is ambiguous and you will need to read each question more than once before answering. This is not a medical questionnaire but a questionnaire to establish whether you are able to return to work. If you need help in completing the form, please telephone the SIA Advice Line on Tel: 0800 980 0501. Assessment Phase When you first make a claim for ESA, a period of time called the 13-week assessment phase starts. During this time, healthcare professionals (a GP or a nurse or Occupational Therapist or a Physiotherapist) will usually test how your illness or disability affects your ability to work and carryout day-to-day activities. This is called a Work Capability Assessment which will determine whether: •

You have a ‘limited capability for work’

•

You have a ‘limited capability for work-related activity’

The limited capability for work

The Limited Capability for Work Questionnaire form (ESA50) is to be completed by everyone whether you are a first time claimant or one of those being migrated onto Employment and Support Allowance from IB, IS and SDA. Most claimants will have to attend a face-to-face assessment to decide if they satisfy the limited capability for work assessment. The assessment will look at your ability to carry out a number of physical and/or mental, cognitive & intellectual activities that determine whether you are unable to work. If you do not satisfy the limited capability for work assessment, you will not qualify for ESA and so, you may need to apply for Job Seekers Allowance (JSA). If you feel that this outcome is incorrect, you may appeal the decision. What is Job Seekers Allowance? It is a benefit for people who are currently not working. However, to be eligible for JSA you must be ‘actively seeking employment ‘. To receive the benefit, you will need to meet with a personal adviser at the Job Centre on their request at least once every 2 weeks. You will be expected to show evidence to them of what efforts you are making to find employment; such as applications that you have made and interviews you have attended. Your personal adviser is there to explain what other support is available to you and advise you on interview skills and techniques you can use to give you the best chance of successfully finding employment. For those being migrated onto ESA from Incapacity Benefit, Income Support and Severe Disablement Allowance, you will receive a letter from Jobcentre Plus advising you that these benefits are stopping and that you will be migrated onto ESA. You will also need to complete and return the Limited Capability for Work Questionnaire form (ESA50) and as above, if you do not pass the assessment because you are considered not to have a limited capability for work, you will not qualify for ESA and so move on to Job Seekers Allowance (JSA). The limited capability for work questionnaire is divided into Physical functions, Mental, Cognitive & Intellectual functions and Eating and Drinking functions. The physical functions are:Moving around and using steps Standing and sitting Reaching Picking up and moving things Manual dexterity Communicating with people Other people communicating with you Getting around safely Controlling your bowels and bladder Staying conscious when awake

The Mental, Cognitive and Intellectual functions are, including those with brain or neurological conditions and depression:Learning how to do tasks Awareness of hazards of danger Starting and finishing tasks Coping with changes Going out Coping with social situations Behaving appropriately Eating and drinking function:Eating and drinking What are the descriptors? Each question carries a points system which has been determined by the way it has been answered. The descriptors range from 0 points, 6 points, 9 points to 12 points. If you score 15 points in any one activity, you automatically pass the test. If you only scored 6 points for one question, you can pick up points from other questions and if you have accrued a total of 15 points or more, you have passed the test and qualify for ESA. The second part of the assessment, whether this is your first claim for ESA or you are being migrated onto ESA, determines which of the 2 groups you will be placed in: •

Work Related Activity Group

•

Support Group

Work Related Activity Group If you pass the assessment and it has been decided you do not have limited capability for work-related activity you will be placed in the work-related activity group of claimants. You will have to adhere to strict work-related conditions in order to continue receiving the benefit in full. This may involve attending work focused interviews. At these interviews, you will be appointed a personal adviser who will try to help you back into work. The adviser will draw up an ‘action plan’, which will outline the activities that you could undertake to help you move into work. Work-related activity can be things such as voluntary work, work trials, or a training programme but you won't have to apply for jobs or undergo medical treatment.

If you are placed in the Work Related Activity Group, you will receive a lower level payment of ESA than if you were placed in the Support Group. Also, if you are entitled to Contribution Based ESA and were placed in the Work Related Activity Group (WRAG), the award of it will be limited to just 12 months. After the 12 months is up, you may be able to claim Income-related ESA. You will also not be required to take part in work related activity if:   

you are in the ESA support group you are a lone parent and you have a child under the age of 5 you receive carers allowance or a carer’s premium

Support Group If it is decided that you have a limited capability for work-related activity, you will be placed in the support group of claimants. If you are placed in this group, you will not have to undertake work-related activities (although you can volunteer or do Permitted or Supported Permitted Work if you want). What is Permitted Work? You can’t usually work while claiming Employment and Support Allowance. However, you may be able to do some types of work – within limits. This is called Permitted work, but you would be advised to check with your local Jobcentre Plus office before you start, to confirm it applies to you. If you are receiving Employment and Support Allowance (ESA) , Incapacity Benefit (IB), Severe Disablement Allowance (SDA), National Insurance credits or Income Support (IS) because of incapacity for work, you are allowed to do some permitted work. It is purely a benefit arrangement; employers cannot offer ‘permitted work’, it is to help people move closer to the labour market, and test your own capacity for doing some work and perhaps gain new skills. From October 2008 permitted work will become more flexible for people to use, by increasing the type of work that can be carried out under this scheme. You can work for up to 16 hours a week on average, and earn up to £95.50 a week, for a 52 week period. At the end of 52 weeks if you do not start employment; you must wait another 52 weeks before applying for permitted work again. Permitted work lower rate To encourage social inclusion, you can earn up to £20.00 a week. This rule operates for an unlimited period of time and an unlimited period of hours as long as you are receiving the benefits above. If your circumstances change in any way, it is always advisable to contact your personal adviser or Disability Employment Adviser at your local Jobcentre Plus for advice.

Supported Permitted Work Supported permitted work is work done by people who have a long term disability that has had "a significant impact on their ability to learn or sustain a traditional job which will always, or for a number of years, prevent them from working more than a few hours each week". People with a disability who do not need a medical examination can work up to 16 hours for no more than £99.50. It should also be work that a person can do only with the support and supervision of someone other than their employer and be supervised by someone employed by a public or local authority or voluntary organisation which provides or finds work for people with disabilities. The support worker must direct and oversee the performance of the worker regularly and the supervision must be more than the normal support provided in the workplace by employers. Support Workers/Supervisors The Spinal Injuries Association has for some years, acted as Support Workers/Supervisors under the Supported Permitted Work Scheme with the agreement of the Department of Work and Pensions. In their letter to us of 20 June 2003, the Department described SIA as: ‘…a voluntary organisation arranging work for people with disabilities and as such is an example of an organisation for whom this aspect of the supported permitted work was introduced. The view of the (DWP) officials is that SIA is providing support in addition to just the natural supports in the workplace…’ Our role as supervisors to the more than one dozen people we assist (who carry out a range of jobs in various parts of the country) is to assist in helping managing their impairment in order to enable them to undertake limited employment. Our role is not to supervise the process of the work itself, as this is the responsibility of the employer, but to support the spinal cord injured person in their ability to carry out the job. Once you have completed the PW1 form, please forward it to Bernadette Murphy, here at SIA House, for the SIA to agree to supervise yourself while doing Supported Permitted Work. Please inform the DWP of any changes. Please note that this is available for members only. What is Work Choice? Work Choice is a Government supported employment programme designed specifically for people who due to their disability, may find it difficult to find or keep a job.

Work Choice enables people to find and retain work by identifying their needs and providing the necessary support to fit their requirements. It is often the stepping stone into full unsupported employment for many people. Work Choice is a three part modular programme. Module 1: Work entry support, lasts up to six months and includes a choice of activities. Module 2: In-work support. Once someone has found paid employment, or selfemployment the provider will work with them and their employer to identify the support they need to stay in work. This module can last up to two years. Module 3: Longer term in-work support. The longer-term supported employment strand will focus on helping provide a stable working environment and helping the individual develop their career. More information at: www.gov.uk/work-choice Aditional support available from SIA - Employment Clinics SIA are well aware that returning to work after SCI can be a very daunting experience. Whether you are able to return to your previous employment or not, is unlikely to be easy, and the right type of support can be difficult to access. One area where support is readily available is the employment clinics running at most of the Spinal Cord Injures Centres. Employment clinics offer support to every patient at an early stage of rehabilitation enabling people to explore the options available and to take these forward when they feel ready. They are not exclusively for in-patients; at most centres, people can be referred through their out-patients department, or through the SIA. We hope to encourage people who have had their SCI for some time and now feel ready to look for sustainable employment to request an appointment. Our Vocational Support Officer attends the clinics with Occupational Therapists from the Centre and representatives from the National Careers Service. What topics are discussed at a Clinic Session?  Returning to work  Future career options  Education and training  Voluntary work  Leisure and recreation, i.e. sport, fitness and health Objectives?  To provide an initial contact for in-patients and out-patients to discuss issues relating to employment careers advice.  To assist individuals with exploring different career and employment options by empowering and providing direction  To give advice on returning to their previous employment



To hold evidence based literature in the form of current research and publications containing relevant materials.

What happens at the end of the session? From the ideas that are discussed at the meeting, it is agreed with the individual what needs to have further research on their behalf. Unless they prefer to research the information themselves; this is usually carried out by the SIA Vocational Support Officer. Further information To find out more contact Jamie Rhind on 0845 678 6633 or email [email protected] Additional information can be found on the following websites. www.dwp.gov.uk/esa www.disabilityalliance.org www.direct.gov.uk www.rightsnet.org.uk www.jobcentreplus.gov.uk

This factsheet has been prepared by SIA and contains general advice only which we hope will be of use to you. Nothing in this factsheet should be construed as the giving of specific advice and it should not be relied on as a basis for any decision or action. SIA does not accept any liability arising from its use. We aim to ensure the information is as up to date and accurate as possible, but please be warned that certain areas are subject to change from time to time. Please note that the inclusion of named agencies, companies, products, services or publications in this factsheet does not constitute a recommendation or endorsement by SIA.

SIA Registered Charity Number: 1054097 Reviewed and revised October 2013 (RC)