Your ESA claim

After you’ve made your claim, you’ll be told if you need to have a ‘Work Capability Assessment’ and what group you’ll be put in.

Work Capability Assessment

A Work Capability Assessment is used to find out if your illness or disability affects how much you can work.

You might not need one, for example if you’re in hospital or a medical professional has said you might have 12 months or less to live.

If you need a Work Capability Assessment you’ll get a letter telling you to fill in the ‘Capability for work questionnaire’ and send it to the Health Assessment Advisory Service. The address is on the form. There is a different questionnaire in Northern Ireland.

You’ll be told what happens next, for example if you need an appointment to understand your health condition better.

If you’re claiming both Universal Credit and New Style ESA, you’ll only have one Work Capability Assessment.

You can ask for your assessment to be recorded. If you would like this, tell the Health Assessment Advisory Service using the contact details in your appointment invite letter.

How the assessment happens

Assessments can be in person, by video call or on the phone. You’ll be told how your assessment will take place.

You can have someone else with you at the assessment, such as a friend or support worker. If your assessment is by phone or video call, you can ask the assessor to call them if they’re not with you when the assessment starts.

You’ll stay on the ‘assessment rate’ until a decision can be made on your Work Capability Assessment.

After your claim is assessed

If you’re entitled to ESA you’ll be placed in one of 2 groups:

  • a work-related activity group (you cannot work now, but can prepare to work in the future, for example by writing a CV)
  • a support group (you cannot work now and you’re not expected to prepare for work in the future)

You will:

  • usually be in the support group if your illness or disability severely limits what you can do
  • be in the support group if a medical professional has said you might have 12 months or less to live

You must attend regular interviews with a work coach. They can help you improve your skills or write a CV to help you get back into work.

If you’re in the support group

You do not have to go to interviews. You can tell your work coach if you’d like to take part in work-related activities.

How long you’ll get ESA for

You cannot make a new claim for income-related ESA. You’ll continue to get payments while you’re eligible until your claim ends.

New Style and contribution-based ESA last for 365 days if you’re in the work-related activity group.

There’s no time limit if you’re in the support group, or if you’re getting income-related ESA.

To keep getting ESA you must report any change in your circumstances. You may also need to send fit notes regularly.

If you get a sanction

Your ESA can be reduced if you do not attend interviews or do work-related activity as agreed with your work coach in your ‘Claimant Commitment’. This reduction can continue for up to 4 weeks after you restart work-related activities.

You’ll get a letter to say you may be sanctioned. Tell your work coach if you have a good reason for not doing what was agreed in your Claimant Commitment.

You’ll get another letter if the decision is made to give you a sanction. Your benefit will only be affected once a decision has been made.

You should contact your local council immediately if you claim Housing Benefit or Council Tax Reduction. They’ll tell you what to do to continue getting support.

If you get a sanction you can:

You will not get a sanction if you’re in the support group.

Hardship payments

If you get income-related ESA, you may be able to get a hardship payment if your benefit has been reduced because of a sanction or a penalty due to suspected benefit fraud.

A hardship payment is a reduced amount of your ESA. You do not have to pay it back.

You can get a hardship payment if you cannot pay for rent, heating, food or other basic needs for you or your family. You must be 18 or over.

Speak to your Jobcentre Plus adviser or work coach to find out how to claim a hardship payment.