Guidance

Incapacity benefits: reassessing claims: guidance for advisers and intermediaries

Updated 27 February 2020

This page provides guidance for advisers and intermediaries. We’ve published separate information about Employment and Support Allowance for claimants

We are reassessing the claims of people who receive Income Support paid on the grounds of illness or disability, Incapacity Benefit and Severe Disablement Allowance. These benefits are being phased out and we need to see if people who have been receiving them are entitled to ESA.

The change will not affect:

• people who are already being paid ESA
• people who reach State Pension age before 6 April 2014

Following the reassessment:

• people who are capable of work will move onto Jobseeker’s Allowance if they are entitled to it
• people who need more support while they prepare for work will get that help on ESA
• those people who are most disabled or terminally ill will not be expected to look for work and will get the extra support they need on ESA

1. Timetable

Trials of the incapacity benefits (IB) reassessment process began in 2010 and reassessment started nationally in 2011. We’ve discussed the changes with external stakeholders and customer representative groups.

2. Information for advisers

We’ve published the following information to help advisers support customers who are being reassessed:

• customer fact sheet
• additional support for people with special communication and support needs
• stakeholder information pack
• information you can edit and reuse
• questions and answers – based on our discussions with stakeholders
• protecting benefit rates at the point of change
• overseas claimants

3. The reassessment process

We will write to people when their benefit becomes due for reassessment to tell them about the changes. We will also phone them to answer any questions they may have and find out if they need extra help. They do not need to contact us before they receive this letter.

We will send claimants a medical questionnaire to complete and return. We will use this to decide if they need to attend a Work Capability Assessment. It’s important that they provide as much detail as possible when completing the questionnaire as this will help us decide if they are entitled to ESA.

If they need to attend an assessment, we will phone them to arrange an appointment. They will not need to attend an assessment if a decision can be made on the information provided on the medical questionnaire.

Using the information from the questionnaire, the Work Capability Assessment and any other evidence provided we will then decide if they are entitled to ESA. They will continue to receive their current benefit, as long as they meet the conditions of entitlement, until we have reassessed their claim.

If someone does not return their medical questionnaire or attend a Work Capability Assessment when asked, this may affect their benefit.

4. If someone can get ESA

If someone can get ESA we will phone them and write to them to let them know. We will transfer their claim automatically and they will not need to do anything.

No one moving from their existing benefit to ESA will see a reduction in the level of their benefit entitlement at the point of change.

If we assess that an eventual return to work is realistic, we will place the customer in the ESA Work Related Activity Group. This means they will:

• have to take part in Work Focused Interviews with their personal adviser
• get support to help them prepare for suitable work
• get extra money on top of their basic benefit called a ‘work related activity component’

If we assess the customer’s illness or disability has a severe effect on their ability to work, we will place them in the Support Group. This means they will:

• not have to take part in any work related activity, although they can do so voluntarily if they want to
• get extra money on top of their basic benefit called a ‘support component’

5. If someone can’t get ESA

We will phone and write to people who can’t get ESA to tell them our decision and what to do if they think it is wrong. We will also explain their options which may include the following courses of action.

5.1 Claim Jobseeker’s Allowance

They will need to make a new claim for Jobseeker’s Allowance. We can transfer them at the end of the call or give them a number to call later.

5.2 Continue to claim Income Support

Some customers may still be able to receive Income Support if they qualify under another condition of entitlement, for example if they have young children. If we know of this entitlement they will not need to make a new claim, but the amount they get may change.

5.3 Claim Pension Credit

We will give them the phone number to claim Pension Credit and tell them what they will need to do.

6. If the claimant thinks the decision is wrong

If the claimant thinks the decision is wrong, they need to contact us within 1 month of the date of issue of the decision letter. If they contact us later we may not be able to help. The customer, or someone else who has the authority to act on their behalf, can:

• ask us to explain our decision
• ask us to write with the reasons for our decision
• ask us to look at our decision again, for example if they think we have overlooked some facts or they may have more information to give us which affects our decision
• appeal against our decision to an independent tribunal – this must be in writing

7. Supporting disabled people who need more help to find and keep a job

We provide a range of support to help disabled people and people with health conditions who want to find and keep a job.