Form

New Style Employment and Support Allowance (ESA) claim form

This form is currently unavailable online. You can claim New Style Employment and Support Allowance online or by phone.

• From: Department for Work and Pensions
• Published: 6 March 2019
• Last updated: 23 October 2020
  Show all updates

  1. 23 October 2020

     Removed the claim forms you can print as they are not the valid versions for claiming New Style ESA.

  2. 27 March 2020

     Updated with new guidance on how to claim New Style Employment and Support Allowance.

  3. 18 October 2019

     Updated version of 'New Style' Employment and Support Allowance claim form you can download, fill in on screen, save, and then print - English version only.

  4. 30 April 2019

     Removed options to choose when phoning to book a new claim appointment as these are no longer correct.

  5. 13 March 2019

     Added welsh version of the form.

  6. 6 March 2019

     First published.

This publication was withdrawn on 30 October 2020

You can claim New Style Employment and Support Allowance online or by phone.

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This form is currently unavailable online.

You can claim New Style Employment and Support Allowance online or by phone.