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Employment Support Allowance

Employment Support Allowance - Are you prepared...?

Three-quarters of people applying for the new Employment and Support Allowance programme (ESA) are being found fit for work.

Applicants are either being told to look for work after undergoing the Work Capability Assessment or stop their claim before they complete their medical assessment, according to Department of Work and Pensions statistics.

The ESA replaced the Incapacity Benefit and Income Support benefit.

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The Welfare Reform Bill came into force in October 2008 and spells a number of changes in the social and welfare system within the UK. The Act has in many respects been shadowed by the recent global recession, and as a result, few people are aware of the changes until it impacts upon them.

Currently, there are approximately 2.6 million people in the UK currently claiming Sickness benefits and the government aims to reduce this by around 1 million. The new system is called the Employment Support Allowance and applies to all new entrants into the system. However, the government intends to start migrating existing claimants in to this new system during 2012-2013 from Incapacity Benefits and Invalidity Benefits.

Ed Stuart-Brown, head of protection sales at Friends Provident said: "People need to take responsibility to protect themselves from the financial hardship of an illness or injury by ensuring they have adequate Income Protection.
"They need to switch on to the fact that the State is unlikely to meet their needs should the worst happen. We are encouraging people to think about the consequences of not having adequate provision."

Numbers are being reduced and those claiming will also be monitored more closely to assist those getting back to work. Individuals are to be assessed using the Personal Capability Assessment which is a combination of mental and physical health tests.

The benefit rates will depend upon your age and circumstances, however as a rough guide the following will be applied:

The assessment phase rate is paid for the first 13 weeks of your claim while a decision is made on your capability for work through the Work Capability Assessment.

Under 25 years of age: up to £50.95 a week
Over 25 years of age: up to £64.30 a week

The main phase starts from week 14 of your claim, if the Work Capability Assessment shows that your illness or disability does limit your ability to work.

A single person in the Work Related Activity Group up to £89.80
A single person in the Support Group up to £95.15

October 2010 Update:
Employment and Support Allowance (ESA) claimants will be limited to one year of benefit payments for those expected to prepare to return to work, the Chancellor George Osborne has announced.

The ESA reform could impact one million people and applies to those placed in the Work Related Activity Group.

Only the most severly disabled claimants, who are placed in the support group which includes those terminally ill and on certain types of chemotherapy, will be exempt.

Work Capability Assessment - click to expand

An approved healthcare professional, who has been trained in handling Employment and Support Allowance claims, will assess how your illness or disability affects your capability for work or work related activity, and provide advice to the Department for Work and Pensions (DWP), which is responsible for administering benefit claims.
The approved healthcare professional may recommend that you attend a medical assessment if they feel they need more information about your condition.

How it works
When you make a claim for Employment and Support Allowance, you have to complete a questionnaire about how your illness or disability affects your ability to complete everyday tasks.
Your own doctor may be asked to provide a medical report.
An approved healthcare professional will consider the questionnaire and any medical reports, along with any other information you may have provided.
If the approved healthcare professional feels that the DWP will need more information to make a decision on your benefit claim, they will recommend that you attend a face-to-face medical assessment.

Reasons for a medical assessment
You may have been asked to attend a medical assessment for a number of reasons. It is often because more medical information is needed before your claim can be approved.
Most people are asked to attend one. It doesn't mean the information you've provided on your claim form is being treated as suspicious or that your claim will be turned down.
Your benefit claim will not be turned down without you either having a medical assessment or being offered one.

About the medical assessment
The medical assessment will usually take place at a Medical Centre near where you live. If you're unfit to travel or you live more than 90 minutes' journey from the nearest centre, the approved healthcare professional may visit you at home.

You will usually be contacted by telephone by our Medical Services provider. You will be given notice of your appointment and the option to change it if the time doesn't suit you.
It is very important to attend and fully participate in your medical assessment as your benefit may be affected if you don't. If for any reason you cannot attend, you should contact the Medical Centre beforehand and arrange another appointment.

Your rights at the assessment
You have the right to:
• have a friend, relative or support worker with you at the medical assessment
• ask for an interpreter if you need one
• ask to be assessed by an approved healthcare professional of the same gender as yourself

You need to let the Medical Centre know ahead of time if you want an interpreter or same-gender approved healthcare professional. They will try to find one for you, although this may not always be possible in some areas.

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Could you survive on State Benefits Alone?

It is not something we like to think about, but the reality is that if you are unable to work for any period of time due to illness or injury, you will have to face the fact that State Benefits alone do not provide a great deal of cover. State benefits are designed purely for the essentials in life, so any lifestyle needs you may experience would need to be addressed by alternative funding.

Mind the Gap?

State Benefits have always been intended for the essentials in life and nothing more. Therefore, the prudent thing to do is make private provisions to ‘top up’ your State Benefit in the event of illness or injury. This can be done quite simply by looking at Accident & Sickness insurance, Accident, Sickness and Unemployment cover or Long Term Income Protection (PHI). The insurance plan pays out a set amount each month on top of any eligible state benefits. These additional funds can be used to maintain the standard of living you have become accustomed to until you either return to work, retire or pass away.

Recent Polls have indicated that the public really does not understand the Benefits System, and the majority of them feel that the state will be able to provide for them in their moment of need.

Don’t get caught out in a Benefit Trap, take a moment now to investigate just how little it could cost to protect your greatest asset; your income.

Quick Response Form:

Essential Health is an independent health insurance specialist broker, we deal with all aspects of Health Insurance with a specific interest in Income Protection, Life Cover, Critical Illness and Medical Insurance.

If you would like to speak to a Protection Specialist Adviser, please complete the following short form:

Who Should Enquire?

* Anyone with No Insurance in place…
* Anyone who has Mortgage Protection over 5 years old or needs a second opinion.
* Anyone of working age who has an income to protect…
* Anyone working with a Family to protect...

If your Income were to suddenly stop, how long would it be before your lifestyle dramatically changes?

Common Concerns..

My work is quite manual and no one will insure me.

A: We can insure virtually any occupation base din the UK…

I am self employed and would struggle to prove my income..

A: We have specialist policies designed for the Self Employed; no proof of income is required.

I need a substantial amount of cover, not just to protect my mortgage.

A: We understand this and can advise you on both Mortgage Protection and Personal Protection plans to suit your needs.

I already have an existing medical condition, will I be able to cover this.

A: This will vary depending upon the condition, however we also use specialist providers who are experienced in this field so it might be possible… it costs you nothing to find out…

I have enquired about Income Protection (PHI) before and found it quite expensive.

A: In recent years, many insurers have addressed this problem and a number of ‘low cost’ products now exist to keep premiums in line for those on a tighter budget.

I have recently taken out a loan, the terms offered to me by my bank seem quite expensive to insure this, and can you help?

A: Most certainly, we frequently provide quotations for those looking to protect specific assets such as loans or guarantees.

I spend a lot of time overseas, could I insure my income?

A: In short yes, if you do not pay tax in the UK, your choices will be limited, but it is possible to insure life and income while living or working overseas.