Employment and Support Allowance
Employment and Support Allowance has been designed to enable your patients to achieve their full potential through work and to help them to gain independence from benefits. It starts in October 2008 and, for new customers, it will replace Incapacity Benefit, Income Support paid on grounds of incapacity, and Severe Disablement Allowance.
Focus on abilities
Employment and Support Allowance focuses on the patient’s abilities – on what they can do rather than what they cannot. The overarching principle of Employment and Support Allowance is that everyone should have the opportunity to work and that people with an illness or disability should get the help and support necessary for them to engage in appropriate work, if they are able. It builds on the successful “Pathways to Work” programme, which is now available nationally. We are investing in every region to ensure that a range of services is available for your patients, including condition management programmes specifically designed to help your patients manage their conditions in preparation for a return to work.
This principle is in keeping with the body of evidence that people are better off in work – not only financially, but in terms of their health and well-being, their self-esteem and the future prospects for themselves and their family. For instance, people who are long-term unemployed or who have never worked are up to three times more likely to have poor health than those in work.
Employment and Support Allowance requires all but those patients with the most severe illnesses or disabilities to engage in a programme of work-focused interviews and develop a work-related action plan as a condition of receiving the allowance.
If a patient with a severe illness or disability makes a claim for Employment and Support Allowance, they will become members of the Support Group in Employment and Support Allowance. Those in the Support Group will not have to attend interviews with advisers, actively prepare for work nor undertake other return to work activity. However, they will be able to volunteer for help if they do want to consider working.
Work Capability Assessment
For Incapacity Benefit, the Personal Capability Assessment (PCA) determines what a customer is entitled to. For Employment and Support Allowance, the new Work Capability Assessment (WCA) replaces the PCA.
Healthcare professionals carry out the WCA on behalf of the Department for Work and Pensions. Atos Healthcare currently provide this service.
The WCA has two parts:
Assessment of limited capability for work – this part resembles the PCA for Incapacity Benefit, but applying reviewed and revised descriptors and scores for both physical and mental functional capabilities.
Assessment of limited capability for work-related activity – this part identifies, through a series of descriptors, those patients with the most severe illnesses or disabilities. These patients will be members of the Support Group of Employment and Support Allowance and will not have to engage in work-focused interviews as a condition of receiving benefit – although they can volunteer to do so if they choose.
What will the change mean for me?
The introduction of Employment and Support Allowance will not make significant changes to your dealings with patients, or the amount of paperwork you need to complete. DWP already asks you to fill in forms to provide us with information about your patients, and some of the forms are changing.
As a GP, you will still provide “statements of incapacity for work” (usually on form Med 3) until the WCA assessment is carried out, usually within the first 13 weeks of a claim for Employment and Support Allowance.
DWP may ask you to complete a factual ESA113 report on your patient. You can complete this form from your medical records. There is no need to carry out a separate examination of your patient.
DWP will only ask you to complete an ESA113 if:
- it could result in your patient’s entitlement to additional financial support being confirmed on paper evidence, without need for a face to face assessment, or
- if, in the case of reassessing your patient’s continuing entitlement to Employment and Support Allowance, it could result in ongoing entitlement being confirmed without need for another face to face assessment.
Occasionally a healthcare professional from Atos Healthcare may phone you for more information. It is not necessary for you to discuss with your patient before releasing clinical information because they have already given their consent for this as part of the claim procedure.
Your patient will not be denied benefits solely based on the information on this form. An expert decision maker makes the decision to award Employment and Support Allowance based on a range of information and evidence, including independent medical advice.
DWP may ask you to provide a DS1500 report for patients who tell DWP they are terminally ill (a life expectancy of no more than 6 months). This is a factual report, in which you provide details of your patient’s condition and their current and planned future treatment. We do not ask you to give an opinion on prognosis or life expectancy. We need your help with this information so we can ensure that your patient receives everything they are entitled to as quickly as possible.
Special rules apply to people who are terminally ill. We will fast-track customers with a terminal illness into the Support Group of Employment and Support Allowance so that we can ensure they receive everything that they are entitled to as quickly as possible. They will not have to participate in a work-focussed health-related assessment or any other work-related activity but they can volunteer to do so if they wish.