Employment Support Allowance (ESA)
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Employment and Support Allowance (ESA)

  • been designed to "..enable your patients to achieve their full potential through work and to help them to gain independence from benefits.."
  • the ESA began in October 2008 and, for new customers, it relaced Incapacity Benefit, Income Support paid on grounds of incapacity, and Severe Disablement Allowance

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.

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
    • WCA has three parts:
      • assessment of limited capability for work
        • resembles the current PCA, but applies reviewed and revised descriptors and scores for both physical and mental functional capabilities
      • assessment of limited capability for work-related activity
        • 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
      • a work-focused health-related assessment (WFHRA)
        • comprises an interview with a healthcare professional, to explore the patient's views about moving into work, and any health related interventions that would support this
        • report is sent from the WFHRA to the patient's personal adviser
          • personal advisers (Jobcentre Plus or provider, where applicable) are able to refer patients for a package of employment, training or condition management support
          • patient will receive a copy of the report from their WFHRA and will be encouraged to share it with his or her treating healthcare professionals.

What about the GP's role?

  • introduction of Employment and Support Allowance will not make significant changes to a GP's dealings with patients, or the amount of paperwork a GP needs to complete
  • 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
  • a GP may be asked by DWP to complete a factual ESA113 report on a patient
    • form can be completed from medical records
    • no need to carry out a separate examination of patient
    • DWP will only ask for an ESA113 to be completed if:
      • could result in 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 a 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 carrying out the WCA may phone for more information
    • not necessary to discuss with 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

     

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