Claiming Employment and Support Allowance or Universal Credit when unfit for work?
New rules came into effect from 3 April 2017 that may affect you.
If you make a new claim for ESA on or after 3 April 2017 (either Contributory or Income-Related), and you are put in the Work Related Activity Group, you will not receive the Work Related Activity Component, which is worth £29.05 per week. However, if you are put in the Support Group, you will receive the Support Component of £36.55.
If you are claiming Universal Credit and you become sick on or after this date, similar rules mean you cannot have the Limited Capability for Work Element included in your award.
BUT it is still worth making a claim – or perhaps even challenging a previous 'found fit' decision.
There is a similar rule for Universal Credit if you make a new claim for Universal Credit on or after 3 April 2017 because you have become too sick to work (note this is only possible in areas which have the Digital UC service), or you have been claiming Universal Credit as a jobseeker, but you have become ill, so you make a request to be referred for a Work Capability Assessment on or after 3 April 2017. If you are found to have a ‘Limited Capability for Work’, the Limited Capability for Work element will not be included in your award. However, if you are found to have a Limited Capability for Work Related Activity you will receive the LCWRA Element.
There is protection if you were already on these benefits with a limited capability for work when the new rules came in: If your ESA award includes the Work Related Activity Component, or you already have a LCW element included in your Universal Credit award, this will continue and will only end if you are found fit for work, or there is a break in your claim.
Also, if your ESA claim was made before 3 April 2017 and are in the Support Group, and, when you are next re-assessed, you are moved to the Work Related Activity Group, you will be paid the Work Related Activity Component. Similar rules apply to Universal Credit claimants; if when the rules came in on 3 April 2017 you had the Limited Capability for Work Related Activity Element included in your assessment. If, following your next Work Capability Assessment you are found to have Limited Capability for Work but not a Limited Capability for Work Related Activities, you can have a LCW element included in your Universal Credit assessment.
If you are making a new claim for ESA after 3 April 2017 but before 3 July 2017, requesting a backdate may be particularly useful, because if the claim is dated before 3 April 2017 and you are put in the Work Related Activity Group, you will be paid the Work Related Activity Component. So, if you made your claim later than you could or should have done, you can ask for your ESA claim to be backdated by up to 3 months. Note that ESA cannot be backdated further than the day after your Statutory Sick Pay ended, or if you were claiming a different benefit which cannot be claimed at the same time as ESA.
If you are or have been found fit for work following a Work Capability Assessment and you do not think you are fit for work, get advice about challenging the decision. Many people who take their challenges to appeal stage are successful. If the decision that you were fit for work was made less than 13 months ago, it could still be possible to challenge it. If you win your challenge, this could mean that your period of limited capability for work started before 3 April 2017, so you will be paid the relevant component / element.
Susan has been getting ESA for 2 years, but in June 2017 after a re-assessment, she is found fit for work. She claims Universal Credit. She decides to challenge the decision, she asks for a Mandatory Reconsideration and then she appeals. In December 2017 she wins her appeal and is found to have a limited capability for work. A LCW Element gets added into her UC claim back to June 2017 as her current period of limited capability for work started when she claimed ESA back in 2015.
I get Universal Credit as a jobseeker, but now I have some health problems. Is it worth requesting a Work Capability Assessment? The new rules mean it is unlikely I will get any extra money.
Yes! As a jobseeker, you can be expected to spend up to 35 hours in job seeking activities every week. If you fail to meet the requirements in your Claimant Commitment, you may lose benefit through a sanction. If, after your Work Capability Assessment, you are found to have a limited capability for work, you will no longer be required to look for work as a condition of receiving UC.
While you are waiting for your Work Capability Assessment you will remain in the ‘All Work Requirements’ group, but your work coach can adjust your work search requirements. Remember that you can ask for your Claimant Commitment to be reviewed at any time (whether you request a Work Capability Assessment or not) – so if you have health problems, discuss these with your work coach. It is important that your Claimant Commitment is realistic, to avoid the risk of being sanctioned.
And if you are found to have a limited capability for work related activities through the Work Capability Assessment, you will get the LCWRA element included in your UC assessment.