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Learn how ESA replaces IB and IS, its structure, assessment, benefits, and impact on claimants. Discover the changes and transition process to ESA. Get insights on sanctions, medical tests, and work-related activities.
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Employment andSupport Allowance NAWRA, Glasgow, 12th September 2008
What is ESA? • New benefit replacing IB and IS, on ‘disability’ grounds, for new claimants • Contributory and means-tested routes • Pathways To Work model • ‘Goes live’ on 27th October 2008 • Aim to reduce claimants by 1 million
What is different? • Structure • Assessment phase • Different ‘groups’ of claimant • Medical tests • ‘Limited capability’ for work • Increased conditionality • Sanctions • Work related activity
Support component Work related activity component ESA Structure Extra premiums where appropriate First contact by customer 13 week Assessment Phase during which a Work Capability Assessment will be undertaken and WFI action initiated. Main Phase Sanctions applied in this phase only Allowance set at JSA level
Moving onto ESA • All new claims from 28th October unless: • backdated IB or IS claim; or • linked to a previous IB, SDA or IS claim • Existing claimants stay on old benefit initially… • Move to new ESA medical regime • From 2009 (under 25s) • Between 2010-2013 (everyone else) • All move to ESA in 2013 (transitional protection)
Rates of benefit • Income-related ESA • Assessment phase = applicable amount minus income • Main phase = applicable amount plus ‘component’ (£24 or £29) minus income • Contributory ESA • Assessment phase = basic amount • Main phase = basic amount plus ‘component’ (£24 or £29)
“Better off” calculations • Key differences: • no disability premium • no couple rate • SC is also a new route to Enhanced Disability Premium • higher permitted work limit extended to Income-related ESA • Claimant may have a choice • Income Support (e.g. asa lone parent or carer) • Jobseekers Allowance • Partner could claim
New Work Capability Assessment • Based on current PCA but: • Fewer exemptions • Revised activities, descriptors and scores • More likely to be carried out • Includes a further test of ‘limited capability for work-related activity’ • Plus a ‘work focused health related assessment’
Conditionality • Compulsory • medical tests • work-focused interviews (WFIs) • work-related activity (planned) • Sanctions for not participating • loss of 50% of work-related activity component (£12) for 4 weeks • then 100% (£24) indefinitely • Provision for ‘good cause’ and appeals
The good news? • Extra £1 billion for ‘Pathways’ over next 3 years • More intensive help through access to: • Training • Job search • Condition management programmes • Work trials • Tailored support • Benefit simplification?
Benefit simplification in action… 20) ‘Propriety of behaviour with other people’ a) Has unpredictable outbursts of, aggressive, disinhibited, or bizarre behaviour, being either: (i) sufficient to cause distress to others on a daily basis, OR (ii) of such severity that although occurring less frequently than on a daily basis, no reasonable person would be expected to tolerate them (15) b) Has a completely disproportionate reaction to minor events or to criticism to the extent that he has an extreme violent outburst leading to threatening behaviour or actual physical violence (15) c) Has unpredictable outbursts of aggressive, disinhibited or bizarre behaviour, sufficient in frequency and severity to cause disruption for the majority of the time (9) d) Has a strongly disproportionate reaction to minor events or to criticism, to the extent that he cannot manage overall day to day life when such events or criticism occur (9) e) Has unpredictable outbursts of, aggressive, disinhibited or bizarre behaviour, sufficient to cause frequent disruption (6) f) Frequently demonstrates a moderately disproportionate reaction to minor events or to criticism but not to such an extent that he cannot manage overall day to day life when such events or criticism occur (6)
But? • Private sector providers paid by results • Employer attitudes • Other barriers to work • Resources actually available • Is there a need for compulsion? • Disproportionate effect on most disadvantaged • More complex so more appeals?
DWP Impact Assessment • Increased failure rates (per year): • an extra 12% of total claims will fail (up by a third) • 60,000 more failing the WCA than fail PCA • 6,000 exempt under PCA will not get Support Component • 27,500 extra appeals (per year): • 1,500 against sanctions • 6,000 against ‘support group’ refusal • 20,000 extra for failure of WCA • What happens to those who fail? • 50% will switch to JSA • 50% will come off benefit altogether
Appeal issues • Harder test, so those just under 15 points will be less well • Will include some from groups previously exempt • New area of appeals (Support group) affecting the most unwell 10% • Much existing IB caselaw will still apply – especially physical • New caselaw will develop around new descriptors • Until then try arguments and use any guidance • Greater use of “substantial risk…” provisions - BUT now 2 versions!
Appeal issues • Income while appealing: • either sign on for JSA under protest; or • “Assessment Phase” ESA after appeal lodged until determined • No 20% reduction (unlike reduced rate Income Support) • BUT no chance of a disability premium via DLA • Tactics: • build on existing skills for incapacity appeals • Review ESA50: has claimant understated difficulties? But also look at issues around each descriptor, not just those on ESA50 • Review ESA85 medical report: is it consistent? proper test of descriptor etc? • Gather supporting evidence – medical, support workers, friends, families, attempted activities, diaries etc.