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Frequently Asked Questions

Question	Answer
What is ESA about?	Employment and Support Allowance (ESA) is about focusing on what a person can do, rather than what they can’t. Under Incapacity Benefit, statistics showed that after 2 years on the benefit someone was more likely to die or retire than to find a job again. ESA aims to ensure that no-one is written off and that everyone who is able to work is given assistance to help them back into employment.
	It is a new way of helping people with an illness or disability move into work, rather than stay on benefits. ESA offers personalised support and financial help for customers who are not able to work. Central to ESA is the new medical assessment which examines what customers can do, rather than what they can’t.
	The Work-focused Interview (WfI) is an important part of the return to work process for clients claiming ESA. A WfI is arranged with a Department for Employment and Learning Personal Adviser (DEL) during which the PA will discuss the client’s barriers to returning to work and agree a package of support to help them progress and/or move into work.
	It is fairer, giving more financial support to most claimants sooner, paying the work-related activity or support component after 13 weeks, rather than higher rates after 28 or 52 weeks under previous incapacity benefits.

Are you forcing people into work?	Asking people to take part in some form of work-related activity is not the same as forcing them into work. What ESA offers is more help and support which can transform lives. Those with the most severe conditions will receive more financial help through the Support component and will be able to volunteer for any appropriate support on offer if they wish.

What is the target group for Employment and Support Allowance?	Employment and Support Allowance is aimed at people whose capability for work is limited by a physical or mental condition and the limitation is such that it is not reasonable to require them to work.

What about people with the most severe conditions?	People who are assessed as having the severest disabilities or health conditions will go into the ‘support group’ and be exempt from the Work Focused Health Related Assessment and the Work Focused Interviews.
	Support Group customers are people who are so severely ill or disabled it is unreasonable to require them to engage in work-related activity as a condition for receiving ESA. Support Group customers will have periodical medical assessment reviews (every 3 years at a maximum). Medical conditions can improve with treatment, or they may decline. Depending on the WCA outcome, customers who are placed in the Support Group may be removed from that group and placed in the Work-Related Activity Group, and vice versa.
	Employment and Support Allowance focuses additional resources on the most severely disabled. Many of the poorest and most severely disabled claimants can be nearly £17 a week better off under Employment and Support Allowance than they would have been on incapacity benefits

The Work-Related Activity component can be sanctioned if people don’t comply – what are the safe guards?	The benefit can be sanctioned for not attending or participating fully in a work-focused interview. There are of course appropriate safeguards in place to ensure that the system is fair, for example, ensuring those with mental health conditions are visited before any sanction may be imposed.

What work-related conditionality do claimants have to undertake? Is there a compulsion to attend job interviews?	Claimants not in the support group may be required to take part in work-focused health-related assessments and work-focused interviews. Although the Welfare Reform Act (Northern Ireland) 2007 includes provision for additional work-related activity, it has not been introduced at this stage and further regulations would be required. However, there is no intention that work-related conditionality would include any compulsion to apply for or attend job interviews.

If the Government is offering a more attractive system of support, do we need conditionality / sanctions? Won't people want to volunteer?	Many of the people on incapacity benefits have lost the motivation and confidence and would not readily volunteer. Experience from existing programmes shows the importance of engaging people, and the difference this makes in their aspirations to return to work. Based on the experience of Pathways to Work it is not envisaged that sanctions will be widely used. The aim is to encourage people to avail of the help being offered, however it is necessary to have a sanction available for use if needed.

Does the potential additional stress of work-focused interviews not act as a disincentive for vulnerable people to offer themselves for work?	Claimants with all conditions are dealt with sensitively. Additionally there is a system of safeguards particularly geared to claimants with mental health problems. It is believed that engagement with the community and some form of work-related activity is good for most claimants. The work-focused health-related assessment explores appropriate health interventions. It will also explore the claimant’s beliefs and perceptions about their disabling condition, which may be acting as a barrier preventing return to work.

What is the effect of imposing work-focused interviews on vulnerable people, especially those with mental health conditions?	Such cases are approached with sensitivity, applying the full range of safeguards, such as home visits, encouraging a support worker to be present and ensuring that there is pre-interview contact with the claimant when personal advisers can explain their purpose. There will of course be cases where mandatory intervention is clearly inappropriate. Those with the most severe mental health conditions will already be in the support group and not required to attend WFIs. Personal advisers have the ability to defer interviews where a claimant is clearly not able to attend or to effectively take part. This is particularly useful in cases where, for example, there is a fluctuating condition.

In what circumstances are work-focused interviews waived or deferred?	Personal advisers are able to waive an interview when a claimant is very close to returning to employment, for example, where an imminent start date for work has been agreed and an interview would be of no assistance to the claimant.
	Deferrals are used to cover a wide range of circumstances and for varying periods of time. Where there is a short term problem affecting attendance on a particular day, the interview would be re-arranged in the days following the original date. Where problems are longer term, such as a period in hospital, deferral could last months.

Is there sufficient suitably trained support for people with learning disabilities?	Personal advisers receive specialist training to give them the skills, knowledge, techniques and confidence to deal with people with a disability or illness including people with learning disabilities. Work-focused health-related assessment reports, provided by trained health care professionals who have the appropriate skills, are available to personal advisers. This assessment is about identifying health-related barriers to work and possible solutions. Also, the condition management programmes are delivered by qualified health professionals.

This is all a waste of time, given the state of the economy and very high levels of unemployment?	Unemployment has certainly risen during the past year but employers are still recruiting and DEL has an Employment Service available to assist employers to fill vacancies. One consequence of the recessions of the 1980s and early 1990s was that people were effectively written off on inactive benefits with no support to get back to work when the job market strengthened. We need to avoid those mistakes and the long-term social and economic costs that resulted.
	To support this goal, Employment and Support Allowance has replaced incapacity benefits and return to work support is available through Personal Advisers. This has improved the personalised support available to disabled people or people with a health condition who are on benefits and on their own journey back to work.
	The Disablement Advisory Service has a range of programmes and services providing opportunities that encompass work placements, training, employment, and retention in work, for people with disabilities.

Work Capability Assessment and medical evidence

Question	Answer
Why are you making people attend a medical assessment?	This is not new; similar arrangements were in place for the old Incapacity Benefit

But why is it needed at all and why the change?	The new Work Capability Assessment provides a professional assessment of an individual’s eligibility for ESA based on what they can do rather than what they cannot do.
	While the criteria used for Incapacity Benefit, the personal capability assessment, provided a robust evaluation, it focused on what a person is incapable of doing. Developed in 1995, it has become out-dated in relation to the modern workplace, developments in medical therapy and the conditions prevalent in society today.
	The WCA has been developed as a more positive assessment; it focuses on what a person is capable of doing and through a new element, the work-focused health-related assessment, identifies the help they need to overcome their challenges getting into work. The mental health section in particular has been expanded to include intellectual and cognitive function. This section has been given equal weighting to the physical section to remove previous bias.
	The WCA is therefore a more robust and accurate assessment, and provides a better means to correctly identify people with health conditions which make it unreasonable to expect them to work and therefore give them the support they require.
	The key change is that it identifies those people who are capable of taking part in work-related activity and the support and interventions required to help them get back to work;
	It also identifies people who are so limited by their illness or disability that it would be unreasonable to require them to undertake any form of work-related activity in the foreseeable future.

Does everyone who applies have to attend a medical assessment?	Most new customers are required to attend an assessment.
	Whenever possible, however, a decision will be made using documentary evidence for those with the most severe illnesses and disabilities who are likely to be in the Support Group.

Why do I have to provide medical certificate and/or a medical report for my patient?	Under the terms of your current contract as a General Practitioner, you are required to provide these documents and to do so in a timely manner

Why are so many people being disallowed after their medial assessment?	Up to 4th September 09, 3,806 ESA customers had a Work Capability Assessment carried out. As a result 2,634 (69%) were found not to have a limited capability for work and were therefore not entitled to ESA. The Incapacity Benefit disallowance rate was 27%
	This demonstrates the new approach – that no one is written off because of illness or disability, ESA focuses on what a customer can do, not what they cannot do.
	Of those customers who were disallowed ESA 36% appealed the decision. Those first ESA appeal hearings have been completed and the original decision was upheld in approximately 92% of cases – 6% were overturned, and the remaining 2% withdrawn.

What happens if a customer doesn’t go for their assessment?	If a customer fails to attend an appointment for a medical assessment, we will write to then and ask them for their reasons for not attending. Their reply is considered by a Decision Maker, who may decide that the customer has shown good cause for not attending and refer the case for a new appointment; if the Decision Maker takes the view that good cause has not been shown, ESA will be disallowed and benefit stopped.

Why aren’t the assessments for people with mental health conditions carried out by health care professionals who are experts in the condition?	The work capability assessment and the work-focused health-related assessment differ from the task of a clinician. Clinicians make diagnoses and plan treatment for patients and this needs expertise in medical conditions. All health care professionals carrying out assessments are specially trained in assessing the effects a condition has on a person’s functional ability. They do not need expert knowledge of the condition to do this competently; their expertise lies in disability analysis.

Why is there no disability premium in Employment and Support Allowance when it remains in other benefits?	The new Employment and Support Allowance is not structured in the same way as the old incapacity benefits of incapacity benefit and income support. There is not the concept of a disability premium in the new allowance, but it is not that the new allowance ignores the needs of people with disabilities; rather it takes account of these needs in a different way. Other benefits do not include work-related activity or support components. We believe that those capable of some form of work-related activity will benefit from, and have a responsibility to engage in undertaking work-focused interviews and this concept is reflected in the benefit structure.

Is the new work capability assessment just making it more difficult for people to get benefit?	The work capability assessment descriptors are not about tightening the gateway to benefit. They are about ensuring the assessment remains relevant to today’s environment, which has seen changes in the prevalence of disabling conditions, advances in medical interventions available, and changes in the tasks and activities employers expect their workforce to be able to carry out. The new descriptors are about creating a fairer and more accurate assessment of a person’s entitlement to benefit, that will correctly identify those people who have limited capability for work because of a physical or mental condition.
	The WCA is designed to provide a comprehensive assessment of an individual’s mental, cognitive and intellectual functions, by using more descriptors addressing a wider range of functions. The scoring system has also been changed in order to remove the perceived bias in the PCA against people with mental health problems as opposed to limitation of physical function.

Why have many of the current descriptors been changed?	The activities that employers expect of their workforce have changed. Those descriptors not relevant to claimants’ ability to work have been dropped and, where gaps have been identified, new descriptors have been added. In relation to mental health the new approach of the assessment takes better account of the needs of people with conditions like learning disabilities.
	Work was undertaken with medical experts in re-focusing descriptors and scores to identify more accurately the overall functional limitation at which it is unreasonable to expect a person to engage in work.

People with a mental health problem may not be able to comply with the need to provide information. Will they be penalised?	It is recognised that people with a mental health condition may have difficulty in complying. Before applying sanctions, every effort will be made to contact claimants and make sure they understand what is required of them. A person with mental health problems would not be sanctioned without first contacting them or their carer or health care professional, to ensure they understand what is required of them.

People with severe learning disabilities are exempt from the personal capability assessment under Incapacity Benefit. What assurance is there that they are properly assessed under Employment and Support Allowance?	Appropriate training is provided for health care professionals carrying out the work capability assessment to ensure they are aware of the special needs of people with learning disabilities. Supportive evidence may also be obtained from the most appropriate source, who best knows the person and their difficulties. Work was undertaken with organisations that have experience of supporting people with learning disability as the revised assessment was being developed.

Making claim/contact by phone

Question	Answer
Why should people bother to phone to make their claim?	Claiming by telephone is by far the most effective method of ensuring clients obtain the benefit most appropriate to them and that it is paid promptly.
	The customer is assisted by a member of staff throughout the process who can help determine if ESA is the most appropriate benefit for the customer, provide advice if required and sign-post the customer to any secondary benefits they may be entitled to.
	The staff member will also inform the customer of any evidence they must provide before their claim can be processed (providing clarification if required).
	The customer is also given the opportunity to make a claim for both contribution and income related parts and there has been a significant number who have claimed both parts since ESA was introduced.

How long does it take to make a claim over the phone?	From the convenience of their own home a customer can make a claim for ESA over the phone in about 20 - 25 minutes. This is considerably more convenient and quicker than completing a paper form and now includes collecting the information required for an application to Housing Benefit.

Why should changes in circumstances be made by phone?	Reporting changes of circumstances by phone benefits the customer as some changes can be recorded immediately. This saves time and the costs associated with sending documents to the Centre.

Who pays for these calls?	There is no charge for customers who use a BT telephone line to contact the 0800 line to make a new claim. Calls to the 0845 enquiry line may also be free to BT customers depending on their Calling Plan.
	Customers ringing from a non BT landline or mobile may be charged by their network provider for the connection onto the BT number. However, in these circumstances, customers can request a call-back at the outset of the call.

How long does this it take to get through?	Currently call waiting time on the phone lines is between 1 minute and 1 Minute and 30 Seconds on the 0800 line. On the 0845 line the call waiting time is less than 1 minute.

How many telephone calls are going unanswered in the ESA Centre?	In October 2009, over 25,000 calls were answered first time, representing about 94% of all calls.

What opportunities are in place for customers who have difficulty in making a claim to ESA by telephone?	A small percentage of customers may be unable to use the new telephony service and in these cases they can ask that a claim form be issued. Vulnerable customers who contact the ESA Centre are directed to their local Jobs & Benefits Office for assistance in completing an ESA claim form. Arrangements are also in place to enable ESA claims to be made on behalf of vulnerable customers by representatives, family members or other advocates using the telephone claim service.

What arrangements are there in place to ensure that customers do not lose benefit because they have difficulty getting through?	The law protects customers in these circumstances. A claim may be accepted covering a period up to 3 months before the date on which a customer notifies the Department of their intention to claim the benefit, as long as they can provide medical evidence to support the claim.

Why does ESA Centre not call customers back	If a customer requests a call back the details will be recorded on a priority case list, which is used to manage return calls to customers. Once on this list a call will be made as soon as a manager is available.
	Due to the high volume of calls received in the ESA Centre between April and June not all calls would have been returned as promised. This issue has been addressed with the deployment of additional staff in the Centre.

What arrangements are there in place to ensure vulnerable people can access information on ESA?	Information about ESA is available from the ESA Centre and can be obtained by calling the freephone number. Like other benefits information is also available in all Jobs and Benefits/Social Security Offices and on the Department’s website.
	Information leaflets on ESA are provided in Braille and audio for the visually impaired and a text phone service is available for customers with hearing difficulties who wish to contact the ESA Centre.
	Arrangements are also in place to provide interpreting services for customers with limited understanding of English.

Why is there a delay between making a claim and getting payment?	A substantial number of customers are under the false impression that once they make their claim (either by telephone or a clerical claim form) that their payment will be automatically issued. However, payment cannot be issued until certain evidence has been provided by the customer - (e.g. medical evidence, bank statements, P45/P60s, pension details).
	Customers are reminded about their responsibility to provide outstanding evidence at several points during the claim-take process- during the initial telephony claim-take, in their customer statement and, if the information is still outstanding 14 days after the claim has been received, a reminder letter is issued to the customer. The responsibility to provide outstanding evidence lies with the customer. The claim is made defective unless the Department is provided with all the information required to determine the claim.

What protection is there for customers who are in financial distress?	An interim payment of ESA can be considered pending determination of entitlement. Customers can apply for a crisis loan from the Social Fund.
	If a payment of ESA is requested urgently a personal issue cheque can be authorised through LPS and collected at the local benefit office.

Why does the Department close an ESA claim if a customer cannot be contacted by telephone?	If a customer is asked to provide further evidence in support of a claim they have one month to provide this. If the evidence is not received within one month at least two further requests for the information will be made. If evidence is not provided within the stipulated one month period consideration will be given to closing the claim. A claim will only be closed if there is insufficient evidence available to make a decision on entitlement to benefit. The same rules apply to customers claiming Incapacity Benefit and Income Support.

Interface with JBO/SSOs

Question	Answer
Why was the ESA process imposed on JBOs/SSOs?	Prior to the launch of ESA, the process was designed in close consultation with and in full agreement with operational managers representing the local office network and DEL.
	The process is designed to encourage customers to make their ESA claims and enquiries by telephone.

JBOs/SSOs are being swamped by ESA customers who can’t get through on the phone	Information from the Queue Management System does not support this assertion. The deployment of additional staff in the ESA Centre has reduced the waiting time for calls to be answered. ESA caller traffic is also pro-actively managed with resources re-deployed, if necessary, to deal with peak call times.
	There are currently no delays in getting through to the ESA Centre on the telephones. The average call waiting time for the 0800 number is between 1 minute and 1 minute 30 seconds and for the 0845 number it is less than 1 minute.
	There is an established process for assisting all ESA customers who do call at their JBO/SSO and this should be adhered to –
	staff in the CET should first ask them if they have contacted the ESA Centre on the appropriate phone line. If not, then the customer should be encouraged to ring the appropriate number. If the customer has already rung the relevant number but still requires further assistance with an existing case, the local office staff member should access the system dialogues available to view the status of the case. In the majority of instances, the information available should resolve the customer’s query. In a minority of cases, the customer may still require further assistance/information. In these instances, the local office staff member should contact the appropriate team leader or manager in the ESA Centre to obtain the relevant information. All team leaders and managers in the ESA Centre are on the DIAL network.
	Adherence to the agreed operating model ensures that team leads/ management in the ESA Centre are not unnecessarily dealing with queries which could be resolved by other means.

It is impossible for JBO/SSO staff to get through to the ESA Centre	ESA dialogs are available on JSAPS to staff in the local offices. In the majority of cases, the information needed to assist the customer is available by accessing these dialogs. Staff should always access these dialogs before contacting the ESA Centre.
	A number of phones on the ‘dial’ network have been placed in the ESA Centre specifically to allow staff to deal with enquiries from local offices.

Medical Certificates are being lost by the ESA Centre	The ESA Centre operates a database for recording details of all medical certificates that are received. This system minimises the risk of medical certificates being misplaced and also ensures that the relevant information is available to process benefit claims.
	If a medical certificate is received in a benefit office arrangements are in place for a copy to be faxed to the ESA Centre. This will be accepted by the Centre to release benefit payments.

How are issues between ESA Centre and JBOs/SSOs raised and resolved	There is a joint ESA/local operations forum in place to deal with operational issues in relation to ESA. This forum is headed by Tony Murphy (Manager, ESA Centre) and Lyzan Martin (District Manager, Belfast West and Lisburn District).
	There is a forum set up between operational staff in the local office network and the ESA Centre.
	There is a programme of job-shadowing in place to allow staff from the local office network to see the work of the ESA Centre.

Operational Performance

Question	Answer
Why all the negative publicity about backlogs, delays and inability to get through to the ESA Centre?	The introduction of ESA was the single biggest change in social security for a decade. And like any new, major initiative, the ESA Centre, which opened for business on 27 October 2008, has taken a number of months to stabilise. There have been teething problems but these are now resolved and the new operation is stable and meeting targets.
	Customers are able to get through to make their claims and enquiries without delay.

How many claims are received?	We are getting around 160 claims per day on average.

Why does it take so long to process a claim?	The average clearance time for an ESA claim is now around 15 days. This compares favourably with the old Incapacity Benefit, which was 21.9 days at October 2008.
	The processing of Income Related ESA claims can sometimes be delayed if it is necessary to obtain additional evidence from a customer.

Why are customers being asked to go and get duplicate medical certificates?	The ESA Centre receives more than 2000 medical certificates each week. In view of the large volumes involved there is a risk that some certificates may be mislaid.
	Measures are in place to ensure that all medical certificates are recorded into the ESA Centre and processed quickly – at present there are no backlogs and certificates are being recorded on the database within 24 hours. This means JSAPS will normally be updated within 48 hours of a medical certificate being received.
	Customers are only asked to obtain a duplicate certificate by the ESA Centre on occasions when there is no evidence of the certificate having been received.