Ask CPAG Online - Should you claim ESA?

Should  / can you claim ESA?

In order to be entitled to contributory ESA (CESA), you will need to satisfy the national insurance contribution conditions (NICs). In practice, this means that you will need to have paid sufficient NICs in the two previous financial years to the one in which you make your claim, although there are exceptions. See chapters 28 and 42 of the CPAG Handbook for more details. 

In order to be entitled to income-related ESA (IRESA), you will need to satisfy a means-test. In practice, this means that you need to have income and capital (or savings) that are below certain limits, depending on your household circumstances. See chapter 3 of the Handbook for more details.

You can claim both CESA and IRESA if you satisfy both sets of conditions.

As well as satisfying these conditions, you will also need to supply evidence from your GP that you have a limited capability for work, usually with a fit note. This allows you to claim ESA for at least 13 weeks during which time the Department for Work and Pensions should arrange for a work capability assessment (WCA) to take place (although there are long delays presently).

You only qualify for ESA after the 13 week ‘assessment phase’ if you are assessed as having ‘limited capability work’ (LCW). To be treated as having LCW, you must score 15 points in the WCA or be treated as having LCW (e.g. because there would otherwise be a substantial risk to your health). See chapter 44 of the CPAG Handbook for more details.

If you are an EEA national, you must also have a ‘right to reside’ in the UK to qualify for IRESA and should seek advice about this before, for example, claiming IRESA instead of jobseeker’s allowance (JSA).

It is important to consider whether you are entitled to be paid ESA while you are waiting to be assessed, and if not, whether you should claim another benefit (e.g. jobseeker’s allowance (see Can you get paid while waiting for a decision?).

If you live in a universal credit 'full service area', you can no longer claim IRESA (see 'Universal Credit: 'Natural Migration')