How to claim ESA for mental health
How to claim New Style ESA
If your mental health condition affects how much you can work, you might be able to apply for ‘new style’ ESA. You can apply for new style ESA if:
- You are under the State Pension age and
- You have a mental health, disability or other health condition that affects how much you can work.
If you meet both conditions, then before you apply you must also have:
- Worked as an employee or been self-employed and
- Paid enough National Insurance (NI) contributions over the past 2-3 tax years or
- Received enough NI credits over the past 2-3 tax years.
What is a tax year?
The tax year starts and ends in April every year. For example, the tax year for 2021-2022 runs from 6th April 2021 to 5th April 2022.
How Daisy was able to apply for ESA
Daisy is 35. For the past 5 years, Daisy has been working as an employee for a large insurance firm in the city. She has paid tax and NI contributions throughout her employment with the firm.
Daisy developed Post Traumatic Stress Disorder (PTSD) following the birth of her son, Alfie, three years ago. Daisy struggles to sleep, feels constantly anxious, and has withdrawn from her friends and family. Her GP has prescribed a mix of medication and talking therapy to help Daisy manage her mental health condition, but Daisy finds it difficult to function and work normally on a day-to-day basis.
Daisy’s condition has forced her to take time off work. She has claimed all her company sick pay entitlement (CSP) and her statutory sick pay (SSP) entitlement. Daisy’s mental health condition is making it difficult to manage her money and mental health whilst looking after her son. She cannot currently work more than a few hours a week due to her mental health treatment and childcare obligations.
Under these conditions, Daisy can apply for new style Employment and Support Allowance (ESA).
What do I need when applying for new style ESA?
To claim new style ESA you will need all of the following information:
Your National Insurance (NI) numberYou can find this on your payslips, any tax documents sent to you by Her Majesty's Revenue & Customs (HMRC) or the Department for Work & Pensions (DWP), or your national insurance card if you were issued one.
Your bank or building society account number and sort code.If you do not have a bank or building society account, you can ask a friend or family member if you can use their account. Your claim will not be affected by this. (NB: Benefits can no longer be paid into a Post office account)
Your GPs name, surgery address and contact telephone numberIf you do not know your GPs address you can telephone your surgery to find out or use the online NHS Find a GP service to help. When you enter your postcode, this service will bring up the address and contact details of every registered GP in your local area. You can also ask a friend or support worker to help you.
How much money you earn when working (income from working)If you are an employee, you can find out how much money you earn by looking at your payslips or P60 end of year tax certificate. If you are self-employed you should keep records of how much money you earn on a monthly and yearly basis. You can ask a friend or support worker to help you with this.
The date your Statutory Sick Pay (SSP) ends if you are still claiming itIf you are an employee, your employer should be able to tell you when your SSP will end. If you are self-employed and have been claiming SSP yourself, the DWP will be able to tell you when your SSP will end.
For the first seven days of your LCW claim, the DWP should accept a self-certificate as medical evidence. After seven days you must provide a medical certificate (Fit-note/Sicknote) from your doctor and continue to provide this until a decision is made.
Why you should always get a fit-note/sick note from the doctor
It is important to ask your doctor for a fit note after 7 days of being off work sick because if you are placed in the Limited Capability for Work-Related Activity (LCWRA) group, your ESA will be backdated to 3 months after the medical certificate is received.
Apply for ESA online or by telephone
Once you have gathered all the details you need, you can begin your new style ESA claim. You can apply for ESA online here.
If you cannot apply online you can call the helpline on 0800 328 5644 and choose option 3. The helpline is open Monday to Friday from 8am to 6pm.
What happens when I apply online?
The website will ask you a short set of questions to check if you can apply for ESA. Read the questions carefully and answer ‘yes’ or ‘no’ to each one. If the website confirms you are eligible to apply, it will take you through the new style ESA application process. If you find this too difficult to manage alone, you can ask a friend, carer, support worker or family member to help you.
What are National Insurance (NI) credits?
NI credits will help fill any gaps in your National Insurance record. We all pay national insurance when we work to help fund certain benefits including the State Pension. You can receive NI credits if you are not paying National Insurance. Examples of when you might receive NI credits include:
- You are claiming benefits because you are ill or unemployed
- You are claiming benefits because you are a full-time carer
How to fill in the ESA Capability for Work questionnaire
When you apply for new style ESA, you may be asked to do a Work Capability Assessment. Part of the assessment involves completing a Capability for Work questionnaire as part of the assessment. This questionnaire is also called ESA50.
The Capability for Work questionnaire (ESA50) gives you an opportunity to communicate how your mental health condition affects your ability to work. There are 28 pages so it can feel overwhelming. You can ask a friend, carer, support worker or family member to help you complete the form.
How long do I have to complete and return the form?
The DWP will give you around 4 weeks to complete and return the form.
To help you fill out the form, we suggest doing the following:
1. Make a plan to complete the questionnaire
The local Jobcentre Plus office will send you a letter with the Capability for Work questionnaire. The letter will tell you when you must return the completed questionnaire (usually 4 weeks from the date the letter was sent to you). You should plan when and how you will complete the questionnaire. Useful things to think about include:
- What times of the day do you concentrate the best?
- Do you need someone to help you complete paperwork?
- Will you need to book a time for a friend or support worker to come and help you fill out the questionnaire?
2. Give yourself enough time
4 weeks seems like a long time, but it can go very fast if you don’t have a plan. Remember, you don’t have to complete the questionnaire in one go. You can take breaks or come back to it the following day. Give yourself enough time to complete the questionnaire.
3. Don’t ignore the questionnaire
It is very important you try to complete and return the Capability for Work questionnaire. If you ignore it, the Jobcentre can stop your ESA claim and you will not receive any money. Remember, you can ask for help from the DWP or your local Jobcentre Plus office. You can also ask a friend, family member or support worker to help you.
4. Allow for postage time
Once you have completed the questionnaire, you need to make sure the Jobcentre Plus office receives it before their deadline - the date they have asked you to return the form by.
The questionnaire will come with an envelope that has the address of the Jobcentre Plus office on it. You can use this envelope to post your completed questionnaire back to the Jobcentre Plus office. The Jobcentre will have paid for postage, so you do not need a stamp. Make sure your plan allows enough time for the form to reach the Jobcentre Plus office before the deadline. First-class post can take up to 3 working days to be delivered.
How Kiran completed and posted his ESA50 questionnaire
Kiran is applying for new style ESA. He receives a Capability for Work questionnaire (ESA50) from his local Jobcentre Plus office on Wednesday 28th July. The letter is dated Friday 23rd July.
It has taken 3 working days (Friday, Monday, Tuesday) for the form to arrive at Kiran’s house.
The letter asks Kiran to complete and return the Capability for Work questionnaire (ESA50) by Friday 20th August. This is 4 weeks from the date the letter was sent (Friday 23rd July). As Kiran did not receive the letter until Wednesday 28th July, he only has 3 weeks and 2 days to complete and return the form to the Jobcentre Plus office.
Kiran should post his completed form by no later than Monday 16th August. This will make sure the Jobcentre Plus office receives his form by Friday 20th August.
Supporting evidence for an ESA claim
If your mental health condition makes it difficult for you to work, you can send evidence of your condition back with your Capability for Work questionnaire. A healthcare professional like your GP, or an approved mental health professional (AMHP) can help to support your ESA claim. They can provide you with copies of:
- Any mental health treatment plans you have (eg. therapies, medication, counselling)
- Test results from any scans or other medical assessments you have undergone
- Your current medication list (if any)
- A statement of any special educational needs (SEN) you have
- Hospital passports – this is a written record kept by people with learning disabilities. This provides care teams and hospital staff with important information about you and your mental health when you are admitted to hospital.
Who can help provide evidence about my mental health condition?
The following medical professionals should be able to provide you with evidence about your mental health condition:
- A hospital doctor
- Specialist nurse – eg. Mental Health nurse
- Community psychiatric nurse
- Occupational therapist
- Social or support worker
- A counsellor or registered carer
You should attach any medical evidence to the Capability for Work questionnaire. Write your name and National Insurance (NI) number on every separate sheet of paper you attach to the questionnaire. This will help prevent anything from being lost.
If you can, make copies of your completed questionnaire and any medical evidence you send with it. This will help you prepare for any further questions or assessments from the DWP. You can ask a friend, family member or support worker to help with this.
How to prepare for your ESA medical assessment
The DWP can ask you to attend an ESA medical assessment with a healthcare professional (HCP) from the Health Assessment Advisory Service (HAAS). HAAS carry out health assessments on behalf of the DWP.
You will often receive a letter inviting you to an ESA medical assessment 1 – 2 months after your Capability for Work questionnaire has been processed. You will still receive your ESA assessment payments whilst this is happening. The letter should tell you:
- The date and time of your medical assessment
- Where the medical assessment will take place
- Who will conduct the medical assessment
The person conducting your assessment may be a doctor, a nurse or other healthcare professional (HCP).
Before attending your ESA medical assessment, you can prepare by thinking about how your mental health condition affects your daily activities, including work. Examples could include:
- How your mental health condition makes it difficult to concentrate (eg. due to PTSD)
- How your mental health condition means you cannot leave the house (eg. due to an anxiety disorder)
- How you need help with shopping in a supermarket (eg. due to depression)
- How you find it difficult to work regular shifts because you experience periods of mania and depression (e.g. triggered by bipolar disorder)
- How you cannot travel by yourself due to panic attacks (eg. caused by PTSD)
The HCP can ask questions that seem meaningless, but you should think carefully about your answers.
How a WCA health assessment can easily confuse people
Radhika has been experiencing severe panic attacks triggered by Post-Traumatic Stress Disorder (PTSD).
She receives a letter from the DWP asking her to attend a medical assessment with a healthcare professional (HCP) at 10am on the 2nd of September at the Hilltree Clinic.
The Hilltree Clinic is 2 miles from where Radhika lives. Radhika finds it difficult to travel by herself due to her panic attacks. She doesn’t have a car, so leaves her house early on the 2nd of September to catch a bus. At the bus stop she experiences a severe panic attack. Despite this, Radhika manages to get to Hilltree Clinic five minutes before her medical assessment is due to take place. Radhika is exhausted, upset, and frightened.
The HCP invites Radhika into a private room to begin the assessment. The HCP asks Radhika how she travelled to the clinic today? Radhika answers honestly that she came by herself on the bus. She is embarrassed so does not tell the HCP that she experienced a severe panic attack brought on by her journey to the clinic.
The HCP notes that Radhika can travel alone on public transport.
Think carefully about your answers during the assessment
Even though Radhika’s mental health condition makes it difficult for her to perform everyday tasks like travelling on a bus, the HCP has noted that Radhika is capable of taking public transport by herself.
Radhika could have spoken about:
- How her PTSD and panic attacks affect her life
- How her mental health condition makes it harder for her to do every-day things like taking a bus
- How frightening and exhausting her journey to the assessment centre was
You must think carefully and tell the HCP everything you struggle with. To help you prepare, think about telling the HCP about all the things you have difficulty with because of your mental health condition.