How long do decision making take after an ESA assessment?

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In this article we will be discussing how long it takes for the ESA assessment decision to be made.

We will also be exploring what the ESA assessment is and what is the process and timeline of the ESA assessment.

How long do decision making take after an ESA assessment?

In the most ideal situation, if you have completed your questionnaire and your assessment, and you have provided evidence of your need for ESA, you should receive your decision from the decision maker in about four to six weeks after the assessment.

However, there is a possibility, due to unseen events- such as a global pandemic- that there could be an exception to this time period. 

Statistics from the Department of work and pension say that as of recent years assessment decisions are now taking as long as 14- 19 weeks due to the increase in people who have become unemployed and are struggling with mental and physical disability.

What is an ESA assessment?

Once you have filed for claim of Employment and SUpport Allowance at the Deparment of Work and Pensions, UK, the process of assessments for your eliiliblty begins. 

The ESA assessments also known as the Work Capability Assessment, done by the ESA department of DWP, UK, involves two steps: 

  • A questionnaire for you to complete
  • A medical assessment for you to attend

What is the process of the ESA assessment?

The process of the ESA assessment is as follows:

Limited Capability for Work (LCW) questionnaire

Once you have filed for a claim of Employment and Support Allowance, you are sent a Limited Capability for Work (LCW) questionnaire (ESA50) to complete and return.

If you have filed for a claim of Universal Credit and submit sick notes from a medical professional, you will be sent a UC50 to fill out which will take around 3 months after you have filed and handed in your medical notes. 

These questionnaires are sent through work coaches and if you have not received the form after three months, you should ask your work coach to send you one.

The form explores your medical condition and also the effects that any physical disabilities or any mental health problems and intellectual difficulties have on certain activities. You can also supply extra information from yourGP, consultant or other professional. 

If you do not complete this form the DWP will automatically refuse or stop your ESA unless you show ‘good cause’ for failing to return it. 

Medical assessment

Next, once you have returned the completed questionnaire you will be asked to attend a medical assessment either in person or you might be assessed over the phone or on a video call if mobility is an issue. 

This medical assessment looks at your responses given on the questionnaire and the verbal and physical evidence that you provide via the assessment. 

If you don’t attend the assessment, it is likely the Department for Work and Pensions (DWP) will decide that you are fit for work. If you cannot attend an assessment, it is important to contact the assessment centre and rearrange the appointment.

Following this assessment, the healthcare professional will send their report to the DWP for a decision to be made about your claim and whether you are eligible to avail ESA. 

Decision making

Now, Your completed ESA50, the medical assessment report and any other evidence you have provided will be taken into consideration and reviewed by a decision maker at the DWP. 

During this process the decision maker will determine whether you are sick enough to avail ESA and what group you fall into. 

If your ‘limited capability for work’ test determines that you are eligible, your decision maker will determine whether you have ‘limited capability for work related activity’ or not.

This particular process should take 4-6 weeks since you filed your claim if there is no change in process and no issues that hinder the process. 

If you haven’t heard anything after 8 weeks from the date of your assessment, contact the DWP to ask them what’s happening. You can ask them by:

  • writing to the address on any ESA letters you’ve received
  • calling Jobcentre Plus at Telephone: 0800 169 0310 or Textphone: 0800 169 0314

What happens after the decision has been made?

Based on the assessment made by the decision maker, they will write to you via mail or email and inform you whether you have passed the assessment and will continue to receive ESA, or have failed and therefore will not be entitled to carry on getting ESA. 

After this, you will be placed in a Support Group based on your assessment and they will also calculate whether you are owed any back pay and will arrange for it to be paid to you. 

If you get Universal Credit, the decision maker will income you whether you have passed the assessment or not. Whatever the outcome,  You can continue to get Universal Credit. However, if you fail, you might have to start looking for work. 

The letter sent by the decision maker will confirm what group you have been placed in if you have passed the assessment and also should contain a summary of the healthcare professional’s report and a summary of the points you scored.

In case you disagree with the assessment and the decision made, you can request a reconsideration of the decision.

What are the Eligibility criteria to avail ESA?

The eligibility criteria for availing ESA includes the following. These criteria have been referred from the Employment and Support Allowance (ESA) Gov.UK website.

You can apply for ‘new style’ Employment and Support Allowance (ESA) if you’re under State Pension age and you have a disability or health condition that affects how much you can work.

You also need to have both:

  • worked as an employee or have been self-employed
  • paid enough National Insurance contributions, usually in the last 2 to 3 years – National Insurance credits also count

You are eligible if you get Universal Credit, you could get ‘new style’ ESA at the same time however, you get both benefits, your Universal Credit payment is reduced by the amount you get for ‘new style’ ESA.

You can apply for ‘new style’ ESA up to 3 months before your SSP ends. You’ll start getting ‘new style’ ESA as soon as your SSP ends.

You can apply whether you’re in or out of work. There are conditions to working while claiming ESA.

You can apply for ‘new style’ ESA if you’re unable to claim Statutory Sick Pay and one of the following applies:

  • you or your child might have COVID-19 or you’re recovering from it
  • you or your child are self-isolating because you came into contact with someone who might have COVID-19
  • you’ve been advised by your doctor or healthcare professional to self-isolate before going into hospital for surgery
  • you’re quarantining due to rules about returning from abroad

If you’re claiming ESA because of COVID-19, you’ll need to give evidence to support your claim.

Note that You cannot get ‘new style’ ESA or is not eligible if you:

  • claim Jobseeker’s Allowance
  • claim Statutory Sick Pay

What is the process of applying for ESA?

The process of applying for ESA follows the following steps:

You need to check for eligibility.

If you are eligible, you can start your claim by applying online via this link.

You will need the following documents:

  • Your National Insurance number
  • Bank account number and sort code
  • Name, address and phone number of your doctor
  • Details of income if working
  • The date your Statutory Sick Pay ends if you are claiming it

Next, you have to Attend the appointment with your work coach where you must form what is called the Claimant Commitment which details the actions you need to take to get payment. 

The Department of Work and Pensions include a medical assessment in the process of checking for the eligibility for ESA applicants. 

Some ESA assessment of mental health questions that are generally asked in the assessment interview include questions related to your medical condition such as:

  • What are your medical conditions?
  • How long have you had these conditions?
  • How do these conditions affect you?

Based on your assessment you will be assigned to two groups- 

A work-related activity group: This is to prepare employees who with some support are able to return to work.

A support group: This group is for people who are unable to return to work due to their illness of disability.

At times the DWP also do at-home assessments if the claimant’s illnesses or disability make it difficult for them to travel and move; however, they will ask individuals to provide information from a medical professional supporting their request for a home visit.

If you fail to attend an appointment for a medical assessment, they will investigate your reasons for not attending. If the reason is not a good cause, ESA will be disallowed and benefits stopped.

Then, you will get a letter telling you if you’ll get ‘new style’ ESA and how much.

Once you start getting your ESA, you will have to Give updates about your health and circumstances. 

Conclusion

In this article we have discussed how long it takes for the ESA assessment decision to be made.

We have also explored what the ESA assessment is and what is the process and timeline of the ESA assessment.

References:

Getting your ESA decision after an assessment. CitizenAdvice. Retrieved on 4th Dec 2021. https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/help-with-your-esa-claim/getting-your-esa-decision/

Work Capability Assessment – After the Work Capability assessment. Turn2us. Retrieved on 4th Dec 2021.https://www.turn2us.org.uk/Benefit-guides/Work-Capability-Assessment/After-the-Work-Capability-assessment

FAQ about ESA assessments, how long for a decision 

How long do DWP decision-makers take?

DWP decision-makers can take up to 12 weeks from weeks from the date you started your claim to make a decision.

How long does work capability assessment take?

The work capability assessment should take place within 3 months of you providing the Department for Work and Pensions with evidence of your limited capability for work.

How long does the support group ESA last?

ESA support group lasts over 12 months, this being the time limit on payment of contributory Employment and Support Allowance (ESA) for people in the Work-Related Activity Group.

Will DWP know if I go abroad?

DWP can’t know if you go abroad unless you tell them. If you’re going abroad for less than 4 weeks, it won’t affect your ESA – but you should still tell the DWP.

If you’re going abroad for 4 weeks or more, contact your nearest Citizens Advice to check if it will affect your ESA. 

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