Incapacity benefits reassessment

Rosie Wilson

Incapacity benefits reassessmentsummary

• Current incapacity benefits abolished by 2014• Most getting these benefits to be reassessed under

the Employment and Support Allowance test• Started from 28 February 2011(limited numbers till

May)• People reaching pension age by March 2014 not

affected• “Linked” claims for incapacity benefits abolished

from 31 January 2011• No PCAs after March 31

Timetable

• Started from 28 February 2011. 1000 a week nationally till April

• 7000 a week from beginning of April

• 11,000 a week from beginning of May

Order of reassessment

• People getting Incapacity Benefit, Income Support or both

• People getting SDA or SDA with Income Support

• Credits only claimants after March 2014

The process

• JC+ send letter to claimant telling them about reassessment, at the time they are due to reassessed for old benefit (?)

• JC+ contact centre phones claimant to ask if need additional support

• Most claimants (probably) asked to complete ESA50 form

• Most claimants (probably) asked to attend medical• Decision made by JC+ decision maker

Process (continued)

• JC+ decision maker phones claimant to tell them about decision

• Claimant gets decision notice (letter)• Possible outcomes:

• Qualify for ESA and transfer 2 to 4 weeks after date of decision with transitional addition if ESA less than old benefit

• Do not qualify for ESA and sign on for Jobseekers Allowance or claim another benefit

• Do not qualify for ESA and appeal• “Move off” benefit

Internal

Customer Touchpoints – Overview

Someone calls me to give

further information and

advice, find out if I need extra help with the process

Someone calls me to arrange a

Work Capability

Assessment appointment

ESA 50ESA 50

£

Work

Related

Activity

group

Support Group

I attend the Work Focused

Interview

/

Appeals

I write a letter / call to appeal*

I receive a letter informing me that

changes are about to commence and advising me on the next steps

The Jobcentre contacts me to arrange a Work

Focused interview

I attend the Work

Capability Assessment with the Atos Health Care

Service

I receive a letter with my

Employment Support Allowance award notification

Atos Health Care call me to arrange & conduct a Work Focused Health Related Assessment

(WFHRA)

ALLOWED

Someone calls to gather any

missing information and

explain the next steps (this TP only applies to

customers with missing

information)

I receive a medical

questionnaire to fill out

I become aware about forthcoming

changes to my benefits

I receive a letter informing me of

benefit disallowance and the Work

Capability Assessment

outcome

DISALLOWED

12

34

56

9

11

12

1314

15

GENERAL ENQUIRIES/HELP/SUPPORTGENERAL ENQUIRIES/HELP/SUPPORT

Someone calls to inform me of the

entitlement decision and advises me of

my options. If I wish to claim Jobseeker’s

Allowance I am transferred to

someone who takes my claim details

7I receive a letter with

my Jobseeker’s Allowance

(JSA)award notification

£

17

*if customer calls they will be told appeal needs to be in writing

Cases with Child Dependency Addition begin migration to Child Tax Credit at Touchpoint 3

For disallowed cases entitlement to Income Support on grounds other than incapacity is checked prior to Touchpoint 13

7

Someone calls to advise on Employment

Support Allowance

(ESA) entitlement and next steps in the

ESA regime

Someone calls to confirm

information for reconsideration^

16

Face to

Face

8

10

08/09/10

Version: 4.0

~suspended for 2 years from 19/07/2010

Assessment process overview

• ESA50• Not if terminally ill and submit DS1500• Or enough other evidence• Must complete and return within 6 weeks or

treated as fit for work

• Medical• Not if terminally ill or enough evidence to show

unfit for work and work related activity

• Decision

Transitional additions

• If ESA is less than claimant’s old benefit is made up to the same amount with a transitional addition

• This amount then frozen until normal ESA rates catch up

• TAs reduce in certain circumstances: For example, no longer entitled to dependant’s addition

• TAs not paid pending appeal

Issues - locally

• High percentage claiming incapacity benefits/ESA

• Over 80 reassessments a week• More than 6,000 expected to fail the WCA• 3,600 likely to “move off benefit”• Newcastle Medical Examination Centre has

highest WCA failure rate in the country

Issues - generally

• Increase in demand

• “Revolving door” problem of frequent reassessments

• Quality of assessments

• Reassessments and appeals

Issues - generally

• Potential drop in income• 12 month limit for contribution based ESA for

those in work related activity group, and abolition of youth rules

• Work related activity requirement and sanctions

• ESA and the Work Programme

What we are doing so far

• Briefed over 100 professionals about the reassessments

• One day training course on ESA and mental health

• From November 2010 introduced:• Triage system for referrals and telephone

enquiries from professionals• Dedicated tribunal unit

What we are doing so far

• Website• More involvement with corporate

appointeeships• Factsheets:

• ESA – basic explanation• Incapacity benefits reassessment• Completing the ESA50 (work in progress…)

• The briefing paper