There are a variety of benefits available to disabled people over 16, depending on whether or not they work or are considered to be able to work. If a young person aged 16 to 19 lives with their parents or carers, there may be a choice about who claims benefits – we give advice about this in our transition guide. Working Families runs a project for the parents of disabled children, Waving not Drowning.
If you are 16 or over and not working because of sickness or disability, you may be able to claim Statutory Sick Pay if you have an employer, or Employment and Support Allowance. Any new claims for income-related Employment and Support Allowance or Working Tax Credit will be a claim for Universal Credit, unless you are in receipt of an existing Severe Disability Premium.
Employment and Support Allowance (ESA) is paid to people who have ‘limited capability for work’ and are either not in paid work, are not entitled to Statutory Sick Pay (SSP), or their SSP has run out. There are three different types of ESA – (1) ‘New Style’ ESA; (2) contribution-based ESA; and (3) income-based ESA. In order to be eligible for ‘new style’ ESA you need to have been an employee or self-employed and paid enough national insurance contributions and have an illness or disability that affects your ability to work.
If you’re eligible for Universal Credit you can claim ‘new style’ ESA at the same time or instead of it.
If you have an existing claim for contributory ESA based on your national insurance contribution record this will continue, and/or you may be able to continue with an existing income-related ESA because you are on a low income. Contributory ESA lasts for one year, unless you are in the ‘support group’ (this means you have met an extra test about your capability for work). Income-related ESA can be paid indefinitely as long as you meet the conditions. For income-related ESA you have to continue to meet other conditions too, for example, your partner must not work 24 hours or more a week. Most people have to have a medical assessment called a Work Capability Assessment in order to continue getting ESA. New claims for contribution-based or income-based ESA can no longer be made unless you are in receipt of severe disability premium. See the GOV.UK guidance for more information.
If you meet the eligibility requirements for Universal Credit you may be able to claim the limited capability for work and work-related activity element of Universal Credit, as well as other elements to help towards costs such as rent, your children, or caring. To claim the limited capability for work and work-related activity element you will need to have a medical certificate from your doctor and will probably need to attend a work capability assessment with a medical professional.
If you are under 65 and have difficulty with everyday tasks because of your disability, or you have problems with getting around, you may be able to claim Personal Independence Payment (PIP). PIP replaces a benefit called Disability Living Allowance (DLA). If you are already on DLA, you will probably have to claim PIP at some point. You can find out more about PIP and how it affects people already on DLA on the GOV.UK site.
If you are 65 or over you cannot get help with mobility problems unless you have already claimed DLA or PIP, but you can claim Attendance Allowance (AA) if you have care needs. For more information about all these benefits, and other help, see the Citizens Advice website. If you look after a person who is disabled and on DLA, AA or PIP you may be able to get Carer’s Allowance. You can get more information on help with money for carers of disabled people from Carers UK.
If you receive a decision letter telling you that you are not entitled to claim either ESA, PIP or AA and you wish to challenge this decision then you will have one month from the decision date to request a Mandatory Reconsideration. You can request it verbally over the phone by calling the number provided on the decision letter, however, it is always best to make a request in writing. There are circumstances where you may be able to an out of time request if you have reasonable grounds for not requesting a Mandatory Reconsideration within the one month time limit. You should seek independent advice, for example from the Citizens Advice regarding this. A Mandatory Reconsideration gives you an opportunity for the decision maker to review your claim for either ESA, PIP or AA in hope that they change their decision. You will then be sent a further decision letter called the Mandatory Reconsideration Notice. If you are still unhappy with the outcome you will then have one month from the Mandatory Reconsideration Notice to submit and Appeal Form called an SSCS1 Appeal form which you can find from the GOV.UK website in order to have your appeal heard by an independent benefits Tribunal. You can get more help with a Mandatory Reconsideration or an Appeal from the Citizens Advice.
This advice applies in England, Wales, Scotland and Northern Ireland. If you live in another part of the UK, the law may differ. Please call our helpline for more details.
If you have further questions and would like to contact our advice team please use our advice contact form below or call us.