Coronavirus: during the Covid-19 pandemic, there are some situations where you may not need a fit note to get Employment and Support Allowance (ESA), see below. These can include if you are required to self-isolate due to contact with a known case, or if you are in quarantine for up to 14 days after returning from abroad. For more information, see our coronavirus and financial support page.
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 (SSP) if you have an employer, or if you are not entitled to SSP, you may be able to claim Employment and Support Allowance. New claims for this are usually only possible based on national insurance, but some people may be able to carry on getting the income-related form of the benefit and in some limited circumstances, new claims for the income-related form are possible (this will not apply to young people who haven’t been on income-related benefits before).
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. To begin with, you would get ESA based on fit notes before having an assessment to see if you have ‘limited capability for work’.
If you are under state pension age 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 state pension age 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 and/or extra amounts of income-based benefits such as Universal Credit or Income Support. You can get more information on help with money for carers of disabled people from Carers UK.
If you meet the eligibility requirements for Universal Credit you may be able to claim the limited capability for 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-related activity (LCWRA) 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 found to have limited capability for work, but not LCWRA, you may not get any extra money unless you are working (when having this status can make you better off in work on UC). The LCWRA element is worth quite a lot, but it can’t usually be paid until you have been on UC for three months. There are exceptions, for example, where you already had LCWRA status before you claimed UC. If you already get any Income Support, income-related ESA, income-based JSA, housing benefit or tax credit, you should not claim Universal Credit without first getting advice, as you could end up worse off.
If you receive a decision letter telling you that you are not entitled to claim either ESA, PIP or AA, or that you do not have limited capability for work or do not have limited capability for work-related activity in UC, and you wish to challenge this decision then you must first request a Mandatory Reconsideration. Try to do this within a month of the decision if you can. You can request it verbally over the phone by calling the number provided on the decision letter if you have one. However, it is always best to make a request in writing (for example, on your UC journal if you claim online). If you are outside the one month time limit then it can often still be worth asking for a Mandatory Reconsideration as you may have good reasons for lateness, and/or the decision can still be changed if the DWP made an official error (for example ignoring relevant evidence). You should point out your reasons to make sure the DWP consider the request.
A Mandatory Reconsideration gives you an opportunity for the decision maker to reconsider the 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 an 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 tribunal. You can get more help with a Mandatory Reconsideration or an Appeal from 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.