1. Employment and Support Allowance Information Pack
External | Employment and Support Allowance November 2007
Employment and Support Allowance Information Pack
Note to presenter:
This presentation provides background information on the ESA “Customer Journey”. This pack has been developed for the external audience and should not be used for internal communications. A separate Internal Communications Pack has already been issued and a Customer Journey for use with customer representative groups and Partner organisations will be made available in January. In addition to this information there is a separate Internal Communications Pack issued 20 November 2007 which provides line managers with detailed information on ESA.
Operational Leads and Transformation Managers are informed about ESA and will be happy to support.
“Work for those who can;
improved support for those who can’t”

2. Why are we introducing the Employment and Support Allowance?
The Employment and Support Allowance plays a pivotal role in delivering the Government’s vision of a modern active welfare state, as a replacement for Incapacity Benefits.
Focus on helping individuals realise their full potential and a better life through the world of work.
Employment and Support Allowance will provide a gateway to work, assessing people’s capability to work and not just their entitlement to benefit; whilst ensuring that people who are unable to work receive the support they need.
Bullet Point 1 - The Government published a Green Paper 'A new deal for welfare:
Empowering people to work' on 24 January This was a landmark document for the
Department in meeting its objectives of promoting opportunity and independence for all. It
contained major proposals to help individuals achieve their potential through work.
2.66m people in receipt of Incapacity Benefit – these figures have been broadly static over last 10 years
1 million Incapacity Benefit customers say they want to work
If on Incapacity Benefit for 2 years, a person is more likely to retire or die on the benefit than return to work
Inactivity worsens the health of many customers
Incapacity Benefit is geared to proving incapacity rather than supporting and promoting capability for work
Bullet Point 2 - An independent review of the scientific evidence shows that work is generally
good for health and well-being. Long periods out of work are among the greatest known risks to
health. For people with common health problems, there is strong evidence that work:
promotes recovery and aids rehabilitation;
leads to better health outcomes;
minimises the harmful physical, mental and social effects of long-term sickness absence;
improves quality of life and well-being
reduces social exclusion and poverty
(Waddell G, Burton AK. Is work good for your health and well-being? The Stationery Office, 2006)

3. What is Employment and Support Allowance?
Employment and Support Allowance will bring a more active system of support for people who have a health condition or disability, which will be introduced from October 2008.
The Employment and Support Allowance regime will be delivered through existing Jobcentre Plus network of Contact Centres, Benefit Delivery Centres and Jobcentre Plus offices.
Bullet point 1 - Employment and Support Allowance will be introduced from October 2008 for new and non-linking claims only. Customers who have a current claim for Incapacity Benefit or Income Support at October 2008 will remain on those benefits. If a customer makes a claim after October 2008, which links to a prior claim of Incapacity Benefit or Income Support, then they will continue to receive those benefits.
Bullet Point 2 – Additional Information for Presenter
Your local Contact Centres and Benefit Delivery Centres site info can be found on the Employment and Support Allowance Intranet site.

4. Cont…
It will bring together Incapacity Benefit and Income Support into a single benefit for people with health problems or disabilities, combined with a work focused support regime for those who can benefit from work, and condition management support.
Pathways to Work will underpin the new Employment and Support Allowance, by providing work focused interviews and work related activity.

5. What has Pathways to Work achieved so far?
Almost 32,000 recorded job entries for Incapacity Benefit (IB) customers.
A significant increase in the number of customers leaving IB in the first 6 months of their claim compared to non-Pathways Districts.
Additional Information for Presenter
Please note – this is the latest statistical information available from the Pathways Project. The early findings from the independent research conducted by the Institute for Fiscal Studies shows a nine percentage point increase in the proportion of people who are employed ten and a half months after claiming incapacity benefits and there is also a significant impact on net monthly earnings.

6. ( National Figures for period Oct 2003 – March 2006)
Cont….
Research shows that after 10.5 months, 32% of new IB customers in Pathways districts were in employment compared to an expectation of only 22.5% without Pathways.
25,380 people have been awarded the Return to Work Credit.
14,520 people were referred to the Condition Management Programme.
( National Figures for period Oct 2003 – March 2006)
Bullet Point 2 – Return To Work Credit is a non-taxable weekly payment of £40, paid
for a maximum of 52 weeks to customers who work 16 hours or more a week and earn
£15,000 gross or less a year.
Bullet Point 3 - The Condition Management Programme is a scheme established to
help people who are claiming a benefit due to ill health, manage their health condition
sufficiently to enable them to return to work. The scheme was established through the
joint working of Jobcentre Plus and the local NHS. The scheme is completely voluntary
and does not affect the client’s entitlement to benefit. It is designed for those people
who wish to overcome their health barriers to work and who would like to learn how to
manage their condition more effectively.
Jobcentre Plus led Districts work with the NHS to deliver the Condition Management
Programme. In provider led Districts, providers will work with health care professionals
to deliver the Condition Management Programme.

7. Employment and Support Allowance will…
Provide a gateway to work; assessing people’s capability for work and not just their entitlement to benefit, while ensuring that people who are unable to work receive support.
Quickly and sensitively identify those eligible for enhanced support.
Provide improved customer experience by making it easier and simpler to apply for benefits, with quick and sensitive handling to confirm eligibility, rights and responsibilities.
Bullet Point 1 - The Employment and Support Allowance represents much more than a replacement for Incapacity Benefit. It is a huge culture change that shifts the emphasis from incapacity to capacity and concentrates on support built around individual customer needs.
Bullet Point 2 - Those customers with the most severe disabilities or illnesses such as those who are terminally ill, (those who have been assessed as having limited or no capability for work related activity – expected to be 5 – 10%) will receive the basic allowance and a support component, which will be set at a higher rate than the work-related activity component. Receipt is not dependent on the customer’s participation in work-related activity. However, if customers wish, on a voluntary basis, to take appropriate steps towards work, they will be able to do so, by using Pathways to Work to access work related activity.
Bullet Point 3 – Automating processes, using existing customer data where possible, maximising the use of successful existing technologies and training and supporting Jobcentre Plus people to deliver an effective and efficient service.

8. Employment and Support Allowance Process
Extra premiums where appropriate
Work related activity component
Support component
First contact by customer
Notes to Presenter:
When a customer applies for ESA they enter a 13-week assessment phase. The customer will receive a basic rate equivalent to the personal age related allowance paid in Jobseeker’s Allowance for the first 13 weeks (the amount for those claiming the income related element will also depend on whether they have a partner).
After week 9 the vast majority of customers will attend an initial Work Focused Interview (WFI). This will start the customer looking at their future work prospects and aspirations. It will also be used to introduce the customer to the WFI regime and assist the customer in their WCA journey.
During the assessment phase a customer will participate in a Work Capability Assessment, which will determine their eligibility for ESA after 13 weeks.
As part of the Work Capability Assessment, a Work Focused Health Related Assessment takes place for all customers who have a face to face assessment, focusing on the customers ability to work and to advise what help and support they may need to go back to work.
Once the assessment phase is complete and a customer has completed the Work Capability Assessment and found to have limited capability for work, they will move on to the main phase of ESA
Customers will be placed in the Work Related Activity group or Support Group.
ESA made up of different amounts, Basic Allowance, Work-Related Activity Component or Support Component with Extra Premiums (in income-related benefit only).
Sanctions are only applied to the main phase benefit (more on sanctions later).
Assessment Phase where a Personal Capability Assessment will be undertaken
When a customer applies for Employment and Support Allowance they will enter a 13-week assessment phase. The customer will receive a basic rate equivalent to the personal age related allowance paid in Jobseeker’s Allowance for those first 13 weeks (the amount for those claiming the income related element will also depend on whether they have a partner).
During the assessment phase a customer will go through a revised Personal Capability Assessment, which will determine their eligibility for Employment and Support Allowance.
As part of the Personal Capability Assessment, a Work Focused Health Related Assessment takes place, focusing on the customers ability to work and to advise what help and support they may need to re-enter the work arena.
Once the assessment phase is complete and a customer has completed the Personal Capability Assessment, they will move on to the main phase of Employment and Support Allowance.
Customers will be placed in the Work Activity Related group or Support Group.
Employment and Support Allowance is made up of different amounts, Basic Allowance, Work-Related Activity Component or Support Component, Extra Premiums (in income-related benefit only).
Allowance set at JSA level
13 weeks
Main Phase

9. The Work Capability Assessment will…
Include updated mental and physical health assessments, including the interaction between physical and mental health.
Incorporate a Work Focused Health Related Assessment to look at what the customer can do, not just what they cannot do, and identify any health barriers to work.
Bullet Point 1 – The new personal Capability Assessment means that there will be no exemption process for customers – this is replaced by the Support Group criteria.
There are special provisions for customers claiming under “Special Rules” – i.e. Terminal Illnesses. All first referrals will be “face to face” examinations, with revised descriptors for both physical and mental health conditions.
Bullet Point 2 - The Work Focused Health Related Assessment (WHFHRA) is a new element of the PCA process that will ensure that we accurately assess what a customer can do and the help and support they will need to manage their condition and increase the likelihood of a return to work. It will include exploring with the customer their beliefs and perceptions about themselves and their disabling condition, that may be preventing them from returning to work. It will enable us to develop a plan of support tailored to the individual’s needs.
WFHRA replaces the current Capability Report (CR1)
More detail than the current Capability Report
Made available to Incapacity Benefit Personal Adviser/Providers only
Produced in first referrals only

10. What does Employment and Support Allowance mean for customers?
We will offer customers the choice on how to claim Employment and Support Allowance. For most, a single telephone call, with no forms to complete will be all that is needed to start the process.
We will of course see customers at a Jobcentre if they wish to have a face to face interview.
Bullet Point 2 - The Pathways-style support on offer will provide a range of options including Condition Management Programmes. There will be no obligation on the customer to take up the Condition Management Programmes support at the time the allowance is introduced.

11. Cont….
We will ask customers to attend a Work Focused Interview at the Jobcentre around 9 weeks after they have claimed.
A Personal Adviser will discuss with the customer their entitlement, their aspirations for work, the steps they might take to help them take up a job and the support that is available to them.
Bullet Point 1 - These will usually take place monthly although there is flexibility around this. The information from the Work Focused Health Related Assessment will help inform discussion at these subsequent interviews.

12. Cont….
Most customers in the work-related activity group will have a further series of five interviews with a Personal Adviser from Shaw Trust, our contracted partner focused on helping them back to work.
The customer will be provided with an action plan, which will reflect the discussion at each interview, including the steps a customer could take to help them take up a job or prepare to return to work.

13. What about existing customers?
Existing customers on incapacity benefits will continue to receive Incapacity Benefit after October 2008 and will have their benefit levels protected.
Anyone on incapacity benefits will be able to volunteer for appropriate support through Pathways to Work (fully rolled out nationally by April 2008).
At some point in the future existing incapacity benefits customers will move to the Employment and Support Allowance, as resources allow.
Additional Information for Presenter
The migration of current Incapacity Benefits/Income Support customers is currently out of scope for the Employment and Support Allowance Programme. Any questions about existing customers moving onto Employment and Support Allowance cannot be answered. No decision has been made about migration of existing customers who currently claim Incapacity Benefits/Income Support.

14. Employment and Support Allowance The Customer Journey
External | Employment and Support Allowance November 2007
Employment and Support Allowance The Customer Journey
“Work for those who can;
improved support for those who can’t”

15. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY
BENEFIT ENTITLEMENT
This shows the steps taken to establish the customer’s benefit entitlement.
WORK CAPABILITY ASSESSMENT
This shows the steps taken to determine the customers ‘Limited capability for work’.
WORK-FOCUSED SUPPORT
Jobcentre services, including Pathways provider services, are available to the customer from Day 1.

16. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY 1
BENEFIT ENTITLEMENT
Customer rings 0800 number to make a claim for benefit.
The customer selects the new claim option for sick/disabled people.
Jobcentre Plus receives the call, confirms identity and takes the claim. Asks the customers if they wish to claim under ‘Special Rules'. Call recording means there is no requirement for a customer signature.
WORK CAPABILITY ASSESSMENT
WORK-FOCUSED SUPPORT
Jobcentre services, including Pathways provider services, are available to the customer from Day 1.
Presenter Notes.
Jobcentre Plus asks the customer for their national insurance number and a number of security questions to confirm their identify.
The customer is then asked a series of questions to complete the information needed for the claim.
They will also be asked if they wish to claim under Special Rules. These are terminally ill customers. This allows their claim to be fast-tracked for both the ‘Support group’ payment and WCA process.
At the same time they will be asked associated benefit questions, such as ‘If they would like to claim HB/ CTB etc’.
If the customer requests a call back, one will be arranged.
If the customer asks for benefit advice they will be offered an interview with a Financial Adviser in their local Jobcentre.
At the end of the call the customer is advised of their rights and responsibilities and asked to forward any evidence that is required within a calendar month.
A customer statement is issued for the customer to check. This does not need to be signed due to call recording.
Our most vulnerable customers can also access this service via most Jobcentres where a claim may be taken face to face.

17. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY 2 - 3
DAY 5
DAY 8 / 9
BENEFIT
ENTITLEMENT
The Customer receives a printed Customer Statement for checking, and gathers any further evidence required.
The Customer continues to gather required evidence.
Jobcentre Plus receives medical services report for ‘Special Rules’ customers and makes a decision on Limited Capability for Work and ‘group’.
The Customer sends required evidence to the Benefit Delivery Centre in envelope provided.
Evidence received in Benefit Delivery Centre.
Medical Certificate received and consideration for early entry to WCA process by Jobcentre Plus.
WORK CAPABILITY ASSESSMENT
If the Customer is claiming under Special Rules their GP or HCP may be contacted for further evidence.
WORK-FOCUSED SUPPORT
Jobcentre services, including Pathways provider services, are available to the Customer.
Presenters Notes
Day2/3
The customer statement does not have to be signed or returned.
Evidence required might be: sick note from their doctor, evidence of wages from employer, evidence of outgoings, eg. Rent and mortgage details.
At the same time they will be asked associated benefit questions, such as ‘If they would like to claim HB/ CTB etc’.
Terminally Ill customers are referred for WCA immediately with a very quick response from medical Services. They will contact the customers GP or Health Care professional for more evidence to enable an assessment to be made.
Day 5
A report is issued to Jobcentre Plus for consideration. Special Rules cases can be identified by BDCs in first week.
Once a customer is in the ‘support group’ they are no longer required to participate in the work focused regime.
Day 8/9
Claim evidence is received. The benefit processing Officer considers the nature of the customers incapacity and if it is expected to be more than 4 weeks the customer is referred to Medical Services at this point.

18. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY 11
DAY 30
DAY 33
BENEFIT ENTITLEMENT
The Customer’s claim to ESA processed.
The Customer receives payment on the due pay day.
The Local Authority is also advised of the customer’s ESA entitlement.
If customer has not returned the required evidence claim may be considered as defective.
WORK CAPABILITY ASSESSMENT
The customer receives a questionnaire from Medical Services (If early referral made on receipt of Med Cert)
This needs to be completed and returned as soon as possible, but within 6 weeks from date of issue.
All remaining customers will receive a questionnaire from Medical Services.
WORK-FOCUSED SUPPORT
Jobcentre services, including Pathways provider services, are available to the customer.
Presenters Notes:
Day 11
The customer’s claim is processed and entitlement notification issued. A report is also sent to the Local Authority on entitlement to ESA to consider eligibility to associated LA benefits.
If referred to the WCA early the customer will receive a Self Assessment Questionnaire to complete. The customer has up to 6 weeks to return this but most return it in 7 days.
by Day 30
If a customer is still in receipt of benefit by day 28 and has not been referred to Medical Services by this point their details will be passed across to start the WCA process. The customer will receive their self assessment questionnaire.
Day 33
‘Defective Claim’ is a claim which has not met the evidence requirements within the prescribed time limits.

19. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY 34
DAY 36
DAY 37
BENEFIT ENTITLEMENT
Customers allocated to the Support Group from the information on the questionnaire receive their decision.
WORK CAPABILITY ASSESSMENT
The customer completes and returns the questionnaire in the envelope provided.
Other customers receive an appointment for their Work Capability and Work Focused Health Related Assessments.
WORK-FOCUSED SUPPORT
Jobcentre services, including Pathways provider services, are available to the customer.
Presenters Notes
Day 34
The customer completes their self assessment questionnaire and returns it to medical services.
Day 36
If there is enough information in the Self Assessment Questionnaire to assess limited capability for work this will be done and Jobcentre Plus advised. Jobcentre Plus will then decide on limited Capability for work using the medical services report and assign the customer to the ‘Support’ group. All possible ‘Work Related Activity Group’ customer are required to attend a face to face assessment with a few exceptions.
Customers in the support group are not required to participate in the Work Focussed Regime.
Day 37
The customer receives a telephone call to agree an appointment for the WCA and WFHRA. If no telephone number is available Medical Services will issue a letter asking the customer to contact to arrange an appointment. If no contact is made an appointment will then be set and issued. The new assessment will replace the current Personal Capability Assessment. The WFHRA test will focus less on what a person can’t do and more on what an individual can do, such as if they are able to operate IT equipment. It will also identify health-related support that could help an individual return to work.
40% of those who take the test will not pass it – resulting in 20,000 fewer people joining the sickness benefits system each year.
(Additional info - The new test is part of a wide range of measures to make sure that everyone has the opportunity to work, even if they have a health condition or disability. There are currently 2.64 million people of working age claiming incapacity benefits and in 2006/7 this cost nearly £12.5 billion).

20. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY 43
DAY 45
DAY 47
BENEFIT ENTITLEMENT
The customer receives their benefit payment decision.
WORK CAPABILITY ASSESSMENT
The customer attends a joint appointment for a Work Capability and a Work Focused Health Related Assessment.
The customer receives an outcome letter for the Work Capability Assessment and a copy of the Work Focused Health Related Assessment report.
WORK-FOCUSED SUPPORT
Jobcentre services, including Pathways provider services, are available to the customer.
The customer receives a phone call from the Jobcentre inviting them to attend a Work Focused Interview with a Personal Adviser.
Then customer receives a letter from the Jobcentre confirming their Work Focused Interview appointment.
Presenter’s Notes
Day 43
The customer attends an appointment for WCA and WFHRA. Medical Services conduct the WCA and WFHRA and complete required reports. The WCA report is made available for BDC staff electronically via MSRS. The BDC Decision Maker makes a decision and the claim is processed. The customer is either placed in the Support Group, Work Related Activity Group or Disallowed. A copy of the WFHRA is sent to the customer and JCP PA or the Provider-Led PA as advised in the referral from the BDC.
Day 45
The customer receives a notification about benefit entitlement, an outcome letter for the WCA and a copy of the WFHRA.
If the customer is still entitled to ESA the Jobcentre will contact them to arrange their initial Work Focussed interview. The Personal Adviser will consider deferring the WFI if appropriate.
Day 47
The customer receives confirmation of his Work Focussed Interview.

21. WORK CAPABILITY ASSESSMENT
ESA Customer Journey
DAY 55
DAY 57
DAY 92 
BENEFIT ENTITLEMENT
The customer enters the main phase of Employment and Support Allowance and is paid at either the Support Group or the Work Related rate.
WORK CAPABILITY ASSESSMENT
WORK-FOCUSED SUPPORT
The customer receives a phone call reminder from the Jobcentre to attend Work Focused Interview.
The customer attends and participates in a Work Focused Interview with a Personal Adviser at the Jobcentre.
Customers in the Work Related Group start to receive Pathways support to return to work.
Customers in the Support Group can access these services on a voluntary basis.
Presenter’s Notes
Day 55
The customer receives a call from the Jobcentre reminding them of their interview. If the customer cannot attend the Personal Adviser considers deferral / re-books the appointment.
Day 57
The customer attends for their initial WFI. This covers looking at assisting the customer in the WCA process if they are having any difficulties, looking at their previous work / skills experience and considering barriers they may have. At the end an action plan is developed and copied to the customer. If in a Provider Led Pathways District the customer’s details will be referred to the Provider.
Day 92
The customer enters the main phase and the Work Related Activity Component or Support Component is paid.

22. Customers’ Rights and Responsibilities
Ensure personal details are accurate at first contact and correctly answer three security questions to confirm own identity.
Agree the next steps and responsibilities as described by the Contact Centre in the ‘wrap-up’ to the telephone call.
Ensure Customer Statement is correct, notifying changes to the Benefit Delivery Centre.
Provide appropriate evidence to support their claim to benefit within one calendar month.
Return form ESA50 to Medical Services within agreed time limit.
Attend Work Capability Assessment where appropriate.
Attend and participate in 1st and subsequent Work Focused Interviews where appropriate.
Ensure all further changes of circumstances are notified to the Benefit Delivery Centre/ Jobcentre or Provider as they occur.
The customer will have to answer 3 out of 5 security questions before the CCA will proceed with the claim. Further work is currently underway to map out the process should a customer fail to answer these questions correctly.
Wrap up call is to:
Advise the customer of the need to attend work focused interviews and to get their agreement in principle to do this.
To advise them of the next steps and that once they receive their customer statement they will only be required to notify us if the details are incorrect or they need to provide further evidence. The customer will not have to sign the statement as their call to the Contact Centre will be recorded.
Where a vulnerable customer visits a jobcentre and a new claim is taken face to face, and CAM is available, the claim will be input directly onto the system. If CAM is not in the Jobcentre concerned then a clerical claim form will be used which they will be required to sign to ratify their claim.
Form ESA50 is the self assessment of a customer’s ability to do certain tasks. E.g. How far can they walk before discomfort, how much can they lift etc. It is issued by ATOS, completed by the customer and returned to ATOS (they have 42 days to do this). If they do not return the form, a Decision Maker in the BDC will issue a disallowance with the exception of those customers with mental health issues.

23. Sanction and Appeal Rights
Behaviour
Sanction
Questionnaire not received (without an acceptable good cause).
Customer does not attend WCA Assessment (without an acceptable good cause)
Customer does not have limited capability
for work.
Customer fails to attend Work Focused Interview (without an acceptable good cause).
Customer fails to attend Work Focused Health Related Assessment (without an acceptable good cause).
Benefit withdrawn – customer has right of appeal.
Sanction of ESA – 50% of personal allowance rate implemented. Customer has right of appeal against sanction.
Form ESA50 is the self assessment of a customer’s ability to do certain tasks. E.g. How far can they walk before discomfort, how much can they lift etc. It is issued by ATOS, completed by the customer and returned to ATOS (they have 42 days to do this). If they do not return the form, a Decision Maker in the BDC will issue a disallowance with the exception of those customers with mental health issues.
If a customer does not attend a WCA, a form BF223, will be issued by ATOS to the customer to establish the reasons for non-attendance. If they cannot provide good cause the BDC will issue a disallowance to the customer.
If a customer fails to attend a WFI and good cause is not accepted, a sanction at 50% of the work related activity component will be applied for 4 weeks then 100% until the customer complies.
Presenter’
However, it should be noted that there are various steps which will be taken before the sanction is applied, particularly for customers with mental health / learning difficulties problems. Prior to any sanction being applied the customer will be visited to ensure they understand the impact of their non-compliance and to try and move the customer back into the process.
The sanction cannot be applied within the assessment phase. Therefore if a customer does not attend the first WFI which should take place at week 9, then the sanction will not be applied until the work capability component is in payment at week 13.
A similar process is applied to the WFHRA.

24. Any Questions ? Employment and Support Allowance The Customer Journey
External | Employment and Support Allowance November 2007
Employment and Support Allowance The Customer Journey
Any Questions ?
“Work for those who can;
improved support for those who can’t”