CAB evidence on the administration of ESA in Northern Ireland
This report presents a substantial body of evidence from Citizens Advice to show that many CAB clients are experiencing problems with the administration of their ESA claims. This is leaving many clients in financial hardship and causing stress and anxiety for many people who are by definition already experiencing difficult circumstances and who may be coping with serious health problems.
Introduction
Since 27 October 2008, Employment and Support Allowance (ESA) has replaced Incapacity Benefit and Income Support paid on the grounds of incapacity for new claimants.
The policy motivations for the introduction of ESA were driven by the Government’s desire to reduce the number of people on Incapacity Benefit and to ensure that more people were defined as capable of carrying out some type of work.
The application and assessment process for ESA consists of two phases:
- the assessment phase – during this phase applicants will be paid a basic rate equivalent to Jobseeker’s Allowance. This rate is paid for the first 13 weeks of the claim while a decision is made on capability for work through a medical assessment called the Work Capability Assessment (WCA)
- the main phase – if the WCA shows that the applicant’s illness or disability does limit their ability to work they will be placed in one of two groups – either the work related activity group or the support group. If the WCA shows that ability to work is not limited, entitlement to ESA will stop.
Claimants who are placed in the work related activity group will be expected to take steps to prepare for work including attending work-focused interviews with a personal adviser.
A small percentage of claimants will be placed in the support group and this will entitle them to receive a higher rate of financial support than those in the work related activity group. Claimants in the support groups are not required to take part in work related activity.
Main Findings
Statistics show that during 2009/10 advisers working in Citizens Advice Bureaux across Northern Ireland dealt with 11,428 ESA issues. In the first six months of this year (Jan-June 2010) advisers have dealt with 8,400 ESA issues. In addition, since its introduction ESA has continued to be one of the top social policy areas reported by CAB advisers (see case studies below).
Since ESA was introduced, CAB advisers in Northern Ireland have been reporting a number of problems with ESA.
Delays
Citizens Advice recognises the effort made by ESA to speed up clearance times and the significant improvements that have been achieved.
However some clients still experience delays in processing their ESA claims.
These delays are often caused by the loss of documentation supporting their claim or a lack of communication/follow-up from ESA on individual claims. This has led to severe financial hardship for some clients.
Waiting times and call costs to ESA
At the introduction of ESA many clients were concerned about not being able to get through to the ESA call centre and about being on hold for long periods of time. However this situation has improved with call handling times showing a marked improvement.
However, for some clients who use mobile telephones the cost of calling the ESA call centre can be prohibitive. This is particularly the case if the client has to make repeated calls to the ESA call centre about the progress of their claim.
Incomplete or incorrect information from ESA
Many clients who come to CAB for help do not have a detailed knowledge of social security benefits and how the different benefits interact with each other. It is therefore vital that the information and advice provided by ESA staff is as accurate and holistic as possible.
Some clients have received incomplete, incorrect or misleading advice from ESA which can have potentially serious implications for them. For example, some claimants are not being advised of the need to apply for both contributory and income-related ESA which means that they could potentially miss out on help with their housing costs or additional premiums payable on their claim.
Problems with the WCA
CAB advisers are noting that the WCA is more rigid than the previous assessment for Incapacity Benefit and that some clients who are seriously ill are being found fit for work. There are particular concerns for those suffering from mental health problems many of whom are awarded no or only a few points on their WCA only to be awarded the benefit on appeal.
Advisers are concerned that the descriptors for ESA are inappropriately worded for those suffering from mental health issues. Also, those conducting the assessment are not suitably trained in mental health issues which needed to recognise the potential effects of mental health problems on a person’s ability to work.
Delays have also been reported in getting a medical assessment. The WCA is supposed to take place within the initial phase of ESA which should last 13 weeks.
Unfortunately it has been the experience of many CAB clients that they are not being given their medical assessment within 13 weeks. This leads to financial hardship for clients who have been left on the basic rate of ESA for long periods of time.
Transferring from other benefits
Some problems have been reported when clients move from another benefit to ESA. Where individuals are already receiving one social security benefit and are required to transfer to ESA it is likely that they are already experiencing financial strain.
Their situation is not helped by delays in transferring to ESA. In some cases ESA have given out incorrect advice which has resulted in delays to their claim.
Migration of Incapacity Benefit claimants
The migration of existing Incapacity Benefit (IB) claimants will take place from April 2011. This will mean that most existing IB claimants will have their claims reassessed and be asked to attend a medical.
Given the problems reported by many CAB clients with the administration of ESA and problems with the WCA, Citizens Advice has concerns that many ill people in Northern Ireland will find themselves deemed fit for work. Moving large numbers of people from benefits to work gives cause for concern as many could lose out on much needed support on returning to work.
Case Studies
A client of Craigavon CAB was awarded DLA and became entitled to a severe disability premium on his ESA claim. He reported this to ESA but was told that he was not entitled as he was receiving contribution-based ESA. This was incorrect advice and if the client had accepted this advice he would have missed out on £53.65 per week.
A client of Newry CAB suffered from severe depression and had alcohol and drug dependency issues. He had been sleeping rough and was in receipt of low rate mobility and medium rate care DLA. The client was awarded no points on his Work Capability Assessment. On appeal he was awarded the required points to become entitled to ESA.
A client of Belfast CAB was not advised when making a claim for ESA of the difference between contributory ESA and income-related ESA and that she could apply for both. The client made a claim for ESA but unknown to her it was for contributory ESA only. The client suffers from mental health problems, is an owner-occupier and is in receipt of middle rate care and low rate mobility DLA. The client missed out on a severe disability premium and help with her housing costs for over 10 weeks before coming to CAB where this was identified.
A client of Newtownards CAB came to the bureau for help with his ESA claim. He had received an appointment for his Work Capability Assessment but had not received any ESA payments. He was owed over £850 in ESA payments and had tried numerous times to sort this out with the agency. He had been promised a call back from ESA but did not receive it. The client had no money to live on and had to rely on handouts from his family which was putting a strain on family relationships.
A client of Fermanagh CAB claimed ESA but six months later had not received the correct rate which should have included a severe disability premium. The client was incorrectly advised by ESA that he could not get the severe disability premium until after his medical assessment. The CAB adviser helped the client to make a formal complaint but received no response in relation to this. This caused the client severe financial hardship.
An adviser at Strabane CAB was given three different explanations from ESA of why a client was being paid for a single person when she should have been paid as a couple.
A client of Craigavon CAB successfully appealed her entitlement to ESA and then received a letter from ESA stating that she was no longer entitled and that her claim was closed. The CAB adviser contacted ESA and requested an urgent call back which did not happen. The CAB adviser contacted ESA again and was informed that the case had been closed in error. The client has mental health problems and found the claim process extremely stressful.
A client of Newtownabbey CAB had experienced delays with his ESA claim. ESA had stopped his benefit because he failed to complete a medical questionnaire which had been sent to him. However, the client had not received the form and did not know he had to complete it until his benefit stopped. The client has made many telephone calls to ESA to try and get his claim reinstated and was promised call backs which were never made.
Key Recommendations
- Greater ownership of cases by ESA staff so that communication between them and claimants/advisers is improved so that any issues are progressed and claimants are kept informed about the status of their claim and any action they may need to take.
- Improved recording systems to acknowledge the receipt of documents and track their progress through internal systems need to be established.
- Improved staff training in relation to ESA itself, and also across the whole social security benefits system, is of critical importance. This would help to reduce instances of misinformation and incorrect advice. It would also help to speed up clearance times and assist claimants to identify and access other social security benefits where appropriate.
- The ESA call centre should be evaluated to ensure that it is handling calls in the most effective manner and the performance of call handling staff should be continually reviewed to ensure that time spent on hold is reduced.
- All telephone numbers used to contact ESA for both claimants and third sector organisations should become Freephone numbers. This should include callers from all mobile phone networks.
- The Work Capability Assessment (WCA) should be reviewed with a view to assessing its suitability in identifying those with limited capability for work.
- The descriptors used to award points for mental health issues should be reviewed.
- Where mental health conditions are present a specialist in mental health should carry out the WCA.
- Medical Support Services (MSS) should seek to ensure that there are suitable numbers of qualified doctors available to perform Work Capability Assessments to ensure that claimants do not suffer financial hardship due to delays in getting a WCA.
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