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Universal Credit if you're ill or disabled

Information on Universal Credit (UC) if you are ill or disabled.


If you've moved to UC from Income-Related Employment and Support Allowance but still not fit for work

If you've claimed UC because you were found fit for work after a work capability assessment and your ESA has stopped but you dispute the decision, seek advice. You can challenge the ESA decision but you'll remain on UC.

A successful challenge to the ESA decision may help your UC claim. You may receive a higher rate of benefit or be allowed to keep more of your earnings before they affect your benefit, if you're working.

Otherwise you can only be moved to UC from ESA if you have a change of circumstances which means that you have to make a claim for a new means-tested benefit. For instance if you move house to a new local authority area and you need to claim help with your rent costs you'll not be able to get Housing Benefit. You'll have to claim UC, and any other legacy benefits you receive will also be replaced by UC.

You can find out more about what situations do and do not require a UC claim.

If you transfer to UC in this way and you were in the ESA Work-Related Activities Group or the Support Group, and you've not been found fit for work, you should not be asked to start handing in doctor's notes and you should not be asked to go through a new work capability assessment. Seek advice if you are told to hand in sick notes or go through a new WCA.

You should be paid an additional amount of UC to reflect the fact that you've moved from ESA and you have limited capability for work (the Work-Related Activity Group of ESA) or limited capability for work-related activity (the Support Group of ESA). You can only qualify for an additional work-related or limited capability payment if you claimed before April 2017.

If you were on ESA and waiting for a work capability assessment when your claim moved to UC, you'll still need to have the WCA, but the time you have already spent waiting for a WCA should be taken in to account by UC.

If you become ill or disabled when you first claim or whilst already on UC

If you're ill when you claim UC and you have not been transferred from an ESA claim or you fall ill when on already UC, it's important to make sure that your UC Claimant Commitment is changed in order to reflect your situation.

The Claimant Commitment is a key feature of UC. Most claimants will be required to do something either to look for work or prepare for work. If you're unemployed and fit for work you'll usually be expected to meet the full conditions set by UC for seeking work.

If you do not meet the requirements of your Claimant Commitment, your UC claim can be sanctioned.

If your ability to meet your UC Claimant Commitment is affected by illness or disability, you should tell the Jobcentre of this change in your situation and request that your Claimant Commitment be changed to take this in to account.

Seek advice if you are in any doubt.

Providing proof that you're ill or disabled

You should also provide doctor's notes to the Jobcentre and ask for a work capability assessment (WCA) because your ability to seek work is affected by illness or disability. WCA will normally start 28 days after you start to hand in doctor's notes (fit notes). Make sure these notes are kept up to date and there are no gaps, otherwise your entitlements will be affected. You should only stop sending in fit notes when the WCA is completed and you are advised to do so.

If you're terminally ill

If you're terminally ill (your death from illness may reasonably be expected within the next 6 months) there are simpler rules for claiming further help with UC and ESA and you can make a claim for Personal Independence Payment (PIP) under special rules. Contact us for advice and support:

Contribution-based Employment and Support Allowance (new-style ESA)

Universal Credit replaces means-tested benefits, so you cannot usually claim Income-Related Employment and Support Allowance. But it's still possible to claim Contribution-Based ESA (known as new-style ESA) if you've paid sufficient National Insurance (NI) contributions.

You may have paid NI as an employee, or if you were self-employed, or both. You may also have been credited with contributions at some times.

If you're an employee and you get Statutory Sick Pay, you can only claim new-style ESA when your SSP has run out. If you're self-employed you can claim right away. Claims for new-style ESA may be subject to a 7-day waiting period.

New-style ESA can be claimed on its own or with UC as a top-up benefit. It counts as income for UC, but claiming new-style ESA will make sure that you have made a formal request for your illness or disability to be taken into account and for an assessment to be made of limited capability for work. New-style ESA has its own Work Capability Assessment but if you claim NSESA and UC together you should only go through one WCA.

Find out if you're eligible for new style ESA.

You can also claim by phone, tel: 0800 328 5644. Follow option 2 and option 6 if you wish to claim new-style ESA only and not UC.

Contact us for further advice on new-style ESA:

Health and work conversation at the start of your claim

If you're making a new claim you may be asked to attend a mandatory appointment, called a health and work conversation, at the beginning of your new-style ESA or Universal Credit claim. If you do not attend the meeting or do not participate in it, your benefit can be sanctioned.

Although being in the Limited Capability for Work-Related Activity or Support Group exempts you from work-related activity and work-focused interviews it does not exempt you from the health and work conversation. This takes place around the fourth week of the claim, before the work capability assessment.

The appointment is a discussion with a work coach about what can be done to help you build up confidence and motivation for returning to work. Attending the meeting is compulsory but any actions you agree to are not compulsory and you can't be sanctioned for not carrying them out.

You should be exempt from the appointment if you are treated as having limited capability for work because:

  • you're terminally ill
  • you're receiving chemotherapy or radiotherapy for cancer, or you are likely to receive it within 6 months or you are recovering from treatment
  • you've been given official notice not to work as you have been in contact with an infectious disease or contamination
  • you're pregnant and there would be serious risk to your health or your child's if you do not refrain from work
  • you're pregnant or have recently given birth, you qualify for Maternity Allowance (MA)  and you're within the MA payment period
  • you're pregnant or have recently given birth but you are not entitled to MA or Statutory Maternity Pay (from 6 weeks before the birth, to 2 weeks after)
  • you're a hospital inpatient
  • you have regular treatment such as weekly haemodialysis for chronic renal failure, plasmapheresis, regular weekly total parenteral nutrition for gross impairment of enteric function
  • you provide care of at least 35 hours a week to a severely disabled person who receives benefits such as Attendance Allowance, Disability Allowance and personal Independence Payment or has made a claim and is awaiting the outcome - see benefits for carers
  • you're a disabled student in full time education (seek advice)
  • you're a young person in full-time non-advanced education and you are without parental support (seek advice)
  • you're a lone parent caring for a child aged under one year
  • you're the main carer for a child you adopted within the last year
  • you only receive National Insurance credits for ESA through limited capability for work
  • for UC - there would be a substantial risk to any person's physical or mental health if you were not treated as having limited capability for work, and there are no reasonable adjustments that can be made to significantly reduce this
  • for UC - you're suffering from a life-threatening disease which cannot be controlled
  • for UC - you've reached pension age and you are entitled to Disability Living Allowance or Personal Independence Payment

Unless you're exempt, you'll also have to attend other regular work-focused Interviews.

Work-focused interviews (WFI)

Once the work capability assessment is complete, you may be required to attend WFI as a condition of receiving UC, new-style ESA, or both.

If you're placed in the Work-Related Activity Group for ESA (Limited Capability for Work for UC), you'll usually be asked to attend a series of work-focused interviews with a work coach from Jobcentre Plus or an organisation working with them. You'll not be expected to apply for jobs, but the interview will cover possible ways to get back to work, including education, training and rehabilitation.

WFI should assess your prospects for work and assist and encourage you to think about how to obtain work and to identify future work opportunities or possible self-employment that would be relevant to your needs and abilities.

  • you should be told that you are required to attend WFI, and the date, time and venue should be arranged with you
  • WFI can be carried out at your home or over the phone if it would be difficult for you or harmful to your health to go to the Jobcentre
  • you may be asked what activities you would be willing to undertake to improve your chances of going back to work, anything you have done previously and any progress you think you have made
  • you may be asked about your skills, qualifications and training, work history, and paid or unpaid work you are doing, what you aim to do in the future
  • you may be asked if you have any caring responsibilities, or how your condition affects your ability to seek work or remain in work

It's essential that you attend these interviews and participate in them. If you don't, and you have no good reason for doing so, your benefit may be sanctioned. If you have good cause for not attending, challenge any sanction decisions and seek advice and support. 

You don't have to take part in WFI if:

  • you are old enough to qualify for Pension Credit (seek advice on this – owing to pension-age reforms the age at which you may claim PC is changing)
  • if you are a lone parent with a child under the age of one year
  • you are only getting National Insurance Credits for ESA through limited capability for work

Putting back or cancelling the interview

This can only be done with the agreement of your work coach. A WFI can be waived (so it doesn't go ahead) if your work coach thinks it would not be of help to you because you are going back to work or likely to start work soon.

WFI can be deferred (put back) if the work coach thinks it would be more helpful and appropriate to hold it at a later date.

After the WFI - work preparation requirement if you have limited capability for work

For information about work-related activity, see work-related activity and benefits sanctions.

Under Universal Credit, you may be required to undertake work preparation as well as attending a WFI. This should not include looking for work.

The Jobcentre specifies what work preparation should be in your case, and how long you should spend doing it. But it should be particular action which makes it more likely that you will obtain paid work (or more/better work). It could include attending a skills assessment, improving your personal presentation, undertaking work experience or a work placement or developing a business plan.

If you have a disability you can request specialist employability support (intensive training and support) for up to 12 months. You can request an assessment via the Jobcentre.

If you consider that you're being asked to undertake tasks that are unreasonable or beyond your ability owing to your health condition, seek advice.

The work capability assessment

For at least 13 weeks (the ESA/UC assessment phase) your entitlement will remain unchanged but you must continue to provide medical certificates to show that you are unwell.

You should also ask your work coach to reduce the requirements in your Claimant Commitment if you can no longer meet them owing to illness. If you're still being asked to do tasks that you cannot manage, seek advice.

You also need to ask your work coach to confirm that the Jobcentre has started the process of referring you for a work capability assessment. This should normally be done from day 29 of your claim.

If you've claimed new-style ESA, during the assessment phase you will get £59.20 weekly if you're under 25 or £74.70 weekly if you're 25 or over. Remember that this counts as income for Universal Credit. Make sure that UC know what income you are receiving.

At some point after 13 weeks you'll receive a limited capability for work questionnaire and you'll usually be required to attend a meeting with a health care professional. This process is called the work capability assessment.

It's important to fill this questionnaire in detail (don't just tick boxes) and show how your illness or disability affects your daily life. See completing the ESA form.

It's also very important to send in any supporting medical evidence that you may have from any health professionals who are helping you.

If there's sufficient evidence in the form and any supporting letters, the DWP may be able to make a decision without needing to ask you to attend a medical examination.

Medical examination

You may be asked to attend a medical examination by a health professional working for the DWP. This could be at an examination centre, or you may be able to request a home visit if you cannot get to a centre and you have evidence from your GP to support your request.

The health care professional should ask you relevant questions about your physical and/or mental health, and may undertake a physical examination.

You may take someone with you if you need them to help or support you.

The health professional does not make the decision on your UC or new-style ESA entitlement, but the Jobcentre may rely considerably on their report. So it's very important to explain your full situation to the health professional and to provide written evidence from your own doctors, support workers.

If you fail to return the form or attend a medical examination without good reason, your new-style ESA claim will be stopped. You'll not qualify for additional UC. If you're having problems, tell the Jobcentre as soon as possible. Seek advice if your benefit is stopped.

The scoring system

Both the form and the medical examination are there to assess you in the light of work capability criteria set in law. Even if your own GP says you're not fit for work, it's possible to be found fit for work because the criteria are not met.

You must score 15 points in total to be found to have limited capability for work. If you are found to have limited capability for work you're placed in the Work-Related Activity Group for new-style ESA and you qualify for additional help under UC.

It's also possible to be found to have limited capability for work if there would be a substantial risk to your health (or to someone else) if you were found capable of work.

If you're also found to have limited capability for work-related activities you're placed in the Support Group for CESA.

If you're in one of these groups, you're in the main phase of ESA and your payment will increase.

If you're found fit for work after the work capability assessment, your UC will continue but you may have to meet full work-related requirements in your Claimant Commitment. Seek advice if you want to challenge the decision that you are fit for work.

Remember to tell Universal Credit when this happens.

Limited capability for work (the work-related activity group)

If you score 15 points or more, you're regarded as having limited capability for work. This means that it's accepted that you have an illness or disability which means that you cannot work or be expected to look for work at the moment. However, you'll be expected to do some work-related activity, which should be agreed between you and the Jobcentre.

If you claimed CESA and/or UC before 6 April 2017 - if you are in the Work-Related Activity Group your CESA will increase by £29.70 weekly. In the main phase you do not get less CESA if you are under 25 and so your CESA will be £104.40.

Your monthly allowance for Universal Credit will increase by £128.89 (roughly the same as the CESA increase).

If you claimed CESA and/or UC on or after 6 April 2017 you'll not receive any additional payment if you're placed in the Work-Related Activity Group.

On UC, you'll still qualify for a work allowance which will mean you may keep more of what you earn if you wish to do some work.

Your UC Claimant Commitment should also be altered to take your changed situation in to account. Seek advice if you are not happy with the amended Claimant Commitment.

Limited capability for work and limited capability for work-related activity (the support group)

If you have not only limited capability for work but also limited capability for work-related activity, you should be placed in the Support Group for new-style ESA and given a higher UC allowance.

See the limited capability for work-related activity test for details. Instead of scoring points, one of the descriptors listed must apply to you. Or you'll need to show that there would be a serious risk to your mental or physical health if you were expected to undertake work-related activities. New-style ESA will increase by £39.40 to £114.10 a week.

Your monthly allowance for Universal Credit will increase by £343.63.

If you're in the limited capability for Work-Related Activity/Support Group, you are not compelled to undertake any work-related activity. You can volunteer to do this, or you may do permitted work or voluntary work.

You should ask for your UC Claimant Commitment to be changed - you should not be subject to any requirements to attend work-focused interviews, seek work or prepare for work.

For CESA you may do permitted work - see Employment and Support Allowance.

If you're placed in the Work-Related Activity Group and think you should be in the Support Group you can dispute this decision. Seek advice.

Trying working when getting UC and you're ill or disabled

You can try working when getting UC and you're ill or disabled. And if you receive extra UC for having limited capability for work you'll have a higher work allowance under UC (meaning you can keep more of what you earn).

But if you earn at or over a set level (£617.76 a month - the equivalent of working 16 hours a week at the minimum wage), your UC entitlement may be affected:

  • if you have not yet been assessed for work capability, no assessment can take place while you earn over this limit - unless you receive Personal Independence Payment, Disability Living Allowance, Attendance Allowance or Armed Forces Independence Payment

or

  • if, before you start work, a decision has already been made that you have limited capability for work/work-related activity, you'll continue to get this element of UC but you are likely to be subject to a further Work Capability Assessment

New-style ESA has a permitted work rule. You can work under 16 hours a week, for under £143 a week.

As the Universal Credit rules for people with disabilities are still quite new and untested, please seek advice before you start any work.