What is an ESA assessment?

Employment and Support Allowance (ESA) is a benefit in the UK that offers support and financial assistance to individuals who may be unable to work due to an illness and/or disability. It is a type of Health and Disability Assessment. Some may confuse this with Universal Credit – which is a singly monthly payment, while ESA may be paid fortnightly and includes additional payments for specific needs.

The Department of Work and Pensions (DWP) uses an ESA work capability assessment to assess an employee’s claim for ESA. It focuses on how the condition may affect an employee on a day-to-day basis. Discover how ESA assessments work, how to qualify and claim it.

Changes to ESA (correct as of July 2025)

In early 2025, changes to the DWP and ESA were announced. The ‘New Style’ ESA is said to replace the previous contribution and income-based ESA for new claimants. Plus, the time limit for receiving contribution-based ESA (for those in the work-related activity group) has been capped at 365 days and is no longer payable for new claims made on or after April 3, 2017 - unless linked to a previous ESA claim.

What about ESA assessments?

Reassessments will only take place under the following circumstances:

• When a claimant reports a change of circumstances in their health condition

• If a claimant has been awarded limited capability for work-related activity (LCWRA) for pregnancy risk, or cancer treatment where the prognosis for recovery is expected to be short-term

• If a claimant has been declared as having LCWRA under the new risk provisions

• In cases of suspected fraud.

With the above in mind, the following information presented in this article is subject to change when official rules are more concrete. More information on upcoming changes can be found on Disability Rights UK.

Qualifying for ESA

You may be wondering ‘How do you qualify for ESA?’ – there are various criteria to determine whether you do:

Applicants may be eligible for ESA if they are:

• Under state pension age (currently 66)

• Not getting Statutory Sick Pay (SSP) or Statutory Maternity Pay (SMP)

• Not getting Jobseekers Allowance (JSA)

There are two types of ESA

• Contribution based: Provides financial support if claimants have paid sufficient National Insurance (NI) contributions

• Income-related: Applicants on a low income can get this either on its own or in addition to contribution-based ESA

ESA support group criteria

Depending on the outcome of this assessment, claimants go into one of two ESA groups which affects how much they’ll continue to receive.

Claimants are either in:

• A work-related activity group: This is to prepare employees who with some support are able to return to work

• A support group: This group is for people who are unable to return to work due to their illness of disability

ESA medical assessment questions

Claimants are also asked questions relating to their mental and physical health. They use these descriptors to determine the level to which their disability or illness affects their ability to work.

Some ESA assessment of mental health questions include:

• Do you know what you are here for?

• What are your medical conditions?

• How long have you had these conditions?

• How do these conditions affect you?

• Is there an upstairs or downstairs bathroom?

• How often do you shop?

• Do you do shopping on your own?

• Do you drive?

• Is the car automatic or manual?

• How long can you drive for?

• Do you have any hobbies or interests?

Some activities relating to the physical health assessment include:

• Mobilising and navigation

• Picking up and moving

• Manual dexterity

ESA medical assessment home visit

In cases where a claimant’s illness or disability makes it difficult or impossible to travel to the allocated assessment centre, they can put in a request for a home assessment.

When necessary, the Health Assessment Advisory Service will ask individuals to provide information from a medical professional supporting their request for a home visit.

How to claim ESA for depression and anxiety?

A majority of ESA claims are for stress, anxiety and depression. Once the applicant collects a medical certificate (fit note) for their medical specialist, they can then make an ESA claim with the DWP.

It’s worth noting there might be overlapping issues if the applicant collects other benefits like SSP or SSM.

ESA medical assessment points system

If an applicant scores 15 points in any individual activities (or a total of 15 points for a combination of the physical or mental activities) they’ve met the criterion for limited capability for work.

It’s at this stage the decision maker will consider if it places the claimant in a support or limited capability for work-related activity group.

If a claimant scores below 15 points, they aren't classes as having limited capability to work and so not entitled to ESA.

How long does it take to get ESA?

You’ll usually get your first ESA payment a few weeks after applying. When sending in the claim form, the claimant must provide a ‘fit note’ from their GP which confirms they’re not fit to work.

Keep in mind that due to demand, it can take several months for the DWP to make a decision. Generally, applicants that haven’t heard anything regarding their claim can contact the DWP after eight weeks of sending off the ESA50 questionnaire.

They should receive the first ESA payment into their bank account within three weeks.

After the assessment, a professional healthcare assessor will pass on recommendations to someone at the DWP. They’ll then use this information to decide if you get ESA or not. From the ESA50 form to finish, the whole process can take as much as a year to receive a final decision.

If the DWP eventually decides a claimant isn’t eligible for ESA, claimants won’t have to pay the money already received back. They’re also able to backdate claims for up to three months.

Is ESA better than PIP?

ESA and PIP serve different purposes, meaning neither is better than one or the other. PIP is intended to cover the costs of those who have a long-term health condition and is available to individuals in or out of work. ESA differs, as it is an out-of-work benefit only.

Can I get more money on ESA if I also get PIP

No, ESA does not have a disability premium, so you will not receive additional funds from ESA if you already claim PIP.

How an Employee Assistance Programme can support those looking to claim through ESA

Whether you have a staff member that’s been recently diagnosed with a disability or have limited working capacity for any other reason, it’s important to ensure your workplace takes the right measures for legal compliance under duty of care and The Equality Act (2010).

Our leading Employee Assistance Programme (EAP) can support your people by offering occupational health assessments, as well as supporting those who have produced a fit note for stress and/or anxiety with our unique Active Care service. By showing your commitment to individuals who need to claim (for ESA, PIP or other DWP benefits), you can help them feel assured you care about their wellbeing and even facilitate their return to work.

To find out more information about health assessments, contact HA | Wisdom Wellbeing free on: 0800 030 5182