Claiming Universal Credit If You Are Sick

medical-563427_640If you are claiming benefits on the basis of having health problems (ie you are sick or disabled) you can expect there to be changes in the amount of benefit you get and/or the conditions attaching to your award when you start claiming Universal Credit (UC). There is a high risk that claimants who are sick and disabled will get less benefit and have more onerous conditions applied to them when they are moved on to UC.

What is Universal Credit?

UC is a new benefit which is replacing 6 existing means-tested benefit including Income related Employment and Support Allowance. UC is different to the benefits it is replacing. It is paid calendar monthly and has an on line claims process. UC is currently mostly being claimed by newly unemployed single people. However everyone claiming any of the benefits which it replaces will be eventually moved on to the new system. Also the circumstances of claimants already on UC can change and this may mean that they develop a health problem and are no longer well enough to work. unemployed-icon

More information about UC can be found in some other posts listed below in related information.

If you are getting Income Related Employment and Support Allowance (IRESA) you are likely to be migrated on to UC between 2018 and 2021. When we have more details about the migration timetable this will be available here. Until then you can continue to claim your existing benefits.

What will happen if you are found capable of work before the migration?

If you are receiving IRESA you can expect to be invited to attend medical assessments from time to time. If the outcome of an ESA medical assessment is that you are found to be capable of work there is a risk that this could mean that you fit in to the existing gateway conditions and may be asked to claim UC.   For most people with health problems it will be advisable to delay your transfer on to UC because for many people income will reduce and conditionality increase under UC. You should check the post Are You Eligible for Universal Credit to see if you will be expected to claim this benefit. This test is also known as the Universal Credit Gateway.

You will not be expected to claim UC if you are disputing the outcome of your ESA medical so it would be advisable in these circumstances, if none of the other ways of remaining outside the Universal Credit  Gateway apply, to start a Mandatory Reconsideration as quickly as possible. If you need further advice about this contact a local advice organisation. While you are going through the Mandatory reconsideration process you are eligible to claim Job Seekers Allowance. You are allowed to claim Job Seekers Allowance on the basis of a temporary sickness for up to 13 weeks and you are not required to look for work during this period.

How your UC is calculated if you are sick or disabled

The current benefits system includes a range of premiums which are included in the means-tested benefits paid to disabled people some of which are triggered by receipt of Disability Living Allowance and Personal Independence Payment and some by the outcome of the Work Capability Assessment. Under UC additional amounts for adults, known as elements, are triggered only by the outcome of a work capability assessment. This means that the following premiums are not available under UC:

  • Severe Disability Premium,
  • Disability Premium
  • Enhanced Disability Premium where this is triggered by an award of higher rate of Disability Living Allowance care component or enhanced rate of daily living component of Personal Independence Payment tablets-icon

The level of the limited capability for work and work related activity element paid under UC is higher than the current equivalent but this is not sufficient to compensate for the loss of the premiums listed above.

If you are moved on to UC after 2018 as a part of the migration you will receive Transitional Protection if the level of your UC is less than the rate of the benefits which it is replacing.

What will happen to disabled people who do not get Work Related Activity Component or Support Group component when they are transferred to UC?

If you are working and receiving Disability Living Allowance (DLA), Personal Independence Payment (PIP) or Attendance Allowance (AA) but are managing to earn more than the equivalent of 16 hours paid at  National Living Wage  you are automatically treated as being capable of work and so will not be able to qualify for any disability related elements paid on your Universal Credit

If you are working and earning less than the equivalent of 16 hours paid at National Living Wage  and receiving Disability Living Allowance (DLA), Personal Independence Payment (PIP) or Attendance Allowance (AA) you will have to undergo a work capability assessment before you can be treated as eligible for any elements linked to your disability under UC.  You will be sent a UC 50 form. It is recommended that you get help with completing this form from an advisor as it can be difficult to get a positive outcome from this assessment when you are working. The assessment is the same as the assessment under ESA.

If you are disabled and earning less than the equivalent of 16 hours paid at  National Living Wage and not getting DLA, PIP or AA you will be treated as not having a limited capability for work if you have failed the capability for work assessment in the past whether that was when claiming Employment and Support Allowance or UC. You can only get a new assessment in this situation if you can argue that there was a mistake in the decision or that there has been a change in your medical condition. You may need to take advice about this.

If you are disabled and not working and have not been assessed under the work capability assessment you should ask your doctor for a fit note (previously called a sick note) and ask for your benefit to be reassessed as soon as possible. This is important as otherwise you could have problems with the claimant commitment.

Claimant Commitment

When you make a claim for UC you and your partner will have to sign the claimant commitment. The claimant commitment group you are placed in will depend on the work related group you are in if you are claiming on the basis of being incapable of work. More information about this is available in the post Your responsibilities if you get Universal Credit which is listed below.

Related Information

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