Welfare Reform The Impact on People With Brain Injury Kathleen McMonagle Client Support Manager

Welfare Reform Act 2012 The Welfare Reform Act received Royal Assent on 8 March Major reforms to UK’s welfare system

Timetable for Disability Related Benefit reforms May 2012 – Changes to Employment and Support Allowance (ESA) April 2013 – DLA replaced by Personal Independence Payment (PIP) October 2013 – Universal Credit introduced

Employment and Support Allowance Employment and Support Allowance (ESA) is a benefit which was introduced in October 2008 to replace Incapacity Benefit and Income Support on the grounds of incapacity for work. ESA is the main earnings replacement benefit payable to someone who is incapable of work.

Employment and Support Allowance There are two types of ESA: Contribution based ESA – based on a claimant’s National Insurance contributions Income Related ESA – means tested, based on a claimant’s income and capital

Who Gets ESA? Most new benefit claims made after 27 October 2008, which are based on incapacity for work, are claims for ESA. Most people receiving Incapacity Benefit/Income Support based on incapacity before 2008, will transfer onto ESA. The transfer is happening between now and Spring 2014.

ESA Medical Assessment Most people claiming or moving onto ESA will be required to attend a medical assessment, called the Work Capability Assessment Prior to this assessment, they will be required to complete a questionnaire (Form ESA50) detailing how their disability affects their day to day living. The questionnaire is 21 pages long.

Work Capability Assessment The information provided in the ESA50 questionnaire and at the medical assessment is absolutely crucial to the outcome of the assessment. If the medical assessor does not take sufficient care to extract the relevant information from a claimant about the effects of brain injury on their daily lives, there could be a major impact on the claimant’s benefits.

Work Capability Assessment The Work Capability Assessment for ESA is a much stricter test than the Personal Capability assessment for Incapacity Benefit. Another change, is that people are assessed not just to decide if they are incapable of work, but also, which ESA group they should be placed in.

Work Related Activity Group People who with the right help can learn skills to help them into work and get a paid job will be placed in the work related activity group. People placed in this group will be required to attend work focussed related interviews and may be required to attend training programmes. They will not be required to look for work.

Support Group If it is decided that, at present, there is no reasonable prospect of the claimant being fit for work, they will be placed in the support group. People in this Group will not be required to undertake any work related activity, but they may choose to.

Loss Of ESA If a claimant is disallowed ESA for failing to satisfy the work capability assessment, they will lose any title to automatic Housing or Council Tax Benefit. This can have a knock on effect on their lives and lead to greater distress and confusion trying to re-navigate the benefits system.

Appeals There is a right of Appeal against failing to satisfy the work capability assessment. Appeals should be made in writing within one calendar month, although late appeals may be accepted up to 13 months after the date of the decision. A basic rate of ESA, along with any housing or council tax benefit will be paid pending the Appeal hearing Appeals have a good chance of success.

Will I be better or worse off on ESA? Some people may be better off, if, for example, they are placed in the support group. The DWP say that when you are worse off on ESA, your present rate of benefit will be paid to you and frozen until the rate of ESA catches up.

ESA Reforms May 2012: Contribution based ESA limited to 12 months in many cases Youth based ESA abolished

Personal Independence Payment A new benefit called Personal Independence Payment (PIP) will be introduced from 2013 to replace Disability Living Allowance (DLA) for people of working age (16-64). There are no current plans to replace DLA for children aged under 16. People over the age of 65 who are already receiving DLA will not be reassessed.

PIP Timetable April 2013 – some parts of England will start to take new claims for PIP June 2013 – All new claims for people aged will be for PIP, not DLA. October 2013 – A number of existing DLA claims will be transferred to PIP as part of a Pilot January 2014 – Full scale national re-assessment of DLA claims will begin March 2016 – Estimated date by which all DLA claimants will have been contacted regarding transfer to PIP.

Differences between DLA and PIP Anticipated needs for a minimum of one year (DLA is 9 months) Care component will now be “Daily living component” Daily living component will only have 2 rates (care component has 3) Points based system for awards

Differences Between DLA and PIP Most claimants will have a medical assessment Awards will be shorter All cases will be periodically reassessed There will be greater use of “evidence” DWP states PIP will take better account of mental, intellectual and cognitive and developmental impairments

Daily Living Activities 1. Preparing food and drink. 2. Taking nutrition. 3. Managing therapy or monitoring a health condition. 4. Bathing and grooming. 5. Managing toilet needs or incontinence. 6. Dressing and undressing. 7. Communicating. 8. Engaging socially. 9. Making financial decisions

Mobility 1. Planning and following a journey. 2. Moving around.

The Points System To get an award of either the daily living or mobility component, you need to score: 8 points for the standard rate 12 points for the enhanced rate You may get an award of one or other or both components

The Points System You can only score one set of points from each activity, if two or more apply from the same activity only the highest will count. So, for example, if for bathing and grooming - 4 d. Needs assistance to groom. 2 points 4 g. Needs assistance to bathe. 4 points both apply you will receive only the 4 points for the ‘Bathing and grooming’ activity. These can then be added to points for other activities, such as 'Dressing and undressing'

Cooking a Meal DLA has a “main meal” test, that is you cannot safely plan and prepare a cooked main meal (from scratch) for one person. Many people with ABI meet this test and currently qualify for DLA lower rate care component To qualify for PIP daily living component on cooking alone, people will need to demonstrate that they “Cannot prepare and cook food and drink at all.”

DLA – Lower Rate Mobility Many people with brain injury qualify for lower rate mobility component on the grounds that “ignoring any ability to use familiar routes” they are “…unable to walk outdoors without guidance or supervision from another person most of the time.”

PIP – Standard Rate Mobility Needs either- Supervision, prompting or a support dog to follow a journey to an unfamiliar destination OR A journey to an unfamiliar destination to have been entirely planned by another person. OR Cannot follow any journey because it would cause overwhelming psychological distress to the claimant NB In addition, there are other physical disabilities which could also allow standard rate mobility

Case Law Much of how the new rules for PIP are put into practice will be determined by case law. This will take some time to come through the system. Cases will need to go through the First Tier and then Upper Tier Tribunals.

Universal Credit From October 2013: The current range of working-age benefits and Tax Credits is to be replaced by a new benefit called Universal Credit. The process of moving existing claimants on to Universal Credit will be gradual and should be completed by October 2017.

Universal Credit Universal Credit will replace: Employment and Support Allowance - income based Jobseekers Allowance - income based Housing Benefit Parts of Social Fund Working Tax Credits (from 2014) Child Tax Credit (from 2014)

Timetable for Other Reforms April 2013: Council Tax Benefit is to be replaced by localised support for Council Tax Housing Benefit - Size criteria will apply in the social rented sector A cap on the amount of benefits a working-age household can receive, capped at the level of the average earnings of a working family. Social Fund Reforms

Timescales and Rules None of these are written in a tablet of stone Timescales for transfer to new benefits may slide if DWP and medical services struggle to cope with the scale of the changes Benefit rules may be modified as they are interpreted and re-interpreted.