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2. Who is eligible

To qualify for new-style employment and support allowance (ESA), you must meet all the following conditions.1

You have limited capability for work (LCW – see here).

  • You are 16 or over and under pension age.
  • You have paid sufficient national insurance (NI) contributions. You must have paid class 1 contributions on earnings of at least the lower earnings limit in 26 weeks, which need not be consecutive, usually in one of the two complete tax years (6 April to 5 April) before the start of the benefit year (which runs from the first Sunday in January) in which you claim. You also must have paid or been credited with class 1 contributions on earnings of 50 times the lower earnings limit in these years. For example, you qualify if you claim ESA in 2026 and you paid contributions on earnings of £6,150 in each of the tax years April 2023 to April 2024 and April 2024 to April 2025, earning in one of the years £123 a week or more, for at least 26 weeks. See CPAG’s Welfare Benefits Handbook for details.
  • You are in Great Britain (although some absences are allowed, and new-style ESA can be paid in other countries in limited circumstances – see CPAG’s Welfare Benefits Handbook for more details).
  • You are not entitled to statutory sick pay or new-style jobseeker’s allowance.
  • You are not working, although some ‘permitted work’ is allowed. See CPAG’s Welfare Benefits Handbook for more details.

New-style ESA is not means tested. To qualify, you must meet the conditions above. You can also claim it in order to get NI credits for LCW.

There are no special rules for students, so you can claim new-style ESA whether you study full time or part time, including if you are taking time out from your course because of ill health (see here).

Reference
References
  • 1

    s1 WRA 2007; reg 37 ESA Regs

Limited capability for work

One of the basic rules of entitlement to new-style ESA is that you must be assessed as having LCW. This means that your mental or physical health condition makes it unreasonable to require you to work. You are normally assessed at a medical, known as the ‘work capability assessment’. This also assesses whether you have limited capability for work-related activity (LCWRA). If you are assessed as having both LCW and LCWRA, you are in the ‘support group’ and your new-style ESA includes an amount called a ‘support component’.

If you are assessed as only having LCW you are in the ‘work-related activity group’. You are expected to attend work-focused interviews and may be required to undertake work-related activity. If you do not do so, your benefit may be reduced. If your claim began before 3 April 2017, your ESA includes a ‘work-related activity component’. If it began on or after this date, it does not.

If you are assessed as not having LCW, you are not entitled to ESA. However, you can challenge this decision if you disagree with it (see here).

All students, unless they are in the support group, must take part in work-focused interviews and may have to undertake work-related activity as a condition of getting full benefit.1

Starting to study may prompt the DWP to call you for a reassessment, although this should not happen routinely. At the next assessment, your ability to perform the set activities is considered in the context of what you can do in a typical day, including your college or university routines. For example, you may be asked questions about your ability to get around campus, your ability to get to and from lectures, how long you can sit comfortably to study, or your ability to use a pen or a keyboard and mouse.

The questions you are asked depend on which of the set activities (such as standing and sitting, manual dexterity and understanding communication) are relevant to your condition.

See CPAG’s Welfare Benefits Handbook for advice on medical examinations and what to do if you do not pass the assessment.

Example

Rachel (29) is getting new-style ESA that includes a support component. She starts a full-time course of study in August 2026. She continues to be eligible for new-style ESA, but she is called for a medical reassessment. Her condition is still the same; she remains in the support group and her new-style ESA continues.

Reference
References
  • 1

    Regs 54 and 63(1) ESA Regs

3. Amount of benefit

New-style employment and support allowance (ESA) is usually payable after seven ‘waiting days’. You are paid a limited amount of new-style ESA during an initial ‘assessment phase’. In most cases, this lasts 13 weeks. After this, you may then be paid more in the ‘main phase’ (see below).

New-style ESA is worked out as follows.

In the assessment phase, you get a basic allowance of new-style ESA, based on your age. Once you have been assessed, you move into the main phase (usually from 13 weeks after your award started).

In the main phase, if you are in the support group, you get a support component of £50.35 a week. If you are in the work-related activity group and you claimed before 3 April 2017, you get a work-related activity component of £37.95 a week. If you claimed on or after 3 April 2017, no work-related activity component can be added. The component, if applicable, is added to the basic allowance.

You may get a reduced amount of new-style ESA if you have certain pension payments. See CPAG’s Welfare Benefits Handbook for details.

Weekly rate from April 20261
Assessment phase, basic allowance (under 25)£75.65
Assessment phase, basic allowance (25 or over)£95.55
Main phase, basic allowance (under 25)£95.55
Main phase, basic allowance (25 or over)£95.55
Main phase, support component£50.35
Main phase, work-related activity component (claims before 3 April 2017 only)£37.95

New-style ESA is paid for up to a year if you are in the work-related activity group, or indefinitely if you are in the support group.

Reference
References
  • 1

    s2 WRA 2007; reg 62 ESA Regs

4. Claiming new-style employment and support allowance

Check how to claim new-style employment and support allowance (ESA) at gov.uk/employment-support-allowance/how-to-claim.

You claim new-style ESA for yourself only.

You are usually interviewed after you claim. You must provide medical certificates from your GP (or similar) until you are assessed under the work capability assessment.

Claims for new-style ESA can be backdated for up to three months if you met the conditions during that time (you don’t need a reason for a late claim).

5. Challenging a decision

If you think a decision about your new-style employment and support allowance is wrong, you can ask the DWP to look at it again. This process is known as a ‘mandatory reconsideration’. Provided you ask within the time limit (usually one month), the DWP notifies you of the decision in a ‘mandatory reconsideration notice’. If you are still not happy when you get this notice, you can appeal to the independent First-tier Tribunal. If it was not possible to ask the DWP to reconsider the decision within a month, you can ask for a late revision (within 13 months), explaining why it is late. You can also ask the DWP to look at a decision again at any time if certain grounds are met – eg, if there has been an official error.

6. Other benefits

You cannot get new-style employment and support allowance (ESA) if you are getting statutory sick pay (SSP) from an employer.1 SSP runs out after 28 weeks, after which you can claim new-style ESA.

You can claim new-style ESA and have this topped up by universal credit. You cannot get new-style ESA if you are getting new-style jobseeker’s allowance.2

New-style ESA is taken into account when calculating whether the benefit cap applies, unless you or your partner get a support component in your new-style ESA. If this is the case, you are exempt from the benefit cap (see here and here).

Reference
References
  • 1

    s20 WRA 2007

  • 2

    s1(3)(f) WRA 2007

1. What are health benefits

There are charges for some NHS treatments and services including:

  • glasses and contact lenses;
  • dental treatment.

There are also often costs incurred in getting to hospital. You may be exempt from these charges or be able to claim help with them on low income grounds.1

There is no charge for NHS eye and dental checks, or for prescriptions. Note: if you have an English prescription form there may be a charge, but there are exemptions.2

Reference
References
  • 1

    NHS(TERC)(S) Regs, as amended (most recently in 2021 by SI No.241); The National Health Service (Optical Charges and Payments) (Scotland) Regulations 1998 No.642, as amended (most recently in 2024 by SI No.38); The National Health Service (Free Prescriptions and Charges for Drugs and Appliances) (Scotland) Regulations 2011 No.55, as amended (most recently in 2024 by SI No.233); The National Health Service (Dental Charges) (Scotland) Regulations 2003 No.158, as amended (most recently in 2011 by SI No.168)

  • 2

    Reg 4 The National Health Service (Free Prescriptions and Charges for Drugs and Appliances) (Scotland) Regulations 2011 No.55, as amended (most recently in 2024 by SI No.233)

2. Who is eligible

Under age 19

If you are in full-time education, you are entitled to vouchers for glasses.

If you are in part-time education, you are not automatically exempt from NHS charges, but you may get help because you get a qualifying benefit, are in an exempt group or qualify under the low income scheme (see here).

Under age 26

If you are under 26, you are entitled to free NHS dental treatment. It does not matter if you are studying full time or part time or not studying at all.

Age 26 or over

You are not automatically exempt from NHS charges because you are a student, but you may get help because you get a qualifying benefit, are in an exempt group or qualify under the low income scheme.

Qualifying benefits

You get free NHS dental treatment, vouchers for glasses and certain fares to hospital if you get:

  • universal credit (UC) and you:1
    • have no earnings; or
    • earn £435 or less a month (or, if you have a partner, your combined earnings are £435 or less a month); or
    • have a child element in your UC, or you or your partner (or both of you) have limited capability for work (LCW) or limited capability for work-related activity (LCWRA) and earn £935 or less a month (or, if you have a partner, your combined earnings are £935 or less a month); or
  • guarantee credit of pension credit.

Reference
References
  • 1

    NHS(TERC)(S) Regs, as amended (most recently in 2021 by SI No.241)

Exempt groups

Dental treatment

You are eligible for free NHS dental treatment if:

  • you are pregnant or have given birth in the last year; or
  • you are under the Public Dental Service (for people who have difficulty getting treatment for reasons such as a disability); or
  • you are an asylum seeker getting asylum support; or
  • you get a war pension and need treatment for your war disablement; or
  • you are a care leaver getting support from the local authority under section 29 of the Children (Scotland) Act 1995.

Vouchers for glasses or contact lenses

You are eligible for vouchers for glasses if:

  • you are aged under 16; or
  • you have a prescription for complex lenses; or
  • you are a Hospital Eye Service patient; or
  • you are an asylum seeker getting asylum support; or
  • you get a war pension and need treatment for your war disablement; or
  • you are a care leaver getting support from the local authority under section 29 of the Children (Scotland) Act 1995.

Fares to hospital

You are eligible for help with fares to hospital if:

  • it is 30 miles or more away or involves a journey of five miles or more by sea, and you live in the Highlands or Islands – ie:
    • the Highland region, Western Isles, Orkney Islands, Shetland Islands;
    • Arran, Great Cumbrae, Little Cumbrae;
    • the area formerly covered by Argyll and Bute District Council;
    • parts of Moray (Aberlour, Cabrach, Dallas, Dyke, Edinkillie, Forres, Inveravon, Kinloss, Kirkmichael, Knockando, Mortlach, Rafford, Rothes); or
  • you are an asylum seeker getting asylum support; or
  • you get a war pension and need treatment for your war disablement; or
  • you are a care leaver getting support from the local authority under section 29 of the Children (Scotland) Act 1995.

Low income scheme

If you are on a low income, you may be eligible for help under the low income scheme, even if you do not qualify on other grounds.

Under the low income scheme, your income is worked out in a similar way to housing benefit, and it is compared with your needs in the form of premiums and allowances, similar to housing benefit but with certain housing costs added.

Step 1: capital

You do not qualify if your capital is over £16,000. If your capital is between £6,000.01 and £16,000, add £1 to your income for every £250, or part of £250, between these limits.

Step 2: work out your requirements

This is an amount for basic weekly needs. See Chapter 6 for details of how to qualify for each premium. Your requirements are made up of:

  • personal allowances
CircumstancesRate
Single person aged under 25£75.65
Single person aged under 25, has claimed ESA and been assessed as having LCW or LCWRA£95.55
Single person aged 25 or over£95.55
Lone parent aged 18 or over£95.55
Couple, both aged 18 or over£150.15
Couple, both pension age or over (both reached pension age on or after 1 April 2021)£363.25
Couple, one or both pension age or over (and reached pension age before 1 April 2021)£383.35
  • premiums
    • carer (as for housing benefit (HB));
    • disability (this is included after 28 weeks of incapacity for work). You also get a disability premium if you (or your partner) are under 60 and get new-style ESA with a work-related activity or support component, or have been getting new-style ESA for at least 28 weeks, or have had LCW for at least 28 weeks. The amount of the disability premium increases to £50.35 if you are single or a lone parent and get new-style ESA with the support component, get the Scottish adult disability living allowance middle or highest rate care component or get the standard or enhanced rate of the daily living component of adult disability payment, and have been incapable of work for at least 28 weeks;
    • enhanced disability for an adult (as for HB and also if you (or your partner) are under 60 and get ESA with a support component);
    • severe disability (as for HB);
  • weekly rent less any HB and non-dependant deductions;
  • weekly council tax, if you are liable, less any council tax reduction;
  • mortgage interest, endowment payments and capital repayments on your home, as well as on loans to adapt a home for a disabled person, deducting any non-dependant deductions.

Step 3: work out your weekly income

Income is calculated in a very similar way as it is for HB, with some modifications. See CPAG’s Welfare Benefits Handbook for more details. Your income is taken into account, as well as the income of your partner. Information about how your income is calculated and how student income is treated is in Chapter 14.

Step 4: deduct weekly income from requirements

If your income is less than your requirements or no more than £4.95 (half the cost of an English prescription) higher, you are entitled to maximum help with health benefits. If your income is more than £4.95 higher than your needs, you may get partial help.

You are expected to contribute your ‘excess income’ (the amount by which your income exceeds your needs) towards hospital fares, and you can get help with the rest of the costs up to the maximum amount allowed. You are expected to contribute twice your excess income towards help with glasses or contact lenses and three times your excess income towards help with dental charges.1

Examples

Madhu is a second-year undergraduate aged 20. She has a student loan of £9,400 (including £2,400 special support loan) and a young students’ bursary of £2,000. She is single, has no children and pays £75 rent a week. She gets no UC or HB. Under the low income scheme, her requirements are £150.65 (£75.65 personal allowance, plus £75 rent). Her income from her student loan is £121.29 (see here). Her income is below her requirements so she is entitled to free NHS dental treatment and vouchers for glasses.

Lewis is 26 and is a second-year undergraduate. He needs dental treatment costing £140. His weekly income for health benefits is £140.52 student loan, plus £50 earnings, making a total of £190.52 (see here). His requirements are £95.55 personal allowance plus £80 weekly rent, a total of £175.55. His excess income is £14.97. He must contribute £44.91 (three times his excess income) to his dental treatment. The other £95.09 is paid for him under the low income scheme.

Reference
References
  • 1

    Reg 5 NHS(TERC)(S) Regs, as amended (most recently in 2021 by SI No.241); regs 14 and 19 The National Health Service (Optical Charges and Payments) (Scotland) Regulations 1998 No.642, as amended (most recently in 2024 by SI No.38)

1. What is child benefit

Child benefit is paid to people who are responsible for a child or qualifying young person. You do not have to have paid national insurance contributions to qualify for child benefit. It is not means tested, so the amount you get is not affected by your student loan, grant or other income. If you (or your partner) earn over £60,000 per year and you (or your partner) get child benefit, you may have extra income tax to pay (known as the ‘high-income child benefit charge’).