Scribd
Upload
501 views

Health Conditions and Disabilities v5.0

This document summarizes the health condition and disability policies for Universal Credit claimants in the UK. It outlines the different provisions and requirements for claimants depending on whether they are within the first 14 days, 15-28 days, or 29+ days of reporting a health condition. It also describes the work capability assessment process and how claimants are assigned to different support regimes based on the assessment outcome.

Uploaded by

Gail Ward
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
501 views

Health Conditions and Disabilities v5.0

This document summarizes the health condition and disability policies for Universal Credit claimants in the UK. It outlines the different provisions and requirements for claimants depending on whether they are within the first 14 days, 15-28 days, or 29+ days of reporting a health condition. It also describes the work capability assessment process and how claimants are assigned to different support regimes based on the assessment outcome.

Uploaded by

Gail Ward
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 8

Health conditions and disabilities hub

First published: 17 September 2015 (version 1)


Last updated: 22 September 2016 (version 5)

Contents
At a Glance - Health Conditions and Disabilities
Day 1 to Day 29
Work related requirements and ongoing contact
Employed claimants
Statutory Sickness Payment
Work Capability Assessments

Health conditions and disabilities hub - at a glance


Universal Credit supports people with health conditions and disabilities by
helping them into work that they can do. This involves keeping in touch with the
claimant and preparing claimants to take up work when they are able to do so.

Once claimants report a health condition or disability, the work related


requirements they can be asked to agree and the amount of Universal Credit
they are paid depend on their capability to work. There are different provisions
relating to:

the first 14 days of a health condition


the period from day 15 onwards
the period from the 29th day
the period following the determination based on the outcome of a Work
Capability Assessment

Claimants must produce a Statement of Fitness for Work (SoFFW) from day 8 of
their reported health condition. Employed claimants can produce a Return to
Work Plan instead of a SoFFW.
In most cases, a claimant must be referred for a Work Capability Assessment (WCA)
at the 29th day. The WCA provides an assessment of what a claimant can do as
well as what he or she can't do.

The outcome of the WCA is used to determine if the claimant:

has limited capability for work (LCW)


has limited capability for work and work related activity (LCWRA)
does not have limited capability for work

In some circumstances, a claimant can be referred for a WCA immediately when the
health condition or disability is reported.

Claimants awaiting a WCA are usually allocated to the Intensive Work Search
Labour Market regime but can be allocated to an alternative regime depending
on individual circumstances.

Once a claimant produces a SoFFW or RtWP the work related requirements they
can be asked to accept and the frequency and channel of intervention will be
tailored according to individual need. This applies until a determination is made
following the outcome of a WCA.

The determination following the outcome of a claimants WCA is used to:

award, where the claimant has LCW or LCWRA, the LCW or LCWRA
calculation
allocate the claimant to the appropriate Labour Market regime
allocate the claimant with the relevant work allowance

Back to contents

Health conditions and disabilities day 1 to day 29

First 14 days
Claimants can self-certify for the first 7 days after they report being unfit for work
due to a health condition or disability.

From day 8 a Statement of Fitness for Work (SoFFW) is required from the
claimants GP or other healthcare professional.

When a claimant reports that they have a health condition or disability, they do
not have to look for work or be available for work for the duration of their medical
evidence for up to the first 14 days after it is reported.
This is the case for the first 2 periods of a reported health condition in a rolling
12-month period in receipt of Universal Credit.

If a claimant has more than 2 periods of sickness in a rolling 12 month period


they can be asked to undertake work search activities or be available for work
from Day 1, subject to their individual circumstances and what may be
reasonable based on their health condition.

During this 14 day period the claimant may be set WFI requirements and tailored
work preparation activities.

More detailed guidance on switching off work related requirements can be found
in the Claimants Commitment Hub.

Day 15 onwards
From day 15, any work-related activities can be agreed in a claimants
commitment.

Work-related activities must be reasonable based on the claimants


circumstances, taking account of the impact of their health and their ability to find
and take up work.

For work search/availability requirements to be switched off, the period of


sickness must be supported by a Fit Note.

The impact of the claimants current health condition must be considered in


relation to the number of hours they are expected to search for work and the
hours, type and location of work they are expected to search for.

More detailed guidance can be found in the Claimants Commitment Hub.

Day 29
At day 29 providing the claimant has a current Fit Note, he or she must be
referred for a Work Capability Assessment (WCA).

Work related requirements and ongoing contact


The work related requirements a claimant is asked to undertake once a health
condition is reported and the frequency and means of ongoing contact must be
reasonable in light of the claimants health condition and other circumstances.
Work related requirements and health conditions
The following are key factors to be taken into account when agreeing work
related requirements for a claimant with a health condition:
the number of hours work search, the type and location of work must be
considered in the light of the claimants health condition. Where appropriate
the claimants expected hours should be adjusted.
work preparation requirements should be suitable for the nature of their health
condition

Ongoing contact
Once a claimant reports a health condition, the frequency and means of contact
can be adjusted taking into account the nature of that condition. The claimant
may not be required to attend a fortnightly face to face interview if work
search/availability requirements have been switched off.

The channel of contact or meeting must be the most appropriate, in order to


support the claimant when needed or to check progress on activities. It can be
Face to Face, via the claimants online account or by telephone.

Examples
A claimant with a mental health condition such as mild/moderate
depression/anxiety may benefit from regular face to face interventions to build
their confidence. There may also be occasions when they cannot attend and
would benefit instead from a telephone or online contact or from re-arranging the
appointment.

A commitments meeting may be all they can be expected to do initially and it


may be appropriate to set voluntary activities then build these over time to
include mandatory work related requirements.

A claimant who has a long term condition may need support to build motivation
and confidence to consider an alternative career path. Searching for work and
looking at job specifications may be helpful in identifying a claimants skills and
experience which they can match to a job.

The condition may mean that the types of jobs which are suitable and the
distance they can travel to a job are reduced. In addition, their hours of work
search and any other actions must be appropriate and fit with medical
appointments.
Additionally, trying out work experience and volunteering may build the claimants
CV and confidence and help them to identify and enhance existing skills.

Employed claimants - fit for work support


Claimants in employment who are off work sick for more than 4 weeks will
usually be referred by their employer or health care professional to occupational
health professionals for health and work advice and a fitness for work
assessment.

Claimants in the Intensive Work Search Regime should be encouraged to


maintain active contact with their employer or health care professional at this
time.

Employees can agree to a Return to Work Plan. This may include a timetable for
returning to work, if appropriate.

Claimants with a Return to Work Plan (RtWP) may choose to share its content in
agreeing their commitments. The RtWP has the same status as a SoFFW.

The RtWP can be used as medical evidence in place of a SoFFW. If it is being


used for that purpose the claimant would need to share it at the point that
evidence is required.

Statutory Sickness Payment (SSP)


Claimants are not required to agree any work related requirements or be
available for work if the level of Statutory Sick Pay (SSP) means they exceed the
Conditionality Earnings Threshold.

Work capability assessments


Work capability assessments (WCA) are carried out by external providers as part
of the Health Assessment Advisory Service.

The WCA is a functional assessment which assesses what a claimant can do, as
well as what they can't do.

WCA for claimants in employment


Claimants in employment may claim Universal Credit on the grounds of having a
health condition or disability. A WCA referral can only be made if specific
circumstances apply.
If the claimant has weekly earnings equal to or exceeding the weekly earnings
threshold of 16 hours at National Minimum or Living Wage a referral for a WCA
can only be made if he or she is entitled to any of the following:
Disability Living Allowance
Personal Independence Payment
Armed Forces Independence Payment
Attendance Allowance

Claimants with weekly earnings that are equal to or exceed that earnings
threshold and who are not entitled to one of those benefits cannot be referred for
a WCA.

Claimants with weekly earnings below the threshold can be referred for WCA.

Immediate WCA referrals


A WCA referral must be made immediately if a claimant reports:
circumstances that mean they can be treated as having LCW
circumstances that mean they can be treated as having LCWRA including
terminal illness

Claimants can be treated as having LCW if evidence is provided which shows


they:

are receiving or recovering from treatment for:


haemodialysis for chronic renal failure
plasmapheresis
total parenteral nutrition for gross impairment of enteric function
are undergoing or recovering from medical or other treatment as a patient in a
hospital or similar institution (for 24 hours or more), including residential
programmes of rehabilitation for the treatment of drug or alcohol dependency
are prevented from working by law due to actual or suspected infection or
contamination
have reached the qualifying age for State Pension Credit and are entitled to
disability living allowance or personal independence payment

Claimants treated as having LCW remain in the Intensive Work Search regime,
until the outcome of their WCA. Claimants can be set WFI and work preparation
requirements, tailored to their individual needs.

Claimants can be treated as having LCWRA if they:


are terminally ill
are pregnant and there is a serious risk of damage to her health or to the
health of her unborn child if she does not refrain from work and work-related
activity
are receiving or recovering from treatment for cancer by way of chemotherapy
or radiotherapy
are likely to receive cancer treatment within 6 months of the date of the
determination of capability for work and work-related activity
have reached the qualifying age for State Pension Credit and are entitled to
AA, the Care Component of DLA at the highest rate or the Daily Living
Component of the Personal Independence Payment (PIP) at the enhanced
rate

Claimants treated as having LCWRA remain in the Intensive Work Search


regime, until the outcome of their WCA. All work-related requirements for these
claimants must be switched-off.

More detailed guidance on switching off work related requirements can be found
in the Claimants Commitment Hub.

WCA outcomes
Following the WCA, a decision maker makes one of three possible
determinations that the claimant:
has LCW
has LCWRA
does not have LCW (is fit for work)

Limited capability for work


If a claimant is determined to have LCW it means their ability to work is limited by
their physical or mental condition. Although they are not required to search for,
be available for and start work, the claimant is required to accept work
preparation requirements within their commitment and attend WFIs.

A claimant determined to have LCW will be allocated to the Work Preparation


regime.

Limited capability for work and work related activity


A claimant found to have LCWRA is allocated to the No Work Related
Requirements regime. They are not required to fulfil any work related
requirements but the claimant may wish to volunteer to do so if they wish.
No LCW
Claimants found not to have LCW or LCWRA remain in the Intensive Work
Search regime unless other circumstances mean the claimant is already
allocated to a less intensive regime.

The claimants work related requirements or availability for work must be


considered, taking into account their health condition or disability. More detailed
guidance can be found in the Claimants Commitment Hub.

Universal Credit award


Additional amounts of Universal Credit may be awarded when claimants are
found to have LCW or LCWRA. More guidance can be found in Rates for Universal
Credit.

Back to contents

You might also like