ESA Decision Phone Call: Should I be Worried? (A guide)

In this brief guide, we will look at ESA decision phone calls, and whether the DWP phoning you about an ESA decision is a good thing.

ESA Decision Phone Call

There usually is no ESA decision phone call, and if the DWP does make a phone call pertaining to the ESA decision, they will do so because the ESA claim is lacking in some way and they want to know if the claimant has further evidence that they would like to provide to strengthen the claim.

ESA decisions are usually not conveyed over phone calls, the DWP sends letters regarding their ESA decisions in which one may find that they are either in an ESA support group, an ESA work-related activity group, or they are not going to receive ESA.

When the ESA decision process is going on and the DWp calls you on the phone, it is not something to worry about, and it means that they are essentially giving you an opportunity to provide documents or evidence that you may not have included before or that your claim is currently lacking.

Other cases where the DWP phones someone in relation to their ESA decision may be that the claim is missing some forms or is perhaps poorly filled out, or the person has not passed their work capability assessment properly.

There may be an ESA decision phone call in ‘borderline’ Employment and Support Allowance (ESA) claims, which make up a minority of ESA cases and tend to be more complex to assess.

The complexities of these cases may arise out of any reason, like where there is contradictory evidence, or where paperwork is poorly completed. 

There are also various ways in which the DWP decision makers may deal with the complexities, and the DWP also supports the DMs in this undertaking.

To be eligible for the ESA benefit, a claimant must score a total of fifteen points at their work capability assessment, and this assessment is usually done by a private contractor known as Atos Healthcare

Atos provides a healthcare report to the DWP decision makers, and they will assign statements or descriptors that best fit how a claimant’s condition affects their execution of daily tasks or activities. 

These activity descriptors are split into physical and mental functionality and are graded in terms of severity, in a way that each grade equates to a certain number of points. 

Based on this report, the decision maker reviews the Atos medical report alongside the claimant’s ESA50 any other additional evidence. 

If there is something in the Atos report that indicates that the person may have a disability or might need the ESA but they have not received the 15 points that are necessary for qualification, the ESA decision is held back till the decision maker can make a phone call to the person and ask for the additional evidence that may help their case.

This evidence can be anything from medical visitation proofs, medical manuscripts or prescriptions, x-rays or MRIs and so on, anything that proves that the person actually has a disability and needs to be provided an ESA.

ESA Process

The ESA process is not that complicated if the individual does their homework and diligently provides the documents and evidence of their disability, and the benefit of the process is great.

To qualify for the ESA benefit, the person should first of all have something called a limited capacity to work, which means that they should be able to prove that they are claiming ESA because they are not able to work regularly and therefore need assistance.

The stages of the ESA process are as follows:

  • The completion of an ESA50 (a medical questionnaire) by the claimant which is then returned to Atos Healthcare;
  • A work capability assessment attended by the claimant and conducted by an Atos Healthcare Professional (HCP);
  • The gathering and assessing of evidence by the Decision Maker (DM) to decide the outcome of the claim – including the ESA50 and Atos medical report, alongside any other medical evidence the claimant may have supplied;
  • ESA decision related phone call to the claimant by the decision maker to advise them of their claim outcome and to ask for any other evidence that might support their claim;
  • an outcome notification in the form of a letter 

This final outcome can be challenged if the person feels that it is unjust in some way or that their claim needs to be reconsidered, and this may be done by calling the DWP or starting a new claim.

ESA Activity Descriptors

As mentioned previously, the ESA decision may be preceded by a phone call by the DWP decision makers if it is seen that the person’s claim is missing something or if it is found that there are not enough activity descriptors in their assessment report by Atos.

Following is the list of activity descriptors one may find in the Atos assessment report which decide how many points the person gets and therefore, whether they get the ESA or not.

1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid is normally, or could reasonably be, worn or used.

(a)  Cannot either 

(i) mobilise more than 50 meters on level ground without stopping in order to avoid significant discomfort or exhaustion

or

(ii) repeatedly mobilise 50 meters within a reasonable timescale because of significant discomfort or exhaustion.  15 points

(b) Cannot mount or descend two steps unaided by another person even with the  support of a handrail.  9 points

(c) Cannot either 

(i) mobilise more than 100 meters on level ground without stopping in order to avoid significant discomfort or exhaustion

or

(ii) repeatedly mobilise 100 meters within a reasonable timescale because of significant discomfort or exhaustion.  9 points

(d) Cannot either 

(i) mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion

or

(ii) repeatedly mobilise 200 meters within a reasonable timescale because of significant discomfort or exhaustion. 6 points

(e) None of the above apply.  0 points

2. Standing and sitting.

(a) Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person. 15 points

(b) Cannot, for the majority of the time, remain at a workstation, either:

(i) standing unassisted by another person (even if free to move around) or;

(ii) sitting (even in an adjustable chair); or

(iii) a combination of (i) and (ii),

for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion. 9 points.

(c) Cannot, for the majority of the time, remain at a workstation, either:

(i) standing unassisted by another person (even if free to move around) or;

(ii) sitting (even in an adjustable chair); or

(iii) a combination of (i) and (ii),

for more than an hour, before needing to move away in order to avoid significant discomfort or exhaustion. 6 points.

(d) None of the above apply. 0 points

3. Reaching.

(a) Cannot raise either arm as if to put something in the top pocket of a coat or jacket.  15 points

(b) Cannot raise either arm to top of head as if to put on a hat.  9 points

(c) Cannot raise either arm above head height as if to reach for something. 6 points.

(d) None of the above apply.  0 points

4. Picking up and moving or transferring by the use of the upper body and arms.

(a) Cannot pick up and move a 0.5 litre carton full of liquid. 15 points

(b) Cannot pick up and move a one litre carton full of liquid. 9 points

(c) Cannot transfer a light but bulky object such as an empty cardboard box. 6

(d) None of the above apply.  0 points

5. Manual dexterity.

(a) Cannot either:

(i) press a button, such as a telephone keypad or;

(ii) turn the pages of a book

with either hand.  15 points

(b) Cannot pick up a £1 coin or equivalent with either hand. 15 points

(c) Cannot use a pen or pencil to make a meaningful mark.9 points

(d) Cannot single-handedly use a suitable keyboard or mouse. 9 points

(e) None of the above apply.  0 points

6.  Making self understood through speaking, writing, typing, or other means which are normally, or could reasonably be, used, unaided by another person.

(a) Cannot convey a simple message, such as the presence of a hazard.  15 points

(b) Has significant difficulty conveying a simple message to strangers.  15 points

(c) Has some difficulty conveying a simple message to strangers.  6 points

(d) None of the above apply.  0 points

7.  Understanding communication by—

(a) verbal means (such as hearing or lip reading) alone,

(b) non-verbal means (such as reading 16 point print or Braille) alone, or

(c) a combination of (a) and (b),

using any aid that is normally, or could reasonably be, used, unaided by another person.

(a) Cannot understand a simple message due to sensory impairment, such as the location of a fire escape.  15 points

(b)  Has significant difficulty understanding a simple message from a stranger due to sensory impairment. 15 points

(c) Has some difficulty understanding a simple message from a stranger due to sensory impairment.  6 points

(d) None of the above apply.  0 points

8.  Navigation and maintaining safety, using a guide dog or other aid if either or both are normally, or could reasonably be, used.

(a) Unable to navigate around familiar surroundings, without being accompanied by another person, due to sensory impairment.  15 points

(b) Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment.  15 points

(c) Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment.  9 points

(d) None of the above apply.  0 points

9.  Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting), despite the wearing or use of any aids or adaptations which are normally, or could reasonably be, worn or used.

(a) At least once a month experiences 

(i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or

(ii) substantial leakage of the contents of a collecting device;

sufficient to require cleaning and a change in clothing.  15 points

(b) The majority of the time is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly. 6 points.

 (c) None of the above apply.  0 points

10. Consciousness during waking moments.

 (a) At least once a week, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration.  15 points

 (b) At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration.  6 points

 (c)  None of the above apply.  0 points

Limited capability for work, cognitive and intellectual function assessment

11. Learning tasks.

 (a) Cannot learn how to complete a simple task, such as setting an alarm clock.  15 points

 (b) Cannot learn anything beyond a simple task, such as setting an alarm clock.  9 points

 (c) Cannot learn anything beyond a moderately complex task, such as the steps involved in operating a washing machine to clean clothes.  6 points

 (d) None of the above apply.  0 points

12. Awareness of everyday hazards (such as boiling water or sharp objects).

(a) Reduced awareness of everyday hazards leads to a significant risk of: 

(i) injury to self or others; or

(ii) damage to property or possessions,

such that they require supervision for the majority of the time to maintain safety. 15 points

(b) Reduced awareness of everyday hazards leads to a significant risk of

(i) injury to self or others; or

(ii) damage to property or possessions,

such that they frequently require supervision to maintain safety.  9 points

(c) Reduced awareness of everyday hazards leads to a significant risk of: 

(i) injury to self or others; or

(ii) damage to property or possessions,

such that they occasionally require supervision to maintain safety.  6 points.

(d) None of the above apply.  0 points

13. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks).

(a) Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions.  15 points

(b) Cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions for the majority of the time.  9 points

(c) Frequently cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions.  6 points

(d) None of the above apply.  0 points

14. Coping with change

(a) Cannot cope with any change to the extent that day to day life cannot be managed.  15 points

(b) Cannot cope with minor planned changes (such as a pre-arranged change to the routine time scheduled for a lunch break), to the extent that overall day to day life is made significantly more difficult.  9 points

(c) Cannot cope with minor unplanned change (such as the timing of an appointment on the day it is due to occur), to the extent that overall, day to day life is made significantly more difficult.  6 points

(d) None of the above apply.  0 points

15. Getting about

(a)  Cannot get to any place outside the claimant’s home with which the claimant is familiar.  15 points.

(b) Is unable to get to a specified place with  which the claimant is familiar, without being accompanied by another person  9 points

(c) Is unable to get to a specified place with which the claimant is unfamiliar without being accompanied by another person.  6 points

(d) None of the above apply.  0 points

16. Coping with social engagement due to cognitive impairment or mental disorder

(a) Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual.  15 points

(b) Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual.  9 points

(c) Engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to difficulty relating to others or significant distress experienced by the individual.  6 points

(d) None of the above apply.  0 points

17. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder

(a) Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.  15 points

(b) Frequently has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.  15 points

(c) Occasionally has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.  9 points

(d) None of the above apply.  0 points”

The points in front of each of the activity descriptors ascertain what the person’s final score will be.

Conclusion

In this brief guide, we looked at ESA decision phone calls, and whether the DWP phoning you about an ESA decision is a good thing.

ESA can help people find their financial footing again, and help those with severe disabilities of the physical or mental kind to come out of their problems and be able to make a living at the same time.

However, in some cases, ESA decisions can be wrong too, and some people may suffer greatly while waiting for a decision as well as when they get a decision that is not in their favor.

If you have any questions or comments about the ESA decision phone call, please feel free to reach out to us at any time.

Frequently Asked Questions (FAQs): ESA decision phone call

Why would ESA call me?

The ESA might call you to notify you that you might be found disallowed for ESA and to check if you have any additional evidence that you might want to submit that would further support your claim.

The DWP usually lets the people who have claimed an ESA about the decision that has been made via letter, and they usually don’t call people to let them know of the final decision.

Why do DWP phone after an assessment?

The DWP may phone after an assessment when they have found that the claimant has not been awarded the requisite minimum 15 points required for an ESA award, after an F2F assessment, and they might want to know whether there is any further evidence that the claimant can provide to persuade the DM that they should indeed be awarded ESA.

How long does it take to get a decision on ESA?

It may take up to 12-13 weeks to get a decision on ESA, and while in some cases it can take much shorter, in some cases it may take that entire time, and the process may even go over if there are any documents missing or if the decision makers at the DWP need more information.

Citations

https://healthunlocked.com/fibromyalgia-action-uk/posts/131499914/esa-decision-maker-is-calling-me-on-monday-should-i-be-worried

https://www.benefitsandwork.co.uk/forum/10-dla-esa-queries-results/108679-esa-phone-call-from-decision-maker

https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/help-with-your-esa-claim/getting-your-esa-decision/

https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/employment-and-support-allowance/problems-with-esa/esa-appealing/

Divya is currently a Clinical Psychology Trainee in a Master of Philosophy program and holds a Master’s in clinical psychology. She has a special interest in Personality studies and disorders, having researched the subject before, and Neuropsychology; with an additional interest being Mood disorders. She likes to write about Psychiatric issues, having worked in multiple specialty setups during her time as a clinical psychology student, and in her free time she likes to cook and read.