Form

New Style Employment and Support Allowance (ESA) claim form

This form is currently unavailable online. You can claim New Style Employment and Support Allowance online or by phone.

• From: Department for Work and Pensions
• Published: 6 March 2019
• Last updated: 23 October 2020 — See all updates

This publication was withdrawn on 30 October 2020

You can claim New Style Employment and Support Allowance online or by phone.

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Form no longer available online

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This form is currently unavailable online.

You can claim New Style Employment and Support Allowance online or by phone.

Published 6 March 2019
Last updated 23 October 2020 + show all updates

1. 23 October 2020

   Removed the claim forms you can print as they are not the valid versions for claiming New Style ESA.

2. 27 March 2020

   Updated with new guidance on how to claim New Style Employment and Support Allowance.

3. 18 October 2019

   Updated version of 'New Style' Employment and Support Allowance claim form you can download, fill in on screen, save, and then print - English version only.

4. 30 April 2019

   Removed options to choose when phoning to book a new claim appointment as these are no longer correct.

5. 13 March 2019

   Added welsh version of the form.

6. 6 March 2019

   First published.