ESA: outcomes of Work Capability Assessments including mandatory reconsiderations and appeals: March 2021

Question 1

1.  Main stories

Accepted Answer

Figures for this release reflect the disruptions caused by the coronavirus (COVID‑19) pandemic. It should also be noted that Universal Credit has now replaced income-related ESA for most new claimants and this is changing the volume and characteristics of ESA WCAs.

The statistics show:

The number of completed ESA WCAs has reduced considerably when compared with the same quarter a year earlier, falling from 170,000 to 37,000 in the latest quarter to September 2020
Repeat assessments have experienced the biggest fall when compared with the same quarter a year earlier, decreasing from 140,000 to 25,000 in the latest quarter to September 2020
The majority, 25,000 (68%), of the total 37,000 ESA assessments completed in the latest quarter to September 2020 were repeat assessments
There were 12,000 completed initial ESA WCAs in the latest quarter, a fall of 47% compared to the same period a year earlier
Outcomes for initial WCAs for the latest quarter show the majority (84%) to be in the SG, followed by 12% FFW and 4% WRAG allocations
The number of registered MRs has continued to fall, however there was a slight increase in the latest three months from 170 in October 2020 to 290 in January 2021
The MR monthly median clearance time decreased from 8 days in October 2020 to 3 days in January 2021
The median end-to-end clearance time for claimants completing their initial WCA increased noticeably, from 74 days in June 2020 to reach 107 days in September 2020

Question 2

2.  What you need to know

Accepted Answer

The sources of the statistics are:

DWP’s benefit administration datasets including MR data
Healthcare provider assessment data

Information is only available for claims that began at least 6 months following the assessment date, or 9 months following the date of claim. This is because of the time required for the customer journey to end and for the information recorded to be as complete as possible.

Universal Credit (UC) was rolled out to every Jobcentre across Great Britain by December 2018 and has now replaced income-related ESA for most new claimants. This has greatly changed the volume and composition of new claims to ESA.

COVID-19 operational easements

Figures for this release reflect the disruptions caused by the coronavirus (COVID‑19) pandemic, which has led to changes to operational procedures. Such changes were necessary to process claims and ensure people in need of financial help could access benefits, while keeping customers and staff safe.

DWP temporarily suspended face-to-face health assessments from 17 March 2020. This aimed at reducing the risk of exposure to coronavirus, hence safeguarding the health of individuals claiming health and disability-related benefits, many of whom are likely to be at greater risk due to their pre-existing health conditions. This means that people claiming ESA were not required to attend face-to-face assessments. However, paper-based assessments continued and telephone assessments were introduced from 7 May 2020.

The typical customer journey, prior to the COVID-19 easements, is detailed below:

Claimant registers for ESA – payment issued at assessment rate
Claimant referred for WCA and issued the “Capability to Work” questionnaire
Claimant completes and returns questionnaire
Assessment Provider (AP) may conduct face-to-face assessment or paper-based assessment and provides recommendation to DWP
DWP makes a decision based on the AP recommendation. Those found eligible for ESA are either placed in the WRAG, which offers support in preparing for work, or the SG if they are unable to work or complete work-related activity. Those not eligible are found FfW
If the claimant disagrees with this decision, then depending on the nature of the decision they will either (i) have to request an MR (before they can appeal); or (ii) be able to appeal straightaway

Note: As a result of High Court decision in July 2020, MR has been discontinued for any claimant who, having been found Fit for Work (FfW) following a WCA would, if they appealed, be paid ESA pending the outcome of that appeal. This is known as Payment Pending Appeal (PPA). Not all claimants qualify, and it applies only to Fit for Work disallowance decisions, not decisions such as disallowance due to Failure to Return a Questionnaire or Failure to Attend a WCA.

Rounding policy

Since March 2017, the following rounding policy has been applied to the statistical release. Please note that percentages shown within the release are calculated using figures prior to rounding.

From	To	Rounded to
0	1,000	10
1,001	10,000	100
10,001	100,000	1,000
100,001	1,000,000	10,000
1,000,001	10,000,000	100,000
10,000,001	100,000,000	1,000,000

Question 3

3.  Assessment volumes and outcomes: ESA initial and repeat assessments

Accepted Answer

Initial and repeat assessment volumes for all outcomes have decreased this quarter.

ESA and WCAs were introduced in 2008. Claimants who had previously been on Incapacity Benefit (IB), or who claimed ESA, would receive an initial assessment. If they remained on the benefit, they might then get repeat assessments to ensure they were still receiving the appropriate amount of support.

All completed assessments by quarter, December 2008 to September 2020

Source: Data tables: ESA Work Capability Assessments outcomes by date of decision

In the quarter to September 2020, the majority (68%) of completed ESA WCA were repeat assessments. The remaining 32% were initial WCAs.

The first WCAs were mostly initial assessments. At first, many of these related to claimants who were transferred from IB, and the winding down of the IB reassessment programme is reflected in the fall in the number of initial assessments after 2013. Repeat assessments are usually due between 3 months and 3 years after the previous assessment, and so the number of these increased gradually over the first years of the benefit, reaching a peak of 43,000 in May 2013. From January 2014, a period began in which repeat assessments were suppressed in order to focus on clearing initial assessments, hence managing the number of outstanding cases awaiting a decision and reduce delays for claimants. This reduced the overall number of assessments. During this period, claimants could still request a repeat assessment due to a change of circumstances, such as the development of a new condition or deterioration of the existing one.

From late 2013 onwards, the number of ESA WCA completed had risen substantially up to 270,000 in March 2017. This increase could be attributed to a variety of factors, including the focus on clearing initial assessments following changes in operational procedures and the re-introduction of repeat assessments in December 2015. The introduction of Universal Credit (UC), replacing most income-related new claims to ESA from December 2018 has also greatly changed the volume and composition of new claims to ESA, leading to a reduction in the number of initial assessments required.

Following this period of growth, the number of completed assessments levelled off and then followed a mainly downward trend, with only 37,000 assessments being completed in the quarter to September 2020, a decrease of 36% when compared to the previous quarter. This can be partly attributed to the suspension of face-to-face assessments in March 2020 in response to the COVID-19 pandemic and UC replacing most income-related ESA new claims. This has been the second lowest number of completed assessments since the introduction of ESA.

Initial and repeat assessment outcomes, December 2008 to September 2020

Source: Data tables: ESA Work Capability Assessments outcomes by date of decision

Of the 12,000 initial assessments completed in the quarter to September 2020, 10,000 resulted in ESA entitlement.

In the quarter to September 2020 repeat assessments accounted for 68% of completed ESA WCAs, despite numbers falling by 51% from previous quarter to stand at 25,000.

The remaining 32% of completed assessments were initial assessments. Numbers of initial WCAs have been falling over the last couple of years, however the latest quarter to September 2020 saw an increase from 6,000 to 12,000. The overall decreasing trend in the number of initial assessments in recent years can be attributed to UC replacing most income-related new claims to ESA from December 2018 following the national rollout.

The decrease in the total number of assessments for ESA, from 57,000 in the quarter to June 2020 to 37,000 in the latest quarter will be impacted by both the introduction of Universal Credit (UC) and the operational changes implemented as a result of COVID-19.

Assessment outcomes for ESA initial assessments by date of decision made, December 2008 to September 2020

Source: Data tables: ESA Work Capability Assessments outcomes by date of decision

Outcomes of both ESA initial and repeat assessments for the latest quarter show the majority of ESA claimants are assigned to the Support Group (84% and 94% respectively).

Assessment outcomes for ESA initial assessments for the quarter ending in September 2020

ESA Initial	Percentages
Support Group	84%
Work Related Activity Group	4%
Fit For Work	12%

Assessment outcomes for ESA repeat assessments for the quarter ending in September 2020

ESA Repeat	Percentages
Support Group	94%
Work Related Activity Group	5%
Fit For Work	1%

The proportion of ESA repeat assessments assigned to Support Group (SG) remained fairly stable, changing from 96% last quarter to 94% in the latest quarter, while the proportion found FfW increased slightly to 1%. This is a direct result of the suspension of face-to-face assessments in favour of paper-based and telephony assessments. The latest trend for WCA outcomes is a direct result of the suspension of face-to-face assessments, as at their introduction in May 2020 only SG decisions could be made via telephone assessments. From September 2020 WRAG decisions could also be made via telephone assessment.

Question 4

4.  ESA WCA Mandatory Reconsideration registrations, clearances and clearance times

Accepted Answer

MR registrations have been following a downward trend but increased in the latest quarter to reach 290 in January 2021.

By the end of January 2021, a total of 850,000 MRs have been registered. Of these, 99.6% had been cleared. The number of MR registrations and clearances within each month fluctuate over time:

the number of MR registrations and clearances gradually increased between April 2013 and March 2017 as volumes of ESA customers increased
MR registrations and clearances volumes peaked in March 2017 but have followed a downward trend since
latest figures for MR registrations in January 2021 is 290. Although there has been a slight increase in previous months, the overall number has fallen considerably since the same month a year earlier, when the number of registrations was 2,500

When the MR process was first introduced, the number of MR decisions was lower than the number of MRs registered. As the MRs became established, clearance volumes started increasing and became comparable to registration volumes in recent years.

The number of ESA WCA MR registrations and clearances should be seen in context with the decrease of ESA claims as UC is rolled out, the changing composition of assessment outcomes, the effect of the COVID-19 pandemic and that, in some circumstances, MR has now been discontinued and claimants can appeal straightaway.

For the purpose of these statistics, we consider all reconsiderations occurring after the WCA to be MRs. For more information on what we have counted as an MR see section 7 of this release and the methodology note .

Mandatory reconsiderations registrations and clearances, October 2013 to January 2021

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations – Registrations and Mandatory Reconsiderations - Clearances.

The median MR clearance dropped to 3 days in January 2021.

The MR average clearance times is derived using calendar days by calculating the median of the time taken from the date the Benefit Centre (BC) has decided the MR to be valid, having considered any new information, until the date the decision is cleared by the decision maker at the Dispute Resolution Team (DRT). These dates are obtained from the DWP Decision Making and Appeals Case Recorder (DMACR) reporting system. The total clearance time therefore includes the time taken to transfer the case to DRT.

Immediately after the introduction of MRs, in October 2013, the median average time taken to clear MRs had sharply increased to stand at 37 calendar days in May 2014. MR clearance times have significantly decreased from their peak in May 2014, and have been quite volatile since, with peaks in September 2016 (15 days), August 2018 (16 days) and January 2020 (16 days).

For the month ending January 2021, it took on average 3 calendar days to clear MRs, a 5 calendar days’ decrease from October 2020.

Mandatory reconsiderations median clearance times, October 2013 to January 2021

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations - Clearances.

Question 5

5.  ESA WCA Mandatory Reconsiderations outcomes

Accepted Answer

Since January 2020 there has been a mainly decreasing trend in the number of MR decisions, with only 280 MR decisions being made in January 2021.

From October 2013 to October 2019, the majority of MRs disputing ESA WCA assessment outcomes were not revised at MR stage. Since then, the proportion of assessment outcomes where the award changed after the MR gradually increased, with some fluctuation. The proportion of MR decisions resulting in a change in award rose from 54% in February 2020 to 82% in April 2020, reflecting the new operational approaches as well as COVID-19 impact. Between October 2020 and January 2021, the proportion of MR decisions leading to a change in award increased from 60% to 69% in the latest month (January 2021).

Percentage of ESA WCA mandatory reconsiderations by outcome, October 2013 to January 2021

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations – Clearances.

The increase in the proportion of revised decisions since 2019 should be seen in context alongside the large reduction in MRs, the new operational approaches to gather additional oral and written evidence at the MR stage, as well as the changing composition of WCA decisions caused by a number of factors. These include the COVID-19 pandemic and the introduction of UC replacing most income-related new claims to ESA.

Mandatory Reconsiderations – Decisions by type for the quarter ending in January 2021

Decisions Made	Percentages
Customer failed to attend WCA, provide medical evidence or return questionnaire	6%
Customer disputes FFW decision	10%
Customer disputes ESA group allocations	83%
Others/Unknown	1%

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations – Clearances.

Mandatory Reconsiderations – Decision Outcomes for the quarter ending in January 2021

Decision Outcomes	Revised	Not Revised
Customer failed to attend WCA, provide medical evidence or return questionnaire	83%	17%
Customer disputes FFW decision	44%	56%
Customer disputes ESA group allocations	65%	35%

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations – Clearances.

The majority of ESA WCA MRs cleared in the quarter to January 2021 were made on disputes about ESA group allocations and FfW decisions.

In the quarter ending January 2021 approximately 83% of MR decisions were made on disputes on ESA group allocation, followed by disputes on FfW assessment outcomes (10%). Of all MR decisions made in the quarter to January 2021, 6% were on disputes where the claimant had not followed the claim procedures correctly. These reasons include failing to return the initial questionnaire, failing to provide medical evidence or not attending the assessment. Across all categories, a majority of disputes were revised.

Patterns in the reasons for why customers go on and register an MR, are different in recent months due to ongoing COVID-19 disruption, since reassessment activity has not restarted for all types of claim and overall numbers of ESA WCA reassessments are low.

Question 6

6. 	ESA WCA customer journey clearance times for initial claims (experimental statistics)

Accepted Answer

The median end-to-end clearance times for initial ESA WCA claims is 107 calendar days for the latest month in September 2020.

After 2008, the median end-to-end clearance time generally followed an upward trend, reaching a peak of 192 calendar days in August 2014. Since then, it has reduced considerably to 93 days in February 2016 and 79 days in December 2018. The end-to-end clearance time saw sharp increases in early 2019 (103 days in March 2019 and 107 in July 2019), to fall again to 70 days in September 2019. In the month to September 2020, the end-to-end median clearance times (claim registration to final DWP award decision) for initial claims increased noticeably from 74 (in June 2020) to reach 107 calendar days, as telephone assessments begin to tackle some of the cases affected by COVID-19 delays. This is the highest recorded end-to-end median clearance time since July 2019, directly reflecting the impact of COVID-19 delays.

One of the stages of the end-to-end process accounts for the time between the customer’s referral to the Assessment Provider (AP) and the AP recommendation. This stage will usually involve a WCA assessment and includes the waiting time for the customer to complete and return the questionnaire. Multiple referrals are sometimes required before an assessment is completed and a recommendation received, as customers may not attend appointments or return questionnaires.

In September 2020, the median time between referral to the AP and their recommendation was 46 days. The AP clearance times has followed an increasing trend since the 37 days in May 2020, however the 46 days recorded in September 2020 is comparable to the 45 days recorded in February 2020 (pre COVID-19 period).

Median clearance times for completed initial claims, October 2008 to September 2020

Source: Stat-Xplore: ESA Work Capability Assessments under Clearance Times for Initial Claims.

Monthly clearance times (in weekdays) for individual stages of the ESA WCA process

Clearance Type	July 2020	August 2020	September 2020
Claim Registration to WCA Referral	16	20	25
WCA Referral to Assessment Provider (AP) Recommendation	50	53	46
AP recommendation to DWP decision	8	7	7
End-to-End ESA claim	86	98	107

Note: The ‘end-to-end clearance times’ refer to time taken from claim registration to date of DWP decision. Claim registration date is the date the claimant has first contact with the department when making a claim to ESA. The DWP decision will include MRs where there is a completed decision.

Question 7

7.  About these statistics

Accepted Answer

The UK Statistics Authority has designated these statistics as National Statistics, in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics. This badge does not currently apply to the experimental cohort figures or ESA clearance times.

Key uses of the statistics include:

providing the evidence base for assessing the potential effect of changes, monitoring and evaluation of DWP policy
answering Parliamentary Questions and Freedom of Information requests and Forecasting benefit expenditure (in conjunction with expenditure statistics)
policy development and evaluation by local authorities and other welfare to work and pensions stakeholders and providers

This release only includes ESA WCAs.

This release does not capture:

UC WCAs
UC MRs
UC appeals

Recent trends in these ESA WCA statistics will be affected by the roll out of UC.

Terminology

Term	Definition
Registration	Claimant registers an application for a WCA, MR or appeal.
Clearance	DWP decision maker has determined whether the claimant should or should not be entitled to claim ESA.
Mandatory Reconsideration	Claimant wishes to dispute a decision made on their claim and requests DWP to reconsider the decision. Due to operational practices performed within the DMACR system, some MRs are recorded on the source data as ‘reconsiderations’. Therefore, for the purpose of these statistics, all ‘reconsiderations’ occurring after the WCA (for reasons typically associated with MRs) have been included within the total number of MRs.
MR clearance time	The clearance time begins from the point the MR is raised on the DWP administrative system by the Benefit Centre as a valid MR, having considered whether they can initially change the decision in the light of any new information. The total clearance time therefore includes the time taken to transfer the case to the Dispute Resolution Team and the time taken for the decision maker to make a decision.
Repeat assessment	An existing claim that has been reassessed for ESA, as opposed to a new claim. A repeat assessment is the second or subsequent WCA undertaken on an existing, continuous ESA claim, usually between 3 and 24 months after the previous assessment. These claimants will have already been assessed as having a limited capability for work at their initial WCA and the repeat assessment will assess if their capability for work has changed.

Development of UC WCA official statistics

DWP are currently developing official statistics on numbers of UC claimants who go through a WCA and related outcomes. When the information will be robust and accurate enough for publication as official statistics, we will preannounce its release in the GOV.UK release calendar.

Where to find out more

Only the information for MRs and end-to-end clearance times for initial claims is published on Stat-Xplore, while the remaining information is published as data tables. Once the issues with the appeals data is resolved, future publications will include a complete back-series covering any missing tables.

Read the methodology note for more detailed information on these statistics.

ESA: outcomes of Work Capability Assessments including mandatory reconsiderations and appeals: March 2021

Applies to England, Scotland and Wales

1. Main stories