Incapacity benefit

Incapacity Benefit is for people unable to work because of illness or disability. Whether you have recently become ill, have suffered from a mental illness for a length of time, or are caring for someone with a mental illness, it is important to sort out what you are entitled to at your earliest convenience.

Incapacity Benefit can be claimed if you:

  • Have paid sufficient national insurance contributions
  • Are accepted as incapable of work
  • Do not have too much income from a pension or occupational pension or some types of health insurance
  • Are under pension age (60 for women; 65 for men)
  • Have no entitlement to statutory sick pay

Special rules exist for young people under 20 (and in some circumstances under 25) years old.

How do I qualify for Incapacity Benefit?

In order to qualify for Incapacity Benefit you must prove that you are incapable of work. If you have worked for at least 16 hours a week for more than 8 out of the last 21 weeks, then for the first 28 weeks of a period when you are unable to work, you can claim Incapacity Benefit by submitting sick notes from your GP stating that you are not fit to do your normal job.

The scale on ICB goes up after 28 weeks and then up again after 52 weeks of sickness, when an addition based on the age you were when you first claimed ICB is paid. There are also additions for dependents.

There are many complex rules surrounding period of incapacity to work. If you are in any doubt as to whether you can claim, please contact your nearest Citizens Advice who should be able to help.

The personal capability assessment

After 28 weeks, if you haven't worked recently, or if you've used up your statutory sick pay, you will have to fill out a questionnaire to see if you can get ICB.

The questionnaire is also called the Personal Capability Assessment form (IB50). It is divided into two parts: physical and mental health tests.

You should fill out whichever applies to you. If you have physical and mental health problems, fill out both. You should bear in mind that sometimes the side effects of the medication you take may affect your physical health. If you fill out the mental health test you will need medical evidence that you have a mental health condition.

The assessment is based on a points system. In order to be found incapable of work on mental health grounds, you have to score a minimum of 10 points. Points are awarded based on a set of questions divided into four groups. Choose all the statements that you think apply to you. If your illness fluctuates, think about what you are like when you are not well as well as when you can manage.

Answer the questions in as full an answer as possible. Try to think about your ability to carry out the mentioned tasks regularly, safely and efficiently. Give details of situations when you have been unable to cope or complete a task. You need to explain if you are able to do something sometimes and not other times. If you take medication or treatment, or have side effects from this medication which affect your ability to carry out the tasks, write this down.

If you would like to speak to someone about completing the questions then the advisors at Citizens Advice  or the Rethink National Advice Service may be able to help.

Exemption from the questionnaire

You may be exempt from the questionnaire if:

  • There is medical evidence that you have a severe mental illness
  • Your mental illness severely and adversely affects your mood or behaviour
  • Your mental illness severely restricts your social functioning, or your awareness of your immediate environment.

You may be regarded as severely mentally ill if you are receiving ongoing psychiatric care such as visiting a day centre, or are on long-term medication. People who are likely to pose a threat or danger to themselves or other people are also regarded as severely mentally ill.

Decisions on exemption
If there is enough information from your medical certificate to decide you are exempt, you do not have to do anything further and do not need to fill in a questionnaire.

If there is some doubt whether you are exempt or not, the DWP will send a form (IB113) to your GP to complete and a questionnaire for you to fill in. If you are not happy with the DWP’s decision on your exemption you need to get evidence from a doctor, hospital, day centre or community mental health team, that you have a severe mental illness and that it affects you in the ways described in the assessment.

The medical examination

If you do not score enough on the physical disabilities scale, you will be offered a medical examination so that a doctor can go through the mental health assessment with you.

If you are called for an examination you will expected to go to a medical examinations centre unless you are too unable, in which case your doctor should provide a note stating this. If you cannot make this appointment you should inform the office that arranged the examinations as soon as possible.

The medical examination starts from the moment the doctor meets you and takes you to the examination room. S/he will be looking at the way you walk, move, how you communicate etc.

The doctor will ask you questions about your everyday activities and give you an examination. People with a mental health problem will be asked questions to determine how able you are at completing tasks, getting on with daily living, coping with pressure and interacting with people. If your condition changes from day to day, make sure you tell him/her about how you are affected from day to day.

Remember you can take a friend or interpreter with you, or notes to help you remember things.

Appeals

You can appeal against a decision that you are capable of work. You must appeal within one month of the date the decision is sent to you, so check the decision letter and make sure you keep to the deadline. It is worth appealing if you disagree with the decision that you are fit to work.

For help in making an appeal, contact your local Citizens Advice , a mental health advocate or the Rethink National Advice Service.

National Advice Service Factsheets

The information on this page is taken from the NAS factsheet, which you can download in pdf format and print for individual use.

Incapacity benefit factsheet