ESA Application Form October 21

Closes 31 Oct 2021

Opened 1 Oct 2021

Overview

How to claim

You can submit a claim to New Style Employment and Support Allowance (ESA) online by following the link below. Entitlement to New Style ESA is dependent on your National Insurance record. For more information on the entitlement conditions, please visit NI Direct.

You can ask a friend or relative or an organisation that you know and trust to help you. Alternatively you can contact ESA for help on 0800 085 6318.

If you have speech or hearing difficulties and would like help submitting a claim you can contact ESA using a textphone on 0800 328 3419.

About this form

You may not get Employment and Support Allowance if you do not  

  • answer all the questions on the form that apply to you, and  
  • send us all the documents we ask for straight away. If you do not, you may only get benefit from the date you give us all the information we need.

If you are unable to do this, please tell us why in Part 13 Other information. Sometimes we may still be able to deal with your claim.

Further information about Employment and Support Allowance and other financial support can be found on NIDirect.gov.uk

Income Related ESA has been replaced by Universal Credit. You may be eligible to claim New Style ESA at the same time as Universal Credit.

Employment and Support Allowance Claim Form

Audiences

  • All stakeholders

Interests

  • Income