The Work Capability Assessment involves:

• A questionnaire for you to complete
• A medical assessment for you to attend

When you claim Employment and Support Allowance, you are sent a Limited Capability for Work (LCW) questionnaire (ESA50) to complete and return.

When you claim Universal Credit and submit sick notes, you will be sent a UC50 to fill out. It usually takes around three months of submitting sick notes before you are sent a UC50, though work coaches can arrange for them to be sent out before this in some circumstances. If you have been submitting sick notes for a long time and have not received a UC50 to complete, you should ask your work coach to send you one.

In most cases, once you have returned the completed questionnaire you will be asked to attend a medical assessment.

The sections of the questionnaire

The questionnaire is an opportunity for you to describe the problems you have in carrying out certain activities.

It begins by asking for your name, address, doctor’s details etc. and also for a brief description of your illness, disability, medication and treatment(s).

The rest of the questionnaire is divided into two parts:

• Questions 1-10 are about your ability to carry out certain physical activities like mobilising, standing and sitting

• Questions 11-17 are about mental and intellectual functions that you may need to carry out in your daily life. The questions relate to mental health conditions such as depression, learning difficulties or the effects of head injuries.  

What to think about when completing the questionnaire

The questionnaire will be read by the healthcare professional before your medical assessment, the Department for Work and Pensions (DWP) decision maker, and (if you appeal the decision) by the Tribunal Appeal panel. You must therefore be as thorough as possible in answering the questions.

When answering the questions think about whether you can do the activity safely, reliably and repeatedly.

Consider the side effects of any medication you take on the performance of the activities. 

It can be helpful to keep a diary for a week or two before completing the form so you can get a clearer picture of your problems - but make sure you return the form within the deadline.

Completing the questionnaire

If you tick a box which indicates that you have difficulty with an activity, write something about how performing that activity affects you or why it is difficult to perform the activity.

If you have good and bad days, describe these and what happens to you on bad days. How often do the 'bad days' occur?

It is not enough to just tick ‘it varies’.

If you can, give examples of any problems you have had with the activity and when these problems occurred, or how frequently they occur.
 
Examples of the type of information to include in the questionnaire

Mobilising

If you can, measure the distance you walk from your home to a local place like your nearest shop.

Describe what happens when you walk – for example, tiredness, breathlessness and/or pain.

If you can walk a distance of 50 metres can you then repeat this activity? How long does it take you to recover from any pain or breathlessness before you can continue walking?

The DWP considers whether you would be able to move the distance using a manual wheelchair - even if you don't usually use a wheelchair. If there are reasons why you don't or can't use a wheelchair to improve your ability to get around, explain them here.

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

This activity is to test your ability to pick up and move fairly light objects, for example a one litre carton of liquid.

You are not asked about bending down to pick something up, just whether you can do it from about waist height.

If you could do this activity once, but not repeatedly, you should put this on the questionnaire, and also explain why you cannot repeat the activity.

If you are prone to dropping objects because of problems with gripping, then you should mention this.

Learning tasks

If you have problems concentrating or remembering then explain this in the answers.

If you are able to learn to do a simple task but only after it has been explained to you several times, then write this in the questionnaire.

It is also worth writing down if you can remember simple instructions but then forget them soon afterwards,, such as the next day.

Coping with social situations

The DWP give examples of people affected by severe anxiety, autism, psychosis or learning disability who may have problems coping with social situations.

If you become very anxious, you may have feelings of severe anxiety, depression, and/or panic attacks. You need to describe how these affect your ability to meet with people you know or meet people for the first time.

The medical assessor often notes whether you attended the medical examination alone or with someone.

If you attend alone, explain to the assessor how the journey affected you, for example did it cause you distress or anxiety? What planning went into the journey?

Medical evidence

It is a good idea to send medical evidence with your UC50/ESA50 form.

Examples of medical evidence include:

• Your patient summary (ask your GP surgery for this)

• Copies of your prescriptions

• Paperwork about your health from clinics or consultants.

You may be expected to attend an assessment in person, or you might be assessed over the phone or on a video call. 

If you want the assessment recorded, you will need to request this in advance by calling the number on the letter you receive inviting you to the assessment.

If you don't attend the assessment, it is likely the Department for Work and Pensions (DWP) will decide that you are fit for work. If you cannot attend an assessment, it is important to contact the assessment centre and rearrange the appointment.

The healthcare professional should have read your questionnaire and should ask you questions about your typical day and any problems you have.

Following this assessment, the healthcare professional will send their report to the DWP.

This is the part of the Work Capability Assessment to see whether you will be placed in the support group for Employment and Support Allowance (ESA) or considered to have Limited Capability for Work Related Activity (LCWRA) for Universal Credit.

There are descriptors (examples below) and if one or more descriptors applies to you, you will be put in the support group.

Limited Capability for Work-Related Activity Descriptors

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.

Cannot either:

• Mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or

• Repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.

2. Transferring from one seated position to another.

Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person.

3. Reaching.

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

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

Cannot pick up and move a 0.5 litre carton full of liquid.

5. Manual dexterity.

Cannot either:

• Press a button, such as a telephone keypad; or
• Turn the pages of a book with either hand.

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

Cannot convey a simple message, such as the presence of a hazard.

7. Understanding communication by hearing, lip reading, reading 16 point print or using any aid if reasonably used.

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

8.  Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or voiding of the 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.

At least once a week experiences:

• Loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or
• Substantial leakage of the contents of a collecting device sufficient to require the individual to clean themselves and change clothing.

9. Learning tasks.

Cannot learn how to complete a simple task, such as setting an alarm clock, due to cognitive impairment or mental disorder.

10. Awareness of hazard.

• Reduced awareness of everyday hazards, due to cognitive impairment or mental disorder, leads to a significant risk of injury to self or others; or
• Damage to property or possessions such that they require supervision for the majority of the time to maintain safety.

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

Cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions.

12. Coping with change.

Cannot cope with any change, due to cognitive impairment or mental disorder, to the extent that day to day life cannot be managed.

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

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

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

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

15. Conveying food or drink to the mouth.

• Cannot convey food or drink to the claimant’s own mouth without receiving physical assistance from someone else;
• Cannot convey food or drink to the claimant’s own mouth without repeatedly stopping, experiencing breathlessness or severe discomfort;
• Cannot convey food or drink to the claimant’s own mouth without receiving regular prompting given by someone else in the claimant’s physical presence; or
• Owing to a severe disorder of mood or behaviour, fails to convey food or drink to the claimant’s own mouth without receiving physical assistance from someone else; or regular prompting given by someone else in the claimant’s presence.

16. Chewing or swallowing food or drink.

• Owing to a severe disorder of mood or behaviour, fails to chew or swallow food or drink; or chew or swallow food or drink without regular prompting given by someone else in the claimant’s presence
• Cannot chew or swallow food or drink;
• Cannot chew or swallow food or drink without repeatedly stopping, experiencing breathlessness or severe discomfort;
• Cannot chew or swallow food or drink without repeatedly receiving regular prompting given by someone else in the claimant’s presence.

After looking at the health care professional's report, and also your questionnaire, the Department for Work and Pensions (DWP) decision maker will decide whether you have scored enough points (fifteen points) to be considered to have Limited Capability for Work (LCW), and whether you satisfy any of the descriptors to have Limited Capability for Work Related Activity (LCWRA) / be placed in the Support Group.

If you get Employment and Support Allowance (ESA), the decision maker will write to you to say whether you have passed the assessment and will continue to receive ESA, or have failed and therefore will not be entitled to carry on getting ESA. If you are placed in the Support Group, they will also calculate whether you are owed any back pay and will arrange for it to be paid to you. You won't be entitled to the Support Component for the first three months of your claim, but most people in the Support Group do get some back pay as it usually takes more than three months from the beginning of an ESA claim to complete a Work Capability Assessment.

If you get Universal Credit, the decision maker will attach a letter to your journal to say whether you have passed the assessment or not. You can continue to get Universal Credit whether or not you pass. However, if you fail, you might have to start looking for work. 

The letter will confirm what group you have been placed in if you have passed the assessment. If you have been placed in the Limited Capability for Work Related Activity (LCWRA) group, you will usually get extra money on your Universal Credit claim. You may also receive some back payment. 

The decision maker’s decision letter should contain a summary of the healthcare professional's report and a summary of the points you scored.

If you disagree with the decision, you can request a reconsideration of the decision.

See:

• Challenging an Employment and Support Allowance decision  
• How do I challenge a Universal Credit decision?