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Wednesday, 3 October 2023

The Work Capability Assessment

When you make a claim for Employment and Support Allowance (ESA), you will usually have a Work Capability Assessment. You may also be asked to take part in a medical assessment.

About the Work Capability Assessment

Work Capability Assessment is the main assessment for Employment and Support Allowance claims.

It may include a medical assessment if more information is needed about your illness or disability before a decision can be made on your capability for work.

An approved healthcare professional, who has been trained in handling Employment and Support Allowance claims, will assess how your illness or disability affects your capability for work or work related activity, and provide advice to the Department for Work and Pensions (DWP), which is responsible for administering benefit claims.

The approved healthcare professional may recommend that you attend a medical assessment if they feel they need more information about your condition.

How it works

After your initial claim for Employment and Support Allowance, you have to complete a questionnaire about how your illness or disability affects your ability to complete everyday tasks.

Your own doctor may be asked to provide a medical report.

An approved healthcare professional will consider the questionnaire and any medical reports, along with any other information you may have provided.

If the approved healthcare professional feels that the DWP will need more information to make a decision on your benefit claim, they will recommend that you attend a face-to-face medical assessment.

After your initial claim for Employment and Support Allowance, you have to complete a questionnaire - 'Limited capability for work questionnaire ESA50'. The answers you give in the questionnaire should explain how your illness or disability affects your ability to complete everyday tasks. Your own doctor may be asked to provide a medical report. You can download a copy of the 'Limited capability for work questionnaire ESA50' using the following link.

Reasons for a medical assessment

You may have been asked to attend a medical assessment for a number of reasons.

Most people are asked to attend one. It doesn't mean the information you've provided on your claim form is being treated as suspicious or that your claim will be turned down.

Your benefit claim will not be turned down without you either having a medical assessment or being offered one.

About the medical assessment

The medical assessment will usually take place at a Medical Centre near where you live. If you're unfit to travel or you live more than 90 minutes' journey from the nearest centre, the approved healthcare professional may visit you at home.

You will usually be contacted by telephone by the Medical Services provider. This can be any time between 8.30 am and 8.00 pm. You will be given notice of your appointment and the option to change it if the time doesn't suit you. Your appointment time will be between 9.00 am and 5.00 pm.

It is very important to attend and fully participate in your medical assessment as your benefit may be affected if you don't. If for any reason you cannot attend, you should contact the Medical Centre beforehand and arrange another appointment.

Your rights at the assessment

You have the right to:

  • have a friend, relative or support worker with you at the medical assessment
  • ask for an interpreter if you cannot speak in English
  • Welsh speaking healthcare professionals (HCP) are available in Wales if you wish to have your assessment conducted in Welsh
  • ask to be assessed by an approved healthcare professional of the same gender as yourself

You need to let the Medical Centre know ahead of time if you want an interpreter or same-gender approved healthcare professional. They will try to find one for you, although this may not always be possible in some areas.

Terminal illness

There are special rules if your doctor doesn’t think you’ll live for more than six months. These rules make sure you get the most money you can. If this applies to you, please speak to a Jobcentre Plus adviser.

Mental health conditions

If you have a mental health condition, Jobcentre Plus may ask you to fill in a questionnaire about how this affects you.

A mental health condition could affect:

  • your mood
  • the way you behave
  • the way you relate to the world around you
  • how you cope with things from day to day

You must tell Jobcentre Plus if you have other health problems as well. Jobcentre Plus may talk to your doctor, and you may have to see one of their healthcare professionals.

Further details

There is a very detailed guide to the Work Capability Assessment (ESA214) in PDF format. It is published by Jobcentre Plus and is aimed mainly at professionals, but you may find it useful. Because the information is detailed and technical, some of it can be quite hard to understand.

See the link 'Guide to Employment and Support Allowance - the Work Capability Assessment ESA214'.

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