Who completes this form?

These forms are sent to you if you have limited capability to work and you told Department for Work and Pension that your health and difficulties mean you are restricted to be able to work.

You get a form when you have claimed either:

  • Employment Support Allowance- form ESA50 is sent
  • Universal Credit-form UC50 is sent

Both of these forms are work capability questionnaires that ask questions about how your health and difficulties limit your ability to complete certain described activities.

It is important to return the form by the date asked. You may lose benefit if you don’t do this, if there is a good reason you can’t get it done in time you must contact the office that sent the form to ask if they can give more time.

  • The form asks for your doctor’s details and also about anyone else who knows about your difficulties. So include details of anyone who knows about how your health impacts your ability to do things. A good supporting letter from someone like a health professional that mentions how the issues on the form cause you difficulty and how your health affects you can help to get a good assessment. Don’t send the original letter, send a copy with the form.

Things to consider

Don’t miss out any health conditions or difficulties, even if you feel embarrassed to mention things, all health problems and difficulties should be put on the form.

All medications and treatments should be mentioned not just those on your repeat prescription. If you buy things over the counter or have other complementary medicine mention these too. If you cannot take some medication for any reason or have side effects from taking something, mention this.

Part 1 of the form asks questions about your physical ability to complete the described activities of the form

Part 2 looks at mental, cognitive and intellectual function so the described activities look at mental health and difficulties.

Remember to mention if a physical difficulty has caused mental health/functioning difficulties for example ongoing physical pain from a health condition may cause depression. Also where mental health or disablement/difficulties cause physical difficulties or example bowel problems.

The form has tick boxes no and yes, to ask if you can do the activities described. By ticking no you cannot do the activity doesn’t mean it is impossible but means you struggle or have difficulty doing it. If you can’t do the activity safely, repeatedly or reliably, or it takes you much longer to do it, this should also be noted, give all details in the boxes, give the reasons why . This could be pain/discomfort, restricted mobility or strength, confusion/ memory problems, difficulties with vision/hearing or other sensory problems, lack of motivation, exhaustion etc. If you need prompted by someone, someone has to do some things for you, or to be there whilst you do the activity, this should also be noted on the form.

Physical Function

Difficulties you have must relate to the following these described activities:

Part 1: Physical disabilities

Activity 1: Moving around and using steps

Activity2: Standing and sitting

Activity3: Reaching

Activity 4: Picking up and moving things or transferring by the use of the upper body and arms

Activity 5: Manual dexterity (using your hands)

Activity 6: Making yourself understood through speaking, writing, typing, or other means normally used, unaided by another person

Activity 7: Understanding communication hearing and reading (such as hearing or lip reading) and non-verbal means (such as reading 16 point print) using any aid it is reasonable to expect you to use, unaided by another person

Activity 8: Getting around safety, using a guide dog or other aid if normally used

Activity 9: Loss of bladder and or bowel control

Activity 10: Staying conscious during waking moments (such as faints/fits/blackouts)

Part 2: Mental, cognitive and intellectual function assessment

Activity 11: Learning how to do tasks

Activity 12: Awareness of everyday hazards/danger (such as boiling water or sharp objects)

Activity 13 Starting and finishing tasks (which means planning, organisation, problem solving, prioritising or switching tasks)

Activity 14: Coping with change

Activity 15: Going out/Getting about

Activity 16: Coping with social situations

Activity 17: Appropriate behaviour with other people

Activity 18: Eating or drinking

The Health Assessment

The last stage is having a health assessment.

Remember if you are asked to attend a centre for assessment, they will ask about how you managed the journey there. They will observe you from calling your name in the waiting room, then mobilising into the assessment room. The assessment considers how you respond to the questions, how well you mobilised there, how you coped with the experience sitting and talking.  You can ask for a home assessment on the form but need to provide a letter from a health professional to say why you need this to happen.

During Covid-19 restrictions, assessments have been done over the phone.

If you don’t agree with the award decision

If you do not agree with the award decision, you must first ask for a mandatory reconsideration where they look again at the decision. This should be done within a month of the date on your decision letter. You can send in more information or new support letters from professionals who know about your difficulties. If the result still isn’t in your favour you can request an appeal which is sent to the tribunal service. This should be done within a month of the date on the mandatory reconsideration decision letter.

You can lose or gain points at the appeal, as they look at the whole decision again. Seek advice.

Review Form

  • Keep a copy of your last completed form to remind yourself of what was written
  • If you don’t have a copy you may be unsure of what was written, then you can call to ask for them to send a copy of your last form to you.
  • Keep your last award letter to show any award details.
  • Sending supporting letters from a professional who knows your difficulties can help, e.g. from a GP, consultant, physiotherapist, psychiatrist, community psychiatric nurse, social worker etc.

If you ask for a review as your health has changed

If you feel your difficulties have become worse and think you want to ask for a review of your entitlement, please be aware you may lose entitlement or gain in their reassessment process, as they look at the whole decision again.  Seek advice.