Work Capability Assessment

Contents

What is the work capability assessment?

The limited capability for work assessment

The limited capability for work-related activity assessment

When will the work capability assessment take place?

Universal credit

Employment and support allowance

Cases where only one assessment is needed

If your condition gets worse

How is the work capability assessment applied?

Completing the 'capability for work' questionnaire

The assessment

Challenging work capability assessment decisions

WCA limited capability for work-related activity assessment

Appendix 1: WCA limited capability for work assessment descriptors

Appendix 2: Treated as having a limited capability for work

Appendix 3: WCA limited capability for work-related activity assessment descriptors

Appendix 4: Treated as having a limited capability for work-related activity

More information

 

What is the work capability assessment?

Universal credit

The ‘work capability assessment’ (WCA) is very important for universal credit. It finds out what work-related conditions you must meet to keep getting the benefit in full. If you are found to have a ‘limited capability for work’ in the assessment, your work-related conditions will be limited. If you are found to have a ‘limited capability for work-related activity’ in the assessment, none of the work-related conditions will apply to you, and you will also be entitled to the work capability amount.

Employment and support allowance

The WCA is central to employment and support allowance (ESA). It has two parts. The first part, the limited capability for work assessment, finds out whether or not you can remain on ESA.

The second part, the limited capability for work-related activity assessment, finds out which of two groups you will be put in: the support group or the work-related activity group. The group you are put in will decide the level of ESA you get, the work-related conditions you must meet to keep getting the benefit in full and whether or not your ESA award may be time-limited.

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The limited capability for work assessment

The first part of the work capability assessment finds out if you have a ‘limited capability for work’.

For universal credit, if you have a limited capability for work, restrictions can be applied to the work-related responsibilities you must meet to keep getting the benefit in full.

For employment and support allowance, if you have a limited capability for work, you can stay on the benefit.

In each case, a points system is used to see how well you can carry out a range of activities, both physical and ‘mental, cognitive and intellectual’.  

Each activity is divided into different descriptors, which explain related tasks of varying degrees of difficulty. These have scores, ranging from 0 to 15 points. You score points when you are not able to perform a task described reliably and repeatedly. You add together the highest score from each activity that applies to you.

For a list of the descriptors and the points that you get from each, see here.

If you score 15 points, you qualify as having a limited capability for work. If you fail to score 15 points, you can challenge the decision.

You will be automatically treated as having a limited capability for work in some circumstances.

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The limited capability for work-related activity assessment

For universal credit, the limited capability for work-related activity assessment is used to find out what restrictions can be applied to the work-related conditions that you must meet to keep getting the benefit in full. If it is decided that you have a limited capability for work-related activity, no work-related conditions will apply to you. In addition, you will be entitled to the work capability amount.

For employment and support allowance, the limited capability for work-related activity assessment is used to decide whether you are put in the support group of claimants or the work-related activity group.

The assessment has a list of descriptors, relating to both physical functions and mental, cognitive or intellectual functions. If you meet at least one of them, you will have a limited capability for work-related activity.

You will be automatically treated as having a limited capability for work-related activity in some circumstances.

If you are found not to have a limited capability for work-related activity, you can challenge the decision.

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When will the work capability assessment take place?

Universal credit

In the case of universal credit, the first work capability assessment (WCA) should take place within 3 months of you providing the Department for Work and Pensions with evidence of your limited capability for work (eg a ‘fit note’ from your GP). If it is decided at this assessment that you have a limited capability for work, you may be asked to take part in further WCAs at intervals in the future to find out if the restrictions on your work-related responsibilities should remain the same.

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Employment and support allowance

In the case of employment and support allowance (ESA), the first WCA should take place during the 13-week ‘assessment phase’ that follows your initial claim. If it is decided at this assessment that you have a limited capability for work and can remain on ESA, you may be asked to take part in further WCAs at intervals in the future to find out whether you can still remain on ESA and, if so, whether you should remain in the same group.

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Cases where only one assessment is needed

If you are getting universal credit and have a limited capability for work-related activity or are getting ESA and are in the support group, you will not have to be reassessed following your initial WCA if you:

  • have a severe, lifelong disability, illness or health condition; and
  • are unlikely to ever be able to move into work.

You will be told if you will not be reassessed following your WCA.

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If your condition gets worse

If you are getting universal credit and have been assessed as having a limited capability for work (but not for work-related activity), you can request a WCA if you think that your condition has worsened to the extent that you now have a limited capability for work-related activity.

If you are getting ESA and are in the work-related activity group, you can request a WCA if you think that your condition has worsened to the extent that you should now be placed in the support group.

The DWP has published Guidance on Work Capability Assessment re-assessments

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How is the work capability assessment applied?

A Department for Work and Pensions (DWP) decision maker looks at the information you have provided with your claim for universal credit or employment and support allowance to see, without having to make further enquiries, if there is evidence that you have a limited capability for work and for work-related activity. If the decision maker considers they do not have such evidence, they will send you a 'capability for work questionnaire' for you to complete.

Once the decision maker has received your completed questionnaire, they may decide that there is clear evidence that you have a limited capability for work and for work-related activity. If not, you will be assessed by a healthcare professional working for the Health Assessment Advisory Service. This is operated by Maximus, the organisation delivering the assessment on behalf of the DWP.

Even if the DWP decision maker decides that you do not pass the limited capability for work assessment, they can still treat you as having passed it if one of the exceptional circumstances applies.

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Completing the 'capability for work' questionnaire

The capability for work questionnaire is divided up into a number of sections which relate to the activities in the limited capability for work assessment. In each case, you are asked about your ability to complete different tasks related to each activity. You need to consider whether or not you can complete each task reliably and repeatedly. The tasks, and the points that you can get for each one, are listed here. Use this when you are completing the questionnaire. Note that the wording in the questionnaire is sometimes different from our wording (in which we use the exact wording of the law).

Each section in the questionnaire has a space to provide more detailed information about the difficulties you face. When filling this in, let them know if your ability to complete each task varies. Make it clear if you cannot complete a task reliably and repeatedly. Let them know about any pain, tiredness or discomfort you would feel completing each task.

The Disability Rights Handbook gives more detailed advice on completing the questionnaire.

The time limit for completing and returning the questionnaire is four weeks. Before you return the questionnaire, make a copy of it for future reference.

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The assessment

The assessment can take place over the phone or by video, or face-to-face at an assessment centre.

The healthcare professional should have read a copy of the capability for work questionnaire that you completed. During the assessment they will be trying to identify which descriptors apply to you with respect to both parts of the work capability assessment. They will ask you a series of questions about your day-to-day life, including hobbies or leisure activities.

When answering the healthcare professional, explain your abilities as fully as you can. Tell them about any pain or tiredness you feel, or would feel, while carrying out each task, both on the day of the assessment and over time. Consider how you would feel if you had to do the same task repeatedly. Are you able to complete the task to a reasonable standard? Do you need prompting or encouragement? Let them know if there would be any risk if you tried to complete the task or if it would take you a long time to complete it. If your condition varies, let them know about the variability; and what you are like on bad days as well as on good days.

At a face-to-face assessment, the healthcare professional may then go on to give you a physical examination.

The decisions on whether or not you have a limited capability for work and a limited capability for work-related activity will not, however, be taken by the healthcare professional. They will complete a report of the assessment, which will be sent to a Department for Work and Pensions decision maker, who will make these two decisions.

The healthcare professional will also make recommendations as to when you should be re-tested under the work capability assessment.

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Challenging work capability assessment decisions

You can appeal straight away if you want to challenge a decision that you do not have a limited capability for work for employment and support allowance (ESA), as long as you are eligible to claim ESA while you are appealing, which you can do in most cases. However, you cannot receive ESA pending the appeal if you have had two consecutive decisions that you do not have (and cannot be treated as having) a limited capability for work. Nor can you receive ESA pending the appeal if you are appealing against a decision that you do not have good cause for failing to send back the capability for work questionnaire or take part in an assessment (in these situations, you will need to submit a new claim pending your appeal; payment of ESA may be suspended until you return a capability for work questionnaire or take part in an assessment).

For universal credit, you must first request a mandatory reconsideration of the decision.

Reconsidering decisions on limited capability for work

For ESA, attached to the decision will be a summary of the healthcare professional's report, telling you how many points you scored and from which activities you scored them. Unfortunately, for universal credit, the decision only gives a list of the activities that were considered relevant to your condition, not the points that you scored them with. You will need to ask for the full healthcare professional's report to find out how many points you scored and from which activities you scored them. You can ask for the report when you ask for the mandatory reconsideration; you can do this using your online journal or by calling the universal credit helpline

When you ask for the mandatory reconsideration, you need to make it clear which descriptors you believe should apply to you. For instance, someone with severe arthritis in their arms may explain: "In Activity 3, I cannot raise either arm to the top of my head as if to put on a hat (which would give me 9 points), and in Activity 4, I cannot transfer a light but bulky object such as an empty cardboard box (which would give me 6 points)". For a list of the desciptors and points, see Appendix 1 below.

Once the decision has been reconsidered, the decision maker will send you two copies of the 'mandatory reconsideration notice', to let you know the outcome. If you are not happy with the outcome, you can appeal

Reconsidering decisions on limited capability for work-related activity

If it is decided that you do not have a limited capability for work-related activity and you think that at least one of the decscriptors listed in Appendix 3 applies to you, or that one of the circumstances where you can be treated as having a limited capability for work-related activity applies to you (see Appendix 4), you may wish to ask for a mandatory reconsideration. When you ask for this, you need to make it clear which of the descriptors (or circumstances) applies to you.

Once the decision has been reconsidered, the decision maker will send you two copies of the 'mandatory reconsideration notice', to let you know the outcome. If you are not happy with the outcome, you can appeal

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WCA limited capability for work-related activity assessment

You cannot appeal straight away, you must first request a mandatory reconsideration; once you have received the mandatory reconsideration notice confirming that you are not considered to have a limited capability for work-related activity, you can appeal.

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Appendix 1: WCA limited capability for work assessment descriptors

To be assessed as having a limited capability for work, you need to score 15 points or more. Add together the highest score from each activity that applies to you.

The assessment takes into account your abilities when using any aid or appliance you would normally or could reasonably be expected to use.

If any task is highlighted in italics within the activities, you will also satisfy the limited capability for work-related activity assessment

Part 1: Physical functions

Activity 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. 

Activity 2. Standing and sitting.

Activity 3. Reaching.

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

Activity 5. Manual dexterity.

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

Activity 7. Understanding communication by: (i) verbal means (such as hearing or lip reading) alone; (ii)  non-verbal means (such as reading 16-point print or Braille) alone; or (iii)  a combination of (i) and (ii), using any aid that is normally or could reasonably be used, unaided  by another person.

Activity 8. Navigation and maintaining safety using a guide dog or other aid if either or both are normally or could reasonably be used.

Activity 9. Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or 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.

Activity 10. Consciousness during waking moments.

Part 2: Mental, cognitive and intellectual functions

Activity 11. Learning tasks.

Activity 12. Awareness of everyday hazards (such as boiling water or sharp objects).

Activity 13. Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks).

Activity 14. Coping with change.

Activity 15. Getting about.

Activity 16. Coping with social engagement due to cognitive impairment or mental disorder.

Activity 17. Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder.

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Appendix 2: Treated as having a limited capability for work

You will be automatically treated as having a limited capability for work, without having to score 15 points, in the following circumstances:

  • You are nearing the end of your life. This is defined as a progressive disease and death in consequence of that disease can reasonably be expected within 12 months.
  • You are receiving chemotherapy or radiotherapy for cancer (or are likely to receive it within six months), or you are recovering from that treatment and the DWP is satisfied that you should be treated as having a limited capability for work.
  • You have been given official notice not to work because you have been in contact with an infectious disease or contamination.
  • You are pregnant and there would be a serious risk to the health of you or your child if you worked.
  • You are being treated in a hospital or similar institution (including residential rehabilitation for treatment of drug or alcohol addiction), having been medically advised to stay there for at least 24 hours. The DWP may also treat you as having a limited capability for work on any day you are recovering from such treatment.
  • You are receiving regular weekly haemodialysis for chronic renal failure, plasmapheresis or regular weekly total parenteral nutrition [being fed through a vein, instead of eating] for gross impairment of enteric function. The DWP may also treat you as having a limited capability for work during any week in which you have a day of recovery from such treatment. However, for employment and support allowance (ESA) you will only be treated as having a limited capability for work from the first week in which at least two days of that week are days of treatment or recovery (these days do not have to be consecutive).

Additional circumstances: universal credit

For universal credit, you will also be treated as having a limited capability for work if you have reached pension age and are entitled to disability living allowance, personal independence payment or adult disability payment. 

Additional circumstances: ESA

For ESA, you will also be treated as having a limited capability for work in the following circumstances:

  • You satisfy either descriptor 15 (conveying food or drink to the mouth) or 16 (chewing of swallowing food or drink) in the limited capability for work-related activity assessment
  • You are pregnant or have recently given birth and are entitled to maternity allowance.
  • You are pregnant or have recently given birth but are not entitled to maternity allowance or statutory maternity pay from six weeks before the baby is due to two weeks after the birth.
  • You are a student in full-time education (and not a ‘qualifying young person’ for child benefit purposes) entitled to income-related ESA because you get disability living allowance, child disability payment, personal independence payment, adult disability payment or armed forces independence payment.     

Exceptional circumstances

If the decision maker decides you do not meet the limited capabilty for work assessment, they can still treat you as having a limited capability for work if one of the following 'exceptional circumstances' applies, that is, you have:

  • a life-threatening disease for which there is medical evidence that it is uncontrollable or uncontrolled by a recognised therapeutic procedure (and, in the latter case, there is a reasonable cause for this); or
  • some specific disease or bodily or mental disablement, and because of that there would be a substantial risk to any person's mental or physical health if you were found not to have a limited capability for work. 

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Appendix 3: WCA limited capability for work-related activity assessment descriptors

If one or more of the following descriptors applies to you, you will be assessed as having a limited capability for work-related activity. For universal credit, this will entitle you to the work capability amount. For employment and support allowance, it will place you in the support group of claimants. In each case, you will be exempt from having to meet work-related conditions in order to keep getting the benefit in full.

The assessment takes into account your abilities when using any aid or appliance you would normally or could reasonably be expected to use.

Activity 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:
(a) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or
(b) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.  

Activity 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.

Activity 3. Reaching.

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

Activity 4. Picking up and moving or transferring by the use of the upper body and arms (excluding standing, sitting, bending or kneeling and all other activities specified on this page).

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

Activity 5. Manual dexterity.

Cannot press a button (such as a telephone keypad) with either hand or cannot turn the pages of a book with either hand.

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

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

Activity 7. Understanding communication by:

(i) verbal means (such as hearing or lip reading) alone;

(ii) non-verbal means (such as reading 16-point print or Braille) alone; or

(iii) a combination of (i) and (ii)

using any aid that is normally, or could reasonably be, used unaided by another person.                      

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

Activity 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:
(a) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or
(b) substantial leakage of the contents of a collecting device,
sufficient to require the individual to clean themselves and change clothing.

Activity 9. Learning tasks.

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

Activity 10. Awareness of hazard.

Reduced awareness of everyday hazards, due to cognitive impairment or mental disorder, leads to a significant risk of:
(a) injury to self or others; or
(b) damage to property or possessions
such that the claimant requires supervision for the majority of the time to maintain safety.

Activity 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.

Activity 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.

Activity 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 claimant.

Activity 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.

Activity 15. Conveying food or drink to the mouth.

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

Activity 16. Chewing or swallowing food or drink.

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

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Appendix 4: Treated as having a limited capability for work-related activity

You can be automatically treated as having a limited capability for work-related activity if you are:

  • suffering from a progressive disease and consequently your death can reasonably be expected within 12 months;
  • receiving chemotherapy or radiotherapy (or are likely to receive it within six months) or you are recovering from that treatment, and the Department for Work and Pensions is satisfied that you should be treated as having a limited capability for work-related activity;
  • suffering from some specific disease or bodily or mental disablement and consequently there would be a substantial risk to the mental or physical health of any person if you were found not to have a limited capability for work-related activity;
  • pregnant and there would be a serious risk to the health of you or your child if you did work-related activity; or
  • (for universal credit only) have reached pension age and are entitled to attendance allowance, the highest rate of the care component of disability living allowance or the enhanced rate of the daily living component of personal independence payment or adult disability payment.

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More information

Advice

Enter your postcode on the advicelocal website and find an advice centre in your area.

See also our Getting Advice resource.

Information

The Health Assessment Advisory Service is in charge of the face-to-face assessments by healthcare professionals. For more information about the service it provides go to www.chdauk.co.uk/

For more detailed information aimed at advisers, see our Disability Rights Handbook.

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