Those applying for Employment and Support Allowance (ESA) may be sent a capability for work questionnaire, also known as an ESA50 form. Please complete the form as fully as possible, answering all the questions.
It’s important you return the form by the date on the letter you are sent. We will use the information you provide on the form to decide what type of assessment you may need.
You may also download the ESA50 form to your computer. If you use the online form, fill it out, print it, sign it and then send it to us.
If you need help filling in the form, you can now speak to a dedicated advisor on our helpline by calling 0800 072 0398
You can also go to your local benefits office and speak to your work coach.
Interpreters
Please let us know at least two days before your assessment if you need an interpreter for your assessment.
Appointment arrangements
We’ll call you to arrange a date and time to suit you and follow up with a confirmation letter of the details of your appointment. Your appointment letter will have a contact number and information about the assessment. Please read this letter before your assessment.
If you need help before your assessment contact us.
The Customer Enquiries line is open Monday to Friday 8:30am to 5pm.
What happens with your support before your assessment
Whilst you are waiting for your assessment to be completed, you will be paid the assessment rate appointed under ESA.
You can find more information about Employment and Support Allowance on the DfC website.
Further evidence
You will need to send any medical evidence or other information you might already have such as:
You may be asked for details of the professionals or carers who know the most about your health conditions, illnesses and disabilities (toggle the + to see the list)
Remember – only send us copies of medical or other information if you already have them. Don’t ask or pay for new information or send us original documents. Please write your National Insurance number on each piece of information you send to us.
If you haven’t yet received an ESA50 form, it might be easier for you if you start to gather some of your medical information in advance. This form allows us to decide if you will need an assessment.
As soon as you have completed the form, you need to sign and date it, and return it in the envelope we provided. It is important for you to return the form before its due date.
The DfC may not be able to continue to pay you benefits if we don’t receive this form in time.
If you cannot return the form in time, let us know as soon as possible. There is also a box that allows you to explain why your form was late.
If you have any concerns, please contact us.
The assessment
The functional assessor will introduce themselves and explain the assessment to you. They will record information on a computer. Some questions may not relate directly to your medical condition, but to daily activities. The assessment will last between 20 minutes and 1 hour depending on your health condition or disability.
What to bring to the assessment
- proof of identity
- any medication
- any information from your general practitioner (GP) or specialist which explains how your condition affects you
The assessment questions may include:
- When your illness or disability started
- How your condition changes from day-to-day
- How it affects your daily life
- How it affects your mood and the way you behave
- How you cope with things from day-to-day
The functional assessor will record information about your pain, fatigue, and the medication you take.
Depending on your illness or disability the assessment may include:
- A physical examination
- Movements such as stretching, standing and bending
The functional assessor will not ask you to make any movements that cause you discomfort. If you are worried that certain movements may cause you pain, please tell the functional assessor.
We provide the Department for Communities (DfC) with an assessment report which is impartial and provides justified medical advice about how you are currently affected by your medical condition. This is following government legislation and the processes agreed by DfC.
Companion or chaperone during your assessment
You are welcome to bring a relative, carer or friend with you. Although the assessment will focus on you, a companion can offer useful support to you.
Taking notes
You or your companion are welcome to take notes for your personal use. Your notes will not form part of the medical report that we send to the DfC.
After your assessment our functional assessor completes a report using criteria laid out by the DfC. This is to provide the DfC decision maker with an impartial, justified medical opinion about how you are affected by your medical condition.
The assessment report will describe your medical conditions and the activities you undertake in a typical day. It will also have the Functional assessor’s observations, and the results of any physical examination undertaken.
The report is one piece of information DfC uses in deciding your entitlement. The Functional assessor will not know the outcome of your claim.
You may request a copy of the full report from the DfC office handling your claim.
Decisions on claims
DfC will let you know of the outcome of your claim and why the decision was made. If you have any questions on the outcome of your assessment, please contact the DfC.
We are not involved in the decision-making process.
