The work capability assessment (WCA) is a key part of employment support allowance (ESA). The assessment will be carried out by a health care professional working on behalf of the Department for Work and Pensions. It is intended to:
This factsheet is a brief overview of the ESA medical tests. for a more detailed description see either our Disability Rights Handbook or employment and support allowance guide.
The limited capability for work test decides whether or not you remain on ESA. If you do not pass the test, because you are not considered to have a limited capability for work, you would need to consider appealing this decision and/or claiming jobseeker’s allowance instead.
It is a points-related test. A number of your physical and mental health functions are considered within a range of activities and points are awarded on the basis of your limitations with respect to each function. These are totalled up and if the total reaches the threshold of 15, you are deemed to have limited capability for work and thus stay on ESA.
In order to apply the test a decision maker will first look at the information that you have provided in your initial claim for ESA to see if there is evidence that you have a limited capability for work without having to make further enquiries.
The decision maker should also see if there is evidence that you can be treated as having limited capability for work-related activity (see below).
If the decision maker considers that they do not have enough information to make a decision you will normally be sent a limited capability for work questionnaire to complete – the ESA50. This form has a number of questions about both physical and mental activities. Each activity has a section with tick-boxes and space to provide more detailed information about each activity.
Once the decision maker has received your completed ESA50 they may decide that there is clear evidence that you have limited capability for work. If not, they may then go on to arrange for you to be seen by a health care professional working on behalf of the Department for Work and Pensions.
You will be automatically treated as having a limited capability for work in the following circumstances:
• you are a hospital inpatient
• you are suffering from a progressive disease and consequently your death can reasonably be expected within 6 months;
• you are receiving treatment by way of intravenous, intraperitoneal or intrathecal chemotherapy;
• you have been requested or given notice, under specific legislation, to refrain from work because you are a carrier of , or have been in contact with, an infectious disease;
• you are pregnant and there would be a serious risk to the health of you or your child if you did not refrain from work;
• you are pregnant or have recently given birth and are entitled to maternity allowance and are within the maternity allowance payment period.
• you are pregnant or have recently given birth but are not entitled to maternity allowance or statutory maternity pay, from 6 weeks before the baby is due to 2 weeks after the birth.
The physical descriptors in the limited capability for work test are grouped into 11 different types of activity. These are:
Within each type of activity there is a list of descriptors with associated scores ranging from 0 to 15. The descriptors describe related tasks of varying degrees of difficulty. You score when you are not able to perform the activity described. Though more than one descriptor may apply to you, you can only pick up one score from each type of activity; in each case whichever scores the highest.
If you score 15 in any one activity, you automatically pass the test. If your score is less than 15, it can be added to the scores you pick up from any of the other types of activity (in both the physical and the mental parts of the test). If your total score reaches 15, you pass the test.
For a full list of activities, descriptors and points see www.disabilityalliance.org/esamedtest.pdf.
The mental descriptors in the limited capability for work test are grouped into sets of activities under the following 10 headings:
As with the physical descriptors, there is a list of descriptors under each activity heading. The scoring follows a similar pattern. You score points because you cannot perform the activity described; the highest points you score under each heading are totalled up and the target is again 15. As mentioned above, the points you gain under the mental activities headings can be added to those under the physical activities, to reach the magic 15.
For a full list of activities, descriptors and points see www.disabilityalliance.org/esamedtest.pdf.
The second test within the WCA considers whether you have a ‘limited capability for work-related activity’. Though the wording may seem similar to that of the first test, the second test has a very different function. It is used to determine whether you are placed in the support group of claimants or the work-related activity group.
Which group you are placed in will determine both the level of ESA that you will receive and the responsibilities you will need to meet in order to retain the benefit. The test has a list of 46 descriptors, relating to both physical and mental functions. If at least one of them fits, you will be placed in the support group of claimants. The descriptors are grouped together under the following 11 activity headings:
The process for the 'limited capability for work-related activity test' is very similar to that of the ‘limited capability for work test’ and will usually take place at the same time. A decision maker will first look at the information that you have provided in your initial claim for ESA to see if there is evidence that you have a limited capability for work-related activity without having to make further enquiries.
If the decision maker considers that they do not already have such evidence, they will then normally send you the ESA50 form to complete.
Once the decision maker has received your completed ESA50 they may decide that there is clear evidence that you have limited capability for work-related activity and place you into the support group of claimants. If not, they may then go on to arrange for you to be seen by a health care professional working on behalf of the Department for Work and Pensions.
For a full list of activities, descriptors and points see www.disabilityalliance.org/esamedtest.pdf.
The third test within the WCA is the ‘work-focused health-related assessment’ (WFHRA). The work-focused health-related assessment collects additional information about the things that you can do – your ‘functional capacity’ – despite your condition. In this respect, it is coming from the opposite direction to the first two tests, which focus on the things you can’t do. The WFHRA also collects information about any health interventions that could improve your functional capacity and thus support a move back into work. This could include the use of appropriate aids and adaptations.
The information required for the WFHRA is not obtained from the ESA50 form, but will be collected at some stage, on a WFHRA form, during the medical conducted by the health care professional working on behalf of the Department for Work and Pensions (see below). This information will then be put into a ‘capability report’. If you are placed in the work-related activity group of claimants and are required to attend follow-up work-focused interviews, this report will be made available to both you and the personal adviser at each interview.
The medical will be carried out by a health care professional working on behalf of the Department for Work and Pensions. They will have read a copy of the ESA50 form that you have completed and at the medical they will be trying to identify whether or not your account in that form of your functional limitations corresponds with their findings.
They will ask you a series of questions, relating to both your physical and mental capabilities, guided by what you have put down on the ESA50. Once they have finished this, they will then perform a physical examination on you.
The decisions on whether or not you have limited capability for work and limited capability for work-related activity will not, however, be taken by the health care professional. They will send their medical report to a decision maker, who will make these two decisions. If the decision maker decides that you do not pass the limited capability for work test they can still treat you as having passed it if the health care professional has obtained evidence that one of the following exceptional circumstances apply:
For the moment, if you are claiming incapacity benefit (IB) or income support (IS) on grounds of disability, you still have to satisfy the old personal capability assessment test rather than the new ESA test. The Government has announced its intention to transfer those on IB/IS to ESA and to apply the ESA test at a future date.
If you are a full time student claiming contributory ESA you will have to satisfy the limited capability for work test. If you are claiming income-related ESA you will be treated as having limited capability for work if you are getting disability living allowance (DLA).
Whether or not you automatically satisfy the limited capability for work test you will still be assessed under the limited capability for work-related activity test, which decides whether you are in the support group or the work-related activity group.
If you are in the work-related activity group you will also have to attend a work-focused health-related assessment.
If you are a part-time student you will have to satisfy the limited capability for work test and be assessed under the limited capability for work-related activity test. You may also have to attend a work-focused health-related assessment if you are placed in the work related activity group.
For basic information on ESA see Factsheet F31 - employment and support allowance overview.
For more detailed information on ESA see the following:
You can now view the employment and support allowance (esa) operational guide for local authorities interim process (october2008), which is the official guidance for doctors carrying out medical assessments, on the Child poverty Action Group website at www.cpag.org.uk/esa/.
You can also obtain copies of our factsheets and publications by contacting Disability Alliance on 020 7247 8776 (voice and minicom) or by fax on 020 7247 8765.
www.disabilityalliance.org - 21 December 2009
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