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This questionnaire assesses their limited capability for work by asking questions about their physical and mental abilities.
It’s quite a long form—about 24 pages—and it’s best to fill it in with as much detail as possible. This is because assessments are based on limited capability for work points. These points are ‘scored’ according to the severity of a condition limiting an employee’s ability to work. Each question can score 6, 9 or 15 points—you need to score 15 or over in total to demonstrate a limited capability for work.
No—someone can fill this form in for you. You’ll need to give details of who this person is, how they helped and why you requested the help.
You don’t need to fill this form in if you have cancer and are:
In these cases, you can declare your treatment on page 5, and submit supporting evidence from your healthcare professional on page 24.
The form itself—Capability for work questionnaire (ESA50)—asks you to fill in your name, address, doctor’s details and treatment history. These are fairly straightforward.
If your conditions are diagnosed, you should send supporting evidence. This includes:
While you need to fill out and send the ESA50 form within a strict 4-week deadline, you can send supporting medical evidence at any time later.
The questionnaire is divided into 2 sections. The first section asks questions about a claimant’s physical functions. This covers:
The second section covers mental, cognitive and intellectual capabilities. This includes problems arising from depression or anxiety, conditions like autism, and the effects of head injuries:
Depression is a serious mental health issue. Many people filling in the Capability for work questionnaire are suffering depression, and need to know how to answer the relevant questions correctly.
If your depression affects any of the answers to the second section of the questionnaire, be sure to explain how it affects you in the spaces on each page. Be as detailed as possible—every extra piece of evidence submitted will help.
Also, provide details of your depression on page 6. Try to explain to the best of your knowledge when your depression started and how it affects your day-to-day life. Note down any medication you take—SSRI’s, antipsychotics, etc.—on page 7.
Once all details are filled in and signed, you should send the form back in the envelope that was provided. If no envelope was provided, or you lost yours, contact your Jobcentre Plus immediately.
If you’d like to find out more information on any of the topics mentioned in this article, please contact Health Assured on 0844 892 2493
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