Work Capability Assessments

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Health Assured team

15 July 2022

Employee health and wellbeing need to sit at the top of your business priorities.

In some cases, employees may not be medically fit enough to work. They might have gone through an injury or suffer from an extensive medical history.

When you need to review an employee’s physical or mental health, you can ask them to go through work capability assessments. Through the test, they'll benefit from receiving the right care and entitlements.

But if you fail to provide the right support, you could end up causing a substantial risk to your employees’ and business’ welfare.

In this guide, we’ll look at what a work capability assessment is, who issues them, and how to manage these tests in your workplace.

What is a work capability assessment?

A work capability assessment (WCA) is a review which determines whether an employee can work or not.  

Some employees might be unable to work due to an illness or disability. If their condition or disability affects them for four weeks, you should refer them for a work capability assessment.

Who issues work capability assessments?

The assessment is issued by a healthcare professional who acts on behalf of the Department of Work and Pensions (DWP).

They will judge whether an employee’s condition affects their ability to perform. The test determines one of three factors.

Limited capability for work (LCW)

This means, although the employee may not be able to work, they could prepare to start working at some point in time.

Limited capability for work and work-related activity (LCWRA)

This means the employee will not be asked to look for work, nor needs to prepare for it.

Fit to work

This means the employee is prepared to work or look for it. They won’t receive additional entitlements, like Universal Credit, due to their health condition or disability.

(Work capability assessments are issued by healthcare professionals).

When do you apply for work capability assessments?

An employee can be referred to or apply for a work capability assessment for two reasons. When they want to request an Employment and Support Allowance or Universal Credit claim.

The employee will be asked to provide a fit note from a medical professional. The note will need to last at least 13 weeks.

The medical professional will state whether the employee has limited capability for work. If so, they will ask them to fill in a WCA.

At this stage, the assessment will help the Department of Work and Pensions determine if the employee:

  • Needs further Employment and Support Allowance (ESA) or Universal Credit (UC).
  • Will receive National Insurance (NI) credits based on a limited capability for work.
  • Can receive work-related activity component of Housing Benefits (HB) if they’re already an existing claimant. (This is privy to local authorities where Council Tax Support may also be provided).

If an employee applies for a WCA, due to a mental health condition or disability, the report will outline if they’re well enough to work.

(Employees apply for work capability assessments when they need financial support).

How to manage a work capability assessment in the workplace

At any point in time, you might be faced with how to deal with an employee and their medical condition. You might need to think about how to assess their health or bring up medical referrals.

To help you out, here are a few factors to consider when managing capability assessments:

Refer employees when necessary

The assessment is based on a collection of medical evidence. Along with these findings, medical professionals may choose to book an appointment with the employee to gather further information.

If so, the employee will receive an appointment letter confirming this. This meeting can include a face-to-face assessment; or it could be done through a video-call.

Once all relevant checks are done, an official report is passed. The report will state advice and recommendations regarding the employee’s condition. All findings will be sent to the DWP who will decide the outcome.

Conduct a capability for work questionnaire

The employee will be asked to fill in a capability for work questionnaire. The form outlines the state of their condition and whether they would like to claim a financial benefit. They’ll complete one of two forms:

  1. UC50 form for Universal Credit.
  2. ESA50 form for Employment and Support Allowance.

The questionnaire must be completed and returned to the Health Assessment Advisory Service.

Employees are awarded points for each section of the Capability for Work questionnaire. To attain points, the employee will need to have a health condition which stops them from working or doing a work-related activity.

They need to score 15 points or more to prove limited capability for work. The questionnaire is applicable for a physical and mental health condition or disability. And points can be combined from both medical states.

To qualify for WCA, the employee’s health condition must affect them for 50% of the time. This is examined through assessments, like carrying out everyday activities within a certain timeframe.

If an employee proves a lack of limited capability for work is worsening their health, they could automatically qualify–even without reaching 15 points.

Initiate a medical assessment interview

Alongside the questionnaire, a healthcare professional will conduct a medical assessment interview. This can be done at an assessment centre or as a home assessment.

A relevant healthcare professional may include GPs, nurses, physiotherapists, and psychiatrists. They will provide medical evidence which outlines why an employee can’t fulfil a work-related activity.

In some cases, a physical examination or psychological medical assessment isn’t needed. For example, if the DWP decide there is enough evidence for the case, or if an employee is terminally ill.

Present a final decision

All findings are sent to the Department of Work and Pensions. They will review the whole case and decide if the employee is 'fit for work’.

To reach a final decision, the DWP match the findings to their 'descriptors’. Descriptors are grouped into 17 activities; and they include both physical and mental functions.

Physical activities include:

  • Mobilising.
  • Standing and sitting.
  • Reaching.
  • Picking up and moving an object.
  • Manual dexterity.
  • Making yourself understood.
  • Understanding others.
  • Finding your way round.
  • Continence.
  • Consciousness.

Mental activities include:

  • Learning tasks.
  • Hazard awareness.
  • Planning and problem solving.
  • Coping with change.
  • Getting about.
  • Coping with other people.
  • Behaviour.

The DWP decides on relevant descriptors to establish if an employee:

  1. Has gained at least 15 points needed for 'limited capability for work’.
  2. Has 'limited capability for work-related activity’. (If they don’t gain any points, they’ll need to match one activity to make them eligible).

There are also non-functional descriptors which may be taken into consideration. Like levels of health-deterioration or being pregnant.

Provide relevant benefits

There are different types of benefits an employee may be entitled to during or after the assessment.

To claim Employment and Support Allowance, an employee can be awarded in two methods.

  1. Limited capability for work: They can claim ESA at a lower rate for 52 weeks. (This is called the Work-Related Activity Group).
  2. Limited capability for work-related activity: They can claim ESA at a higher rate. (This is called the Support Group and has no time limits attached).

An employee can only claim Universal Credit if they have limited capability for work-related activity. The current amount awarded is £343.63 per month.

Employees can only make a claim for WCA individually and not as a couple. Even if both people are eligible, their joint household is entitled to one additional amount.

(As an employer, you must support employees with any kind of medical condition).

What if an employee works whilst managing a health condition?

If an employee is working whilst managing a health condition or disability, they may still be entitled to another benefit on top.

Working employees can only receive a WCA referral when they meet certain requirements. Their wages must be below, equal to, or exceed a specified amount.

This specified amount is equivalent to 16 hours of work at the National Minimum Wage or the National Living Wage.

If they meet these criteria, they may also be entitled to other benefits. For example:

  • Disability Living Allowance (DLA).
  • Personal Independence Payment (PIP).
  • Attendance Allowance (AA).
  • Armed Forces Independence Payment (AFIP).

If an employee feels better, worse, or develops a new health condition, they must raise this as a new claim.

Severe disability premium

Severe disability premium (SDP) is extra money provided to employees diagnosed with disability conditions.

If an employee already receives SDP before making their Universal Credit claim, they could be entitled to further benefits.

They could receive SDP-related transitional protection. This transitional protection payment is added in addition to the Universal Credit amount.

If an employee is working, the transitional protection pay may be affected. For every £1 they earn above their work allowance, their Universal Credit decreases by 55p.

Get expert advice on work capability assessments with Health Assured

It’s important to help all employees suffering from a physical or mental health condition. And this can be done in so many ways, from introducing a health support group to helping them with Universal Credit forms.

If you neglect them, they could work unsafely and worsen their health. In the end, you could face tribunal claims, reputational damages, and even business closure.

Health Assured offers expert advice on dealing with work capability assessments. Our teams can help you safeguard employee wellbeing whilst simultaneously meeting your company needs.

We also provide a 24/7 helpline that’s open 365 days a year–helping employers and their business all year round. Arrange a call back from an expert today on 0800 206 2532.

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