How do I fill in the Capability for Work health questionnaire?

Read the Capability for Work (ESA50 or UC50) questionnaire carefully and answer the questions in as much detail as possible.

You have four weeks to fill out the Capability for Work health questionnaire from when the Department for Work and Pensions (DWP) send it to you – the DWP are strict about this. If you need more time, you should tell them as soon as you can, but you will need to explain why you need more time and how much longer you need to finish the form.

Do I have to complete the health questionnaire by myself?

When you get your health questionnaire, you may want some help filling it in, and a local Citizens Advice or welfare benefits advice service may be able to help you. You can also ask a carer, friend, relative or mental health support worker to help you. You can also ask them to fill in the questionnaire on your behalf if you find it too difficult to fill out by yourself. 

You can look for contact details in your local telephone book or on the internet.

Capability for Work questionnaire – Pages 1 to 8

The first 8 pages will ask you about:

• Your personal details – e.g. name, address, contact details, GP details.
• Whether you have served in the Armed Forces.
• Whether you have been released from prison in the last 6 months.
• Whether you are pregnant.
• Whether you are returning the questionnaire late and why.
• Any carers, friends or relatives who know a lot about your illness, health condition or disability.
• Any other information on the medical condition(s) that you have.
• Whether you are receiving treatment for cancer.

Answer the questions in as much detail as possible. Remember, you can ask for help if you need it. We recommend asking a friend, family member, or mental health support worker to help you complete the questionnaire. We explain how to fill out some of the most relevant pages below.

Scoring Points

To score points in the Work Capability Assessment (WCA), you must have a health condition that means you cannot work, and you need to score 15 points in total across the questionnaire to show you have limited capability for work.

Page 4

Page 4 asks about your GP and any other healthcare professionals you work with, such as a:

• Community psychiatric nurse (CPN),
• Psychologist,
• Psychiatrist, or
• Social Worker.

You should put the contact details of the healthcare professional that knows you best, as they will be able to explain how your condition affects your day-to-day life and your ability to work. 

Page 5 – About medical or other information you may already have

Page 5 asks about the things the Health Assessment Advisory Service (HAAS) might like to see if you have them. The DWP calls this ‘supporting evidence’. If you can include supporting evidence with your questionnaire, it will help your claim.

Supporting evidence can include:

• Medical reports about your mental health
• Any medication lists you have
• Any medical test results you have.

You can ask your Approved Mental Health Professional (AMHP) or your doctor (GP) for help with this. An AMHP might be:

• Your mental health nurse
• Your mental health support worker
• Your psychiatrist or counsellor
• Your community psychiatric nurse.

Top Tips

Ask your GP or AMHP to write a letter or report about your ability to work. Your GP or AMHP can comment on how your mental health makes it hard or impossible for you to work. A letter with more than your diagnosis is better because a diagnosis does not show how your mental health condition affects you in everyday life.

You can ask your doctor or AMHP to include the following information in their report or letter:

• Explain how your mental health condition affects your ability to work
• What might happen to your mental health if you were asked to start looking for work
• How you meet the specific criteria for the benefit you are applying for or claiming.

This counts as supporting evidence and will help your claim. Some doctor surgeries are now charging for letters and reports like this. If you are worried you cannot afford to pay for letters or reports, seek help from a Welfare and Benefits advisor through Citizens Advice.

Pages 7 and 8

These pages ask about:

• Your health condition - think about your mental health condition. If you struggle to do something because of your mental health, explain in as much detail as possible.
• How your health condition affects you – think hard about what you can and cannot do on your worst days. Make sure you write it all down on the questionnaire.
• When it started – explain when your mental health started affecting your ability to do things. Be as detailed as you can. The DWP will refer to your answers in their assessment, so the more you can tell them about your mental health and how it affects your ability to do things, the better chance you have of accessing the correct benefits.

If your mental health condition changes, or if you have good days and bad days, explain this here.

Tip

Think about how your mental health condition affects you for at least 50% of the time. Write down how it affects you in this section of the questionnaire.

Page 7

Page 7 asks how your disability, illness or health condition prevents you from carrying out day-to-day tasks. Think about the times your mental health affects your ability to do things like:

• Wash yourself or get dressed
• Cook a meal or go shopping
• Remember the time of a GP appointment
• Leave your house or flat by yourself
• Use public transport alone
• Plan a journey by yourself

Page 8

Page 8 asks about what medication you take and their side effects – you should include the following information in this section:

• Any treatment you are having for your condition.
• The medication you take or are going to start taking.
• Any treatment you are on a waiting list for.
• If you have psychotherapy, counselling, or cognitive behavioural therapy (CBT).
• If you get treatment and care from the Community Mental Health Team (CMHT).
• If you have ever been in hospital under the Mental Health Act (‘sectioned’) or as a voluntary patient.
• Do you have to take your medication when you are at work? Is it easy to do so?
  What is the mental health impact on you if you have to take medication in the workplace?

How does the WCA test my abilities?

Pages 9-20 of the questionnaire are about ‘How your conditions affect you’. This is split into 3 parts:

• Part 1: Physical health problems
• Part 2: Mental health, cognitive and intellectual problems.
• Part 3: Eating and drinking.

Top Tip

If your mental health affects your physical health, try to complete each part even if you don’t think it is relevant to your mental health. Ask a friend, mental health support worker or carer to help if you are unsure.

Part 1: Physical Health problems

Questions 29-66

This part of the questionnaire asks about any physical health problems you have. Think about how your mental health makes it harder for you to:

• Talk to people and make yourself understood.
• Understand when someone is talking to you or trying to warn you about something dangerous.
• Get around somewhere you haven’t been without help. (eg. do you need a carer or friend to help you when you travel to a new place?)
• Concentrate (eg. when you talk to someone do you have trouble remembering parts of the conversation or experience gaps that you cannot explain?)

Part 2: Mental, cognitive, and intellectual capabilities

Questions 67-91

This part of the questionnaire is another place to include lots of detail about your mental health and how it affects your ability to do simple things.

We have listed all the mental health-related questions you will see on your Capability for Work questionnaire below and have included some suggestions of things you can think about when filling in your answers.

We have included the descriptors in the Completing the Health Questionnaire section. They show you what points the DWP will give you for your answers – it is important to think about this when you are filling in the form.

The questions on the form	Tips and suggestions
Q11 - Learning how to do tasks Can you learn how to do an everyday task such as setting an alarm clock? Can you learn how to do a more complicated task such as using a washing machine?	Does your illness or medication make it hard for you to concentrate on everyday tasks? These might be like setting an alarm clock or using the washing machine. Was your concentration better when you were well? Do you feel nervous about making a mistake? Does this mean you just don’t try to complete the task? Does it take you a lot longer? Can you carry out this task repeatedly and to what standard can you do it? Do you need to rush to complete the task? Examples I hear voices that make it hard for me to concentrate when trying to learn new tasks. I get very anxious, which makes it hard to follow instructions. I get worried that I will do something wrong and so I have never learned to use the microwave. If I have to do something new I think it will be hard so I avoid doing it. This means I don’t know how to use a computer and don’t go on the Internet. I struggle to focus and certain activities bring back memories of bad things that happened to me.
The questions on the form	Tips and suggestions
12. Awareness of hazards or danger Do you need someone to stay with you for most of the time to stay safe?	Sometimes people with mental illness can get easily distracted. This can mean they put themselves or other people in danger. Do you ever start to make a meal, but then start doing something else and leave the cooker on? Do you forget to lock your doors at night or when you leave the house? Do you ever act dangerously and do things that you would not do if you were well? Do you self-harm? How often do these things happen? All of the time, most of the time or just sometimes? Eg.Eg. I often walk into traffic because my thoughts are elsewhere.   Possible dangers are: Self-harm, Not being able to concentrate which means you don’t take medication correctly, don’t check ‘use-by’ dates or leave the gas on, or Giving personal information about you to strangers. Examples My depressive thoughts are so bad that sometimes I forget that pans are hot and hurt myself on them. I forget to turn off the gas most of the time because I am constantly worrying about other things. If someone did not supervise me, I would take the wrong amount of medication. This would lead to me becoming unwell and hurting others or myself. I panic when I meet people I don’t know and run away. I get afraid that people I don’t know will harm me.
The questions on the form	Tips and suggestions
13. Starting and finishing tasks Can you manage to plan, start and finish daily tasks?	Think about how your condition changes – what are you like on a ‘bad day’ compared to a ‘good day’? List all the tasks you might not be able to do. Does your condition mean you don’t have any motivation? Does your medication affect your concentration for everyday tasks? How often does it affect you? Is it all the time, most of the time or not at all? Do you need help to plan and organise your day? What would happen if you didn’t have any help? Are you sometimes lost in your own thoughts and, without encouragement from others, would sit on your own? Would you stay in bed all day? Would you not eat all day because you don’t have the motivation to make yourself something to eat? Examples of ‘tasks’. Planning – like cooking and preparing a meal. Organisation – like booking an appointment with a doctor or paying bills on time. Problem solving –dealing with something that happens unexpectedly like a washing machine that breaks down. Prioritising – being able to know what the important things are that you need to take care of like dealing with money, paying rent or your bills. Switching tasks – being able to do different things that are connected like washing dishes and then putting them away. Examples Because of my depression, I cannot find the motivation to plan and then make a meal for myself most of the time. I eat takeaways all the time. When I am in a manic phase, I cannot prioritise what I will do with my money. This means I spend all the money I need for bills on stuff I don’t need. My illness makes me think things that are not real. This means I can never go to appointments with my doctor because I think that people want to harm me. I can’t cope with feeling under pressure to deal with problems. This means my back door has been broken for three months and someone could easily break in. My medication makes it hard to concentrate. This means I can’t do things I need to do like chores or going to my GP. Invasive thoughts make me abandon tasks whilst I’m thinking of something else. Voices in my head tell me I’ve done something well like cooking my dinner even when it’s not cooked and I go do something else instead. Too many different tasks overload me so I abandon them and try to focus on something that isn’t work-related.
The questions on the form	Tips and suggestions
14. Coping with changes Can you cope with small changes to your routine if you know about them before they happen? Can you cope with small changes to your routine if they are unexpected?	Do you find it hard to cope if your day-to-day routine is changed?  What would happen if you were told about a change? How would it make you feel? If you are told about a change in your routine in advance (for example, if your doctors appointment changes), do you worry about it? Does your ability to cope change from day to day or week to week? What would happen if something unexpected happened? How would that make you feel? Examples Because of my Obsessive Compulsive Disorder (OCD), I have to go on the same bus route to my mother’s house every day. If there is an issue with the bus or a diversion I get very unwell. My symptoms get bad for days after and I can’t leave the house.  When I am unexpectedly asked to go to the Job Centre, I feel so anxious that I feel physically sick and can’t think about anything else. If my routine changes, I think that the government are trying to interfere with my life. I don’t go out in case anything bad happens. Even when I plan to go to a hospital appointment, I cannot go unless someone agrees to take me there. If I run out of milk and bread I have a panic attack because I only get my weekly shop when a family member can help me on a Saturday. If I get letters in the post that I don’t recognise, I don’t open them because I think they must be bad news. If my sister cannot come and take me shopping when we agreed I get so angry I break things in my house. I feel angry for a few days.
The questions on the form	Tips and suggestions
15. Going out Can you leave home and go out to places you know? Can you leave home and go to places you don’t know?	Are you able to go out to places that you are familiar with on your own? What would happen if you had to go out? Explain how that would affect you. Can you only go out if someone is with you? Write down how often you need someone with you. Do you need someone with you to make sure you don't cause any harm to yourself? How often could that happen? Are you able to get to places that you don't know on your own? Think about how you would cope: Going on public transport, Getting to doctors appointments, Doing your food shopping, Going to the bank, Going to the Jobcentre Plus, or Visiting friends or family. Examples I feel trapped when I am using public transport and start panicking and so I have to go back to my house. When I have an appointment at the bank I can’t get there. I feel like everyone I walk past in the street is looking at me and wants to hurt me. I always need to go out with someone, otherwise I start to feel anxious and get angry with strangers. If I know I have to go somewhere new that is all I can think about.  I start to panic and self-harm. I live in the countryside so the buses only come every 30 minutes. If someone sits beside me on the bus I get so anxious I have to get off and wait for the next one. This means I am nearly always late for appointments.
The questions on the form	Tips and suggestions
16. Coping with social situations Can you meet people you know without feeling too anxious or scared? Can you meet people you don’t know without feeling too anxious or scared?	Think about how it would make you feel if you had to socialise with other people. If your ability to deal with social situations can change make it clear about how often and when you would have a problem. Do you socialise with other people? If not, why? What would happen if you did socialise? Would you show any physical symptoms? What are they? Are you okay with people you know but don’t go to places where you would have to meet new people?  This could include having difficulties: Using public transport, Shopping, Talking to neighbours, Visiting friends or family, or Taking part in hobbies. Examples I always avoid meeting new people. My heart races, I get dizzy and feel like I can’t breathe. I feel like I am in danger. Because of this, I do all my shopping online so I don’t have to interact with people. Even thinking about meeting someone new is on my mind for days before and I can’t sleep properly. I feel really paranoid and I cannot trust people. If someone tries to talk to me I always tell them to get away from me. If there are people on the street I won’t put my bin out. I am not able to use public transport most of the time because it means I have to be around people I don’t know. I never answer the phone unless I have agreed for someone I know to call me at a certain time. I won’t answer the door unless I know who it is and I am expecting them. I stay at home most of the time and only ask people I trust to bring me the things I need. I don’t have a phone or email because I don’t want people to be able to hack into them and spy on me.
The questions on the form	Tips and suggestions
17. Behaving appropriately How often do you behave in a way that upsets other people?	How do other people describe you? Do people comment that they feel you are aggressive or violent? Has anyone said they felt what you have said or done was inappropriate? Have you noticed a change in the way people act towards you now compared to when you were well? Have you lost friends or relationships because of how you behave? How often do you find these things happen? Daily, a lot of the time or occasionally? Examples I often feel paranoid that people in the street are staring at me so I shout and swear at them.  I lost my last job because I got in an argument with my colleague and then shouted at my boss. When I am on the bus I get really angry when people talk on their phone. I will tell them to shut up and have knocked people’s phones out of their hands if they don’t. I was arrested for this a few times, the police know me now. I feel my neighbour has caused my depression so I write graffiti on their wall. When I am in a manic phase I often try to have sex with lots of people, which makes it hard to have relationships. When I have had panic attacks I have self-harmed at work and in public places. I often say things that other people find insulting or inappropriate.

Part 3: Eating or drinking

Questions 92-94

If your mental health affects your ability to eat and drink, you should fill this section in.

Ask yourself:

• Do you need someone to remind you to eat or drink because your mental health condition makes you forget or not care?

Sharing information about your mental health condition

Page 21

The DWP will ask for consent to contact your GP or Approved Mental Health Professional (AMHP). They do this because they might need to ask for more information about your mental health condition. You can talk to your doctor or AMHP if you are worried or anxious about what they might tell the DWP.

You should give your permission if you are comfortable as it will help the DWP to process your benefit claim. If you do not give permission, the DWP will make their decision based only on the information you have given and any other information they have. Your doctor or AMHP may help speed up the process.

Face-to-Face assessment

You might be asked to attend a face-to-face assessment with a qualified healthcare professional that works for the Health Assessment Advisory Service (HAAS).

Question 95 Tell us about any other help you might need

This is your chance to let the DWP know of any extra help you might need to attend an assessment. You might want to:

• Ask for a home visit if your mental health makes it difficult to travel to an assessment centre
• Write about any help you need at the assessment including:
  - Taking someone with you
• Write about how you might need help getting out of bed, getting washed and dressed because you are anxious about the assessment
• Write about how you become easily confused and need someone with you to help communicate your difficulties with the healthcare professional at the centre.

Other information

Page 24

This is the place to write about anything else about your mental health condition that you think is relevant and will help the DWP decide.

You could include information on:

• Any other benefits you get, for example, PIP
• Any support groups you attend for your mental health
• Any community support you receive
• More details of your mental health history that you didn’t include in the other sections but you believe is important for your ESA or UC with limited capability for work component claim.

Ask for supporting evidence from your AMHP and/or GP

If you are under the care of an Approved Mental Health Professional (AMHP) (e.g. mental health nurse, mental health carer or support worker, psychiatrist, counsellor) or your local doctor, you can ask them to write a letter or report about your ability to work.

They can comment on how your mental health condition makes it hard or impossible for you to work. The DWP call this ‘supporting evidence’ and it can help your benefit claim.

When you receive the letter or report from your AMHP or GP, attach it to the Capability for Work questionnaire (use a staple if you can), before you send the questionnaire back. You can also include:

• Medical test results of any physical health condition
• Your current prescribed medication list

Page 5 of the Capability for Work questionnaire tells you what you can and cannot include as supporting evidence.

Try to make copies of everything you send the DWP.

Send back the Capability for Work questionnaire

Try and make a copy of your completed questionnaire first. A friend, carer, family member or mental health support worker can help you with this.

Making a copy of your completed questionnaire and any supporting evidence will help if:

• You disagree with the DWP’s decision
• The DWP lose your questionnaire
• You need to fill in a new form in the future.

Details of where to send the questionnaire will be included in the letter you are sent with the questionnaire. The questionnaire usually goes back to the Health Assessment Advisory Service (HAAS). They will contact you if they want to conduct a face-to-face assessment.

Useful tools

You can access a sample letter here that you can use to send to healthcare professionals when asking for supporting evidence.