The ESA50 form is your chance to tell the DWP how your illness or disability affects your ability to work. You’re being asked to show why Employment and. Those applying for Employment Support Allowance (ESA) or Universal Credit ( UC) may be sent a capability for work questionnaire, also known as an ESA50 or . Fill esa50 form instantly, download blank or editable online. Get, Create, Make and Sign esa50 40 capability for work questionnaire online form.

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You will be moved over to ESA if you are found to have a limited capacity for work, and you will be placed in either the work-related activity group or the support group.

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Capability for work questionnaire ESA50

This activity looks at your ability to eaa50 and finish tasks without needing prompting by someone else. Northern Ireland region Northern region Southern region Wales region. You can challenge the decision not to award you ESA, and can also challenge a decision not to put you in the support group, if you have been placed in the work-related activity group.

This form allows us to decide if you will need a face-to-face assessment. Is there anything I should know before filling in the ESA50 limited capability for work questionnaire? questionnairr

What is the ESA50 limited capability for work questionnaire?

Think about keeping a diary for a few days and to write down all the day-to-day activities that you have difficulties doing. This cannot be arranged on the day of the assessment. Skip to navigation Skip to content Skip to footer. Make a list of any of the above difficulties on page 5 of the questionnaire where it asks you how your disability affects you. It is always best to select to attend an oral hearing, where you can put your case forward in person. Shine are also be able to provide advice to assist you with filling in your forms.


This activity is relevant if you have hearing or visual problems. It also includes diabetic hypos: For the Welsh language service, please call our Customer Enquiry line and press option 2.

England home Advice can vary depending on where you live. England, Scotland, and Wales see publication for Northern Ireland. You’ve reached the character limit.

Picking up and moving things. These might be a: When you have filled in and returned your questionnaire most people will be asked to attend a face-to-face consultation also known as the assessment.

ESA50 / UC50 Questionnaire

Page 12 also considers staying conscious when awake. Staying conscious when awake.

Every effort has been made to ensure that this information is up to date, however changes in the law over time may affect the accuracy of some content. Tick the boxes that apply to you on pages 3 and 4 then skip to page 20 and sign the box – then get a health professional for example your GP or hospital doctor to fill rsa50 page This should help you to answer the questions and get the benefit.

Page 12 deals with bladder and bowel management. There is also a box that allows you to explain why your form was late. Some national disability organisations may also help with filling in the ESA50 for the particular health condition they deal with.


Help filling in your ESA50 form – Citizens Advice

Starting and finishing tasks. Continue Find out more. Maybe Yes this page is useful No this page is not useful Is there anything wrong with this page? If you have hydrocephalus and need assistance to make your needs known, ensure that you have made a request to be assessed by a mental health and cognitive champion.

When you have lodged your appeal you can be paid quuestionnaire basic allowance of ESA, and any appropriate premiums in the case of income-related ESA, until the appeal is decided. Questilnnaire form explains where to send it. Donate Become a member. You can also get help from your local disability support agency or local mental health charity.

If you have any questions, please contact the office that asked you to fill it in. Part two of the questionnaire deals with Mental, Cognitive and Intellectual functions. Disclaimer Every effort has been made to ensure that this information is up to date, however changes in the law over time may affect the accuracy of some content.

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