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ESA assessment process.


Sunshine Meadows:

The Work Capability Assessment (WCA)

When you make a claim for Employment and Support Allowance (ESA), you will usually have a Work Capability Assessment. You may also be asked to take part in a medical assessment.

WCA is the main assessment for ESA claims.

It may include a medical assessment if more information is needed about your illness or disability before a decision can be made on your capability for work.

An approved healthcare professional, who has been trained in handling ESA claims, will assess how your illness or disability affects your capability for work or work related activity, and provide advice to the Department for Work and Pensions (DWP), which is responsible for administering benefit claims.

The approved healthcare professional may recommend that you attend a medical assessment if they feel they need more information about your condition.

How it works

After your initial claim for ESA, you have to complete a questionnaire - 'Limited capability for work questionnaire ESA50'. The answers you give in the questionnaire should explain how your illness or disability affects your ability to complete everyday tasks. Your own doctor may be asked to provide a medical report.

An approved healthcare professional will consider the questionnaire and any medical reports, along with any other information you may have provided.

If the approved healthcare professional feels that the DWP will need more information to make a decision on your benefit claim, they will recommend that you attend a face-to-face medical assessment.

Reasons for a medical assessment

You may have been asked to attend a medical assessment for a number of reasons.

Most people are asked to attend one. It doesn't mean the information you've provided on your claim form is being treated as suspicious or that your claim will be turned down.

Your benefit claim will not be turned down without you either having a medical assessment or being offered one.

About the medical assessment

The medical assessment will usually take place at a Medical Centre near where you live. If you're unfit to travel or you live more than 90 minutes' journey from the nearest centre, the approved healthcare professional may visit you at home.

You will usually be contacted by telephone by the Medical Services provider. This can be any time between 8.30 am and 8.00 pm. You will be given notice of your appointment and the option to change it if the time doesn't suit you. Your appointment time will be between 9.00 am and 5.00 pm.

It is very important to attend and fully participate in your medical assessment as your benefit may be affected if you don't. If for any reason you cannot attend, you should contact the Medical Centre beforehand and arrange another appointment.

Your rights at the assessment

You have the right to:

  -  have a friend, relative or support worker with you at the medical assessment
  -  ask for an interpreter if you cannot speak in English
  -  Welsh speaking healthcare professionals (HCP) are available in Wales if you wish to have your assessment conducted in
  -  ask to be assessed by an approved healthcare professional of the same gender as yourself

You need to let the Medical Centre know ahead of time if you want an interpreter or same-gender approved healthcare professional. They will try to find one for you, although this may not always be possible in some areas.

Further details

There is a very detailed guide to the Work Capability Assessment (ESA214) in PDF format. It is published by Jobcentre Plus and is aimed mainly at professionals, but you may find it useful. Because the information is detailed and technical, some of it can be quite hard to understand.

(edited for formatting - KK)

Sunshine Meadows:

Medical assessment

The medical assessment consists of up to three parts. Afterwards, a report will be sent to the Department for Work and Pensions (DWP).

Before the medical assessment

To prepare for the medical assessment, you might want to think about:

   - what everyday tasks you have difficulty with, or are unable to do
   - if you can do more on some days than others, what a typical day is like for you
   - how your illness or disability affects your ability to work
   - what support you think you need to improve your ability to work

What to bring on the day of the assessment

The receptionist at the Medical Centre will ask to see some identification to make sure you're the person who has been asked to attend.

Your passport, if you have one, is adequate identification on its own. Otherwise you will be asked to provide three documents which can include your birth certificate, a full driving licence, your life assurance policy and recent bank statements.

You should also bring any pills or medication you're currently taking and any simple aids and appliances that you use such as glasses or hearing aids.

What happens at the medical assessment

The medical assessment will involve an interview and sometimes a physical examination, if the approved healthcare professional feels one is needed.

The assessment is likely to be different from what you would expect from your own doctor. The approved healthcare professional's assessment is not to diagnose or discuss treatment of your illness or disability; it is to assess how it affects you and your ability to work. To find this out, the approved healthcare professional may not need to carry out a physical examination.

You should allow around 40 minutes for the initial assessment.

The interview

The approved healthcare professional will normally begin by taking a brief history, covering:

  - what you did in your old job, if you had one, and when and why you left
  - a brief medical history including details of treatment, medication and any hospital stays
  - your domestic situation (who you live with, what type of house you live in and so on)
  - how your illness or disability affects how you can perform everyday tasks
  - an outline of a typical day for you

If you're claiming ESA because of a mental health problem or a physical illness or disability that could affect your mental health, the approved healthcare professional may ask you about:

  - understanding and focus
  - adapting to change
  - social interaction

The physical examination

After the interview, the approved healthcare professional may decide a physical examination would be helpful.

They will explain what is involved first and check that you're happy for the examination to go ahead. It's important to tell the approved healthcare professional if you feel any discomfort. They will not ask you to carry out any action that causes you discomfort.

The approved healthcare professional's report

The approved healthcare professional will complete the report (ESA85) after the medical assessment. They will submit the report  to the DWP. You will not normally see it before it is submitted.

You can request a copy of the approved healthcare professional's report from the DWP. You will get it through the post.

(edited for formatting - KK)

Sunshine Meadows:

After your medical assessment

The report of your medical assessment will be sent to a decision maker at the Department of Work and Pensions(DWP). The decision maker will decide whether you are entitled to ESA.

The report

After your medical assessment, the approved healthcare professional's report is sent to the decision maker at the DWP. The decision maker is the person who is responsible for making a decision on your claim.

The decision maker will consider the report along with all the other information provided for your claim. The decision maker will decide whether you are entitled to ESA.  If you are entitled, they will also decide whether you should be placed in the Work Related Activity Group or the Support Group. You will receive a letter stating their decision.


All the medical information relating to your claim, including the report from the medical assessment is confidential. This information will not be released to anyone outside the DWP

You can ask to be sent a copy of the medical assessment report at any time. It will be sent to you by post.

Sometimes the approved healthcare professional may want to send some information about your medical assessment to your doctor. In that case, Medical Services, who organise medical assessments on behalf of the DWP, will write to you. Medical Services will ask whether you agree to them giving your doctor the information.

If you are unhappy with the medical assessment

If you are not happy with the way the medical assessment was carried out, you can complain to Medical Services.

The complaints procedure is explained in the letter you received about your medical assessment.

You can also complain to the approved healthcare professional at the time of the assessment. If they cannot resolve the problem, they will give you a brochure explaining the formal complaints procedure.

If you are unhappy with the benefit decision

If you think the decision about your benefit claim is wrong, or you do not understand it, you can:

  - ask the office who made the decision to explain it
  - ask to have the decision reconsidered by another decision maker
  - appeal against the decision to an independent tribunal

(edited for formatting - KK)


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