Work Capability Assessment - The questionnaire - ESA50 / UC50

The Work Capability Assessment is used to decide whether or not you are fit for work for ESA and Universal Credit.

The questionnaire - ESA50 / UC50

When you claim Employment and Support Allowance, you are sent a Limited Capability for Work (LCW) questionnaire (ESA50) to complete and return.

When you claim Universal Credit and submit sick notes, you will be sent a UC50 to fill out. It usually takes around three months of submitting sick notes before you are sent a UC50, though work coaches can arrange for them to be sent out before this in some circumstances. If you have been submitting sick notes for a long time and have not received a UC50 to complete, you should ask your work coach to send you one.

In most cases, once you have returned the completed questionnaire you will be asked to attend a medical assessment.

The sections of the questionnaire

The questionnaire is an opportunity for you to describe the problems you have in carrying out certain activities.

It begins by asking for your name, address, doctor’s details etc. and also for a brief description of your illness, disability, medication and treatment(s).

The rest of the questionnaire is divided into two parts:

  • Questions 1-10 are about your ability to carry out certain physical activities like mobilising, standing and sitting

  • Questions 11-17 are about mental and intellectual functions that you may need to carry out in your daily life. The questions relate to mental health conditions such as depression, learning difficulties or the effects of head injuries.  

What to think about when completing the questionnaire

The questionnaire will be read by the healthcare professional before your medical assessment, the Department for Work and Pensions (DWP) decision maker, and (if you appeal the decision) by the Tribunal Appeal panel. You must therefore be as thorough as possible in answering the questions.

When answering the questions think about whether you can do the activity safely, reliably and repeatedly.

Consider the side effects of any medication you take on the performance of the activities. 

It can be helpful to keep a diary for a week or two before completing the form so you can get a clearer picture of your problems - but make sure you return the form within the deadline.

Completing the questionnaire

If you tick a box which indicates that you have difficulty with an activity, write something about how performing that activity affects you or why it is difficult to perform the activity.

If you have good and bad days, describe these and what happens to you on bad days. How often do the 'bad days' occur?

It is not enough to just tick ‘it varies’.

If you can, give examples of any problems you have had with the activity and when these problems occurred, or how frequently they occur.
Examples of the type of information to include in the questionnaire


If you can, measure the distance you walk from your home to a local place like your nearest shop.

Describe what happens when you walk – for example, tiredness, breathlessness and/or pain.

If you can walk a distance of 50 metres can you then repeat this activity? How long does it take you to recover from any pain or breathlessness before you can continue walking?

The DWP considers whether you would be able to move the distance using a manual wheelchair - even if you don't usually use a wheelchair. If there are reasons why you don't or can't use a wheelchair to improve your ability to get around, explain them here.

Picking up and moving or transferring by the use of the upper body and arms

This activity is to test your ability to pick up and move fairly light objects, for example a one litre carton of liquid.

You are not asked about bending down to pick something up, just whether you can do it from about waist height.

If you could do this activity once, but not repeatedly, you should put this on the questionnaire, and also explain why you cannot repeat the activity.

If you are prone to dropping objects because of problems with gripping, then you should mention this.

Learning tasks

If you have problems concentrating or remembering then explain this in the answers.

If you are able to learn to do a simple task but only after it has been explained to you several times, then write this in the questionnaire.

It is also worth writing down if you can remember simple instructions but then forget them soon afterwards,, such as the next day.

Coping with social situations

The DWP give examples of people affected by severe anxiety, autism, psychosis or learning disability who may have problems coping with social situations.

If you become very anxious, you may have feelings of severe anxiety, depression, and/or panic attacks. You need to describe how these affect your ability to meet with people you know or meet people for the first time.

The medical assessor often notes whether you attended the medical examination alone or with someone.

If you attend alone, explain to the assessor how the journey affected you, for example did it cause you distress or anxiety? What planning went into the journey?

Medical evidence

It is a good idea to send medical evidence with your UC50/ESA50 form.

Examples of medical evidence include:

  • Your patient summary (ask your GP surgery for this)

  • Copies of your prescriptions

  • Paperwork about your health from clinics or consultants.


Printable version of this guide

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