Form ESA50 Capability for Work Questionnaire - United Kingdom

Form ESA50 Capability for Work Questionnaire - United Kingdom

What Is Form ESA50?

Form ESA50, Capability for Work Questionnaire, is a document used by individuals that are required to provide information about their illnesses, disabilities, or health conditions. The purpose of the questionnaire is to collect information about the individual and designate whether the individual is having difficulties working due to their state. The form can be used after the individual has applied for the Employment and Support Allowance (ESA).

Alternate Name:

  • ESA 50 Form.

This form was issued by the United Kingdom Department for Work and Pensions and was last revised on . A fillable ESA50 Form is available for download below.

Generally, individuals receive this form from the Department for Work and Pensions (DWP) after they have filed Form ESA1, Employment and Support Allowance. If the individual has an illness, disability, or a health condition that affects their working capability they must provide this information to the DWP using Form ESA50.

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How to Fill In Capability for Work Questionnaire?

Completing the questionnaire is a time-consuming process. It is presented on 25 pages and consists of many parts, namely:

  1. Personal Information. In the first part of the document, individuals are supposed to designate their name, date of birth, national insurance number, contact details, etc. This information is required for identification purposes.
  2. Late Return. If an individual is submitting their questionnaire later than the date when they were asked to return it in the letter enclosed with it, then they are offered an opportunity to explain why. The DWP can stop ESA payments if the questionnaire was not submitted in a timely fashion, which is why it is necessary to provide reasons why the individual did not have an opportunity to file it on time. If the DWP will find the reasons for late sending exceptional they will not stop the payments.
  3. General Practitioner, Healthcare Professional, etc. Here, individuals are required to provide information about their general practitioner, doctor's surgery, healthcare professionals, carers, friends, or relatives who know the most about the individual's illness, disability, or health condition.
  4. Disabilities, Illnesses, or Health Conditions. Individuals can use this part of the form to describe their disabilities, illnesses, or health conditions in detail, including what exactly they are, how they affect them, and when they started. Individuals can also provide information about any aids they use (wheelchair, hearing aids, etc.), medication they are taking, hospital or clinic treatment they are having, and other details they think the DWP should know.
  5. Conditions' Influence. This part of the document is divided into three sections. In the first section, the individual is supposed to state how their conditions affect their physical functions. The second section is dedicated to the mental health, cognitive and intellectual problems of the individual. In the third section, the individual can designate whether they have any problems eating or drinking.

The questionnaire also includes other types of information, such as guidelines on how to fill out the document, what to do next, information about a face-to-face assessment, disclosure of the provided information, etc. If you need help filling in your ESA50 Form please visit the official website of the Government of the United Kingdom for more information.

Where to Send My ESA50 Form?

After an individual has completed their ESA50 Form they are supposed to send it back to the Health Assessment Advisory Service in the envelope they received with the form. It should be done by the date stated on the letter it came in with. The envelope will already include the ESA50 Form return address and will not need a stamp.

If an individual received the form without the enclosed envelope, they can contact the DWP to find out the return address they should use. The address of the office where they should send it depends on the individual's place of residence.

Download Form ESA50 Capability for Work Questionnaire - United Kingdom

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