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Work capability

If you have a health condition or disability that affects the amount or the type of work you do, you may be able to receive extra support from Universal Credit (UC). This extra support could come in the form of extra financial entitlement or by tailoring your claimant commitment.

NOTE: Special rules apply for people who have a determined award for ESA when they claim UC, who are of pension age and claim disability benefit or for people who are terminally ill. You can read more about this process if you fall into any of these categories, the following would not apply to you.

This page covers:

Eligibility

To be referred for a work capability assessment you must be have a fit note (commonly known as a sick note) from your GP or specialist. You must also be:

  • Not working or

  • Earning less than the equivalent of 16 hours a week at National Minimum Wage. This does not apply if you are in receipt of DLA, PIP or AA.

How to report your condition

If you have a health condition or disability that impacts your ability to work, it's important to report this to UC. If you did not report the health condition on your new claim form or the health condition is recent, you can report it by by logging in to your online account, going to Homepage - Report a change - Health.

 

You will be asked when your condition changed and a brief explanation of your condition. You'll also be prompted to start submitting Fit Notes (these are usually issued by your GP and need to be reported to UC). Be sure to keep submitting Fit Notes until you have a decision. 

The process

From day 29 of submitting Fit Notes you can be referred for a Work Capability Assessment (WCA). You will need to continue submitting Fit Notes until you are assessed and a decision is made on your work capability. While waiting to be referred it is an ideal time to gather any relevant evidence to support your claim (remember evidence should highlight how your condition(s) impact your ability to work rather than simply confirming diagnosis). 

 

Once your have been referred you for a WCA you will receive a journal entry containing a UC35 letter, which will say "we need to find out if your disability, illness or health condition affects you'.

You will then receive a booklet in the post called 'Capability for Work questionnaire' also known as a UC50 which you will be expected to complete and return by the deadline along with any evidence. 

The Health Assessment Advisory Service will review your 'Capability for Work questionnaire' and any evidence to decide what steps they need to carry out to complete their process. This could include one or more of the following:

  • contacting your GP or specialist for further information (known as paper assessment)

  • asking you to take part in a telephone appointment with a health professional

  • asking you to take part in a face to face appointment with a health professional

Once they have gathered the required information, they will send all their information to UC and include a recommendation of outcome. 

A UC Decision Maker will review all the information and the recommendation, make a formal decision and upload it to your journal.

 
 
 
 
 
 

Qualifying for limited capability for work (LCW)

To be awarded for LCW you usually need to score 15 points. More information on descriptors.

There are some circumstances in which a claimant will be automatically treated as having limited capability for work. In other words, there is no need to go through the point scores.

Where possible, DWP will identify these claimants without the need for a face-to-face medical assessment. These include: 

  • People receiving regular weekly haemodialysis for renal failure, plasmapheresis or total parenteral nutrition for gross impairment of enteric function;

  • Recovering from any of the above treatments and the DWP are satisfied that the claimant should be treated as having LCW;

  • People undergoing hospital treatment as an inpatient;

  • Recovering from inpatient treatment and the DWP are satisfied that the claimant should be treated as having LCW;

  • In residential rehabilitation for drug or alcohol dependency;

  • Some people with a notifiable infection or contamination – i.e. prevented from working by law:

  • Substantial risk to self or others - the claimant is suffering from a specific illness, disease or disablement by reason of which there would be a substantial risk to the physical or mental health of any person were the claimant found not to have limited capability for work;

  • Life threatening disease - the claimant is suffering from an uncontrollable or uncontrolled life threatening disease;


Qualifying for limited capability for work and related activity (LCWRA)
To be awarded LCWRA you usually need to meet LCW as above and any one of the LCWRA descriptors.
More information on descriptors.

There are some circumstances in which a claimant will be automatically treated as having Limited Capability for Work Related Activities. In other words, there is no need to go through the point scores.

Where possible, DWP will identify these claimants without the need for a face-to-face medical assessment. These include: 

  • People who are terminally ill and whose death can reasonably be expected within 6 months;, 

  • People undergoing chemotherapy or radiotherapy or recovering from that treatment (and the decision maker agrees that they have limited capability for work-related activity);

  • Pregnant women if there would be a serious risk to their or their child’s health if they took part in work-related activity;

  • Substantial risk of having to do work related activity;

Possible outcomes and next steps

There are three possible outcomes from these assessments:

  • You are found not to have 'limited capability to work'.

    • Your commitments should still take into account your other circumstances and any restrictions based on your health.

    • If you choose to work, you will not  be eligible for a work allowance unless you have a child on your claim.

    • You will not be eligible for LCW or LCWRA element.

    • You may wish to consider challenging this decision by mandatory reconsideration and then appeal, explaining and evidencing how you meet the criteria for LCW or LCWRA. Be aware there are time limits.

  • You are found to have 'limited capability for work' (LCW).

    • You will be placed in 'work prep group' as part of your commitments (unless your other circumstances place you in a lower group). Any activities you are asked to do should take account of your other circumstances and any restrictions based on your health. You cannot be mandated to work search or apply for work.

    • If you choose to work, you will be eligible for a work allowance.

    • If you have a partner who works and you pay childcare costs, you will be eligible for the childcare element.

    • You will only be eligible for LCW element if you were awarded limited capability for work prior to 3/4/17 (see note below). There is no extra entitlement for people awarded after this date.

    • You may wish to consider challenging this decision by mandatory reconsideration and then appeal, explaining and evidencing how you meet the criteria for LCWRA. Be aware there are time limits.

    • You may be reassessed at some point in the future.

The decision of LCW will be applied to your claim from when you reported your condition to UC if you have continuously reported fit notes to UC.

If you have had any earnings on your claim during the period LCW is backdated to and were not previously entitled to a work allowance, your previous statements will be amended to include a work allowance.

If you have reported your health condition and have been continuously handing in sick notes prior to 3/4/17, you may be entitled to LCW element. Due to the 'waiting period', LCW element cannot be included until the fourth full assessment period after you reported and evidenced your health condition. It can be applied to previous assessment periods out with the 'waiting period'.

Your Case Manager will amend your previous statements to calculate any underpayment due to you, if any.

NOTE: 

  • One person eligible for carer's and LCW or LCWRA element - One person cannot have payment for both carer's element and LCW or LCWRA element included. UC would include the highest paying element in your entitlement.

  • Joint claimants with LCW or LCWRA - Both people on a claim can be awarded LCW or LCWRA but only one person can have payment included. They will include the highest paying element in your entitlement.

You can read more information on this.

  • You are found to have 'limited capability for work and work-related activities' (LCWRA).

    • You will be placed in the 'no work group' as part of your commitments. This means you will not be asked to look for work or prepare for work.

    • If you choose to work, you will be eligible for a work allowance.

    • If you have a partner who works and you pay childcare costs, you will be eligible for the childcare element.

    • You will be eligible for LCWRA element (see note below). There is no date restriction on this like LCW.

    • You will be exempt from the benefit cap.

    • You may be reassessed at some point in the future.

The decision of LCWRA will be applied to your claim from when you reported your condition to UC if you have continuously reported fit notes to UC. 

If you have had any earnings on your claim during the period LCWRA is backdated to and were not previously entitled to a work allowance, your previous statements will be amended to include a work allowance.

You will be entitled to LCWRA element. Due to the 'waiting period', LCWRA element cannot be included until the fourth full assessment period after you reported and evidenced your health condition. It can be applied to previous assessment periods out with the 'waiting period'.

Your Case Manager will amend your previous statements to calculate any underpayment due to you.

NOTE: 

  • One person eligible for carer's and LCW or LCWRA element - One person cannot have payment for both carer's element and LCW or LCWRA element included. UC would include have the highest paying element in your entitlement.

  • Joint claimants with LCW or LCWRA - Both people on a claim can be awarded LCW or LCWRA but only one person can have payment included. They will included the highest paying element in your entitlement.

You can read more information on this.