What is the Capability for work questionnaire?

This questionnaire assesses their limited capability for work by asking questions about their physical and mental abilities.

It’s quite a long form—about 24 pages—and it’s best to fill it in with as much detail as possible. This is because assessments are based on limited capability for work points. These points are ‘scored’ according to the severity of a condition limiting an employee’s ability to work. Each question can score 6, 9 or 15 points—you need to score 15 or over in total to demonstrate a limited capability for work.

Do I have to fill this form in myself?

No—someone can fill this form in for you. You’ll need to give details of who this person is, how they helped and why you requested the help.

You don’t need to fill this form in if you have cancer and are:

• Waiting for chemotherapy or radiotherapy.
• Going through chemotherapy or radiotherapy.
• Recovering from chemotherapy or radiotherapy.

In these cases, you can declare your treatment on page 5, and submit supporting evidence from your healthcare professional on page 24.

How to fill in a Capability for work questionnaire

The form itself—Capability for work questionnaire (ESA50)—asks you to fill in your name, address, doctor’s details and treatment history. These are fairly straightforward.

If your conditions are diagnosed, you should send supporting evidence. This includes:

• A print-out of the medication you’re on.
• X-ray results—not the x-rays themselves.
• A hospital discharge sheet.
• An occupational therapist’s care plan.

While you need to fill out and send the ESA50 form within a strict 4-week deadline, you can send supporting medical evidence at any time later.

The questionnaire is divided into 2 sections. The first section asks questions about a claimant’s physical functions. This covers:

• Moving around: your ability to get around safely, without aid.
• Sitting and standing: whether you’re able to remain in a chair, or stand, for periods of half an hour or more.
• Reaching: whether you’re able to reach upward—with either arm—above waist height.
• Picking up and moving things: lifting and moving objects using either arm.
• Manual dexterity: whether you’re affected by a physical condition—such as Parkinson’s—enough to cause difficulty in using your hands.
• Communicating—speaking, writing and typing: this is specifically about your physical ability to make people understand you—for instance, being affected by a stutter.
• Communicating—hearing and reading: whether you have difficulty understanding what people say to you—for instance, due to a hearing aid—and whether you have problems reading.
• Getting around safely: this asks about conditions that affect your safety when going to and from places. If you have issues with vision or vertigo, include them here.
• Controlling your bowels and bladder and using a collective device: whether you have a problem with your bladder or bowels when you’re awake.
• Staying conscious when awake: this covers conditions that make you lose consciousness, or affect your consciousness when awake—for example epilepsy, severe migraines or narcolepsy.

The second section covers mental, cognitive and intellectual capabilities. This includes problems arising from depression or anxiety, conditions like Autism Spectrum Disorder, and the effects of head injuries:

• Learning how to do tasks: this covers your ability to cope with new instructions. This can be affected by learning difficulties, cognitive impairments and depression.
• Awareness of hazards or danger: this covers any cognitive impairments which affect your ability to process hazards—such as understanding the risks of boiling water, or the danger of crossing the road
• Starting and finishing tasks: whether you can plan, organise and complete routine tasks. This question isn’t about physical impairment—it asks whether your mental health affects your ability to complete tasks.
• Coping with changes: this assesses your ability to deal with changes to your routine—like a train being late or having to eat lunch at a different time.
• Going out: this asks whether you can cope with going outside. This isn’t a question about physical ability—it asks whether you suffer anxiety or agoraphobia.
• Coping with social situations: this is about difficulties relating to people, and whether emotional disorders or learning conditions cause significant distress in meeting and speaking with people.
• Behaving appropriately: whether you have difficulties controlling your behaviour, or act in a way that could make others feel uncomfortable, scared or threatened.
• Eating and drinking: this asks whether you have difficulties eating or drinking. It’s not just about physically getting food to your mouth—you may be affected by an eating disorder.

How to fill in limited capability for work questionnaire for depression

Depression is a serious mental health issue. Many people filling in the Capability for work questionnaire are suffering depression, and need to know how to answer the relevant questions correctly.

If your depression affects any of the answers to the second section of the questionnaire, be sure to explain how it affects you in the spaces on each page. Be as detailed as possible—every extra piece of evidence submitted will help.

Also, provide details of your depression on page 6. Try to explain to the best of your knowledge when your depression started and how it affects your day-to-day life. Note down any medication you take—SSRI’s, antipsychotics, etc.—on page 7.

Where to send capability for work questionnaire?

Once all details are filled in and signed, you should send the form back in the envelope that was provided. If no envelope was provided, or you lost yours, contact your Jobcentre Plus immediately.

Expert Advice

If you’d like to find out more information on any of the topics mentioned in this article, please contact Health Assured on 0844 892 2493

Support your employees with an EAP

With a Health Assured Employee Assistance Programme (EAP), we can offer you practical advice and support when it comes to dealing with workplace stress and anxiety issues.

Our EAP service provides guidance and supports your employees with their mental health in the workplace and at home. We can help you create a safe, productive workspace that supports all.