Ask CPAG Online - What are the assessment procedures?

Unless the DWP has evidence which clearly shows that you have Limited Capability for Work (LCW) or can be treated as having LCW, you are normally required to complete an ESA50 questionnaire.

You will then usually be asked to attend a medical examination with a ‘health care professional’ (who could be a doctor, registered nurse. occupational therapist or physiotherapist) employed by Maximus who carry out the face-to-face assessments on behalf of the DWP.

Only a DWP decision-maker can ultimately decide whether you have LCW and Limited Capability for Work-Related Activity (LCWRA) based on all the evidence.

How should you complete the ESA50 questionnaire?

  • Read the notes before answering the questions. It may be helpful to draft your answers on a separate sheet of paper first.

  • Complete the ESA50 with reference to the descriptors and scores set out in schedules 2 and 3 to the ESA Regulations 2008, focussing on showing that you score at least 15 points in relation to the LCW descriptors and, where appropriate, satisfy at least one of the LCWRA descriptors. Part one of the questionnaire relates to the physical LCW and LCWRA descriptors, and Part two relates to the mental descriptors. Part 3 covers the LCRWA descriptors relating to eating and drinking which are not covered by Parts one and two.

  • When ticking the boxes and giving details of whether you can undertake an activity, take into account whether you can do so safely, most of the time, with a reasonable degree of regularity, and without undue pain and fatigue. If your conditions is variable, you can tick the ‘it varies’ box, but you will only score points if you are unable to complete an activity most of the time.

  • Make sure you give full details of all your symptoms and difficulties.

  • Keep a copy of the ESA50 and make sure you return it to the DWP within the time limits specified.

How should you approach the medical examination?

  • Prepare the answers to the questions you are likely to be asked before you attend the examination. Focus on the descriptors you think you satisfy with reference to the wording of the regulations and the information you provided on the ESA50 questionnaire. 

  • If you are unable to attend an examination, contact Maximus as soon as possible to arrange another appointment. If you are physically unable to get to the examination centre, contact Maximus. You may be allowed to have taxi fares reimbursed or, exceptionally, be examined in your own home. 

  • You are entitled to have someone with you during the assessment (e.g. a friend, relative, or adviser). 

  • Remember that you will be observed getting from the waiting area to the examination room and during the examination (e.g. how you walk and get in and out of a chair).

  • You may be asked specific questions relating to the various descriptors. Make sure you explain all the difficulties and symptoms you experience (including pain, fatigue and the effects of medication) and if your condition varies, about good and bad days. You will usually be asked what you do on a ‘typical day’. Bear in mind that your answer needs to be consistent with the difficulties and symptoms you are asserting. You will then be physically examined.

  • Numerous Government, Parliamentary and independent reports (and Upper Tribunal decisions) have criticised the way medical assessments are carried out (until recently by Atos, now replaced by Maximus). In particular, the assessments have been widely criticised for being rushed, formulaic (guided by a rigid computer programme) and carried out by non-specialists. If you are treated unfairly or rudely, or not listened to, you can complain to Maximus.

  • DWP decision makers should decide whether you have LCW and LCRWA on the basis of all the evidence, including the ESA85 report of your examination, completed by the health care professional. In practice, they often ‘rubber stamp’ and follow the assessment set out in the ESA85. If you wish to dispute a decision, you should request a copy of the ESA85 to see if it accurately assesses your condition and difficulties.