What is a Work Capability Assessment?

A Work Capability Assessment decides how far your health condition or disability limits what you can be expected to do, and nothing else. It is not a diagnosis and it is not a ranking of how ill you are. The assessor is a healthcare professional trained as a disability analyst, and their job is to describe function rather than treat you: a precise diagnosis is secondary to what you can and cannot do on an ordinary day. Their report goes to a DWP decision maker, who makes the actual decision on your claim. That split matters more than most people realise. The person you speak to does not decide your award, and the person who decides your award never meets you. Both work from the same written material, which is why what goes on paper counts for so much.

You report a health condition when you claim, or as a change of circumstances if you already claim. You can self-certify for seven days; beyond that a fit note is needed. If the condition limits how much work you can do for longer than 28 days, a referral usually follows, and one fit note covering 29 days or more can be enough by itself. Some circumstances remove the need for an assessment altogether. Chemotherapy or radiotherapy for cancer, a hospital stay of 24 hours or more, dialysis and similar treatments, pregnancy where working would create a serious risk, and being prevented from working by law all mean the law treats you as having limited capability for work, or for work and work-related activity, without assessing you. Say so early if one applies to you. Earning above £881 a month can mean no referral is made. Keep providing fit notes until a decision arrives, because a gap can push you back into looking for work.

Before anyone books an appointment, a healthcare professional reads the file. This stage is called filework, and it decides whether a full assessment is needed at all. Where the questionnaire and the evidence with it already show severe functional restriction, or one of the special circumstances such as cancer treatment or nearing the end of life, the advice can go straight to the decision maker with no interview. The professional can also request further medical evidence from anyone involved in your care, but only where you have given consent, and you can withdraw that consent at any point. If the file does not settle it, you are contacted and an appointment is arranged. Where a claimant has a mental health problem an assessment is normally carried out even if the questionnaire never came back.

A full assessment happens by telephone, by video link or face to face, usually at an assessment centre and in rare cases at home. You are sent a letter with the date, time and channel, plus a leaflet if you are asked to attend in person. You can have someone with you, and they can take notes. Telephone and face to face assessments are audio recorded as standard unless you opt out, which you can do before or during; video assessments have no recording facility. The professional works through the same activities the questionnaire covered, asks about your medication, treatment, a typical day and your previous work, and writes a report. Do not treat the appointment as the whole case. It is one more piece of evidence sitting alongside the form and anything you sent with it.

You are sent a decision saying one of four things. Fit for work adds nothing and leaves a claimant commitment that expects you to look for work suitable for your condition. Limited capability for work means you must prepare for work but not look for it yet, and for almost everyone it adds nothing either, because that element closed to new claims on 3 April 2017. Limited capability for work and work-related activity is the health element, £217.26 or £429.80 a month depending on when you declared the condition. The fourth outcome is LCWRA with a severe, lifelong condition, which carries the higher rate and normally means no further assessment. Whichever it is, your claimant commitment is rewritten around it.