Work Capability Reassessments

Work Capability Assessments are the process  used  in claims for Universal Credit (UC) and Employment and Support Allowance (ESA) to determine whether or not DWP accept that the disabled person is incapable of work and also to award them points to place them in the appropriate category if they are incapable of work.

Work Capability assessments are rearranged at regular intervals.   The intervals for the reassessment periods are determined by advice given by the Healthcare Professional at the previous assessment. The periods recommended can be 3,6,12,18,24 months or “in the longer term”.

 

Attending Reassessments

There is no need for people to attend reassessments if the following conditions are all met

  • The client is placed in the ESA support group or in the equivalent group for UC called limited capability for work related activity
  • The client has a severe, lifelong disability, illness or health condition
  • The client is unlikely to be able to work again

At each ESA assessment the DWP Decision Maker considers whether these conditions are met based on the Healthcare Professional’s assessment and advises those claimants assessed as meeting the conditions that no further assessments are needed (unless circumstances change). The claimant is informed of this decision. There is no right of appeal against a decision that you do not fall into this group although the claimants affected can ask for the matter to be looked at again.

 

 

Severe, lifelong disability, illness or health condition

 

These changes were introduced in September 2017 and were intended to reduce the disruption and burden on the claimants with these conditions as well as to reduce the need to the DWP to arrange unnecessary reassessments.

 

The test of severe lifelong disability is met if the claimant meets all of these conditions:

  • Meeting Support Group/Limited Capability for work criteria through any one of the relevant descriptors in the Schedule but not through the route of substantial risk to mental or physical health (Reg 35 ESA or Schedule 9 of the UC Regs)
  • The claimant has a level of functions which would always meet this standard
  • The condition is lifelong
  • There must be no realistic prospect of recovery of function
  • The condition must have been through relevant clinical investigation and have a recognised medical diagnosis. 

The following are examples of conditions where the test is likely to be considered to have been met:

  • Motor Neurone Disease
  • Severe and Progressive forms of Multiple Sclerosis
  • Parkinson’s
  • All dementias
  • All chromosomal conditions
  • Huntingdon’s
  • Severe Irreversible cardiorespiratory failure
  • Severe acquired brain injury

Other conditions could potentially come within the criteria.

 

The following are examples of situations where the criteria will not be considered to have been met:

  • Fluctuating conditions which may be severe at times but at other times there may be a recovery of function for substantial periods such as occurs in relapsing non progressive forms of MS or some less severe mental health conditions with periods of reasonable function
  • Conditions which might be cured by transplant, surgery or treatments or conditions which might resolve. This decision should be based on currently available NHS treatment not on the possibility of scientists discovering a future cure.
  • People who have had a stroke can be anticipated to recover function during rehabilitation so although the condition can be considered to be lifelong, function might improve
  • Symptoms which have not led to a specific diagnosis or cases still undergoing pre-diagnosis investigation.

 

Disputing decisions`

If you feel that DWP have sent a disabled person to a repeat medical assessment when they should have been covered by the rules on severe lifelong illness then you should seek further advice from an advice agency about challenging this decision.

 

 

 

Related Information

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