Guidance

Universal Credit Work Capability Assessment official statistics: background information

Updated 14 September 2023

Applies to England, Scotland and Wales

Read the Universal Credit Work Capability Assessment statistics.

Benefit introduction

Universal Credit is a benefit for people over 18 but under State Pension age who are either:

• in work but on a low income, or

• out of work

Universal Credit claimants may be eligible for more money if they have a disability, a health condition or caring responsibilities that may prevent them from working.

It was first introduced in Ashton-Under-Lyne in April 2013 and replaces:

• Income-based Jobseeker’s Allowance

• Income-related Employment and Support Allowance

• Income Support

• Working Tax Credit

• Child Tax Credit

• Housing Benefit

Universal Credit (UC) gradually rolled out in stages. It was initially available to a limited range of claimants, principally single working age people with no children and seeking work. The national expansion of UC to the full range of claimants was started in May 2016. By December 2018 it was available in every Jobcentre across Great Britain.

The main developments in the introduction and operation of Universal Credit and in Universal Credit Work Capability Assessment statistics are shown in the following table.

Timeline of Universal Credit Work Capability Assessment key dates

Date	Description
April 2013	Universal Credit system first introduced. Limited to single working age people, seeking work and with no children.
February 2015	The national expansion of Universal Credit live service started.
May 2016	Universal Credit live service was replaced by Universal Credit full service. From May 2016 it was rolled out to other Jobcentre Plus offices and expanded across the country to include all claimant types.
January 2018	Universal Credit Live Service closed to new claims.
December 2018	Universal Credit was available to the full range of applicants in every Jobcentre across Great Britain.
March 2019	All remaining claimants on the live service system were moved to the online full-service system.
July 2019	The testing of moving legacy claimants to Universal Credit pilot.
March 2020	COVID-19 pandemic caused the government to put in place restrictions on businesses and households, leaving many people temporarily unable to work. This resulted in an increase in claims to UC.
March 2020	Suspension of face-to-face WCA assessments. Paper-based assessments were carried out as usual and, wherever possible, telephone assessments were used.
May 2020	Telephone assessments were introduced. Only Limited capability for work and work-related activity (LCWRA) recommendations were available initially.
September 2020	LCW recommendations were available in telephone decisions.
November 2020	Video assessments were trialled for LCWRA.
December 2020	Video assessments were trialled for LCW.
February 2021	LCW recommendations were available in telephone assessments.
April 2021	No Limited Capability for Work (NLCW) recommendations were available, on a trial basis initially, in video assessments.
July 2021	Connor Review ruling modified the pathway to appeals for some NLCW decisions.

Claiming UC with a health condition

1. Reporting a health condition or disability

When a customer makes a claim for Universal Credit they will be asked if they have a mental/physical health condition or a disability which prevents, or limits, their ability to work.

When a claimant declares they have a restricted ability to work due to their health condition, and Department for Work and Pensions (DWP) receives medical evidence in support of the claim, the department places the claimant on UC Health.

Claimants who are in work can also be placed on UC Health if they report a health condition that limits the amount of work they can do.

Claimants who have ongoing health conditions that stop them from working must continue to provide medical evidence until they receive their WCA outcome. If a claimant stops sending medical evidence (or it expires), they will leave UC Health.

Once the medical evidence is reviewed, DWP considers whether the claimant is eligible for a WCA referral.

Note

An employed claimant whose earnings are equal to or exceed the monthly earnings threshold may only be referred for a WCA if they are in receipt of one of the following:

• Disability Living Allowance (DLA)

• Child Disability Payment (CDP) in Scotland

• Personal Independence Payment (PIP)

• Adult Disability Payment (ADP)

• Armed Forces Independence Payment (AFIP)

• Attendance Allowance (AA)

A claimant whose earnings are below the monthly earnings threshold can be referred for a WCA whether or not they are in receipt of DLA, ADP or CDP (in Scotland), PIP, AFIP or AA.

2. Medical evidence and fit notes

Self-certification is the minimum acceptable evidence required for up to the first seven days that a claimant is unfit for work. For any further days the claimant is unfit for work, they must provide acceptable medical evidence.

The following documents are considered acceptable medical evidence:

• statement of fitness for work

• doctor’s letter

• terminally ill form – DS1500 or SR1

• benefits assessment for Special Rules in Scotland (BASRiS) form

• hospital inpatient form – Med 10

• psychiatric hospital admission form

• hospital discharge letter

• private medical certificates

• other evidence

3. Work Capability Assessment Referral

If the medical evidence supports the claimant’s claim to have health condition or disability that may affect their ability to work, Jobcentre Plus work coaches will refer eligible claimants for a Work Capability Assessment (WCA). This applies whether the claimant is in work or out of work.

In most cases, WCA referrals will be considered from the 29th day following the start of the health spell. An immediate, day one WCA referral is made if the medical evidence provided indicates that the treatment or condition is one that can be treated as having:

• limited capability for work (LCW)
• limited capability for work and work-related activity (LCWRA)
• a terminal illness

For more information on eligibility for day one WCA referral check the Universal Credit: health conditions and disability guide.

The referral is sent to the Centre for Health and Disability Assessments (CHDA) or the Health Transformation Programme (HTP) who complete Work Capability Assessments for the DWP.

When the referral is made, the claimant will be issued a Capability for Work questionnaire (UC50) to complete and return to CHDA, to enable a WCA to be arranged. Claimants have four weeks to return the completed UC50 questionnaire. Failure to do so will result in claimants leaving UC Health.

When the UC50 is received by the CHDA or HTP, if the HTP is unable to make a recommendation using the UC50 and any paper medical evidence provided, the Work Capability Assessment appointment is booked.

Claimants with a terminal illness can be determined as having LCWRA without a WCA referral to CHDA/HTP.

4. The Work Capability Assessment

The WCA is used to find out how much a claimant’s health condition or disability affects their ability to work. It assesses what they can do as well as what they can’t do. CHDA and HTP carry out assessments on behalf of DWP. DWP have responsibility for making the final assessment decisions based on CHDA/HTP recommendations.

If a claimant who is on Employment and Support Allowance (ESA) is moving to Universal Credit due to a change in their circumstances and they have already undergone a WCA, the decision made on their ESA claim will be taken into account for their Universal Credit claim as long as there is no break in claim between ESA ending and UC starting. If the claimant has already been determined as having Limited Capability for Work (LCW) or Limited Capability for Work-Related Activity (LCWRA), the claimant will not need to undergo another WCA unless there is a review due, or their health condition changes.

Following the WCA, the health care professional who undertook the assessment will send an outcome report with advice and recommendations to one of Universal Credit’s decision makers. The decision maker will consider that advice and recommendations alongside any other relevant medical information available. Using these resources, they will decide if the claimant is one of the following:

• has Limited Capability for Work

• has Limited Capability for Work and Work-Related Activity (previously known as Support Group in ESA)

• does not have limited capability for work, so is fit for work

The following table shows the 3 possible determinations following a WCA and the claimant requirements.

The claimant is determined as having:	What happens with the claim
Limited Capability for Work	A claimant has Limited Capability for Work (LCW) when their capability for work is limited by their physical or mental condition and it is not reasonable to require them to work. They can prepare for work with the aim of working at some time in the future. The claimant’s health condition is such that they are not expected to look for work right away. However, they should carry out activities that will help prepare them for work in the future Activities could include, for example, writing a CV and undertaking some training.
Limited Capability for Work and Work-Related Activity	The claimant’s health condition is such that they are not expected to look for work or to prepare for work, though they can volunteer.
No Limited Capability for Work (so is fit for work)	If a claimant is found fit for work and their condition is the same, or substantially the same as the condition they were suffering before the WCA, they need to look for work that is suitable for their health condition, and be prepared to work to keep getting Universal Credit.

Review WCAs

All claimants in LCW and LCWRA have a review period set by the Healthcare Professional (HCP)/Decision Maker (DM) indicating a date at which it might be beneficial to reassess the claimant.

Review periods are usually set between 6 and 36 months, depending on the nature of the claimant’s health condition. Not all cases will be reassessed once their initial or last prognosis period has expired. Unlike in ESA, there is no automated process in UC for prioritising cases which have a greater chance of changing award following reassessment.

5. Claimant feedback

Claimants who are unhappy with the WCA decision can:

• ask DWP to explain the decision

• ask DWP to write to them with the reasons for the decision

• ask DWP to look at the decision again through a mandatory reconsideration (the claimant may think something has been overlooked or some facts not taken into account, or they may have more information to provide which could affect the decision)

• appeal against the decision to an independent tribunal. Note: appeals to independent tribunals must be made in writing

Decision making

Reasons for LCWRA assignment

The criteria for being considered to have LCWRA are set out in legislation. These criteria are set in terms of descriptors. The criteria for being considered eligible for LCWRA are the same regardless of whether the claim has been made under UC or ESA.

For a claimant to be assessed as having LCWRA, they should display evidence of:

• a severe functional limitation (due to physical impairment or mental, cognitive and intellectual impairment, or a combination of both)
• special circumstances whereby claimants would be considered unsuitable for Work-Related Activity in the absence of severe functional limitations. In such circumstances, claimants can be treated as having LCWRA. A full list of LCWRA descriptors can be found in the following guide – Work Capability Assessment handbook

Reasons for LCW assignment

The criteria for being considered to have LCW are set out in legislation. These criteria are set in terms of descriptors. The criteria for being considered eligible for LCW are different between UC and ESA.

For a claimant to be assessed as having LCW, they should display evidence of:

• receiving certain treatments

• being in hospital

• prevented from working by law

• risk to self or others

• life threatening disease

• disabled or over the age for pension state credit

Note

Treat as LCW criteria consistent between UC and ESA

The wording for the ‘Treat as LCW’ criteria is different between UC and ESA Regulations for the following criteria:

• Infectious diseases

• Hospital inpatients

• Regular Treatment

Despite this different wording, however, the policy intent is the same for both UC and ESA.

Treat as LCW criteria present in ESA that are not applicable to UC

• Pregnancy

• those in education and entitled to DLA

Treat as LCW criteria present in UC that are not applicable to ESA

• those over the age for pension state credit

A full list of LCW descriptors can be found in the following guide – Work Capability Assessment handbook.

Non-specified reasons for allocation to either LCWRA or LCW

When claims are processed clerically, only a record of initial decision, and decision after reconsiderations or successful appeal is available. For these cases there is no information on functional impairment.

For more information on how the assessment process helps the DM to determine if a claimant has LCW, and if so, whether they also have LCWRA see the Work Capability Assessment handbook.

The Universal Credit: health conditions and disability guide provides a broad explanation, including a document explaining the functional impairments in further detail.