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Work Capability Assessment outcomes
Work capability assessment determinations
Labour market regime
Limited capability for work
Limited capability for work after 3 April 2017 Limited capability for work and work related activity
Exceptional circumstances
Claimants found fit for work
Claimant feedback
Additional amount for caring
Changes to a work capability assessment decision on or after 3 April 2017
Work capability assessment outcome received on or after 3 April 2017
Reconsideration or appeal of employment and support allowance claim
Natural migration to Universal Credit from employment and support allowance
Universal Credit award
Work Capability Assessment determinations
The Work Capability Assessment (WCA) outcome report, together with any other relevant health -
related evidence is used to determine if the claimant:
has Limited Capability for Work
has Limited Capability for Work and Work Related Activity
does not have Limited Capability for Work, so is fit for work
These in turn determine:
the claimant’s Labour Market regime
whether an additional amount can be included in the Universal Credit award
whether a Work Allowance applies
if childcare costs are payable in couple claims where one partner is working
Labour Market regime
The following table shows the three possible determinations following a WCA, the Labour Market
regime and the claimant requirements:
The claimant is
Labour Market
The claimant is
The claimant is
determined as
Regime
required to -
not required to -
having -
Limited
changes to the
participate in
be available for
Capability for
Work Preparation Work Focused
and start work.
Work
regime, unless
Interview and
other
undertake Work
circumstances
Preparation
mean the
activities.
claimant is
inform Universal
already allocated
Credit if there is a
to a less intensive change of
regime.
circumstances.
Limited
changes to No
inform Universal
Fulfil any work
Capability for
Work Related
Credit if there is a related
Work and Work
Requirements
change of
requirements.
Related activity
regime.
circumstances.
They
can access
support on a
voluntary basis.
No Limited
is unchanged.
participate in a
Capability for
They remains in
Work Focused
Work (so is fit
the Intensive
Intervie
w and can
for work)
Work Search
be set any of the
regime unless
work-related
other
requirements, for
circumstances
mean the
example: Work
claimant is
Preparation
already allocated
activities, specific
to a less intensive
work search
regime.
activities and
availability for
work.
inform Universal
Credit if there is a
change of
circumstances.
For more information refer to Work-related activities and the Labour Market regimes and Labour
Market regimes.
The entire Claimant Commitment is reviewed, including the regime, following the WCA decision.
This is to ensure the regime and availability requirements are set as appropriately. More detailed
guidance can be found in Claimant Commitment.
Limited Capability for Work
A claimant has Limited Capability for Work (LCW) where their capability for work is limited by their
physical or mental condition and it is not reasonable to require them to work.
A claimant has LCW where either of the following apply:
it is determined from the WCA decision that they have LCW
they are treated as having LCW
Limited Capability for Work after 3 April 2017
Claimants making a claim on or after 3 April 2017 on health grounds are no longer awarded the
additional amount of Universal Credit for having LCW.
Where payment of the additional amount for having LCW is already in place, payment will continue
as long as the claimant continues to be entitled to Universal Credit and has L CW.
All claimants in the Work Preparation regime who have a LCW decision following the outcome of
their WCA have access to a range of additional support. This support is to help them prepare for,
and move into work. The support is provided through the Enhanced Support Offer (ESO).
Limited Capability for Work and Work Related Activity
A claimant has Limited Capability for Work and Work Related Activity (LCWRA) when their capability
for work and work-related activity is limited by their physical or mental condition and it is not
reasonable to require them to undertake work-related activity.
A claimant has LCWRA where either of the following apply:
it is determined from the WCA
they are treated as having LCWRA
Exceptional circumstances
In addition to the ‘treated as’ circumstances we have just looked at, there are further circumstances
when the claimant can be treated as having LCW or LCWRA. These are known as exceptional
circumstances.
Exceptional circumstances are only considered if the claimant has been found not to have LCW or
LCWRA following application of the WCA.
Exceptional circumstances are considered:
for LCW - where the claimant is a substantial risk to themselves or to others, or has a life
threatening, uncontrollable or uncontrolled disease
for LCWRA - where the claimant is suffering from a specific illness, disease or disablement
where there would be a substantial risk of damage to anyone’s physical or mental health if the
claimant was found not to have LCWRA (in these circumstances ‘anyone' means the claimant
or anyone else who may be affected by the determination
Claimants found fit for work
Fit notes are not required after the WCA decision has been made. Only where the claimant’s
condition has worsened or a new condition is reported do we need another fit note.
Any work-related requirements must take into account any continuing health condition or disa bility
even when the claimant is found fit for work.
Any work the claimant is expected to search for and the hours of work search must be reasonabl e
taking into account their health, abilities and circumstances. Similarly, the type and location of any
work being searched for must be appropriate. Refer to expected hours and availability for work.
Where 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, work search and availability requirements are
not automatically switched-off for up to 14 days.
Refer to switching of for periods of sickness
and
Medical Evidence following WCA or Switching off
requirements for further information.
Claimant feedback
Claimants unhappy with the WCA decision can request an explanation by phoning the Service
Centre. Claimants unhappy with the explanation can request a Mandatory Reconsideration (MR)
through their online account and may provide further medical evidence. If the claimant is unable to
make the request on the online account, then they can do this over the phone.
If they are not happy with the MR decision, there is the facility to lodge an appeal with Her
Majesty’s Courts and Tribunal Service.
Additional amount for caring
The additional amount for caring, and the additional amount for having LCW cannot be paid at the
same time to one claimant. The higher of these additional amounts, the additional amount for
caring is payable. Refer to Claimant in receipt of an additional amount of Universal Credit for
Limited Capability for Work (LCW) or Limited Capability for Work and Work-Related Activity
(LCWRA).
A claimant receiving the additional amount for caring has an underlying entitlement to the
additional amount for having LCW. This is the case where they have been determined as having
LCW based on medical evidence provided prior to 3 April 2017.
Where the claimant no longer meets the carer criteria after the 3 April 2017, the underlying
entitlement to the additional amount for having LCW no longer applies. This means the claimant
will not be entitled to the additional amount for having LCW.
Claimants in receipt of the additional amount for caring who provide medical evidence of being
unfit for work on or after 3 April 2017 will be referred for a WCA where appropriate.
Following the outcome of the WCA, if the claimant is determined as having LCW this is noted on
the Service. The claimant is eligible for a Work Allowance but no additional amount can be
awarded.
Changes to a Work Capability Assessment decision on or after 3 April 2017
When a review WCA decision is made on or after 3 April 2017 which results in a determination that
the claimant has LCW, but before that date the claimant was either:
in receipt of the additional amount for having LCWRA, or
unfit for work and were awaiting the result of a WCA which subsequently determined the
claimant to have LCWRA
The additional amount for having LCW is awarded to the claimant with either of the following
exceptions:
where the claimant is part of a joint claim and their partner has underlying entitlement to the
additional amount for having LCWRA
where the claimant has underlying entitlement to the additional amount for caring
In joint claims, the claimant’s partner may have an underlying entitlement to the additional amount for
having LCWRA. Where this is the case and the partner’s WCA determination is still valid, the partner
is awarded the additional amount for having LCWRA. In this case the additional amount for having
LCW cannot be paid to the claimant. The partner’s additional amount for having LCWRA should be
put into payment.
If the claimant has underlying entitlement to the additional amount for caring and the caring criteria
continues to be met, this should be put into payment.
Work Capability Assessment outcome received on or after 3 April 2017
Where a claimant has made a health condition related claim for Universal credit or ESA on or
before the 2 April 2017 but the WCA outcome report was received on or after the 3 April 2017 and:
the claimant has provided continuous medical evidence up to the date it is decided the
claimant has LCW the additional amount can be paid unless, one of the following applies:
o the claimant is part of a joint claim and the partner is already in receipt of the additional
amount for having LCW or for having LCWRA
o the claimant has been awarded the additional amount for caring and the caring criteria
continue to be met
Reconsideration or Appeal of an Employment and Support Allowance claim
Where an Employment and Support Allowance (ESA) claimant is found fit for work, ESA
entitlement ends. The claimant has a number of options including asking for a MR or claiming
Universal Credit.
If the claimant doesn’t claim Universal Credit, there will be no benefit payable throughout the MR
period.
If an appeal is lodged and Universal Credit is not claimed, then ESA can be reinstated at the
appeal rate until the appeal outcome is notified.
If the claimant made a claim to Universal Credit and then requested an MR, they will remain on
Universal Credit even if their ESA MR or appeal is successful. If the ESA claimant didn’t make a
Universal Credit claim and the MR is successful, the claimant can revert to old style ESA. Refer to
Mandatory Reconsiderations, multi-element MR or Appeal and who can request and MR or appeal
in a joint claim.
The additional amount for having LCW following an appeal:
can be paid if the claimant was in receipt of the ESA work related activity component when
the ESA claim terminated, and either one of the following apply:
o the claimant is part of a joint claim and the partner is already in receipt of the additional
amount for having LCW or LCWRA
o the claimant has been awarded the additional amount for caring and the caring criteria
continue to be met
cannot be paid if the claimant was not eligible for payment of the ESA work related activity
component when the ESA claim was terminated
Natural migration to Universal Credit from Employment and Support Allowance
If an ESA claimant in the work-related activity group migrates to Universal Credit, or makes a joint
claim with a Universal Credit claimant on or after 3 April 2017, the additional amount
cannot be
paid unless:
the claim for ESA was made before 3 April 2017
the claimant was entitled to the Work Related Activity component of ESA
the claimant was continuously entitled to the Work Related Activity component up to the date
on which the Universal Credit claim is made or treated as made
Universal Credit award
Additional amounts of Universal Credit may be awarded when claimants are found to have Limited
Capability for Work or Limited Capability for Work Related Activities. More guidance can be found
in Rates for Universal Credit.
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