Work Capability Assessment

Sometimes, an employee might not be medically fit enough to work. Maybe they're recovering from an injury or suffer from a lifelong disability.

In these circumstances, you may need to refer them for a work capability assessment. This test allows you to support employees at work in the safest manner.

If employers fail to follow the right assessment process, you could cause a substantial risk to employee and business welfare.

In this guide, we’ll look at what a work capability assessment is, who issues them, and how to manage assessments in your workplace.

What is a work capability assessment?

A capability assessment tests whether an employee can work or not.

Work capability assessments check whether they're unable to work because of an illness or disability. Their health condition has to affect them for four weeks. Meaning, they aren't able to carry out or complete their job requirements.

If an employee's health condition meets certain factors, you may have to refer them for a work capability assessment.

Read our article: Health and Disability Assessments Services

Who issues a work capability assessment?

Work capability assessments can only be issued by a healthcare professional. This person acts on behalf of the Department of Work and Pensions (DWP).

They take into account whether an employee’s health does or is expected to affect their ability to work. Capability assessments cover one of three tests:

• Limited capability for work (LCW)

A limited capability for work (LCW) is when an employee cannot work; but they can prepare to work again in the near future.

Their physical or mental health condition makes it hard for them to work. But they're expected to heal or get better soon.

• Limited capability for work and work-related activity (LCWRA)

A limited capability for work and work-related activity (LCWRA) is when an employee cannot work - and isn't expected to work.

Their physical or mental health condition is so severe that they aren't expected to work at all. A work-related activity might be hard to define. But it can include tasks like going to interviews or training for jobs.

• Fit to work

Fit to work is when an employee is medically well enough to work.

This might be determined through a self-evaluation or from a medical professional. During this period, employees aren't entitled to Employment and Support Allowance (ESA), Universal Credit (UC), or any other benefit. That's because they aren't affected by their health condition.

When do you apply for a work capability assessment?

There are a few instances where you should apply for a work capability assessment.

They usually revolve around an employee requesting medical or monetary claims. For example, an Employment and Support Allowance (ESA), Universal Credit (UC), or some other benefit.

To claim them, an employee may be asked to provide a sick note. This must be from a medical professional and needs to last at least 13 weeks. They'll assess whether the employee is able to work or not.

The findings from the work capability assessment are then sent to the Department of Work and Pensions. They will decide if the employee:

• Needs further Employment and Support Allowance (ESA) or Universal Credit (UC).
• Can receive National Insurance (NI) credits based on their limited capability to work.
• Is eligible to receive a work-related activity component for Housing Benefits (HB). (This depends on local authorities who provide Council Tax Support).

If an employee applies for a work capability assessment, due to a mental health condition or disability, the report should be transparent about their ability to work well.

What are the laws on work capability assessments?

Capability is outlined under the Employment Rights Act 1996 (ERA).

The act covers an employee's skills, aptitude, and health (physical and mental). They've legally agreed to fulfil a contractual agreement based on your business needs and their capability.

If they can't or are no longer able to complete their job well, they could face dismissal. But you must prove it's related to capability; and not negligence or carelessness, as this should be dealt with as a misconduct.

Employers are responsible for dealing with capability issues in the proper manner. If you don't, you could end up facing unfair dismissal claims at an employment tribunal.

If the claims are upheld, you could end up reinstating them, paying compensation, and even further business losses.

How to manage a work capability assessment

It can be hard to determine how to support employees with a serious health condition. Especially if it's affecting circumstances in their capability to work in their day-to-day life.

For employers, you need to make sure you follow the right steps when dealing with health issues. Let's look at how to manage a work capability assessment in the workplace:

Only refer when it's necessary

The first step you need to consider is only referring employees for capability assessments when it's absolutely necessary.

Meaning, they've been unable to work for at least four weeks. And their capability needs to be assessed for health and safety matters.

From this point, you'll be able to refer them to a healthcare professional. This could be GPs, nurses, or psychiatrists. They'll gather medical information and evidence through face-to-face assessments.

After the face-to-face assessment, they'll write up a medical report regarding the employee’s condition. The report is then sent to the DWP who'll decide on eligibility for financial support.

Complete a Capability for Work questionnaire

The employee is then asked to complete a Capability for Work questionnaire.

This will help the DWP decide which financial benefit to provide to them. Employees could be asked to answer either a:

• UC50 form for Universal Credit.
• ESA50 form for Employment and Support Allowance.

The Capability for Work questionnaire is then returned to the Health Assessment Advisory Service.

Record the score points

From the Capability for Work questionnaire, employees will have scored points based on their answer.

They'll need to have scored 15 points or more to prove they have limited capability to work. Score points include both physical and mental health conditions.

The aim of the points is to determine whether the employee's health condition affects them for 50% of the time. If their health is worsened by limited capability to work, they could automatically qualify for 15 points.

Alongside the questionnaire, the healthcare professional will also conduct a medical assessment interview. They may carry out a physical or psychological assessment; it depends on what medical evidence they need.

Match findings to descriptors

All reports are sent to the Department of Work and Pensions. They act as the final decision-maker in every case.

The DWP decision-maker will then match the findings to ‘descriptors’. Employees are assessed on 17 depicters found in general work-related activities. These descriptors are divided into physical and mental activities:

A physical work-related activity may include:

• Standing and sitting.
• Picking up and moving an object.
• Manual dexterity.
• Making yourself understood.
• Understanding others.
• Finding your way round.

A mental work-related activity may include:

• Learning tasks.
• Hazard awareness.
• Planning and problem solving.
• Coping with change.
• Getting about.
• Coping with other people.

Collect all the descriptor points

Once you've found descriptors, you'll need to collect all the points they're linked to. The following descriptors will lead to one of two outcomes:

• The employee gains at least 15 points needed for ‘limited capability for work’.
• The employee establishes a ‘limited capability for work-related activity’.

If the employee doesn't gain any points, they must aim to match at least one activity to make them eligible.

Be aware, there are non-functioning descriptors that you have to take into account. For example, if you identify that an employee is pregnant or has health deterioration.

Decide on support benefits

After the employee has been assessed fully, they'll be able to decide on which support benefits to go for.

To claim Employment and Support Allowance, they'll need to be awarded for one of two initial claim processes:

• Limited capability for work: They can claim ESA at the lower rate for 52 weeks. (This is known as the Work-Related Activity Group).
• Limited capability for work-related activity: They can claim ESA at an enhanced rate. (This is known as the Support Group and has no time limits attached).

An employee can only claim Universal Credit if they have limited capability for work-related activity during their job. The current amount awarded to them is £343.63 per month.

Employees can only make claims for work capability assessments individually - and not as a couple. Even if both people are eligible, their joint household is entitled to one additional payment.

What if an employee keeps working whilst managing their health condition?

If an employee keeps working whilst managing their health condition or disability, they may be entitled to another additional benefit.

Working employees can only receive referrals for work capability assessments when they meet certain requirements.

Their wages must be below, equal to, or exceed a specified amount. This specified amount is equivalent to 16 hours of work at the National Minimum Wage or the National Living Wage.

If they meet the criteria, they may also be entitled to another incapacity benefit, like:

• Disability Living Allowance (DLA).
• Personal Independence Payment (PIP).
• Attendance Allowance (AA).
• Armed Forces Independence Payment (AFIP).

If an employee feels better, worse, or develops a new health condition, they must raise this as a new claim.

What is a severe disability premium?

Severe disability premium (SDP) is extra money provided to employees diagnosed with disability conditions.

Disabled people who already receive SDP before making Universal Credit claims could be entitled to an incapacity benefit in the near future.

They could also receive SDP-related transitional protection on top of the payment. The transitional protection pay can even be added in addition to Universal Credit benefits.

If an employee is still working, their transitional protection payment may become affected. For every £1 they earn above their work allowance, their Universal Credit benefit decreases by 55p.

Read our article: What is the Capability for work questionnaire?

Get expert advice on work capability assessments with Health Assured

Employers must support any worker suffering with a physical or mental health condition. You're not expected to heal them - but you do need to help them in the most relevant manner.

There are so many ways you can do this - from referring them to a health-support group, to helping them fill out Universal Credit forms. But if you neglect any of their statutory rights, you could risk their welfare, as well as your business's.

Health Assured offers expert advice on work capability assessments. Our team can help you safeguard employee wellbeing whilst meeting your business needs. We also offer employee assistance programmes (EAPs) to help with health issues at work.

Find out more about our Occupation Health Assessments and speak to one of our wellbeing specialists today.

If you access to our EAP we provide a 24/7 helpline that’s open 365 days a year–helping you care for your staff all year round.