You’ll usually need to fill in an extra form if you get Universal Credit and you can’t work because you’re disabled or have a health condition. The form is called the ‘work capability questionnaire’ or ‘UC50’.

After the first section, the next section of the form is about how your health condition or disability affects what you do.

If you haven’t started the form yet, find out how to start the form.

If you’re getting cancer treatment

You should fill in these sections if you also have other health conditions or disabilities.

If you don’t have any other conditions or disabilities, you don’t need to fill in these sections – you can go straight to pages 22 and 23.

You’ll also need to ask your doctor or someone else who’s treating you to fill in the last page of the form.

Find out how to finish and send the form.

Check when to return the form

You need to send the form back within 4 weeks after you got it. Check the letter that came with the form for the exact date.

If it’s more than 4 weeks since you got the form, you should still fill it in and send it as soon as you can. The Department for Work and Pensions (DWP) might accept it if there’s a good reason you couldn’t send it earlier.

Check what the DWP need to know

The DWP need to know about all the difficulties you have, so they can make the right decision about your Universal Credit.

Take your time answering each question, and have breaks when you need to. This will help you give the DWP all the information they need.

Don't feel embarrassed about your answers. It's fine if you can't do something, or if you need help – but it’s important to tell the DWP. They need to know what you can manage without anyone else's help.

How the DWP make their decision

The DWP use a list of statements to decide how difficult you find the activities in each question. The statements are called ‘descriptors’.

For each question, the DWP will check which descriptor matches your answer.

Some descriptors mean you don’t have to work or prepare for work. This is called ‘limited capability for work-related activity’ (LCWRA). If you get LCWRA, you’ll also get extra money with your claim.

If you don’t get LCWRA, the DWP will check which of the other descriptors you match. Each descriptor has a number of points. The more difficult you find that activity, the more points you might get.

For example, for question 1 if you can’t move more than:

  • 50 metres without help, you can get 15 points

  • 100 metres or use 2 steps without help, you can get 9 points

  • 200 metres without help, you can get 6 points

If you can move more than 200 metres without help, you’ll get 0 points.

The DWP add together all the points you get from the whole form. This means you don't have to get points for every question.

If you get at least 15 points from the whole form, you won’t have to work. You’ll have to do things to prepare for work, such as training or writing a CV. This is called ‘limited capability for work’ (LCW).

If you don’t get 15 points, you might still get LCW or LCWRA if working or preparing for work might be a risk to your health or someone else’s.

It’s important to make sure you explain all the difficulties you have, so the DWP can decide if you have to work or prepare for work.

If you’re not sure how the DWP will assess the questions, you can talk to an adviser.

Answer Part 1: Physical functions

This section is on pages 8 to 13 of the form.

1. Moving around and using steps

If you usually need to use something to help you walk, base your answer on how you walk when you're using it.

If you use a manual wheelchair, base your answer on how you get around when you're using it. If you use an electric wheelchair, base your answer on how you’d get around without it.

Don't feel embarrassed about your answers – it's important for the DWP to know what you can manage without anyone else's help.

"How far can you move safely and repeatedly on level ground without needing to stop?"

  • 50 metres

  • 100 metres

  • 200 metres or more

  • It varies

It's OK if you don't know what to tick straight away. Try moving and see how far you get. 50 metres is about the length of 5 double-decker buses.

What to explain about moving around

It's important to tell the DWP more by explaining your situation in the box. You should explain:

  • how long it usually takes you to move 50 metres, 100 metres and 200 metres or more – if you can't move those distances, you should explain that

  • if moving causes you pain and roughly how long for

  • if it makes you tired, uncomfortable or out of breath

  • if it makes you dizzy or unsteady on your feet

  • if you've fallen in the past – remember to say how often this happens, and whether you needed someone else to help you to get up

  • if you'd be able to move that distance again throughout the day

  • if you have good and bad days, and what the differences are

  • how you get around when you leave the house if you can only move around within your home

"Can you go up or down two steps without help from another person, if there is a rail to hold on to?"

  • Yes

  • No

  • It varies

Don't feel embarrassed about saying "no" – for example you should tick "no" if you wouldn't be able to go up or down 2 steps, or it would leave you exhausted or in pain for the rest of the day. It's important for the DWP to know this.

What to explain about using steps

If using steps would cause you pain, you should explain in the box:

  • how bad the pain would be, for example so bad that you couldn't move

  • the nature of the pain, for example throbbing, stomach pain or sharp pain

  • how long you'd be in pain for, for example about 4 hours

  • whether it would stop you doing anything else and for how long, for example you'd have to lie down for 20 minutes

If going up and down steps would make you tired or breathless, you should say:

  • how tired you'd be, for example whether you'd need to sit or lie down

  • how long you'd be tired for (you can estimate this)

  • whether being tired would stop you doing other things, and for how long

  • how it would affect the rest of your day, for example you'd be too tired to talk to someone

How the DWP give points for question 1

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 1 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
1 (a) Cannot unaided by another person either:(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.
Points
15
Descriptors
(b) Cannot unaided by another person mount or descend two steps even with the support of a handrail.
Points
9
Descriptors
(c) Cannot unaided by another person either:(i) mobilise more than 100 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or(ii) repeatedly mobilise 100 metres within a reasonable timescale because of significant discomfort or exhaustion.
Points
9
Descriptors
(d) Cannot unaided by another person either:(i) mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion; or(ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion.
Points
6
Descriptors
(e) None of the above applies.
Points
0

2. Standing and sitting

This question is about how your condition or disability affects whether you can change seats, sit and stand.

"Can you move from one seat to another right next to it without help from someone else?"

  • No

  • Yes

  • It varies

Think about whether you'd be able to sit in an adjustable office chair, rather than an armchair or any other type of seat you'd use at home.

If you use a wheelchair, think about whether you need physical help getting from your wheelchair into a different seat or into the car.

Don't feel embarrassed to tick "no", for example if:

  • you'd need someone to help you

  • you'd lose your balance and fall over if someone didn't help you

  • you'd struggle to move seats more than once in a day without help from another person – perhaps because it would be uncomfortable, painful, leave you short of breath or tired

"While you are standing or sitting (or a combination of the two) how long can you stay in one place and be pain free without the help of another person?"

  • Less than 30 minutes

  • 30 minutes to one hour

  • More than one hour

  • It varies

Think about when you're waiting for something like a bus or a doctor's appointment. Explain if you have to do things such as get up every 10 minutes to cope with the discomfort of sitting and standing.

Try not to overestimate how long you can stand, sit, or sit and stand for.

For example if you're sitting on a chair at home you might need to stand up after a few minutes, but not notice how often you're doing it.

Don't feel embarrassed if you have to tick "less than 30 minutes", for example if:

  • you can't stand for that length of time unless you have 2 sticks or crutches – and you also can't sit for 30 minutes

  • after 30 minutes you'd be in pain, but you'd force yourself through it

What to explain about standing and sitting

It's important to tell the DWP more by explaining your situation in the box. You should explain things like:

  • if it's difficult for you to change from standing up to sitting down, or from sitting to standing – and what makes it difficult for you

  • if you'd need to do something after sitting or standing for too long, for example relieve the pain by lying down

  • what problems you have when you sit or stand for too long – such as feeling sick, tiredness, trouble breathing, muscle pain or joint pain

  • why you have problems, for example your bad back makes it hard to balance

  • whether there are positions you can't sit in because they cause you pain

How the DWP give points for question 2

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 2 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
2 (a) Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person.
Points
15
Descriptors
(b) Cannot, for the majority of the time, remain at a work station, either:(i) standing unassisted by another person (even if free to move around); or(ii) sitting (even in an adjustable chair); or(iii) a combination of (i) and (ii)for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion.
Points
9
Descriptors
(c) Cannot, for the majority of the time, remain at a work station, either:(i) standing unassisted by another person (even if free to move around); or(ii) sitting (even in an adjustable chair); or(iii) a combination of (i) and (ii)for more than an hour before needing to move away in order to avoid significant discomfort or exhaustion.
Points
6
Descriptors
(d) None of the above applies.
Points
0

3. Reaching

This question is about whether you can reach up with either arm, above waist height.

"Can you lift at least one of your arms high enough as if to put something in the top pocket of a coat or jacket while you're wearing it?"

  • No

  • Yes

  • It varies

When deciding how to answer it might help to think about:

  • how difficult you find it to reach to a pocket

  • whether you could do it more than once, and what would happen if you tried to do it repeatedly

  • whether reaching to a jacket pocket would cause you pain, how severe that pain is, and how it would affect you

"Can you lift one of your arms above your head?"

  • No

  • Yes

  • It varies

When deciding how to answer it might help to think about:

  • how difficult you find it

  • whether it would cause you pain, how severe the pain is, and how it would affect you

  • whether you could do it more than once, and what would happen if you tried to do it repeatedly

What to explain about reaching

Use the box to explain what happens when you try to raise your arms. For example:

  • if you always struggle, or if the way your condition affects you changes – for example 4 out of 7 days

  • how it feels when you try to raise your arms

  • if it causes you pain or discomfort, how severe it is and how it affects you

  • if it makes you tired, how severe the tiredness is and how it affects you

  • if you need help from someone else for certain things – like washing your hair

  • how often you need help, and what you need help doing

  • if you have good days and bad days, and how they differ

  • what happens if you try to reach up on a bad day

How the DWP give points for question 3

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 3 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
3 (a) Cannot raise either arm as if to put something in the top pocket of a coat or jacket.
Points
15
Descriptors
(b) Cannot raise either arm to top of head as if to put on a hat.
Points
9
Descriptors
(c) Cannot raise either arm above head height as if to reach for something.
Points
6
Descriptors
(d) None of the above apply.
Points
0

4. Picking up and moving things

This question is about how easy it is for you to pick up and move different things.

"Can you pick up and move a half-litre (one pint) carton full of liquid?"

  • No

  • Yes

  • It varies

Try picking up a pint of milk or a pint glass of water. Don't feel embarrassed if you have to tick "no", for example if:

  • you can't pick it up – maybe you have to pull it towards you instead

  • it causes you pain – for example in your fingers, arms, back or neck

  • you can't move it smoothly – you'd end up dropping it

"Can you pick up and move a litre (two pint) carton full of liquid?"

  • No

  • Yes

  • It varies

Again, don't feel embarrassed about ticking "no". Try picking up a 2-pint carton of milk if you're not sure.

"Can you pick up and move a large, light object like an empty cardboard box?"

  • No

  • Yes

  • It varies

It's fine if you can't do this – but it's important to tick "no".

The DWP want to know how easy it is for you to move anything that's large and light. If you’re not sure how easy it would be to move a cardboard box, try thinking about shifting a pillow from one side of the bed to the other.

What to explain about picking up and moving things

You should explain in the box:

  • how you usually pick up and move things

  • what happens if you pick up and move things more than once, not just as a one-off

  • if you have problems moving things smoothly, and how this affects whether you pick things up

  • whether you drop things – you could give an example, and say what happened after you dropped something (eg you had to go to A&E)

You should also describe how picking up and moving things makes you feel – for example:

  • whether picking up or moving things causes you pain or discomfort – for example in your fingers, arms, back or neck

  • how long the pain lasts, and how severe it is (if picking up and moving things causes you pain)

  • whether picking up and moving things causes you to be short of breath, feel dizzy or tired

If it’s different on good and bad days, explain what it’s like on a good day and a bad day, and how often you have a bad day.

How the DWP give points for question 4

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 4 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
4 (a) Cannot pick up and move a 0.5 litre carton full of liquid.
Points
15
Descriptors
(b) Cannot pick up and move a one litre carton full of liquid.
Points
9
Descriptors
(c) Cannot transfer a light but bulky object such as an empty cardboard box.
Points
6
Descriptors
(d) None of the above apply.
Points
0

5. Manual dexterity

This question is about whether you find it difficult to use your hands and wrists because of a physical condition like Parkinson's disease or multiple sclerosis (MS).

"Can you use either hand to: press a button, such as a telephone keypad, turn the pages of a book, pick up a £1 coin, use a pen or pencil, use a suitable keyboard or mouse?"

  • Some of these things

  • None of these things

  • It varies

The DWP want to know if you can do any of these tasks well enough with one of your hands. By ‘well enough’ they mean whether you can:

  • make a mark, for example a tick or a cross with a pen or pencil

  • use a keyboard (including an adapted keyboard) with one hand – you don't need to be able to type fast

  • turn the pages of a book smoothly

If you’re not sure about the tasks mentioned in the question, think about whether you have problems doing other tasks, like preparing vegetables, turning on taps or getting your money out of a wallet or purse.

Don't be embarrassed to say you can't do any of the tasks, for example if you have:

  • tremors

  • spasms

  • pain

  • stiffness

  • problems with gripping

  • difficulties pinching

What to explain about using your hands

It's important to tell the DWP more by explaining your situation in the box.

You should explain if, for example:

  • somebody else has to fill in forms for you because you can't grip a pen

  • it takes you a long time to get dressed because it's hard for you to fasten zips, buttons or shoelaces

  • using your hands, for example to open a jar lid or your front door with a key causes you pain

  • you drop things because you can't grip or pinch them

  • you can't drive because of your condition, for example if you can't grip the steering wheel or use a gear stick

How the DWP give points for question 5

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 5 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
5 (a) Cannot press a button (such as a telephone keypad) with either hand or cannot turn the pages of a book with either hand.
Points
15
Descriptors
(b) Cannot pick up a £1 coin or equivalent with either hand.
Points
15
Descriptors
(c) Cannot use a pen or pencil to make a meaningful mark with either hand.
Points
9
Descriptors
(d) Cannot single-handedly use a suitable keyboard or mouse.
Points
9
Descriptors
(e) None of the above apply.
Points
0

6. Communicating (speaking, writing and typing)

This question is about whether you find it hard to make people understand you. It's about physical difficulties, for example having a stammer or being profoundly deaf.

You might also have difficulties because of a physical injury or condition, like a brain injury, stroke or Parkinson’s.

If you have difficulties because of a mental health issue such as anxiety, you can explain that in a later question.

"Can you communicate a simple message to other people such as the presence of something dangerous?"

  • No

  • Yes

  • It varies

For this question, don't just think about telling someone about something dangerous.

For example, could you order what you'd like in a cafe? This could be either by saying what you'd like or writing it down.

Don't feel embarrassed if you have to tick "no", for example if you can't convey a simple message because:

  • you'd need help from someone else, such as a sign language interpreter

  • you have difficulties speaking, you have limited speech, or you can't speak

  • your condition means that you have difficulties writing and typing, as well as speaking

  • you can't speak loudly enough or for long enough to get someone's attention

  • speaking, writing or typing causes you pain or leaves you out of breath

What to explain about speaking, writing and typing

It's important to tell the DWP more by explaining your situation in the box.

Give as much information as you can about your difficulties communicating with people. For example, explain:

  • if people don't understand you – give examples if you can

  • how it makes you feel if when someone can't understand you

  • if you avoid communicating because it's hard, takes too long, or frustrates you

  • whether someone helps you to communicate, and how they help you

  • how often you have difficulties

  • whether you have good days and bad days, and what the differences are

How the DWP give points for question 6

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 6 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
6 (a) Cannot convey a simple message, such as the presence of a hazard.
Points
15
Descriptors
(b) Has significant difficulty conveying a simple message to strangers.
Points
15
Descriptors
(c) Has some difficulty conveying a simple message to strangers.
Points
6
Descriptors
(d) None of the above apply.
Points
0

7. Communicating (hearing and reading)

This question is about whether you have difficulties understanding what people say to you, and if you have problems reading.

"Can you understand simple messages from other people by hearing or lip reading without the help of another person?"

  • No

  • Yes

  • It varies

Don't feel embarrassed if you have to tick "no", for example if:

  • you're deaf or have hearing loss and you don't lip read

  • you can manage to lip read people you know, but not strangers

  • you need a sign language interpreter

  • you sometimes misunderstand things you're told

If you use an aid, such as a hearing aid you should answer the questions as if you're using it.

"Can you understand simple messages from other people by reading large size print or using Braille?"

  • No

  • Yes

  • It varies

Again, don't feel embarrassed if you have to tick "no", for example if you're visually impaired and you don't use Braille.

What to explain about hearing and reading

It's important to tell the DWP more by explaining your situation in the box.

If you use any aids to help you understand other people, or to help you read then give the details in the box.

Examples of aids you could use:

  • Braille, large print or audio formats

  • special lights to help you read

  • a hearing aid or an electro larynx

  • a text telephone or amplification equipment to help you hear

As well as writing about aids that help you, it's important to explain things like:

  • if it takes you a long time to read something, or to understand someone

  • if you use a sign language interpreter, and what would happen if you didn't have one

  • if someone reads things for you, or explains what others have said

  • how not being able to read something or hear someone has caused you problems

  • how you feel when you can't understand what is said or written

How the DWP give points for question 7

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 7 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
7 (a) Cannot understand a simple message, such as the location of a fire escape, due to sensory impairment.
Points
15
Descriptors
(b) Has significant difficulty understanding a simple message from a stranger due to sensory impairment.
Points
15
Descriptors
(c) Has some difficulty understanding a simple message from a stranger due to sensory impairment.
Points
6
Descriptors
(d) None of the above applies.
Points
0

8. Getting around safely

This question is about physical health conditions.

You don't need to write about your mental health here. If you have a mental health condition that makes it hard for you to get around safely on your own (for example anxiety or agoraphobia), write about it in question 15.

If you have a physical condition that affects your ability to get around safely, you should include it – for example:

  • low vision

  • migraines – if they affect your vision or give you dizziness or vertigo

  • hearing loss – if it makes it more difficult for you to get around safely

  • narcolepsy – a disorder that makes people fall asleep at inappropriate times

  • Meniere’s disease – if it makes you dizzy or gives you vertigo

If you normally use glasses or contact lenses, a guide dog, a hearing aid or any other aid, answer the questions based on how you get around when you're using them.

"Can you see to cross the road on your own?"

  • No

  • Yes

  • It varies

Think about trying to cross a road you've never crossed before – for example, on the way to an appointment somewhere new.

Don't feel embarrassed if you have to tick "no", for example if you'd need help from another person.

You could tick "it varies" if it depends on the weather and if it's daytime or if it's after dark.

"Can you get around a place that you haven't been to before without help?"

  • No

  • Yes

  • It varies

Again, don't feel embarrassed if you have to tick "no" because you'd need help from another person – for example if:

  • you couldn't get around a new place without help after dark

  • you have blurred or double vision

  • your hearing difficulties mean you wouldn't be able to ask for help

What to explain about getting around safely

It's important to tell the DWP more by explaining your situation in the box – both for crossing the road and getting around new places. It's important to explain things like:

  • what would stop you from crossing the road on your own

  • whether you've fallen in the past

  • if you have good and bad days (for example, if you have migraines) – and what it's like for you on different days

  • whether you can use public transport to get around – for example you can't see the number on the bus, so don't know if it's the right route

  • if you can get around a supermarket to find what you're looking for

  • if you can focus on things when you need to – for example road signs

How the DWP give points for question 8

The DWP will check which of these descriptors matches your answer.

You can’t get LCWRA from matching any of these descriptors.

The DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
8 (a) Unable to navigate around familiar surroundings, without being accompanied by another person, due to sensory impairment.
Points
15
Descriptors
(b) Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment.
Points
15
Descriptors
(c) Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment.
Points
9
Descriptors
(d) None of the above apply.
Points
0

9. Controlling your bowels and bladder and using a collective device

This question is about whether you have a problem with your bladder or bowels while you're awake – not while you're asleep.

This question is especially relevant for people with conditions like IBS and Crohn's disease.

You might also have problems as a result of your medication or of a different condition or disability – for example if you can't control your bladder when having an epileptic seizure.

"Do you have to wash or change your clothes because of difficulty controlling your bladder, bowels or collecting device?"

  • No

  • Yes – weekly

  • Yes – monthly

  • Yes – less than monthly

  • Yes – but only if I cannot reach a toilet quickly

Try to be honest, even if you find it embarrassing. It's important for the DWP to know what happens so they can make the right decision.

If you have to clean yourself and change your clothes due to incontinence, say how often this happens.

If it hasn't happened, but you're worried that it could, or it hasn't happened because you stay near a toilet, you should tick the last box.

If you can manage your condition with incontinence pads, for example, you should tick "no". If there's a reason why you don't use them, or if you sometimes still have to change your clothes tick "yes" and explain in the box.

What to explain about your bowels and bladder

It's important to tell the DWP more by explaining your situation in the box.

You should explain things like:

  • what happens if you can't reach a toilet quickly

  • how often you need to wash or change your clothes because of difficulty controlling your bladder or bowels

  • whether you carry spare clothes around in case of emergencies

  • if you take medication to control your bladder or bowels, and whether it works

  • the problems you have if you want to go out – for example if you need to stay close to a toilet to avoid accidents

  • how often you have flare-ups, for example if your Crohn's disease is usually well controlled with medication, but you get severe diarrhoea once every 6 months

How the DWP give points for question 9

You’ll get LCWRA if this statement matches your answer:

"At least once a week experiences:

(a) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or

(b) substantial leakage of the contents of a collecting device, sufficient to require the individual to clean themselves and change clothing."

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
9 (a) At least once a month experiences:(i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or(ii) substantial leakage of the contents of a collecting device sufficient to require cleaning and a change in clothing.
Points
15
Descriptors
(b) the majority of time is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly.
Points
6
Descriptors
(c) Neither of the above apply.
Points
0

10. Staying conscious when awake

This question is about whether your condition or disability affects your consciousness. For example your consciousness might be affected by:

  • epilepsy

  • diabetes

  • narcolepsy (a condition that makes you fall asleep at inappropriate times)

  • severe migraine

"While you are awake, how often do you faint or have fits or blackouts?"

  • Daily

  • Weekly

  • Monthly

  • Less than monthly

The DWP want to know how often you have fits, seizures or blackouts or anything else that severely disrupts your awareness and concentration when you're awake.

They're not interested in what happens when you're asleep – whether at night or during the day.

You might not always completely lose consciousness when you have fits or seizures. It's still important to include them and say how they affect you.

What to explain about staying conscious

It's important to tell the DWP more by explaining your situation in the box.

You should explain:

  • if you have any warning that you're about to have a fit or seizure

  • if you've been taken to hospital – say how many times this has happened

  • how long it takes you to recover

  • if you're afraid to go out in case you have a fit or seizure

  • if you've injured yourself or had an accident during a fit or seizure, for example if you've hit your head

  • if your medication gives you side effects – say what they are and what you do about them

  • if you've lost your driving licence (or you've never had one) because of your condition or disability

Write down if, after losing consciousness, you:

  • need to take time to recover, such as going to bed

  • don't know how you'll feel – you may become aggressive or unpredictable

  • are unaware of what's going on around you

  • need someone to care for you

How the DWP give points for question 10

The DWP will check which of these descriptors matches your answer.

You can’t get LCWRA from matching any of these descriptors.

The DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
10 (a) At least once a week, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration.
Points
15
Descriptors
(b) At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration.
Points
6
Descriptors
(c) None of the above apply.
Points
0

Answer Part 2: Mental, cognitive and intellectual capabilities

This section is on pages 14 to 17 of the form.

Take your time answering each question, and have breaks when you need to. It’s important to give the DWP all the information so they can decide what support you need.

11. Learning how to do tasks

This question is about how your ability to do tasks is affected by your mental health condition or cognitive impairment, for example if you have:

  • learning difficulties

  • depression

  • anxiety

  • brain injuries

  • cognitive impairments after a stroke

  • difficulty understanding language, for example receptive dysphasia

Think about whether you tend to have problems focusing or concentrating, or if you get anxious when you have to learn how to do something new.

"Can you learn how to do an everyday task such as setting an alarm clock?"

  • No

  • Yes

  • It varies

Don't feel embarrassed to tick "no", for example if:

  • you'd be confused by the switches

  • you wouldn't be able to work an alarm clock on your own, even if someone showed you how the day before

  • you wouldn't be able to cope if you had to get up at a different time one day (and needed to change the time of your alarm)

This isn't just about setting an alarm clock – it's about doing any basic task. Think about, for example:

  • learning how to turn on a television and then change the channel using your remote control

  • turning on the heating or hot water

"Can you learn how to do a more complicated task such as using a washing machine?"

  • No

  • Yes

  • It varies

This isn't just about using a washing machine – it's about any more complex task. Think about, for example:

  • learning how to use a new computer for things like sending and receiving emails

  • making a cup of tea for someone – so filling a kettle, putting tea bags in a teapot, pouring it into a cup and then adding milk and sugar

What to explain about learning tasks

You should explain in the box:

  • if there's anything that you couldn't learn to do (or struggled with) because you find it too difficult – for example using a dishwasher

  • if you need to practise and repeat tasks regularly to learn them – and how long it would take you

  • if you need someone to show you how to do the task more than once

  • whether medication you're taking has affected your ability to learn new tasks – try to compare what it was like before you started taking the medication

  • whether you can focus on tasks

  • if you have problems with your short-term memory

  • if you have good and bad days – and what it's like for you on different days

  • whether you'd be able to learn more than one new task in a day

How the DWP give points for question 11

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 11 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
11 (a) Cannot learn how to complete a simple task, such as setting an alarm clock.
Points
15
Descriptors
(b) Cannot learn anything beyond a simple task, such as setting an alarm clock.
Points
9
Descriptors
(c) Cannot learn anything beyond a moderately complex task, such as the steps involved in operating a washing machine to clean clothes.
Points
6
Descriptors
(e) None of the above applies.
Points
0

12. Awareness of hazards or danger

This question is about how your mental health or cognitive impairment affects your awareness of hazards or danger. For example, you might be less aware of danger because of:

  • side effects of medication

  • a mental health condition like depression or psychosis

  • a neurological condition like epilepsy

  • a brain injury

  • a learning disability

Think about:

  • whether you understand the risks in everyday tasks like boiling water and using sharp objects

  • whether you can stay safe sometimes, but sometimes have accidents – think about why they happen, such as if you've cut yourself on a sharp object, or burned yourself in the kitchen or with an iron

  • whether you know how to avoid danger, for example you don't worry about traffic or crossing roads

  • if you've ever fallen or injured yourself in the street (think about how it affected you afterwards) – such as you hurt yourself and now avoid certain streets

"Do you need supervision (someone to stay with you) for most of the time to stay safe?"

  • No

  • Yes

  • It varies

If you don't have anyone to supervise you, you should still put down why you're at risk.

Don't feel embarrassed about saying "yes" – if you need someone with you, it's important to say this.

It's important to tell the DWP more by explaining your situation in the box.

What to explain about awareness of danger

You should explain in the box (and give examples):

  • if you're at risk of hurting yourself – for example you don't always notice when something is dangerous because of depression or anxiety

  • if you sometimes act on impulse and only realise how dangerous it was afterwards – for example you have bipolar and take risks when you're on a high

  • if you forget to be careful, behave irrationally or take sudden risks in an unpredictable way

  • if you find it hard to concentrate – for example because of your medication

How the DWP give points for question 12

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 12 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
12 (a) Reduced awareness of everyday hazards leads to a significant risk of:(i) injury to self or others; or(ii) damage to property or possessionssuch that the claimant requires supervision for the majority of the time to maintain safety.
Points
15
Descriptors
(b) Reduced awareness of everyday hazards leads to a significant risk of(i) injury to self or others; or(ii) damage to property or possessionssuch that the claimant frequently requires supervision to maintain safety.
Points
9
Descriptors
(c) Reduced awareness of everyday hazards leads to a significant risk of:(i) injury to self or others; or(ii) damage to property or possessionssuch that the claimant occasionally requires supervision to maintain safety.
Points
6
Descriptors
(d) None of the above apply.
Points
0

13. Starting and finishing tasks

This question is about whether you can plan, organise and complete at least 2 routine tasks, one after the other.

The DWP aren’t asking about your physical problems in this question. They want to know whether you have a mental health condition that affects your ability to start and finish routine tasks.

"Can you manage to plan, start and finish daily tasks?"

  • Never

  • Sometimes

  • It varies

Routine tasks are things including:

  • showering

  • dressing

  • collecting a prescription

  • preparing a basic meal

  • ironing clothes

  • paying a bill

  • making appointments

Think about whether you could complete 2 of these tasks, one after the other, for example before you leave the house to go to an appointment.

For example, imagine you're making a cup of tea and the phone rings. Would you be able to stop making the tea, answer the phone and then finish making the tea after the phone call?

Think about whether you'd be able to do these and other routine tasks repeatedly during the same day.

What to explain about starting and finishing tasks

It's important to tell the DWP more by explaining your situation in the box.

It's important to explain whether:

  • your condition makes it hard for you to concentrate

  • you need to be reminded or encouraged

  • you get confused

  • you get distracted

  • you feel anxious or overwhelmed

  • you forget what you're doing

  • your medication affects how you complete tasks

  • your condition makes you lack motivation

  • your condition makes you lack energy or you get tired

  • you have good days and bad days

How the DWP give points for question 13

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 13 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
13 (a) Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions.
Points
15
Descriptors
(b) Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions for the majority of the time.
Points
9
Descriptors
(c) Frequently cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions.
Points
6
Descriptors
(d) None of the above apply.
Points
0

14. Coping with changes

This question is about what happens and how you feel if your routine or plans change.

"Can you cope with small changes to your routine if you know about them before they happen?"

  • no

  • yes

  • it varies

Think about having to eat lunch at a different time from usual – or a planned bus diversion which takes you on a different route home.

Don't feel embarrassed if you have to tick "no", for example if:

  • you can't deal with change at all – even if you're warned about it

  • change makes you withdraw and refuse help

  • change affects your behaviour

  • change stops you from being your normal self afterwards, for example you need someone to calm you down and it affects you all day

"Can you cope with small changes to your routine if they are unexpected?"

  • no

  • yes

  • it varies

Think about your bus or train being 15 minutes late, or a friend or carer coming to your house earlier or later than planned.

Don't feel embarrassed if you have to tick "no", for example if it takes a lot of planning and mental preparation to get ready for something – and you find it hard to cope if it gets cancelled.

What to explain about coping with changes

It's important to tell the DWP more by explaining your situation in the box.

You should explain things like:

  • whether you have problems coping with planned changes to your day

  • whether you can't cope with sudden changes

  • whether your medication affects how you cope with change

  • how you cope with change – use examples, if you can

  • how your day would be affected if your routine changed, for example whether you'd be able to do what you'd planned

  • how often you'd be affected by change in this way

  • anything you avoid doing because of potential problems, for example you avoid meeting friends for a meal because you'd be upset if you couldn't sit in a window seat

How the DWP give points for question 14

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 14 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
14 (a) Cannot cope with any change to the extent that day to day life cannot be managed.
Points
15
Descriptors
(b) Cannot cope with minor planned change (such as a pre-arranged change to the routine time scheduled for a lunch break), to the extent that overall day to day life is made significantly more difficult.
Points
9
Descriptors
(c) Cannot cope with minor unplanned change (such as the timing of an appointment on the day it is due to occur), to the extent that overall, day to day life is made significantly more difficult.
Points
6
Descriptors
(d) None of the above apply.
Points
0

15. Going out

This question is about whether you can cope mentally or emotionally with going out – for example if you have anxiety, panic attacks or agoraphobia.

You don't need to write about how you'd physically get to places – you just need to write about how it makes you feel when you have to go out.

Explain how you feel getting to places. When thinking about this, ignore any help you may get from maps or mobile phone apps.

If physical problems stop you going out, you should explain this in question 1.

"Can you leave home and go out to places you know?"

  • No

  • Yes, if someone goes with me

  • It varies

This question is about familiar places. Think about what would happen if you had to go to your local Post Office, bank or supermarket on your own.

Don't feel embarrassed to tick "no" or “yes, if someone goes with me” – for example if:

  • most of the time you can't go to familiar places even if another person comes with you

  • you can only go to familiar places if someone comes with you

If you can get to a familiar place, but only if someone comes with you, explain why – for example if you would feel anxious or distressed if you tried to go out without another person.

"Can you leave home and go out to places you don't know?"

  • No

  • Yes, if someone goes with me

  • It varies

This is about places you don't know. Think about what would happen if you had to go to a new place you hadn't been to before.

Don't feel embarrassed if you have to tick "no" or “yes, if someone goes with me” – for example if:

  • you find it difficult to go to an appointment somewhere new, even if another person comes with you

  • you can't go out and buy food on your own in a shop you don't normally go to – you'd only use shops you know or wait until someone can do it for you

  • you can only go to new places if someone comes with you

If you need someone to come with you, explain why in the box.

What to explain about going out

It's important to tell the DWP more by explaining your situation in the box.

You should explain things like:

  • if a mental health condition causes you problems going out – what the condition is and what medication you take for it

  • what would happen if you tried to go to a familiar or unfamiliar place on your own

  • any difficulties you get into when you go out – for example panic attacks, getting lost or road accidents

  • the difference it makes if you have someone with you

  • if you have good and bad days, and what the differences are

How the DWP give points for question 15

The DWP will check which of these descriptors matches your answer.

You can’t get LCWRA from matching any of these descriptors.

The DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
15 (a) Cannot get to any place outside the claimant's house with which the claimant is familiar.
Points
15
Descriptors
(b) Is unable to get to a specified place with which the claimant is familiar, without being accompanied by another person.
Points
9
Descriptors
(c) Is unable to get to a specified place with which the claimant is unfamiliar without being accompanied by another person.
Points
6
Descriptors
(d) None of the above apply.
Points
0

16. Coping with social situations

This question is about how you cope with meeting and speaking to people.

It's about whether you have difficulties relating to people, or if meeting and speaking to people causes you significant distress.

The reason you have difficulties could be because:

  • you have a condition like autism which means you find it hard to relate to people

  • you have a learning disability

  • you have issues with anger or aggression

  • your mental health makes it hard to be around people or talk to them

For example, it might be hard to be around people or talk to them if you have depression, anxiety or post-traumatic stress disorder (PTSD).

The DWP are trying to understand:

  • whether you have difficulties with people you know

  • whether you have difficulties with people you don't know

  • how often you have problems – whether it's all the time or most of the time

"Can you meet people you know without feeling too anxious or scared?"

  • No

  • Yes

  • It varies

This could be anyone you've met before like your doctor, your neighbours or friends. It doesn't just mean people you're close to.

Don't feel embarrassed if you have to tick "no", for example if:

  • seeing people you know makes you anxious or scared, for example because it makes you feel stressed or nervous

  • you avoid meeting up with people

"Can you meet people you don't know without feeling too anxious or scared?"

  • No

  • Yes

  • It varies

This could be someone like a cashier in a shop, a person in the bus queue, or a neighbour you've never met. Consider how you'd feel if you needed to deal with the public in a job, for example in a shop or a hotel.

You might need to tick "no" if:

  • speaking to strangers makes you scared or anxious, for example because it makes you feel stressed or nervous

  • you try to avoid meeting and speaking to new people

  • you try to not go out because you don't want to see people

You might need to tick 'it varies' if meeting people you didn't expect to meet makes you anxious or scared, but you're okay when you plan to meet them.

If this is the case then explain what happens and how it makes you feel in the box.

What to explain about social situations

It's important to tell the DWP more by explaining your situation in the box.

Use the box to explain how you feel about spending time with other people. For example:

  • how you feel when you have to meet and speak to people

  • if you find it hard to relate to people – how they react to you, and how it makes you feel

  • how often you avoid seeing or meeting people

  • whether you find it easier to meet other people if someone you trust is with you

  • whether you have good and bad days

  • if you could cope with meeting or speaking to more than one person at a time

  • whether it physically affects you, for example makes you feel hot, faint or dizzy

How the DWP give points for question 16

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 16 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
16 (a) Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the claimant.
Points
15
Descriptors
(b) Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the claimant.
Points
9
Descriptors
(c) Engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to difficulty relating to others or significant distress experienced by the claimant.
Points
6
Descriptors
(d) None of the above apply.
Points
0

17. Behaving appropriately

This question is about whether it's difficult for you to control your behaviour in front of other people or if you behave in an unusual way in front of them.

This could be because you have a mental health condition, a neurodiverse condition like autism, or a brain injury. It could also be relevant if you have a condition such as epilepsy or diabetes – depending on whether you have hypos or seizures, and how these affect you.

If it’s difficult to control your behaviour because of alcohol, you should fill in this question if you have alcohol dependency.

You should fill in this question if your behaviour has made other people feel uncomfortable, scared, upset or threatened.

"How often do you behave in a way which upsets other people?"

  • Every day

  • Frequently

  • Occasionally

Think about how often you've been unable to control your behaviour or reactions when other people are around. It could be people you know or people you don't know.

Try to be honest about what happens, even if you find it embarrassing.

You should say if you've upset people, for example, by:

  • shouting or screaming

  • hitting or threatening to hurt them

  • completely ignoring them

  • throwing something with the intention of breaking it, like a mug or plate

  • saying inappropriate things, for example if you have a condition that makes you swear

  • crying uncontrollably or all the time – remember to explain why this happens

  • taking your clothes off

What to explain about behaving appropriately

It's important to tell the DWP more by explaining your situation in the box.

You should explain if, for example:

  • you've ever become violent towards someone – and say if you've been arrested because of it

  • you've been barred from a shop, pub or other place

  • your medication makes you behave in an inappropriate or unusual way

  • you have a problem with drugs or alcohol that makes you aggressive or act inappropriately

  • you know you upset people, but you can't control your actions

  • you've been so upset that you can't calm down

  • you won't go out because you're scared you'll do or say something that could affect other people

How the DWP give points for question 17

The DWP will check which of these descriptors matches your answer.

If you meet descriptor 17 (a), you’ll get LCWRA.

If you meet one of the other descriptors, the DWP will add up your points from the whole form to decide if you can get LCW.

Descriptors Points
Descriptors
17 (a) Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.
Points
15
Descriptors
(b) Frequently has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.
Points
15
Descriptors
(c) Occasionally has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.
Points
9
Descriptors
(d) None of the above apply.
Points
0

Answer Part 3: Eating or drinking

This question is on page 18 of the form.

It’s about how hard it is for you to eat and drink. It’s also about if you can't eat, or don't want to eat.

18. Eating or drinking

"Can you get food and drink to your mouth without help or being prompted by another person?"

  • No

  • Yes

  • It varies

This isn't just about whether you can physically get food or a drink to your mouth – it's also about whether you forget to eat or drink, and if you don't want to eat or drink. For example you might:

  • forget to eat because of depression

  • avoid eating because it's painful for you to digest food

  • have an eating disorder

Don't feel embarrassed to tick "no", for example if:

  • you have problems with mobility in your hands or arms

  • a mental health condition makes you forget to eat, or unmotivated to eat

  • you have anorexia, bulimia or another type of eating disorder

  • you have poor coordination or grip, or you have weakness or shaking

  • you use a feeding tube into your stomach, or a feeding line into your veins

"Can you chew and swallow food and drink without help or being prompted by another person?"

  • No

  • Yes

  • It varies

Again, you shouldn't feel embarrassed to tick "no", for example if:

  • you find it hard to chew so mainly consume liquids, like soup

  • eating or drinking makes you cough or choke

  • you bring food back up

  • when you eat it feels like something is stuck in your throat or chest

  • you use a feeding tube into your stomach, or a feeding line into your veins

What to explain in the box

It's important to tell the DWP more by explaining your situation in the box.

Explain what problems you have eating and drinking, for example:

  • if someone needs to remind or prompt you to eat or drink

  • if it causes you pain to eat or drink, or makes you feel out of breath

  • if it takes a long time for you to eat or drink because it's physically difficult for you, or you forget what you're doing

  • if someone physically helps you to eat or drink, and how they help you

  • if your condition means you forget to eat or don't want to eat, how this affects you

How the DWP give points for question 18

You’ll get LCWRA if one of these descriptors matches your answer:

(a) Cannot convey food or drink to the claimant’s own mouth without receiving physical assistance from someone else; or

(b) Cannot convey food to drink to the claimant’s own mouth without repeatedly stopping or experiencing breathlessness or severe discomfort; or

(c) Cannot convey food or drink to the claimant’s own mouth without receiving regular prompting given by someone else in the claimant’s presence; or

(d) Owing to a severe disorder of mood or behaviour, fails to convey food or drink to the claimant’s own mouth without receiving:

(i) physical assistance from someone else; or

(ii) regular prompting given by someone else in the claimant’s presence.

(e) Cannot chew or swallow food or drink; or

(f) Cannot chew or swallow food or drink without repeatedly stopping, experiencing breathlessness or severe discomfort; or

(g) Cannot chew or swallow food or drink without repeatedly receiving regular prompting given by someone else in the claimant’s presence; or

(h) Owing to a severe disorder of mood or behaviour, fails to:

(i) chew or swallow food or drink; or

(ii) chew or swallow food or drink without regular prompting given by someone else in the claimant’s presence.

Finish and send the form

The last section is about sharing information, and what support you’d need if you do a medical assessment. Then you can send the form with any medical evidence you have.

Find out how to finish and send the form.