Form

Capability for work questionnaire

Only fill in this capability for work questionnaire (ESA50) if you’re asked to do so – this is not a claim form.

From:
Department for Work and Pensions
Published
4 April 2013
Last updated
30 October 2023 — See all updates

Applies to England, Scotland and Wales

Documents

Capability for work questionnaire

Ref: ESA50

PDF, 560 KB, 24 pages

Details

Find out how to claim Employment and Support Allowance

Fill in this form only if you’ve been asked to do a Work Capability Assessment.

Before you start this form

If you’re using a mobile phone or tablet

You cannot complete the form using a mobile phone or tablet. You have to either:

  • use a desktop or laptop computer
  • print the form and complete it by hand

If you’re using a desktop or laptop computer

Use a PDF reader to open and fill in this form. You can download a free PDF reader online.

If you are using screen reader software to access the form, we recommend that you review all of the notes and the questions on the form before you complete it. As you complete the form, you will be guided through the questions based on the responses you provide.

Do not use your computer’s browser or, if you are an Apple Macintosh user, the Preview application.

You can save data typed into this form if you use a PDF reader. This means that you do not have to fill in the form in one session.

There are reliability issues with some assistive software, which may mean the form will not save properly.

This form will only save if it is both:

  • saved onto your computer
  • opened in a recent version of PDF reader

The form will not save in:

  • versions of Acrobat Reader older than version XI
  • some other PDF readers, for example Preview on a Mac or Foxit on a PC

Help using this PDF claim form

For help and advice on the information you need to put on the form or about Employment and Support Allowance, contact Jobcentre Plus.

Contact the DWP Online Helpdesk, if you are having technical difficulties:

  • downloading the form
  • navigating around the form
  • printing the form

DWP online helpdesk

Email dwponline.helpdesk@dwp.gov.uk

Telephone 0800 169 0154

Monday to Friday 8am to 6pm
Closed weekends and all public and bank holidays

Find out about call charges

If you need this form in a different format

Contact Jobcentre Plus to ask for:

  • a printed copy of the form
  • a different format, such as large print, braille or audio CD

If you live in Northern Ireland

Do not use this form if you live in Northern Ireland. Contact the Employment and Support Allowance Centre.

Published 4 April 2013
Last updated 30 October 2023 + show all updates

  1. Updated the Capability for work questionnaire (ESA50).

  2. Added accessible version of the questionnaire.

  3. Added updated Welsh version of the ESA50.

  4. Published August 2020 version of the form with updated information on how the Department for Work and Pensions collects and uses information.

  5. Updated version of ESA50 'Capability for work questionnaire' - English version.

  6. Added latest version of ESA50 'Capability for work questionnaire' - English version.

  7. Updated the phone number for requesting alternative formats to 0800 169 0310.

  8. Revised ESA50: Capability for work questionnaire - English and Welsh.

  9. The capability for work questionnaire (ESA50) is currently unavailable. The latest version of the questionnaire will be added to this page shortly.

  10. Published updated version of the ESA50 form - English version.

  11. Updated the DWP online helpdesk contact details.

  12. Published updated English version of the ESA50 form.

  13. Published updated English and Welsh versions of the ESA50 form.

  14. published updated version of the ESA50 form.

  15. First published.

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