Work Capability Assessment
What is the Work Capability Assessment (WCA)?
Due to your Macular Disease you might find it difficult to work or get a job and therefore you may need to claim a Welfare Benefit to cover your day to day living expenses. If you are aged between 16 and pension age and Depending on your circumstances this will be one of two benefits, Employment and Support Allowance (ESA) or Universal Credit (UC).
ESA is paid to people who have worked and who have paid enough National Insurance contributions to qualify.
UC is an income related benefit which is dependent on your circumstances and that of your family.
If you are claiming either benefit because you are unable to work through ill health or disability you will be required to complete the Work Capability Assessment (WCA). This consists of the completion of a form and also a face to face assessment. This factsheet will take you through how to complete the form effectively taking into consideration your Macular Disease and how it affects you in the work place, and also what to expect at a face to face assessment.
The WCA is designed to assess what kind of work you are able to do and what support you would need to do this. Both the form and the subsequent face to face appointment will assess all of the conditions you tell them about and points will be awarded to establish whether you are capable to work, have limited capability for work (ESA Work related Activity Group) or have Limited Capability for Work-related activity (ESA Support Group). This will be explained in more detail later on in this factsheet.
When does the Work Capability Assessment begin?
After making an initial claim for Universal Credit or Employment Support Allowance and providing Jobcentre Plus with a Fit Note ‘sick certificate’ from your GP, you will be sent the Work Capability Assessment form through the post. The form for both benefits is the same and therefore should be completed in the same way.
When you receive the form they will tell you when they need to receive the completed form back by. If the form is not returned within the time specified, the money that you are receiving (assessment rate) will stop. It is essential that you get the form back in time or request an extension if required as any delay to the return of the form could cause complications and delays within your application.
After completing the form, it needs to be returned in the envelope provided but remember to include any additional medical evidence to support your claim. The types of documents that you can send with your application are; your certificate of visual impairment, letters from ophthalmologist, low vision specialist or any other professionals involved in your care. The additional medical evidence that you send enables a fuller assessment of your needs regarding your central vision loss and therefore a better understanding of your capability of work.
After they have received your completed form the assessor will look at the information in the form, along with the additional medical evidence that you have sent and then make a decision on whether you should attend a face to face assessment. The majority of people applying for either ESA or UC as somebody with ill health or a disability will be invited for a WCA face to face assessment.
Completion of the Work Capability Assessment (WCA) form
After the form arrives have a look through it before starting to complete it. The form is quite complicated to complete so give yourself plenty of time when answering the questions. You might want to consider finding an organisation in your local area that have advisors that can help you complete the form.
At the start of the form make sure that you list all of your medical conditions that effect you on a daily basis. These should include your Macular Disease, any condition that you have that you take medication for and any condition that has an impact on your daily life. The rest of the form is broken into 3 sections and you should be able to talk about central vision loss and its impact on your life in each of these 3 parts. If you need more space to explain how your conditions effect, you add this on a separate sheet of paper with its corresponding question number and enclose this within your application.
Part 1: Physical Functions
Question 1, ‘Moving around and using steps’ & ‘Going up or down two steps’
When completing this question make sure you explain how your central vision loss effects your ability to do this safely and repeatedly, explain that seeing obstacles and other hazards increases the length of time it takes you to move around safely. Light changes and other environmental factors, like changes in weather can make even walking a short distance more difficult.
It is likely that you are able to climb 2 steps with no difficulties however explain how you are able to see the step, its length, width and depth and whether you need to use a hand rail for support.
If you use a white cane, guide dog or other mobility aid also mention this in this question.
Question 2, ‘Standing and Sitting’
Again it is likely that you are able to stand and sit without difficulties when considering your Macular Disease however it is worth explaining how due to your lack of fine detail within your vision it is sometimes difficult to see somewhere to sit.
Question 3, 4 & 5
These 3 questions are about your ability to move both yourself and objects around. Again physically these are tasks you may be able to complete with few difficulties however these tasks can be made more difficult if you are unable to see effectively your surroundings. For example, you may be able to pick up a cup and move it safely but are you able to see accurately where you are about to put it down, have you ever knocked over a glass because you haven’t seen it? Talk about this in these sections. Your central vision loss means that you are unable to see accurately directly in front of you, however if you drop something small like a pen, coin or a tablet you should be able to see it with your peripheral vision while its moving however when it lands on a work surface or the floor it may disappear. You would be able to pick it up, if you were able to see it. Explain this lack of fine detail within these sections of the form.
Question 6, ‘Communicating –speaking, writing and typing’
Explain within the form that you would be able to communicate danger or a potential hazard if you were able to see it and also whether you are able to see the person that you wish to convey the message to.
Question 7, ‘Communicating –hearing and reading’
In this question it gives you the opportunity to explain more about how your Macular Disease effects your ability to read. You will be asked to read something at your face to face assessment so remember that this is the ability to read something in your hand at a comfortable reading distance (30cms) using any aids you require. These could include magnifiers, glasses or electronic equipment. If you use large print or are unable to see print explain how large the font you require is and whether you need support from someone else or electronic equipment to read if you cannot see print at all.
You should also explain your ability to see into the distance and how accurate this is, if you are not able to see the location of a fire escape for example, talk about this in the form. Also talk about any other reading you may do outside like identifying a bus number or reading a road sign. They do not give you very much space on the paper form to explain your difficulties so remember to use an additional sheet if needed.
Question 8, ‘Getting around safely’
This questions gives people with Macular Disease a chance to talk about how their central vision loss impacts on their daily life. As it says in the question explain whether or not you use a symbol cane, long cane or guide dog as well as any other mobility aid that you use to move around. Use this section to talk about your difficulties with moving around safely due to weather conditions and changes in light, also what your vision is like at night. What support do you need to identify obstacles and hazards and the difficulties you may have when crossing a road? When crossing a road have you had any near misses? Can you see oncoming traffic? Or the green man when using pedestrian lights? Do you need support to move around familiar areas as you have no control of the environment outside of your home. Explain how even small changes can impact on your ability to move around safely? It could be bin collection day, a car parked on the pavement or road works which reduces your ability to move around outdoors effectively. Don’t forget to mention public transport and any sighted support you need with this.
This question also asks about the kinds of support that you need from somebody else when you go to somewhere you have not been to before. Explain how you use this person to support you in locating places you want to visit both inside and out, how they support you to read and also to find specific places like public toilets. Again if you are using the paper form and need to explain further add an additional page.
Part 2: Mental, cognitive and intellectual capabilities
This section is about explaining how you are able to complete and understand tasks. It does not relate to sight loss however you can use the questions to explain a little more how Macular Disease affects you on a daily basis.
Question 11, ‘Learning how to do tasks’
For this question consider your ability to see and therefore how long it takes you to learn a new task. Can you read the instructions or do you need the support of someone else due to your vision.
Question 12, ‘Awareness of hazards or danger’
If you are unable to see hazards and dangers explain how you need support from somebody else to stay safe.
Question 14, ‘Coping with changes’
If an activity or task change, does your central vision loss inhibit you with coping with the change, therefore do you need support from somebody else to see to understand what the change is?
Question 15, ‘Going out’
Does your central vision loss make you feel anxious when you leave the house? Do you need support from somebody else to reduce this anxiety when moving around both familiar and unfamiliar areas?
Question 16, ‘Coping with social situations’
In this question talk about how your sight loss makes it difficult to recognise people, identify friends and family and other people you may need to meet such as shop assistances and police officers. Explain how you may need sighted support to understand how other people are feeling as you may be unable to see facial expressions and body language. This also gives you the opportunity to explain how you feel when meeting new people.
Part 3: Eating and drinking
Question 18, ‘Eating and Drinking’
In this question explain what support you need with identifying food, can you see the food on your plate? And if so, are you able to identify bones or food that you are potentially don’t like.
When you are eating outside of the home explain what support you need from someone else with reading menus and again identifying the food on your plate from someone with you.
Face to face assessment
After you have completed your form and returned it to Jobcentre Plus you may be asked to attend a face to face assessment. These assessments can be completed either at a specific location or within the home. For an assessment to be carried out at home you will need a letter from your GP stating that you are unable to travel safely to an assessment centre. The medical professional that completes the assessment will have some knowledge of your condition and the assessment will take approximately 1 hour.
The medical professional will have seen a copy of your WCA form and any supporting medical evidence that you have sent in with the form. They will ask you if you have any other medical evidence that you would like to submit before taking you through the assessment. The medical professional will then go through your WCA form and ask for additional information to clarify what you have stated within the form. They may also ask you to complete some basic medical tests to demonstrate how your conditions affect you. People that attend a medical assessment who have central vision loss will be asked to read a letter chart on the wall as well as print in their hands. If you are asked to read something they will ask you to use any aid that you have stated in the form, so remember to take your magnifier, if you use one, with you.
If you have mentioned any other medical conditions within your WCA form they will ask you for more information around those conditions and may ask you to complete other basic medical and physical tests.
The medical professionals are following a script and will do a lot of typing during your assessment, however be aware that your assessment starts from the moment you enter the building it is being held at or when they come into your home. The appointment is not designed to catch you out, and the results will be based on the assessment of that day. It is also worth considering taking someone with you as they will be able to provide support for you.
The face to face medical assessment also gives you the opportunity to explain the impact of your Macular Disease on your ability to complete the daily tasks mentioned in your WCA form. This will provide Jobcentre Plus with the evidence that they require to make a decision on your claim. The more evidence that you can provide within the WCA form will reduce the amount of questions within the assessment, so try to be thorough and open when completing the form.
How Jobcentre Plus reach their decision
After your face to face medical assessment has been completed the medical professional will prepare a report and send this to Jobcentre Plus. It is a Jobcentre Plus decision maker that makes the decision regarding your claim.
The Jobcentre Plus decision maker will use the basic information from your claim, your WCA form, supporting medical evidence and the advice within the medical report to make a decision. The medical professional will advise the decision maker of how they have assessed your ability to complete the tasks within your WCA form based upon the descriptors. However; it is down to the discretion of decision maker on the points that you are awarded for each task and therefore if you have accrued enough points within the claim to receive an award. You need to score 15 points to be awarded the benefit, these points can be awarded from one descriptor or a combination of several descriptors. If you score the 15 points required in one descriptor it is likely that you will be placed in the ‘limited capability for work-related Activity group (ESA Support Group)’.
Jobcentre Plus will then write to you to inform you whether you have made a successful claim. The letter will state whether you have been awarded enough points and which group you have been placed in (limited capability for work group (ESA Work Related Activity Group) or the limited capability for work-related activity group (ESA Support Group), or if you have not been successful. The decision letter will also include an explanation of how they have come to their decision, how many points you have scored and on which descriptor and an explanation of how they have reached their decision. This letter will also include the date of your initial payment and also the length of time you have been awarded either ESA or UC for.
What do you do if you disagree with the decision?
After receiving your award letter from Jobcentre Plus, read it carefully so you understand the award that has been made and decide whether you agree with the decision. If you do not agree with part or all of the decision you have the opportunity to ask for the decision to be looked at again.
If you do not agree with part or all of the decision contact the relevant department using the phone number provided on the letter to request a mandatory reconsideration of your claim. They will ask you in which areas you disagree with the award and if you would like to submit any further evidence to support your claim. This additional evidence can be given either over the phone to the advisor or via a letter. Remember to send any other supporting medical evidence so a full reconsideration can be made. Your claim will be looked at again by a different decision maker, however this decision maker may agree with the decision that has already been made or change the award. If they decided to change the award this could be an increase or decrease in the initial decision. A mandatory reconsideration must be formally submitted within 28 days of the initial award. After your claim has been looked at again you will then receive a letter explaining the decision and how that decision was made.
If the decision remains the same or it is reduced, you are now able to appeal this decision at this point. As part of the mandatory reconsideration letter there is a certificate stating that a mandatory reconsideration has been carried out, HM Courts and Tribunals Service need to have this before being able to proceeding with an appeal. The Tribunal Service has a submission form which needs to be completed outlining the areas in which you feel that an incorrect decision has been made and on which you would like to base your appeal.
The Macular Society strongly recommends that you get professional support with mandatory reconsiderations and tribunals. If you would like further information regarding this, please contact the Advice and Information Line on 0300 3030 111 or email firstname.lastname@example.org