Back to previous
Newer version available

There is a newer version of this publication available:
Mental Health and Benefits Handbook 1st edition - with new material

Chapter 5: Universal credit
Key facts
    Universal credit (UC) is a means-tested benefit for people who are in or out of work, including people with health conditions and disabilities.
    You may be able to get help with your rent and other housing costs through UC.
    If you have a mental health problem that affects your ability to work, you usually have a ‘work capability assessment’. This determines whether you are expected to look for, or prepare for, work in order to get UC, and can also affect the amount of UC you get.
    You can get UC alongside many other benefits, including contributory employment and support allowance (ESA) and disability benefits (eg, personal independence payment or adult disability payment).
    UC is replacing a number of other means-tested benefits including income-related ESA and, for most people, working-age housing benefit. If you are getting one of these benefits you may be asked to move to UC.
    You can challenge decisions about your entitlement to UC and about your work capability.
    Getting UC can mean that you are eligible for other kinds of financial support.
1. Who can get universal credit
Universal credit is now the main means-tested benefit for working-age people. You can claim it whether you are in or out of work, and whether or not you have a health condition or disability. You do not need to have paid national insurance contributions to qualify for UC.
You can qualify for universal credit (UC) if:1ss3-5 WRA 2012
    you are aged 18 or over and under pension age, which is currently 66. Note: some 16/17 year olds, and some people over pension age with younger partners, known as ‘mixed-age couples’ (see here, can get UC); and
    you are not ‘receiving education’ (although there are exceptions to this, see here); and
    you satisfy the ‘habitual residence’ and the ‘right to reside’ tests, are in (or treated as being in) Great Britain, and are not a ‘person subject to immigration control’, see CPAG’s Welfare Benefits and Tax Credits Handbook; and
    you have accepted a ‘claimant commitment’ (see here); and
    your income is not too high (see here); and
    your savings and other capital (eg, shares, certain lump-sum payments and most property that is not your main home) come to £16,000 or less in total.
Note:
    Special rules apply when you are in hospital, staying in a care home and in certain other situations, see Chapter 16.
    You may not have to meet all of these conditions if you transfer to UC under the ‘managed migration’ process (see here).
If you are a member of a couple, you must usually make a joint claim for UC (see here for the practicalities of claiming as a couple).2s2 WRA 2012 Both of you must usually satisfy the conditions above and your income and capital are assessed jointly. If one of you does not satisfy the conditions, there are some circumstances in which you can still claim UC.3Reg 3 UC Regs; reg 9 UC,PIP,JSA&ESA(C&P) Regs
Mental health and the ‘claimant commitment’
To get UC, most people are expected to work or to prepare for and look for work. These expectations are known as ‘work-related requirements’ (see here) and are set out in a ‘claimant commitment’.
UC is designed to treat you differently if you have a health condition or disability such as a mental health problem that restricts your ability to work. In this situation, you usually go through a work capability assessment (WCA) (see here) to decide if you have limited capability for work (LCW) or limited capability for work and work-related activity (LCWRA).
If it is decided that you have LCW or LCWRA you have fewer, or no, work-related requirements (see here).
If it is decided that, despite having a mental health problem, you do not have LCW or LCWRA (ie, that you are ‘fit for work’) you can still receive UC but you are likely to have more work-related requirements (see here).
You can challenge a decision that you are fit for work, or that you have LCW but not LCWRA (see here).
If you have work-related requirements but are struggling to meet them because of your mental health problem, you can ask your work coach to change, reduce or stop them, even when you have been found ‘fit for work’.4Regs 88 and 97 UC Regs; ADM J3160 and J3250-J3270 See here.
If you do not meet your work-related requirements, you may be sanctioned (see here).
If you do not accept your claimant commitment, your eligibility for UC normally ends.
Chapter 15 has more information about work, work-related activity and sanctions. Chapter 18 has more information about getting support in the benefits system.
 
1     ss3-5 WRA 2012 »
2     s2 WRA 2012 »
3     Reg 3 UC Regs; reg 9 UC,PIP,JSA&ESA(C&P) Regs »
4     Regs 88 and 97 UC Regs; ADM J3160 and J3250-J3270 »
Step one: calculate your monthly maximum amount
Your maximum monthly amount of UC is made up of the total of:
    a standard allowance, based on your age and whether you are a single claimant or claiming with a partner;1Reg 36 UC Regs
    a child element for each child or qualifying young person you are responsible for, see here, with an additional amount for a disabled or severely disabled child, see here.2Regs 24-24B UC Regs (Note: you may only be able to get the standard child element for a maximum of two children, depending on when they were born and some other factors,3s10 WRA 2012; reg 24A UC Regs but there is no such limit for the disabled child addition);
    a limited capability for work (LCW) or limited capability for work and work-related activity (LCWRA) element (here) for some claimants with a health condition or disability;
    a carer element;4Regs 29-30 UC Regs
    a housing costs element for people paying rent or service charges (see here);
    a childcare costs element;5Regs 31-35 UC Regs
    a full transitional protection element, if you transfer to UC under the ‘managed migration’ process and your UC is worth less than your old benefits (see here);
    a transitional severe disability premium (SDP) element if you meet the criteria (see here) and are not entitled to a full transitional protection element.6s8 WRA 2012; Sch 2 paras 1, 4 and 7 UC(TP) Regs
See here for the rates of the different UC elements. Also see CPAG’s Welfare Benefits and Tax Credits Handbook for more information on UC amounts.
 
1     Reg 36 UC Regs »
2     Regs 24-24B UC Regs »
3     s10 WRA 2012; reg 24A UC Regs »
4     Regs 29-30 UC Regs »
5     Regs 31-35 UC Regs »
6     s8 WRA 2012; Sch 2 paras 1, 4 and 7 UC(TP) Regs »
Children and young people
As a general rule, a child under 16 or a ‘qualifying young person’ is included in your UC claim if they normally live with you.1Regs 4 and 4A UC Regs There are limited exceptions. If you share care of a child or young person and are not sure if they count as ‘normally’ living with you, seek independent advice – Advicelocal.uk.
A ‘qualifying young person’ is:2Reg 5 UC Regs
    a young person aged 16 who has not yet reached the 1 September after their 16th birthday; or
    in most cases, a young person aged 16 to 19 who has not yet reached the 1 September after their 19th birthday and who is in approved training or non-advanced education for more than 12 hours a week.
 
1     Regs 4 and 4A UC Regs »
2     Reg 5 UC Regs »
Limited capability for work element
If you are assessed as having LCW (see here), your UC award does not usually include an extra element. However, in limited circumstances, a LCW element of £146.31 a month (in 2023/24) is included.1ESAUC (MA) Regs 2017 The main situations in which this happens are if:
    you have continuously received UC since before 3 April 2017 and have had either a LCW element or a LCWRA element continuously included in your award since before 3 April 2017; or
    you had an employment and support allowance (ESA) award immediately before 3 April 2017, and had been getting ESA continuously from 3 April 2017 until you claimed UC; or
    you had national insurance credits for limited capability for work (see here) immediately before 3 April 2017, and had been getting these continuously from 3 April 2017 until you claimed UC.
If you are making a joint UC claim with your partner, only one LCW element can be included, even if you both meet the conditions.2Reg 27(4) UC Regs
 
1     ESAUC (MA) Regs 2017 »
2     Reg 27(4) UC Regs »
Limited capability for work-related activity element
If you are assessed as having LCWRA (see here), a LCWRA element of £390.06 a month (in 2023/24) is usually included in your UC maximum amount. If you are making a joint UC claim with your partner, only one LCWRA element can be included, even if you both meet the conditions.1Reg 27(4) UC Regs
When you start getting the limited capability for work-related activity element
If you qualify for the LCWRA element for the first time, there is usually a three-month waiting period before it is included in your UC calculation. The three-month period usually begins on the day you provide a fit note (or, where it would be unreasonable to require you to provide one, the date you provide other evidence to show you have limited capability for work).2Reg 28 UC Regs; reg 2 SS(ME) Regs. See the official guidance and example in F5046 ADM.
You do not have a waiting period if:
    you are automatically treated as having LCWRA because you are regarded as terminally ill (see here); or
    you have moved from ESA to UC without a gap in entitlement and you were in the work-related activity group or support group for ESA (similar rules apply if you have been getting national insurance credits for LCW or LCWRA);3Regs 19 and 21 UC(TP) Regs or
    you were entitled to the LCWRA or LCW element in a UC award that ended immediately before your current UC award started, and your previous UC award ended because you became a member of a couple or you stopped being a member of a couple; or
    you were entitled to the LCWRA or LCW element in a previous UC award that ended within the six months before your current award started, and your previous UC award ended because your income was too high; or
    you have an award of contributory ESA that includes the support component; or
    you have been getting the LCW element in your UC and are then assessed as entitled to the LCWRA element.
 
1     Reg 27(4) UC Regs »
2     Reg 28 UC Regs; reg 2 SS(ME) Regs. See the official guidance and example in F5046 ADM. »
3     Regs 19 and 21 UC(TP) Regs »
Disabled child addition
Your maximum amount of UC includes a disabled child addition if you are responsible for a child who is entitled to disability living allowance (DLA), child disability payment (CDP), personal independence payment (PIP) or adult disability payment (ADP).
You get the higher rate if the child is entitled to the DLA/CDP care component at the highest rate, the daily living component of PIP/ADP at the enhanced rate, or if they are certified as severely sight impaired or blind.1Reg 24 UC Regs The disabled child addition is still paid for a child even if you cannot get a child element for them because of the ‘two-child limit’.2s10(2) WRA 2012; regs 24 and 36 UC Regs
 
1     Reg 24 UC Regs »
2     s10(2) WRA 2012; regs 24 and 36 UC Regs »
Housing costs element
When you can get a housing costs element
Your UC may include a housing costs element to help with rent and/or service charges. You cannot get the housing costs element to help you to pay a mortgage, but you may be separately eligible for a support for mortgage interest (SMI) loan.1LMI Regs. See gov.uk/support-for-mortgage-interest and CPAG’s Welfare Benefits and Tax Credits Handbook.
Your housing costs element may not cover your full rent. If you are a private tenant, the amount you get is usually based on a ‘local housing allowance’ for a home of the size you are regarded as needing.2Sch 4 paras 25 and 26 UC Regs; see lha-direct.voa.gov.uk for the current rates in your area If you are a social rented tenant, the amount you get may be affected by the so-called ‘bedroom tax’ if you are regarded as having one or more spare bedrooms.3Sch4 paras 2 and 30 UC Regs In either type of housing, your housing costs element could also be reduced if you have a non-dependant living with you.
Non-dependants
A non-dependant is someone in your extended benefit unit who is not your partner, a child or a qualifying young person – eg, an adult relative.4Sch 4 para 9(2) UC Regs
As a general rule, people who are classed as non-dependants attract a non-dependant deduction from your monthly UC (known for UC as a housing costs contribution). The deduction is a fixed amount of £85.73 per non-dependant (in 2023/24), irrespective of the person’s income and what they actually contribute to your housing costs.5Sch 4 paras 13, 14(1), 22 and 33 UC Regs
Some people who are classed as non-dependants do not attract a housing costs contribution. These include people aged under 21, people getting pension credit or carer’s allowance, and people getting attendance allowance (AA), the middle or highest rate of the care component of DLA/CDP or the daily living component of PIP/ADP.6Sch 4 para 16 UC Regs
In addition, you do not have any housing costs contributions applied to your UC if you or your partner are entitled to AA, the middle or highest rate of the care component of DLA/CDP, or the daily living component of PIP/ADP.7Sch 4 para 15 UC Regs
Supported housing and temporary accommodation
You cannot get a UC housing costs element to cover your rent if you live in specified or temporary accommodation. ‘Specified accommodation’ covers many kinds of housing with care and support, and certain kinds of refuge, while ‘temporary accommodation’ covers certain homelessness accommodation.8Sch 1 paras 3A and 3B UC Regs If your housing is provided by the local authority, a housing association or a charity and you moved there to receive care, support or supervision connected with your health, you can usually be confident that you live in ‘specified accommodation.9Sch 1 para 3A(3) and (6) UC Regs
If this applies to you, instead of getting a UC housing costs element, you need to claim housing benefit (HB – see Chapter 7 and here specifically). Although UC is replacing working-age HB for most people, new HB claims are still accepted from people who live in these types of housing. This HB can be paid alongside your UC.10Sch 1 para 3(h) and (i) UC Regs; reg 6(8) UC(TP) Regs; art 6(2) WRA(No.21)O; art 7(3) WRA(No.23)O
If you are not sure whether the housing you live in counts as ‘specified’, or if the local authority and the DWP are in disagreement, ask your landlord to clarify this and/or get independent advice - see Advicelocal.uk.
Other rules
There are more details about the housing costs element of UC in CPAG’s Welfare Benefits and Tax Credits Handbook.
 
1     LMI Regs. See gov.uk/support-for-mortgage-interest and CPAG’s Welfare Benefits and Tax Credits Handbook. »
2     Sch 4 paras 25 and 26 UC Regs; see lha-direct.voa.gov.uk for the current rates in your area »
3     Sch4 paras 2 and 30 UC Regs »
4     Sch 4 para 9(2) UC Regs »
5     Sch 4 paras 13, 14(1), 22 and 33 UC Regs »
6     Sch 4 para 16 UC Regs »
7     Sch 4 para 15 UC Regs »
8     Sch 1 paras 3A and 3B UC Regs »
9     Sch 1 para 3A(3) and (6) UC Regs »
10     Sch 1 para 3(h) and (i) UC Regs; reg 6(8) UC(TP) Regs; art 6(2) WRA(No.21)O; art 7(3) WRA(No.23)O »
Transitional severe disability premium (SDP) element
If a severe disability premium (SDP) (see here) was included in your legacy benefit, you may be eligible for an extra element in your UC maximum amount, so long as you are not entitled to a full transitional protection element.1Reg 63 and Sch 2 UC(TP) Regs See CPAG’s Welfare Benefits and Tax Credit Handbook.
 
1     Reg 63 and Sch 2 UC(TP) Regs »
Step two: calculate your earnings and how much can be ignored
Work out your total earnings in the relevant assessment period. This can often be straightforward, but see CPAG’s Welfare Benefits and Tax Credits Handbook for more detailed information about how to do it. Note that, if you are working for an employer, the DWP uses a ‘real-time information’ system to get information from HMRC about your earnings. If you are self-employed, and your earnings are low, your UC award may be assessed on more earnings than you actually get (this is known as the minimum income floor).1Reg 62 UC Regs
If your earnings are less than your work allowance (see below), they do not reduce your UC. If they exceed your work allowance, your UC is reduced by 55 per cent of the excess amount.2Reg 22(1) UC Regs This is known as the ‘taper rate’.
 
1     Reg 62 UC Regs »
2     Reg 22(1) UC Regs »
Work allowances
A work allowance is an amount you can earn before your earnings start to be taken into account for calculating your UC. You only have a work allowance if you are responsible for a child or if you have limited capability for work.1Reg 22(2)-(3) UC Regs There are two rates.
    If your UC includes a housing costs element: £379 (in 2023/24).
    If your UC does not include a housing costs element: £631 (in 2023/24).
Why is there a work allowance for claimants with limited capability for work?
Unlike ESA, UC does not have special rules about the amount of work that you can do while claiming. If you are assessed as having limited capability for work on the basis of your mental health problem, but are well enough to do some work, this is allowed and actively encouraged by the DWP. However, the tasks you do for work are usually taken into account in your next work capability assessment and might lead to a decision that you are ‘fit for work’.
 
1     Reg 22(2)-(3) UC Regs »
Step three: calculate your other income and how much can be ignored
Different types of income can have different effects on UC. Some income is ignored (eg, PIP, ADP, DLA, CDP and AA), and other income is taken into account (eg, contributory ESA and carer’s allowance). Consider benefits, student finance, maintenance payments and pensions. See CPAG’s Welfare Benefits and Tax Credits Handbook for more about how different kinds of income affect UC.
Step four: calculate your universal credit entitlement
Deduct your total relevant income (Steps two and three) from your maximum UC (Step one). This leaves your UC entitlement for that assessment period.
Note: if, after following these steps, you are not entitled to UC, but you would be if your award included a LCWRA element, you may be able to get UC at one pence per month during the LCWRA waiting period (see here).1Reg 28(7) UC Regs
 
1     Reg 28(7) UC Regs »
Step five: calculate your universal credit payment
Consider the effects of the benefit cap (see here), sanctions (see here), deductions (see below) and ‘alternative payment arrangements’ (see here). These may further reduce the amount of UC you actually receive.
Deductions
Deductions can be made from your UC to recover advances, overpayments, third-party debts and fines, as well as to cover some ongoing costs like electricity and gas charges. They cannot normally exceed 25 per cent of your UC standard allowance or reduce your UC award to less than a penny.1s60 and Sch 6 and 7 UC,PIP,JSA&ESA(C&P) Regs; regs 3 and 11 SS(OR) Regs; SS (PAB) Regs; DWP, Find out about money taken off your Universal Credit payment, 12 April 2021, available at gov.uk/guidance/find-out-about-money-taken-off-your-universal-credit-payment They should not be confused with ‘alternative payment arrangements’. CPAG’s Welfare Benefits and Tax Credits Handbook covers UC deductions in more detail. If you feel your deductions are too high, get independent advice about whether they can be reduced - see Advicelocal.uk.
 
1     s60 and Sch 6 and 7 UC,PIP,JSA&ESA(C&P) Regs; regs 3 and 11 SS(OR) Regs; SS (PAB) Regs; DWP, Find out about money taken off your Universal Credit payment, 12 April 2021, available at gov.uk/guidance/find-out-about-money-taken-off-your-universal-credit-payment  »
Claiming online
Claims for UC are usually made online at gov.uk/apply-universal-credit. You are asked to set up an online account and provide an email address, username, password and security questions.
If you want to claim online but need help, you can call the UC helpline. Staff can complete an online form on your behalf or arrange for you to get help at your local job centre. Alternatively, Citizens Advice can help you make a claim through the free Help to Claim service.
If you claim online, your date of claim is usually the date you submit the completed application (but could be earlier if you asked for help from the DWP or Help to Claim, and see here about backdating).1Reg 10(1)(a) and (b) and (2) UC,PIP,JSA&ESA(C&P) Regs
Universal credit helpline
Freephone 0800 328 5644 (textphone: 0800 328 1344; Welsh language: 0800 328 1744), Relay UK (if you cannot hear or speak on the phone) 18001 then 0800 328 5644, Monday to Friday 8am to 6pm. There is also a British Sign Language video relay service for making a claim.
If you set up an online UC account, it is used on an ongoing basis to send you messages about your UC, including decisions, payment information, information requests and appointment details. However, this online contact is not suitable for everyone. You may want to consider claiming by telephone instead (see below).
What advisers say: online claims
‘Sometimes claiming online suits people well, but for many people the pitfalls of managing an online UC account outweigh the benefits. All sorts might happen on your claim and if you are not checking your online account you could not know about it and now realise you should have been doing things. I do not know of any service that supports people with managing their online account on an ongoing basis – just a few individuals in different services who are doing it because they do not want to leave that person in difficulty.’
 
1     Reg 10(1)(a) and (b) and (2) UC,PIP,JSA&ESA(C&P) Regs »
Claiming by telephone
If you would have trouble managing your UC online, you can claim UC by telephone instead and receive future contact by letter and telephone call. DWP guidance confirms that this option is open to people who would find it difficult to manage an online account because of a mental health problem.1Reg 8 UC,PIP,JSA&ESA(C&P) Regs; DWP, Universal Credit Guidance, ‘Non-digital relationships’, v3.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance To claim by telephone, call the UC helpline (details above). Note: be clear that you wish to make a ‘telephone claim’ and do not just want help by telephone to make an online claim.
If you claim by telephone, your date of claim is usually the date that you call to start your claim (but see here about backdating).2Reg 10(1)(c) and (d) and (2) UC,PIP,JSA&ESA(C&P) Regs
Switching an online account to a telephone and paper account and vice versa
If you have claimed UC online but are finding it difficult to manage your online account, you can still switch to a telephone and paper system, meaning you receive phone calls and letters instead of online notifications.3DWP, Universal Credit Guidance, ‘Reasonable adjustments’, v4.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance The switch is done ‘clerically’: your online account still exists but should no longer be used to contact you. Likewise, if you have claimed by telephone but now feel it would be easier for you to have an online account, you can switch. In this case, a new online account is opened.
If you ask to switch and this is refused, a template for challenging the decision by judicial review is available at cpag.org.uk/jr/letters/claims. Contact an independent advice service if you are considering this step.
 
1     Reg 8 UC,PIP,JSA&ESA(C&P) Regs; DWP, Universal Credit Guidance, ‘Non-digital relationships’, v3.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance »
2     Reg 10(1)(c) and (d) and (2) UC,PIP,JSA&ESA(C&P) Regs »
3     DWP, Universal Credit Guidance, ‘Reasonable adjustments’, v4.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance »
Additional support and appointees
If you have (or will have) difficulty with the claims process and need additional support, see Chapter 18. If you cannot manage the claims process at all you may need an appointee (see here).
Claiming in advance and backdating
You may be able to claim UC in advance – ie, before you have become eligible.1s98 WRA 2012; reg 32 UC,PIP,JSA&ESA(C&P) Regs; para A2048 ADM
In some cases, your claim can be backdated by up to one month. You may be able to have your UC backdated if you have a disability or health condition which stopped you from claiming sooner. You may need medical evidence to support this. It is best to make a clear request for backdating at the point at which you claim, but the DWP should also consider a request made later.2Reg 26 UC,PIP,JSA&ESA(C&P) Regs; AM v SSWP (UC) [2022] UKUT 242 (AAC)
If you might have qualified for UC earlier but did not claim because you were misled or given the wrong information by the DWP, and you are unable to get your claim backdated, you could make a complaint asking for compensation (see here).
Note: the term ‘backdating’ is often informally used to mean getting arrears of your benefit going back to a claim or decision date – eg, after winning an appeal. However, in this Handbook, we use backdating to mean getting paid benefit for a period before the date you claimed.
 
1     s98 WRA 2012; reg 32 UC,PIP,JSA&ESA(C&P) Regs; para A2048 ADM »
2     Reg 26 UC,PIP,JSA&ESA(C&P) Regs; AM v SSWP (UC) [2022] UKUT 242 (AAC) »
Managed migration
If you are transferring to UC from another means-tested benefit under the ‘managed migration’ process, there are some special rules about claiming (see here).
What you will be asked and how long it will take
When you claim UC, you are asked a series of questions to check your eligibility and what amount you might be entitled to receive. See the start of this chapter to get a sense of what you will be asked about. It is usually a good idea to have to hand:
    your national insurance (NI) number, if you have one (if you do not, you can still start a claim for UC, and doing this will prompt the DWP to allocate you a NI number);
    your phone number (you can choose to give the number of someone you trust);
    your bank account details;
    details about your tenancy, including whether you are in private or social rented accommodation, your landlord’s details and the amount of your rent and/or service charges;
    details about anyone who lives with you;
    details about any earnings or other income you have;
    details about your savings or capital (capital includes, for example, savings, shares, certain lump-sum payments and most property that is not your main home).
The DWP says that an online UC claim takes about 20 minutes, but it often takes longer in practice. Telephone claims can also take longer than online claims.
Couples
If you are claiming online as a couple, one of you should usually complete a claim first. That partner gets a linking code. The second partner can then fill out their own claim and use this code to link the two claims. The process may be different if one or both of you already gets UC as a single person, or if you are claiming by telephone.
Evidence to support the claim
After completing a claim, you are asked to provide further information and evidence – eg, proof of your identity, payslips, your rent agreement and bank statements. You may be asked to attend an interview at the job centre to do this.
If you are struggling to supply evidence on time, try to tell the DWP in advance. If you do not comply with a request for further information, the DWP is likely to say that you have made a ‘failed claim’ and that your claim has been ‘closed’ (see here on how to challenge this).
If you have a health condition or disability
If you mention when you claim (or later) that you have a health condition or disability that limits your ability to work, you should usually be referred for a work capability assessment (WCA). There is more information about the WCA, including the capability for work questionnaire (UC50), on here.
To begin the WCA process, you are usually required to provide a fit note showing that your GP or another professional has declared you unfit for work. See here for more information about fit notes.
Natural migration
UC is replacing income support (IS), income-based jobseeker’s allowance (JSA), income-related employment and support allowance (ESA), child tax credit (CTC) and working tax credit (WTC), and, for most people, working-age housing benefit (HB). These are often described as the ‘legacy benefits’. You cannot generally make a new claim for a legacy benefit (but see here about who can start getting income-related ESA without a new claim, and here about who can still claim HB. There is also a very limited exception for refugees claiming tax credits.1Regs 3(4)-(10) and 4 TC(Imm) Regs; FK v HMRC [2009] UKUT 134 (AAC); CBTM10140)
If you are getting one of the legacy benefits but your circumstances change and you are no longer eligible for it, or if you have a change of circumstances that means you need an extra benefit but cannot claim the ‘legacy’ version , you need to make a new claim for UC. You can also switch to UC by choice. Both of these actions are called ‘natural migration’, in contrast with ‘managed migration’ (below).
Examples of natural migration include claiming UC:
    because you have moved to a new home outside of your current local authority area, so your HB has stopped;
    because you need help with housing costs for the first time and cannot make a new HB claim;
    because you have become responsible for your first child and you cannot make a new claim for CTC;
    as a single person after you have separated from a partner with whom you had a joint claim for tax credits;
    because you believe that you will be financially better-off than you were on legacy benefits (the DWP calls this ‘voluntary migration’).
Not every change in your circumstances means that you must claim UC. Some claimants have been wrongly told that they must claim UC following a particular change of circumstances when this is not the case. Before claiming UC, it is always best to get independent advice.
Note: depending on your circumstances, you can be financially better or worse off after you transfer to UC via natural migration. There is no guarantee that your UC will be worth as much as your legacy benefits. However, if you transfer under ‘managed migration’ (see below), you should get full transitional protection to ensure that you are not worse off on UC.
Example
Patrice gets income-related ESA, personal independence payment (PIP) and HB. She moves to a different flat. Because this is in the same local authority area, she does not need to make a new HB claim and both her HB and ESA continue (with her HB amount adjusted for her new rent). Her PIP is unaffected.
Patrice moves again, this time to a property in a different local authority area. Her current HB award ends. Patrice is not in ‘specified’ or ‘temporary’ accommodation (see here) and so cannot make a new claim for HB. Instead, she claims UC. She has now transferred to UC via natural migration, and her entitlement to ESA comes to an end. Again, her PIP is unaffected.
If her ESA included the severe disability premium, Patrice may be entitled to a transitional SDP element in her UC (see here), but she will not get full ‘transitional protection’ on moving to UC.
 
1     Regs 3(4)-(10) and 4 TC(Imm) Regs; FK v HMRC [2009] UKUT 134 (AAC); CBTM10140 »
Managed migration
In early 2022, the DWP started transferring some people still getting the legacy benefits to UC. This process is known as ‘managed migration’.
The main rules and procedures are as follows (these may be subject to change).
    The DWP begins the managed migration process by sending you a ‘migration notice’.1Reg 44 UC(TP) Regs This tells you that your legacy benefit will be ending and invites you to make a claim for UC.
    You are given a date by which you must make your UC claim. This is your ‘deadline day’. This day must be at least three months from the date of your migration notice. You can be given longer to make your claim if the DWP agrees that there is a good reason – eg, if you are unwell or need to arrange help in order to make your claim.2Regs 44(1)(b) and 45 UC(TP) Regs
    As with the normal claim process, you can claim online or by telephone.
    The DWP can cancel your migration notice – eg, if it was sent in error or if this is considered necessary to protect your interests.3Reg 44(5) UC(TP) Regs
    If you have not claimed UC by your deadline day, but you do so within a month of that day (ie, by your ‘final deadline’), you will be treated as having claimed on your deadline day and will still have claimed in time to get a transitional element in your UC.4Regs 46(4) and 48 UC(TP) Regs
Your entitlement to your legacy benefits ends when you claim UC or, if you do not claim, on the day before your deadline day.5Regs 46, 48 and 49 UC(TP) Regs However, legacy benefits other than tax credits continue to be paid for a further two weeks after this, if you would otherwise have remained entitled. This is known as ‘run-on’ (see here). You can get paid both your legacy benefit and UC for the two weeks in question and do not need to pay anything back.
Timetable for managed migration
When you will be asked to move to UC under managed migration depends on several factors, including which legacy benefits you are getting. If you get income-related ESA only, or income-related ESA and HB only, then under current plans you may not be affected by managed migration until 2028. However, if you get tax credits (on their own or in combination with other benefits, including income-related ESA) you are likely to be moved to UC by the end of 2025.6DWP, Completing the Move to Universal Credit: Learning from the discovery phase, 10 January 2023, available at GOV.UK
Eligibility
Most people moved to UC by managed migration must satisfy the normal rules of UC entitlement (see here). However, there are exceptions.
    If you are on a full-time course when your legacy benefits end, you can get UC despite not satisfying the usual UC rules about not ‘receiving education’ (see here).7Reg 60 UC(TP) Regs
    If you are entitled to tax credits when you claim UC and have capital of over £16,000, the capital above £16,000 is ignored when calculating your entitlement to UC. This is called a ‘transitional capital disregard’ and can apply for up to 12 months.8Reg 51 UC(TP) Regs
Transitional protection
If you are transferred to UC under the managed migration process and the amount of your UC is less than the amount you were getting on your legacy benefits, you are entitled to a transitional protection element in your UC calculation (see here). This transitional protection is intended to ensure that you are not worse off at the point you transfer to UC, but the extra amount then reduces (‘erodes’) over time.9Regs 48-57, UC(TP) Regs See CPAG’s Welfare Benefits and Tax Credits Handbook for more information about how to calculate this element and how erosion works.
 
1     Reg 44 UC(TP) Regs »
2     Regs 44(1)(b) and 45 UC(TP) Regs »
3     Reg 44(5) UC(TP) Regs »
4     Regs 46(4) and 48 UC(TP) Regs »
5     Regs 46, 48 and 49 UC(TP) Regs »
6     DWP, Completing the Move to Universal Credit: Learning from the discovery phase, 10 January 2023, available at GOV.UK »
7     Reg 60 UC(TP) Regs »
8     Reg 51 UC(TP) Regs »
9     Regs 48-57, UC(TP) Regs »
Work capability status on moving to universal credit
If you are moving from ESA to UC, whether by natural or managed migration, you can carry your existing limited capability for work or limited capability for work-related activity status over to your new UC award (see here).
Run-on of legacy benefits
On making a new claim for UC, your entitlement to income-based JSA, income-related ESA, IS and HB ends, but payment of these benefits continues for two further weeks, as long as you would otherwise remain entitled to them. You do not have to pay back a run-on payment, it is not taken into account as income for UC and it is ignored for the purposes of the benefit cap.1Regs 8(2A), 8A, 8B, 44, 46(1) and 47(2) UC(TP) Regs; reg 5 UC(MMPMA) Regs
 
1     Regs 8(2A), 8A, 8B, 44, 46(1) and 47(2) UC(TP) Regs; reg 5 UC(MMPMA) Regs »
The work capability assessment
If you claim universal credit (UC) and have told the DWP that your health condition or disability affects your ability to work, you are usually referred for a work capability assessment (WCA).
The WCA is used by the DWP to decide whether:
    you are fit for work and should therefore have some work-related requirements attached to your UC (see here); or
    you have limited capability for work – ie, you can get UC without being required actively to look for work, but are considered well enough to do some work preparation activity such as training or work-focused job centre appointments (see here); or
    you have limited capability for work and work-related activity – ie, your health condition or disability is considered so severe that, in addition to not being able to work, you are not required to take steps to prepare for work.
As well as affecting your work-related requirements, this decision affects the amount of UC you get (see here).
Note: the WCA is also used to decide entitlement to employment and support allowance (ESA – see Chapter 4). The WCA rules and processes in this section apply to ESA as well as UC, except where otherwise stated.
Who is not assessed
Most claimants are assessed using the standard WCA process described below. However, there are some circumstances in which you can be ‘treated as having’ limited capability for work or work-related activity without going through this process (see here).
There are also limited circumstances in which a WCA is simply not offered – eg, where you have previously failed a WCA either for UC or for ‘new-style’ ESA (see here).
If you are over pension age and get UC as part of a ‘mixed-age couple’ (see here), you might be told that you cannot have a WCA. This is incorrect, as the basic rule is that any UC claimant can be assessed, and the limited situations in which an assessment may not be carried out do not include reference to the claimant’s age.1Regs 40 and 41 UC Regs A template for challenging a refusal to carry out an assessment on this basis by judicial review is available at cpag.org.uk/jr/letters/wca. Contact an independent advice service if you are considering this step.
 
1     Regs 40 and 41 UC Regs »
Fit note
To begin the WCA process, you usually need to provide a fit note showing that your GP (or another health professional) has declared you unfit for work. You are generally expected to provide fit notes covering the whole period from the date when you declare a health condition or disability to the date when the DWP makes a decision about your capability for work. You can self-certify for the first seven days. You are not required to supply a fit note if it is unreasonable in the circumstances to expect you to do so and you provide other evidence about your fitness for work – eg, if you have been in hospital and have discharge papers confirming why and how long you were there.1Regs 2 and 5 SS(ME) Regs
Getting a fit note
You can request a fit note from a doctor (including a GP or specialist) or from a nurse, occupational therapist, pharmacist or physiotherapist. You might need an appointment with them before they produce a fit note, or they might be able to do this based on information they already have about you. Ask for the second option to be considered if the professional already knows a lot about your current problems.
There is no charge for a fit note which covers a period of more than a week.
 
1     Regs 2 and 5 SS(ME) Regs »
The questionnaire (UC50/ESA50)
The DWP should refer you for a WCA 28 days after you declare your illness or disability, if not sooner.1DWP, Universal Credit Guidance, ‘Health Conditions and Disabilities - day 1 to day 29’, v13.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance After the DWP’s assessment provider (see here) gets the referral, it usually sends you a questionnaire to complete (UC50 for UC, ESA50 for ESA).
A decision can be made without a questionnaire if it is considered that there is enough other information,2UC Reg 43 UC Regs
ESA Reg 21 ESA Regs; reg 17 ESA Regs 2013
but the assessment provider and DWP decides whether this is the case. If you are sent a form, you need to complete and return it (although see here for DWP guidance about unreturned forms). Even if you have an online UC account, you are sent a paper copy of the form.
If you need support in completing the form, you could ask someone close to you to help, or seek support from an independent advice service - see Advicelocal.uk. If you are unable to get other assistance, you can call the assessment provider (see here) and they can help you to complete the form by telephone.3DWP, Guidance: Capability for work questionnaire, disclosed to CPAG in response to freedom of information request reference FOI2022/102752 on 6 January 2023
Completing the form
1. It may be helpful to draft your answers on a separate piece of paper, or type them, so that you can correct any mistakes.
2. Read the list of activities starting on here to get an idea of what the DWP needs to know about each ‘activity’.
3. Consider all of the mental health symptoms listed on here.
4. If you have good and bad days, explain this (see here). If possible, give a rough estimate of how often you could perform an activity and how often you could not. You might want to describe occasions when you have attempted the activity unsuccessfully.
5. If you can do something, but only slowly, with difficulty, ineffectively, or not with a reasonable degree of regularity, say so.
6. Make sure to list all your symptoms and all side effects of medication. You might decide to do this on the blank Other information page at the end of the UC50/ESA50 form. If you have to appeal, the First-tier Tribunal may be less likely to believe you have symptoms if you did not mention them anywhere on the questionnaire.
7. Read the rules about ‘substantial risk’ on here. Consider whether, and how, work or work-related activity would pose a risk to your health. There is no question on the form that asks you about this, but you can use the blank Other information page at the end to provide details.
8. Compare the draft of your answers with the list of activities beginning on here and work out your score. Your answers should not be exaggerated, but check that you have not underestimated any of your problems and that you have given all the detail you can.
9. Try to include supporting evidence. This might include a prescription list, hospital report, care plan, or supporting statement from a family member. See Chapter 13 for more information about supporting evidence.
10. Ask someone you trust and who knows you well to check your answers.
11. If someone has to complete the questionnaire for you, explain why and include their details at the end where the form asks about this. If you completed the form yourself but could only do so slowly or with difficulty, explain this.
12. Use the questionnaire as an opportunity to explain what your needs or preferences will be if you are required to take part in an assessment. See here for some examples.
13. Keep a copy of your completed questionnaire and ask the Post Office for free proof of posting.
Timescales
You have four weeks from the date the questionnaire is sent to return it. If you do not return the form in time, you may be treated as not having limited capability for work, unless you can show that you had ‘good reason’ for sending the form late (see below).4UC Reg 43 UC Regs
ESA Reg 22 ESA Regs; reg 18 ESA Regs 2013
After returning the form, it may be several months before you are invited to an assessment.
If you are going to be late completing and returning the questionnaire, try to let the DWP know by telephone or through your UC online account as soon as possible. Return the form as soon as you can and explain on the form or in a covering letter why it is late. If the decision is made that you did not have a good reason for being late, but you think you did, consider challenging the decision (see Chapter 17).
‘Good reason’ is not defined for UC. When deciding whether you have ‘good cause’ for ESA, the DWP must consider all the circumstances,5Regs 24 and 39 ESA Regs; regs 20 and 36 ESA Regs 2013 and ‘good cause’ could include being too unwell or distressed to complete the form on time or participate in the medical. In practice, the same sort of things should be taken into account when deciding whether you have ‘good reason’ for UC.
DWP guidance on complex needs and unreturned forms
There are procedures the DWP should follow if you are considered to be vulnerable or to have ‘complex needs’ – eg, if you have a serious mental health problem.6DWP, Universal Credit Guidance, ‘Complex needs overview’, v18.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance These procedures are not a legal requirement but involve extra steps being taken before treating you as not having limited capability for work. If you think this applies to you, ask whether the procedures were followed in your case, and seek advice. See here (and regarding UC50/ESA50 forms see here in particular).
 
1     DWP, Universal Credit Guidance, ‘Health Conditions and Disabilities - day 1 to day 29’, v13.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance »
2     UC Reg 43 UC Regs
ESA Reg 21 ESA Regs; reg 17 ESA Regs 2013 »
3     DWP, Guidance: Capability for work questionnaire, disclosed to CPAG in response to freedom of information request reference FOI2022/102752 on 6 January 2023 »
4     UC Reg 43 UC Regs
ESA Reg 22 ESA Regs; reg 18 ESA Regs 2013 »
5     Regs 24 and 39 ESA Regs; regs 20 and 36 ESA Regs 2013 »
6     DWP, Universal Credit Guidance, ‘Complex needs overview’, v18.0, House of Commons library deposited papers, available at rightsnet.org.uk/universal-credit-guidance »
Medical assessment
As part of the WCA, you are usually asked to take part in a face-to-face, telephone or video assessment with a healthcare professional. A decision can be made without an assessment if it is considered that there is enough other information,1UC Reg 44 UC Regs
ESA Regs 23 and 38 ESA Regs; regs 19 and 35 ESA Regs 2013
but the DWP decides whether this is the case, and if you are asked to attend an assessment, you usually need to go.
UC and ESA assessments are carried out on behalf of the DWP by the Health Assessment Advisory Service. Chapter 14 has more information about the practicalities of assessments, including where they can take place, who assesses you, and what to do if you cannot attend.
 
1     UC Reg 44 UC Regs
ESA Regs 23 and 38 ESA Regs; regs 19 and 35 ESA Regs 2013
 »
Activities, descriptors and points
The WCA is largely a test of your ability to perform certain activities. There are two main lists of activities: one physical (see here) and one mental (see here).
For each activity, there is a list of statements called ‘descriptors’ which describe different levels of difficulty in carrying out the activity.
Every descriptor has a points score. You are awarded the highest scoring descriptor in each activity that applies to you.
The points you score largely determine the outcome of your WCA. There are three possible outcomes.
    You are assessed as having limited capability for work (LCW) if you score a total of 15 points or more across all activities. Note: you are also assessed as having LCW if work poses a ‘substantial risk’ to your health (see here), or in some circumstances you are ‘treated as’ having LCW without actually undergoing the assessment (see here).
    You are assessed as having limited capability for work-related activity (LCWRA) if you satisfy certain 15-point descriptors (see below). Note: you are also assessed as having LCWRA if work-related activity poses a ‘substantial risk’ to your health, (see here), or in some circumstances you are ‘treated as’ having LCWRA without actually undergoing the assessment (see here).
    Otherwise, you are assessed as ‘fit for work’.
There is more information about these outcomes on here.
Good days and bad days
Mental health symptoms can fluctuate. Generally, what counts for the assessment is whether you can do things ‘the majority of the time’.1UC Reg 40 UC Regs
ESA Reg 34(2) ESA Regs; reg 30(2) ESA Regs 2013
Your ability to perform an activity with some degree of repetition should be considered and a ‘broad-brush’ approach applied, rather than just a day-by-day approach.2AF v SSWP (ESA) [2011] UKUT 61 (AAC); SAG v Department for Social Development (ESA) [2011] NICom 171 The severity of your condition, the frequency of your good and bad days and the unpredictability of the bad days are all relevant.3CIB/14534/1996
If you have long periods of remission, you may be considered capable of work during these periods. This depends on the severity of your condition and on the length of your periods of ill health and your periods of remission.4CIB/2620/2000
If you are finding it difficult to ‘score points’ in the WCA because your symptoms are so variable or unpredictable or because you do not have symptoms for the majority of the time, the rules on ‘substantial risk’ (see here) might still help you to qualify for LCW or LCWRA.
Example
Ronan has depression and sometimes has suicidal thoughts. He might have two ‘bad’ days a week, when he cannot start and finish tasks, go out, or interact with other people at all. On other days, he can sometimes do these things, but with difficulty and not repeatedly throughout the day. Sometimes having to do these things makes Ronan exhausted and distressed and makes it difficult for him to manage his suicidal thoughts . All of this must be taken into account when considering what Ronan can do ‘the majority of the time’. An assessor cannot simply say that, because Ronan has more ‘good’ days than ‘bad’ he is fit for work. It would also make sense in Ronan’s case for the DWP to consider whether work or work-related activity poses a ‘substantial risk’ to his health.
Abbie has a long-term mental health condition. When she first began having symptoms, she found she was not well enough to work. Over time she got used to managing her symptoms and found the support she needed to make work possible again. This cycle might happen multiple times during Abbie’s life as her mental health changes, as she starts and finishes different treatments, and as her other circumstances change.
 
1     UC Reg 40 UC Regs
ESA Reg 34(2) ESA Regs; reg 30(2) ESA Regs 2013 »
2     AF v SSWP (ESA) [2011] UKUT 61 (AAC); SAG v Department for Social Development (ESA) [2011] NICom 171 »
3     CIB/14534/1996 »
4     CIB/2620/2000 »
Physical health activities
The first 10 activities in the work capability assessment only apply to you if your difficulties are the result of a physical health condition or if they are the side effect of treatment for a physical health condition.1UC Regs 39(4) and 40(3) and Sch 6 UC Regs
ESA Regs 19(5) and 34(6) and Sch 2 ESA Regs; regs 15(5) and 30(6) and Sch 2 ESA Regs 2013
You cannot ‘score points’ for any of these activities on the basis of a mental health problem alone.
The activities are listed here. See Appendix 3 for the points and descriptors.
1. Physical mobility
2. Standing and sitting
3. Reaching
4. Picking things up and moving them
5. Manual dexterity
6. Making yourself understood
7. Understanding communication
8. Navigating and staying safe
9. Continence
10. Consciousness during waking moments
When mental health affects physical health
Mental and physical health are very closely related. A mental health problem can cause physical symptoms like fatigue, nausea, pain or weakness. Mental health medications can also have physical side effects (see here).
However, physical symptoms which are the result of a mental health problem, or a side effect of mental health medication, can score you points under the headings above only if they can be classed as a ‘specific bodily disease or disablement’ in their own right.
 
1     UC Regs 39(4) and 40(3) and Sch 6 UC Regs
ESA Regs 19(5) and 34(6) and Sch 2 ESA Regs; regs 15(5) and 30(6) and Sch 2 ESA Regs 2013
 »
Mental health activities
You can satisfy descriptors in the second part of the WCA if your difficulties are the result of a ‘specific mental illness or disablement’, or if they are a side effect of treatment for a ‘specific mental illness or disablement’.1UC Regs 39(4) and 40(3) and Sch 6 UC Regs
ESA Regs 19(5) and 34(6) and Sch 2 ESA Regs; regs 15(5) and 30(6) and Sch 2 ESA Regs 2013
In the latter case, the treatment must be provided by a registered medical practitioner.
A ‘specific mental illness or disablement’ is not defined. It is likely to cover a wide range of mental health conditions and symptoms. You do not need to have a diagnosis, but having one is useful as evidence of your difficulties. If you do not have a diagnosis it is particularly important to provide other supporting evidence, see Chapter 13.
Note: if you are concerned that you do not ‘score’ enough points in these categories to satisfy the requirements for LCW or LCWRA (see here), remember that you can also qualify if work or work-related activity presents a ‘substantial risk’ to your health (see here). There is no question on the UC50 form that asks you about this, so you should use the blank Other information page at the end (or extra sheets of paper) to provide details.
 
1     UC Regs 39(4) and 40(3) and Sch 6 UC Regs
ESA Regs 19(5) and 34(6) and Sch 2 ESA Regs; regs 15(5) and 30(6) and Sch 2 ESA Regs 2013
 »
Activity 11: learning tasks
Take note if you have difficulty with: memory; concentration. See here for more mental health symptoms that might be relevant.
This is about your ability to learn new tasks. The specified tasks are just examples. If you cannot repeat a task or have to be shown how to do it again, you have not learned it. Official guidance suggests that a task with one or two steps is considered ‘simple’ while one with three or four steps is considered ‘moderately complex’.1WCA Handbook para 3.5.2 Remember that the assessor must consider both your mental health problem and the side effects of any medication you take, as well as whether you can do these tasks consistently.
Descriptors
Points
(a) Cannot learn how to complete a simple task, such as setting an alarm clock.
15 points*
(b) Cannot learn anything beyond a simple task, such as setting an alarm clock.
9 points
(c) Cannot learn anything beyond a moderately complex task, such as the steps involved in operating a washing machine to clean clothes.
6 points
(d) None of the above applies.
0 points
If you satisfy the 15-point descriptor (a*), you qualify as having LCWRA.
What the form asks
Can you learn how to do an everyday task such as setting an alarm clock? No/Yes/It varies
Before ticking any box, think about other tasks involving one or two steps. Examples in the DWP’s guidance include using basic functions on a TV remote, or brushing teeth. Tick ‘no’ if you cannot learn to do new tasks of this level of complexity for the majority of the time. If you tick ‘it varies’, explain how often you could learn basic tasks like this. Could you do it repeatedly on the same day? Only on good days, and if so, how often are these? Unpredictably, or only under certain conditions?
Can you learn how to do a more complicated task such as using a washing machine? No/Yes/It varies
Other ‘moderately complex’ activities to consider before answering this question could include learning to use a microwave, play a simple computer game, or follow the steps to make a cup of tea.
 
1     WCA Handbook para 3.5.2 »
Activity 12: awareness of hazards
Take note if you have difficulty with: attention; concentration; impulse control; insight into your own difficulties. See here for more mental health symptoms that might be relevant.
This activity covers ‘awareness of everyday hazards (such as boiling water or sharp objects)’. The term ‘everyday hazards’ is likely to cover road safety, electrical safety, and taking care of children or pets, but does not cover risks arising in social situations, such as the risk of being taken advantage of because of your condition.1RR v SSWP (ESA) [2018] UKUT 143 (AAC); WCA Handbook para 3.5.3
A wide range of symptoms could be relevant here – eg, symptoms of depression or psychosis that significantly reduce your attention and concentration. This section might also be relevant if you experience self-harm or some types of impulsive behaviour, or if mental health medication reduces your awareness of hazards. However, the official guidance says that somebody is unlikely to ‘score points’ for this activity as the consequence of an anxiety disorder.2WCA Handbook para 3.5.3 The same guidance states that if you are aware that a particular activity poses a risk because of your condition, and therefore you avoid doing that activity, you cannot ‘score points’ in this category.
It may be difficult to answer this question yourself. It is hard for someone to know if they have a reduced awareness of risks, particularly if they experience a lack of insight as part of a mental health problem. You might decide to speak to someone you trust and who knows you well about this section.
Descriptors
Points
(a) Reduced awareness of everyday hazards leads to a significant risk of:
(i) injury to self or others; or
(ii) damage to property or possessions,
such that the claimant requires supervision for the majority of the time to maintain safety.
15 points*
(b) Reduced awareness of everyday hazards leads to a significant risk of:
(i) injury to self or others; or
(ii) damage to property or possessions,
such that the claimant frequently requires supervision to maintain safety.
9 points
(c) Reduced awareness of everyday hazards leads to a significant risk of:
(i) injury to self or others; or
(ii) damage to property or possessions,
such that the claimant occasionally requires supervision to maintain safety.
6 points
(d) None of the above applies.
0 points
If you satisfy the 15-point descriptor (a*), you qualify as having LCWRA.
What the form asks
Please tick this box if you can stay safe when doing everyday tasks such as boiling water or using sharp objects.
If you tick this box, you will usually score 0 points. Before ticking it, think about other activities that are relevant, like road safety, driving, electrical safety, other kitchen hazards, and taking care of children or pets.
Do you need someone to stay with you for most of the time to stay safe? No/Yes/It varies
Tick ‘yes’ if you think you need this supervision, whether or not you actually get it. When writing your answer, explain all the risks, even ones that might be relatively unlikely. It is a good idea to get your answer(s) checked by somebody who knows you well, like a family member or friend.
 
1     RR v SSWP (ESA) [2018] UKUT 143 (AAC); WCA Handbook para 3.5.3 »
2     WCA Handbook para 3.5.3 »
Activity 13: starting and finishing tasks
Take note if you have difficulty with: motivation; mental fatigue; decisiveness; concentration; memory; hallucinations; compulsions. See here for more mental health symptoms that might be relevant.
This activity covers ‘initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks)’. Guidance states that this category is intended to reflect the kinds of difficulties faced by people with psychosis, obsessive compulsive disorder or depressive illnesses that result in apathy or severe mental fatigue, as well as the side effects of medication.1WCA Handbook para 3.5.4 This category can still be relevant even if you do not have one of these diagnoses.
There is no definition of ‘personal action’ but it covers things like cooking, dressing, washing and brushing your teeth, planning a simple meal, and dealing with finances and appointments.2MP v SSWP (ESA) [2015] UKUT 458 (AAC); WCA Handbook para 3.5.4 You must be able to carry out the personal action reliably and effectively. In one piece of caselaw, someone with obsessive compulsive disorder who took a long time to complete at least two actions was found not to be able to complete them effectively.3MW v SSWP (ESA) [2014] UKUT 112 (AAC) In an example in the guidance, someone experiencing a period of mania that led them to spend a large amount of money on impulse purchases, leaving no money for essentials, was considered not to be initiating effective personal action. This is despite the fact that they were able to wash and dress themselves independently in preparation for going shopping.
Descriptors
Points
(a) Cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions.
15 points*
(b) Cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions for the majority of the time.
9 points
(c) Frequently cannot, due to impaired mental function, reliably initiate or complete at least two sequential personal actions.
6 points
(d) None of the above applies.
0 points
If you satisfy the 15-point descriptor (a*), you qualify as having LCWRA.
What the form asks
Please tick this box if you can manage to do daily tasks without difficulty.
If you tick this box, you are likely to score 0 points. Before ticking it, think about planning, organisation, problem solving, prioritising and switching tasks. If you cannot do all of these things for the majority of the time, do not tick the box.
Can you manage to plan, start and finish daily tasks? Never/Sometimes/It varies
This question may have a long and detailed answer. Use extra sheets of paper as needed. It may also be useful to keep a diary (or for somebody who helps you to keep a diary) for a week or longer, describing the activities you attempt and your difficulties, and to attach a copy of this diary to the form.
 
1     WCA Handbook para 3.5.4 »
2     MP v SSWP (ESA) [2015] UKUT 458 (AAC); WCA Handbook para 3.5.4 »
3     MW v SSWP (ESA) [2014] UKUT 112 (AAC) »
Activity 14: coping with change
Take note if you experience: stress; anxiety; panic attacks; obsessions or compulsions. See here for more mental health symptoms that might be relevant.
Official guidance says that this activity is about your ability to deal with changes in routine, whether temporary or permanent, and that the difficulties described might usually be experienced by claimants with obsessive compulsive disorder, severe anxiety or psychotic illness, although you do not need a specific diagnosis.1WCA Handbook para 3.5.5 Inability to cope could be indicated by a number of responses, including stress reactions and the need for another person to intervene.2GV v SSWP (ESA) [2013] UKUT 405 (AAC)
The guidance suggests that if you manage to attend an assessment centre alone and cope with the assessment, you are unlikely to ‘score points’ in this category.
Descriptors
Points
(a) Cannot cope with any change to the extent that day to day life cannot be managed.
15 points*
(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.
9 points
(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.
6 points
(d) None of the above applies.
0 points
If you satisfy the 15-point descriptor (a*), you qualify as having LCWRA.
What the form asks
Can you cope with small changes to your routine if you know about them before they happen? For example, things like having a meal earlier or later than usual, or an appointment time being changed. No/Yes/It varies
Before answering ‘yes’ to this question, think about what coping means to you. How might you feel and act? How would a change affect the next part of (or the rest of) your day? Could you deal with more than one change in one day? Would the answer be different on good and bad days? Try to explain this in your written answer.
Can you cope with small changes to your routine if they are unexpected? This means things like your bus or train not running on time, or a friend or carer coming to your house earlier or later than planned. No/Yes/It varies
Other examples to consider before answering this question might include an appointment being cancelled or moved at short notice, or products being out of stock at the supermarket.
 
1     WCA Handbook para 3.5.5 »
2     GV v SSWP (ESA) [2013] UKUT 405 (AAC) »
Activity 15: getting about
Take note if you experience: agoraphobia; anxiety; panic attacks; lack of motivation. See here for more mental health symptoms that might be relevant.
This activity is about your ability to go out and covers mental rather than physical health problems. For the purposes of the descriptors below, ‘another person’ is likely to mean someone aged 16 or over.1WCA Handbook para 3.5.6 ‘Being accompanied by another person’ includes taking a taxi or having a lift from a friend,2AB v SSWP (ESA) [2016] UKUT 96 (AAC) but you are unlikely to be seen as ‘accompanied’ by a bus driver. You are unlikely to score points if after being dropped off you are able to navigate to a further destination alone (eg, an unfamiliar department in a large hospital).3WCA Handbook para 3.5.6 If you do not have somebody who is reliably available to accompany you when you need them to, then as well as you scoring points for this activity, a decision maker should consider whether work or work-related activity poses a ‘substantial risk’ to your health (see here).4ETv SSWP (UC) [2021] UKUT 47 (AAC)
Descriptors
Points
(a) Cannot get to any place outside the claimant’s home with which the claimant is familiar.
15 points
(b) Is unable to get to a specified place with which the claimant is familiar, without being accompanied by another person.
9 points
(c) Is unable to get to a specified place with which the claimant is unfamiliar without being accompanied by another person.
6 points
(d) Neither of the above applies.
0 points
You cannot qualify as having LCWRA on the basis of this activity (getting about) even if you satisfy the 15-point descriptor.
What the form asks
Can you leave home and go out to places you know? No/Yes, if someone goes with me/It varies
Do not tick ‘yes(…)’ unless this applies for the majority of the time. When writing your answer, consider your ability to go to a list of familiar places that a person might reasonably need to visit (eg, shops, GP surgery, dentist, bank) not just the ones you actually manage to go to.
Can you leave home and go out to places you do not know? No/Yes, if someone goes with me/It varies
Again, do not tick ‘yes(…)’ unless this applies most of the time. If you manage to do this sometimes, but do not think you could for the majority of the time, try to explain this (eg, if you can only make such journeys on occasional good days, with extra medication, and/or when you have an urgent reason). Consider giving examples of times when you have attempted to go out unsuccessfully.
 
1     WCA Handbook para 3.5.6 »
2     AB v SSWP (ESA) [2016] UKUT 96 (AAC) »
3     WCA Handbook para 3.5.6 »
4     ETv SSWP (UC) [2021] UKUT 47 (AAC) »
Activity 16: coping with social engagement
Take note if you experience: anxiety; low mood; agoraphobia; panic attacks; psychosis. See here for more mental health symptoms that might be relevant.
This activity is about difficulties ‘coping with social engagement due to cognitive impairment or mental disorder’. Your social engagement must be restricted due to ‘difficulty relating to others or significant distress’. Guidance suggests that relevant conditions might include anxiety, depression, agoraphobia, personality disorder and psychosis, but you do not need a diagnosis for your symptoms to be considered.1WCA Handbook para 3.5.7 The same guidance is clear that being able to engage socially some of the time or in some specific contexts will not necessarily stop you from scoring points, and that social situations where you need to be accompanied by another person should be disregarded completely.
‘Always’ in the descriptor does not mean 24 hours a day, seven days a week. If you are only able rarely to engage in social contact, with extreme difficulty, and because you have little or no choice, then a decision maker should find that you are ‘always precluded’ from doing so. 2LM v SSWP (ESA) [2013] UKUT 552 (AAC); WCA Handbook para 3.5.7
This activity is ultimately supposed to be a test of your ability to engage with others in a working environment, so the quality of your social contact is as important as the frequency. A decision maker should consider things like conversational give and take, initiation and response.3JC v SSWP (ESA) [2014] UKUT 352 (AAC), reported as [2015] AACR 6
The decision maker is not limited to looking at face-to-face contact: phone and online social contact are also considered.
If you attend an assessment, the assessor might make ‘informal observations’ about you – eg, your ability to make eye contact and respond to questions, your expression, and any visible symptoms like shaking or sweating. The observations are very limited evidence of your ability to engage in social contact. If it has taken preparation, reassurance or extra medication for you to be able to cope at an assessment, the start or end of the assessment might be a good opportunity to say so. If possible, vocalise ‘invisible’ responses like suicidal thoughts or self-harm urges.
Descriptors
Points
(a) Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the claimant.
15 points*
(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.
9 points
(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.
6 points
(d) None of the above applies.
0 points
If you satisfy the 15-point descriptor (a*), you qualify as having LCWRA.
What the form asks
Can you meet people you know without feeling too anxious or scared? No/Yes/It varies
The question asks about ‘meeting people’ but the legal test is about engaging with them. If you can be face-to-face with somebody familiar, or, for example, begin a video call with them, but cannot have a give-and-take conversation, say so. Likewise, the question asks about feeling ‘anxious or scared’, but these are not the only feelings that are relevant for the legal test. Explain your own feelings in detail. Answer ‘no’ to this question if you can only engage with familiar people rarely, with extreme difficulty, and because you have little or no choice.
Can you meet people you do not know without feeling too anxious or scared? No/Yes/It varies
All of the points above apply. Mention whether you need to be accompanied by another person to do this, some or all of the time. If you can engage with unfamiliar people only in very specific contexts, explain this too.
 
1     WCA Handbook para 3.5.7 »
2     LM v SSWP (ESA) [2013] UKUT 552 (AAC); WCA Handbook para 3.5.7 »
3     JC v SSWP (ESA) [2014] UKUT 352 (AAC), reported as [2015] AACR 6 »
Activity 17: appropriateness of behaviour
Take note if you experience: psychosis; behavioural problems; substance use issues. See here for more mental health symptoms that might be relevant.
This activity covers ‘appropriateness of behaviour with other people, due to cognitive impairment or mental disorder’. It is enough that there is a mental health problem at the root of your behaviour; it does not have to be diagnosed. However, being disinhibited or angry without an underlying mental health problem is not enough to score points. A decision maker will consider whether you can realistically control your actions. Psychosis is likely to be relevant. Alcohol abuse does not count by itself, but if you are assessed as having alcohol (or drug) dependency, the consequences for your behaviour must be considered.1WCA Handbook para 3.5.8; DR v SSWP (ESA) [2014] UKUT 188 (AAC); [2014] AACR 38
All the descriptors look at whether you have ‘uncontrollable episodes of aggressive or disinhibited behaviour which would be unreasonable in any workplace’. The behaviour could include physical action but also significant verbal aggression.2WC v SSWP (ESA) [2014] UKUT 363
It is not clear that ‘disinhibited behaviour’ covers things like uncontrollable tearfulness. If this is something you experience, consider the other activities above, and the ‘substantial risk’ route (see here).
Descriptors
Points
(a) Has, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.
15 points*
(b) Frequently has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.
9 points
(c) Occasionally has uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace.
6 points
(d) None of the above applies.
0 points
If you satisfy the 15-point descriptor (a*), you qualify as having LCWRA.
What the form asks
Please tick this box if your behaviour does not upset other people.
Only tick this box if your behaviour would be reasonable in an average workplace. If the people you see regularly are not ‘upset’ by your behaviour because they know you well, this does not mean you need to tick the box. Likewise, if you do not see other people much or at all, so your aggressive or disinhibited behaviour does not actually have the chance to ‘upset’ anyone, that does not mean you need to tick the box.
How often do you behave in a way which upsets other people? Every day/Frequently/Occasionally/It varies
Again, this question is about behaviour that would be unreasonable in an average workplace. The DWP guidance uses the example of a call centre. It might help to have somebody who knows you well check your answer to this question.
 
1     WCA Handbook para 3.5.8; DR v SSWP (ESA) [2014] UKUT 188 (AAC); [2014] AACR 38 »
2     WC v SSWP (ESA) [2014] UKUT 363 »
Eating and drinking
There are two further assessment categories, which are about eating and drinking. You do not ‘score points’ for these activities, but if one of the descriptors applies to you, you are considered to have LCWRA.
Only descriptors (c) and (d) in each activity are about difficulties connected with your mental health. They are relevant to mental health problems where you limit your food intake (eg, some forms of anorexia, food phobia, delusions or hallucinations around food) or otherwise fail to eat unprompted (eg, due to depression, periods of mania, or strong negative symptoms of schizophrenia). However, the wording of the descriptors means that they do not apply to many other mental health problems relating to food and weight (eg, binge-eating or purging). If your difficulties do not fit the descriptors, consider other point-scoring activities in the WCA, and the rules on ‘substantial risk’ (see here).
1. Conveying food or drink to your mouth
You qualify as having LCWRA if:
(a) You cannot convey food or drink to your own mouth without receiving physical assistance from someone else; or
(b) You cannot convey food or drink to your own mouth without repeatedly stopping or experiencing breathlessness or severe discomfort; or
(c) You cannot convey food or drink to your own mouth without receiving regular prompting given by someone else in your physical presence; or
(d) Owing to a severe disorder of mood or behaviour, you fail to convey food or drink to your own mouth without receiving:
(i) physical assistance from someone else; or
(ii) regular prompting given by someone else in your presence.
2. Chewing or swallowing food or drink
You qualify as having LCWRA if:
(a) You cannot chew or swallow food or drink; or
(b) You cannot chew or swallow food or drink without repeatedly stopping, experiencing breathlessness or severe discomfort; or
(c) You cannot chew or swallow food or drink without repeatedly receiving regular prompting given by someone else in your presence; or
(d) Owing to a severe disorder of mood or behaviour, you fail to:
(i) chew or swallow food or drink; or
(ii) chew or swallow food or drink without regular prompting given by someone else in your presence.
Substantial risk
Note: these rules apply to both UC and ESA.
If you do not have the difficulties described in the activities and descriptors above, you will nonetheless be found to have limited capability for work (LCW) or limited capability for work and work-related activity (LCWRA) in some circumstances.
    You will be found to have LCW if, because of your health condition or disability, there would be a substantial risk to the mental or physical health of any person were you to be found not to have LCW.1UC Sch 8 para 4 UC RegsESA Reg 29 ESA Regs; reg 25 ESA Regs 2013 The ‘substantial risk’ is one that could arise from the sort of work you may be expected to do, although it is not necessary to go into the detail of individual job descriptions. ‘Substantial risk’ will not be accepted if any risk could be significantly reduced by reasonable adjustments in your workplace, or by your taking medication prescribed by your doctor (unless not taking your medication is itself a symptom of your condition);2UC Sch 8 para 4(2) UC RegsESA Reg 29(3) ESA Regs; reg 25(2) ESA Regs 2013
    You will be found to have LCWRA if, because of your health condition or disability, there would be a substantial risk to your mental or physical health or to the mental or physical health of someone else if you were found not to have LCWRA.3UC Sch 9 para 4 UC Regs
    ESA Reg 35 ESA Regs; reg 31 UC Regs 2013
    Regarding work, the same considerations apply as in the point above. Regarding work-related activity, you should explain why activities like training, work-focused interviews at the job centre, or CV-writing might present a substantial risk to your mental health. If you appeal about this rule, the First-tier Tribunal should be given a list of the types of work-related activity available in your area, indicating the most and least difficult, and which activities the DWP says that you can do without substantial risk.4KS v SSWP (UC) [2021] UKUT 132 (AAC)
When explaining the risk, mention:
    the immediate effects of performing an activity (eg, the stress response that might result from being required to attend a job interview or appointments at the job centre);5GS v SSWP (ESA) [2014] UKUT 16 (AAC) and
    the cumulative effects (eg, the likelihood that work or work-related activity will make your mental health worse);6WCA Handbook para 3.8 and
    the risks that would follow from not complying with the requirement (eg, the risks to your mental health if you were sanctioned or threatened with a sanction).
A decision maker should also consider the risks of the journey to or from work, job interviews or the job centre.7Charlton v SSWP [2009] EWCA Civ 42; JW v SSWP [2011] UKUT 416 (AAC); ET v SSWP (UC) [2021] UKUT 47 (AAC) They should not ignore the effects of a journey to work based on the possibility that you might find a job where you can work from home. However, they will consider whether work-related activities can be done from home.8SM v SSWP (ESA) [2014] UKUT 241 (AAC); CL v SSWP (ESA) [2015] UKUT 375 (AAC)
Example
Alicja has post-traumatic stress disorder related to a traumatic experience in a former workplace. Her symptoms can vary widely based on the environment she is in, and she finds they are only severe when she is in a workplace setting or on public transport. She has avoided these places to decrease her symptoms and since stopping work she has been able to manage her mental health well. She does not score many points for any of the activities in the work capability assessment because she does not have major difficulties with any activity for ‘the majority of the time’. In her application she writes about how the workplace is the trigger for her symptoms and she is unable to work when experiencing them. She explains that these symptoms have caused her to self-harm in the past. Despite Alicja scoring a low number of points, the DWP accepts that the workplace environment would pose a substantial risk to her mental health which could not simply be managed through reasonable adjustments by her employer. She is ultimately found to have LCW.
 
1     UC Sch 8 para 4 UC RegsESA Reg 29 ESA Regs; reg 25 ESA Regs 2013 »
2     UC Sch 8 para 4(2) UC RegsESA Reg 29(3) ESA Regs; reg 25(2) ESA Regs 2013 »
3     UC Sch 9 para 4 UC Regs
ESA Reg 35 ESA Regs; reg 31 UC Regs 2013
 »
4     KS v SSWP (UC) [2021] UKUT 132 (AAC) »
5     GS v SSWP (ESA) [2014] UKUT 16 (AAC) »
6     WCA Handbook para 3.8 »
7     Charlton v SSWP [2009] EWCA Civ 42; JW v SSWP [2011] UKUT 416 (AAC); ET v SSWP (UC) [2021] UKUT 47 (AAC) »
8     SM v SSWP (ESA) [2014] UKUT 241 (AAC); CL v SSWP (ESA) [2015] UKUT 375 (AAC) »
Treated as having limited capability for work
Note: these rules apply to UC only. For the rules for ESA, see here.
You are sometimes treated as having LCW without having to go through a new work capability assessment. For UC, this applies if:1Reg 39 and Sch 8 UC Regs
    you have already been assessed as having limited capability for work for ‘new-style’ ESA; or
    you are transferring to UC from ‘old-style’ ESA and you were in the work-related activity group for ESA (see here). Similar rules apply if you have been getting national insurance credits for LCW;2Regs 19(2) and 21(2) UC(TP) Regs or
    you are at least pension age and get adult disability living allowance (adult DLA), personal independence payment (PIP) or adult disability payment (ADP); or
    you have been given official notice not to work because of being in contact with an infectious disease; or
    you are an inpatient in hospital, or are recovering from treatment as an inpatient (and the DWP is satisfied that your condition remains sufficiently serious), including if you are attending a residential programme of rehabilitation for drug or alcohol addiction; or
    you are receiving plasmapheresis, regular weekly treatment for haemodialysis for chronic renal failure, or regular weekly treatment for total parenteral nutrition for gross impairment of enteric function, or are recovering from such treatment; or
    you have an ‘uncontrolled or uncontrollable life-threatening disease’.
 
1     Reg 39 and Sch 8 UC Regs »
2     Regs 19(2) and 21(2) UC(TP) Regs »
Treated as having limited capability for work and work-related activity
Note: these rules apply to UC only. For the rules for ESA, see here.
You are sometimes treated as having LCWRA without having to go through a new work capability assessment. For UC, this applies if:1Reg 39 and Sch 9 UC Regs
    you have already been assessed as having limited capability for work for ‘new-style’ ESA; or
    you are transferring to UC from ‘old-style’ ESA and you were entitled to the support component in your ESA (see here) (similar rules apply if you have been getting national insurance credits for LCWRA);2Regs 19(4) and 21(4) UC(TP) Regs or
    you have reached pension age and are entitled to attendance allowance, the highest rate of the DLA care component or the enhanced rate of the daily living component of PIP or ADP; or
    you are regarded as being terminally ill – ie, your death can reasonably be expected within 12 months; or
    you are receiving chemotherapy or radiotherapy treatment for cancer, or are recovering from that treatment, or you are likely to receive such treatment within six months from the date the DWP determines whether or not you have LCWRA, and the DWP is satisfied that your cancer treatment has side effects which are likely to limit your ability to carry out work-related activity; or
    you are pregnant and there is a serious risk to your health or to your baby’s health if you do not refrain from work and work-related activity.
Are you transferring to universal credit from employment and support allowance?
If you were getting ‘old-style’ ESA and were in the work-related activity group or support group, but then claim UC, you automatically have LCW or LCWRA so long as there was no gap between your ESA stopping and your UC starting.3Reg 19 UC(TP) Regs (See here for more information about moving to UC.)
The DWP may wrongly overlook this rule. If this affects you, do the following.
– Quote the rules. If necessary, challenge the decision on your UC entitlement through a mandatory reconsideration request (see Chapter 17).
– Point out that if you were getting the support component in your ESA, the limited capability for work-related activity element should be included in your UC from your first monthly assessment period.4Reg 19(4), UC(TP) Regs
– Point out that, if you were getting the work-related activity component in your ESA and had been for long enough (see here), the limited capability for work element should be included in your UC from your first monthly assessment period.5Reg 19(2) UC(TP) Regs, with savings regarding pre-April 2017 as in the ESAUC(MA) Regs
– Remember that, despite these rules, the DWP can still choose to reassess you after your UC starts. It is usually still worth getting your status carried over from ESA as this will affect your work-related requirements, your ‘work allowance’ (see here), and possibly your UC amount, while you are waiting for reassessment.
Get independent advice if you need help with any of this, or if you are uncertain whether it applies to you.
 
1     Reg 39 and Sch 9 UC Regs »
2     Regs 19(4) and 21(4) UC(TP) Regs »
3     Reg 19 UC(TP) Regs »
4     Reg 19(4), UC(TP) Regs »
5     Reg 19(2) UC(TP) Regs, with savings regarding pre-April 2017 as in the ESAUC(MA) Regs »
Treated as not having limited capability for work or work-related activity
Note: these rules apply to UC only. For the rules for ESA, see here.
In some circumstances you are treated as not having limited capability for work or work-related activity (ie, you are treated as ‘fit for work’) without this being determined in the normal way through a work capability assessment (WCA).
For UC, this applies if:1Regs 41, 43 and 44 UC Regs
    you have previously failed the WCA, either for UC or for contributory ESA under the UC system (‘new-style’ ESA), and you ask to be assessed again (this applies unless the previous decision was made in ignorance of, or based on a mistake about, a material fact, or there has been a relevant change in your condition); or
    you do not return the UC50 questionnaire or attend an assessment and do not have good reason (see here) for this; or
    you work and your earnings are at or above a certain threshold.2Reg 41(2) and (3) UC Regs See CPAG’s Welfare Benefits and Tax Credits Handbook.
 
1     Regs 41, 43 and 44 UC Regs »
2     Reg 41(2) and (3) UC Regs »
Work capability decisions
The decision on whether you have capability for work may in practice be made between four and eight weeks after you attend an assessment.
There are three possible work capability decisions:
    that you are ‘fit for work’; or
    that you have ‘limited capability for work’ (LCW); or
    that you have ‘limited capability for work and work-related activity’ (LCWRA).
There is more information about these outcomes on here.
If you are found ‘fit for work’
If a decision is made that you are ‘fit for work’ (either following a work capability assessment, or automatically under the rules on here), and you disagree with the decision, you can challenge it by making a mandatory reconsideration request and then pursuing an appeal if necessary, see Chapter 17. Note that there are deadlines for appealing decisions.
You can continue to get UC while challenging a decision. However, if you have been found ‘fit for work’ you are usually placed in the UC ‘all work-related requirements’ group. There is more information about work-related requirements, including about reducing them, on here.
If you are found to have limited capability for work
As well as challenging a decision that you are ‘fit for work’, you can challenge a decision that you have LCW, if you think that the decision is wrong and that you actually have LCWRA. It is usually best to get advice before challenging this kind of decision, as a new decision maker (or the tribunal) will look at the whole decision again and could decide that you are ‘fit for work’.
For information about work-related requirements if you have been found to have LCW, see here.
Length of awards
Awards of UC are not fixed-term. Your work capability is usually reassessed at a future point (see here). You cannot appeal a decision about how often you are reassessed, but you may be able to challenge it through judicial review (see here).
A decision that you are not eligible for UC
After making a new claim for UC, you may receive a decision that you are not eligible for UC because you do not meet the non-health-related conditions listed here – eg, about your education status, your ‘right to reside’ or your capital. You can challenge this decision by mandatory reconsideration and appeal (see Chapter 17), providing further evidence if necessary.
‘Claim closure’, suspension and termination
After making a new claim for UC, you might receive a decision saying that your claim has been ‘closed’ because you did not attend an initial interview or provide requested information. You can challenge this decision through a mandatory reconsideration request and appeal (see Chapter 17). See the AskCPAG tool for challenging a decision to ‘close’ your claim (for subscribers).
After an award of UC has been made, it can be terminated in certain circumstances, after a period of suspension, if you have not provided requested information.1Regs 44-47 UC,PIP,JSA&ESA(DA) Regs Again, you can challenge the decision – eg, if you do not agree that you failed to provide the relevant information.
 
1     Regs 44-47 UC,PIP,JSA&ESA(DA) Regs »
Monthly payment statement
Your monthly UC payment statement confirms the DWP’s calculation of your entitlement to UC. If you have an online UC account, the statement should be viewable in the Payments section. If you have a non-digital account, you should be sent the statement by post. If you disagree with the DWP’s calculation of your entitlement, you can challenge its decision through a mandatory reconsideration request and appeal (see Chapter 17).
Other decisions
While getting UC, you are likely to receive a range of other decisions, including:
    decisions by your work coach about what your work-related requirements are (see here). (These decisions are not appealable but you may be able to challenge them through a complaint or judicial review, see Chapter 17); and
    decisions about whether you have been overpaid UC and whether an overpayment can be recovered (overpayments are not within the scope of this book, see CPAG’s Welfare Benefits and Tax Credits Handbook).
When you are paid
Universal credit (UC) is normally paid monthly, in arrears, seven days after the end of an assessment period.1Reg 47(2) UC,PIP,JSA&ESA(C&P) Regs The payment date is brought forward if it would otherwise fall on a Saturday, Sunday or bank holiday.
If you are having difficulty with budgeting, you may be able to request more frequent payments under an ‘alternative payment arrangement’ (see here). If you live in Scotland, you can be paid twice monthly as a matter of course.2UC(CP)(S) Regs
You can check the dates and details of your payments on your online UC account, or you should be sent monthly statements by post if you have a non-digital account.
In practice, you can expect to get your first UC payment about five weeks after claiming, although it may take longer. If you are in financial need while waiting to be paid, you may be able to get a repayable ‘advance’ payment of UC and/or other financial assistance. See CPAG’s Welfare Benefits and Tax Credits Handbook.
A lump sum of UC arrears (ie, ‘back pay’) may be paid to you in instalments, with your consent, if this is necessary to protect your interests.3Reg 47(6A) UC,PIP,JSA&ESA(C&P) Regs
Note: it is possible for payment of UC to be suspended (see here).
 
1     Reg 47(2) UC,PIP,JSA&ESA(C&P) Regs »
2     UC(CP)(S) Regs »
3     Reg 47(6A) UC,PIP,JSA&ESA(C&P) Regs »
Where your payment goes
The default is that all your UC, including any amount to cover rent, is paid into your bank account.
Couples
If you are in a couple, you usually receive a single UC payment. You can decide whose bank account this goes into. The DWP can decide that the other partner should be paid instead or can split the payments between you (see here) if it considers this to be in your interests or in the interests of your partner, your child or someone you care for.1Reg 47(6) UC,PIP,JSA&ESA(C&P) Regs
 
1     Reg 47(6) UC,PIP,JSA&ESA(C&P) Regs »
Third parties
All or part of your UC can be paid to another person on your behalf if the DWP considers this is necessary to protect your interests (see here).1Reg 58 UC,PIP,JSA&ESA(C&P) Regs This is often described as an ‘alternative payment arrangement’ and is not the same as a third-party ‘deduction’ (see here).
Relevant third parties could include an appointee (see here), a trusted friend or family member, or your landlord .
Managed payment to landlord (MPTL)
An example of part of your UC being paid to a third party on your behalf could be having your rent paid directly by DWP to your landlord, often known as a ‘managed payment to landlord’ (MPTL). In England and Wales, this must usually be necessary to protect your interests, or you must have a certain amount of arrears,2HB Circular A13/2013 but in Scotland, anyone can request a MPTL regardless of their circumstances.3UC(CP)(S) Regs
You can request an MPTL by phoning the UC section of the DWP or putting a message in your journal. Alternatively, your landlord can request it, normally through an online form.
 
1     Reg 58 UC,PIP,JSA&ESA(C&P) Regs »
2     HB Circular A13/2013 »
3     UC(CP)(S) Regs »
No bank account
If you do not have a bank account, you can ask to have your UC paid into a trusted third party’s bank account (see here) or you can ask to be considered for DWP’s payment exception service.1See gov.uk/payment-exception-service
Alternative payment arrangements
This section has described several kinds of alternative payment arrangements (APAs) for UC. These include:
    more regular payments (see here);
    payments being split between couples (see here);
    all or part of your UC being paid to a third party (see here).
Reasons to consider an alternative payment arrangement
You might consider an APA to make your payments more regular if, because of your mental health problem, you are finding it difficult to budget for monthly payments. You might consider a third party APA if, for example, there is a risk that you will not manage to pay your rent reliably unless it goes straight to your landlord; or because you want a trusted family member to look after your UC income because your condition makes it difficult for you to manage money.
Getting an alternative payment arrangement
The DWP can usually make an APA when it considers this to be in your or your partner’s interests, or (in some cases) in the interests of your dependent child or of a person you receive the carer element of UC for looking after.1Reg 47 and 58 UC,PIP,JSA&ESA(C&P) Regs An APA can be set up at any point, not just at the start of a claim. You can request it by calling the UC helpline, by letter, or using your online UC account. If the APA involves your landlord, they can request it (see here).
When deciding whether to make an APA, the DWP splits claimants into two tiers: tier one for those with circumstances with a ‘high likely need’ for APAs and tier two for those with ‘less likely need’. You are in tier one if you have a mental health problem.2DWP, Alternative Payment Arrangements, available at GOV.UK
Note: if you live in Scotland, you have more options for getting fortnightly UC payments (see here) and getting UC paid directly to your landlord (see here).
 
1     Reg 47 and 58 UC,PIP,JSA&ESA(C&P) Regs »
2     DWP, Alternative Payment Arrangements, available at GOV.UK »
7. Reviews and reassessments
Your entitlement to universal credit (UC) can change after an award has been made. In certain circumstances, the DWP reviews your entitlement or reassesses you. This can lead to a supersession (see here).
Work capability
    If there has been a decision that you do not have limited capability for work (LCW), you are not reassessed, unless there is evidence to suggest that the decision was made in ignorance of, or based on a mistake about, a material fact, or there has been a relevant change to your condition.1Reg 41(4) UC Regs
    If there has been a decision that you do have LCW (or limited capability for work-related activity – LCWRA), there are no rules about how often your work capability can be reassessed. Usually, the length of time before a reassessment is recommended by the original assessor. You may be reviewed sooner if you report an improvement or a deterioration in your condition. The DWP has stated that if you are assessed as having LCWRA, have a ‘severe, lifelong’ disability or condition, and are ‘unlikely to ever be able to move into work’, you will not be reassessed.2DWP, Employment and Support Allowance and Universal Credit: changes to the work capability assessment from 29 September 2017, September 2017
 
1     Reg 41(4) UC Regs »
2     DWP, Employment and Support Allowance and Universal Credit: changes to the work capability assessment from 29 September 2017, September 2017 »
Change of circumstances
You should report all changes in your circumstances to the UC section of the DWP as soon as possible. Do not assume that the UC section of the DWP already knows something – eg, about changes to the other DWP benefits you claim. You can report a change on your online journal, by letter or by telephoning the UC helpline. It can be preferable to report a change in writing so that there is a clear record of what you have said and when.
When you notify the DWP of a change of circumstances, it can change the decision on your UC entitlement, usually by ‘supersession’. A change that occurs (or is expected to occur) part-way through an assessment period is usually treated as if it happened on the first day of the assessment period, meaning that your UC entitlement changes for the whole of that assessment period. However, there are some important exceptions.1Sch 1 paras 20-33 UC,PIP,JSA&ESA(DA) Regs There is more information about supersessions in Chapter 17.
Reaching pension age
If you are a single UC claimant and you reach pension age, your UC will stop from the first day of the next assessment period.2Sch 1 para 26 UC,PIP,JSA&ESA(DA) Regs You are likely to be eligible for pension credit (PC) and/or pension-age housing benefit (HB) from the date you reach pension age. You can claim PC up to four months before that date and you can claim HB from the start of your final UC assessment period (ie, the assessment period during which you reach pension age).3Regs 4E and 13D SS(C&P) Regs; reg 6A(3) UC(TP) Regs
You should receive a full month’s UC for your final assessment period. Any PC or HB you receive for the same period should be ignored for the calculation of UC. Similarly, any UC payment should be ignored for the new PC or HB award.4Reg 5(2)(c) UC(TP) Regs; Explanatory Memorandum to the Universal Credit (Persons who have attained state pension credit qualifying age) (Amendment) Regulations 2020 No.655
If you are in a couple claiming UC and one of you (but not the other) reaches pension age, your UC generally continues. In this situation you are regarded as a ‘mixed-age couple’. There is more information about mixed-age couples in CPAG’s Welfare Benefits and Tax Credits Handbook.
If you are in a mixed-age couple getting UC and the younger partner reaches pension age, your UC will stop. The rules (including about claiming PC and pension-age HB) are the same as described above for single people.
 
1     Sch 1 paras 20-33 UC,PIP,JSA&ESA(DA) Regs »
2     Sch 1 para 26 UC,PIP,JSA&ESA(DA) Regs »
3     Regs 4E and 13D SS(C&P) Regs; reg 6A(3) UC(TP) Regs »
4     Reg 5(2)(c) UC(TP) Regs; Explanatory Memorandum to the Universal Credit (Persons who have attained state pension credit qualifying age) (Amendment) Regulations 2020 No.655 »
Ongoing evidence requirement
After you have been awarded UC, you may be asked to provide further information about things like your housing costs or pay, to confirm your ongoing eligibility. If you fail to provide this information or evidence when asked, your UC could be suspended or even terminated (see here).
Means-tested benefits and tax credits
If you make a claim for universal credit (UC), you can no longer get income support (IS), income-based jobseeker’s allowance (JSA), income-related employment and support allowance (ESA), child tax credit (CTC) or working tax credit (WTC). The same applies to working-age housing benefit (HB) except if you are living in ‘specified’ or ‘temporary’ accommodation (see here). If you are in the limited group of people who can get UC alongside HB, your UC entitlement means you automatically qualify for maximum HB (see here).
See here for more information about moving to UC.
In Scotland, UC is a qualifying benefit for Scottish child payment.
Non-means-tested benefits
When you get UC you may be able to claim other benefits, and getting some other benefits may mean you receive more UC.
    You can get ‘new-style’ contribution-based JSA or contributory ESA as well as UC. These are taken into account in full as income for UC (and so reduce your UC entitlement) but it is generally still a good idea to claim them.
    You can claim other non-means-tested benefits at the same time as UC – eg, carer’s allowance, child benefit, personal independence payment (PIP), adult disability payment (ADP), statutory sick pay and statutory maternity, adoption, paternity and shared parental pay. Some are disregarded when working out your income for UC (see here) but some reduce your UC entitlement pound for pound.
    Non-means-tested benefits can sometimes increase your UC. For example, if your child gets disability living allowance (DLA) or child disability payment (CDP), you may be entitled to a disabled child addition (see here).
The benefit cap
In some cases, there is a limit on your total income from specified benefits (the ‘benefit cap’). UC is one of the specified benefits. You are not subject to the benefit cap if you have limited capability for work-related activity for UC, or if you get certain other benefits (eg, if you get PIP, ADP, DLA, CDP or attendance allowance). See CPAG’s Welfare Benefits and Tax Credits Handbook.
Other sources of financial help
If you qualify for UC, you may also be eligible for free prescriptions, council tax reduction, and a range of other financial help. See CPAG’s Welfare Benefits and Tax Credits Handbook.
What advisers say: council tax support
‘For UC claimants, it is important that they realise that they need to put a separate claim in for council tax support. In our local authority area, this involves an online application.’