Chapter 14: Assessments

CPAG

2. In-person, telephone and video assessments

3. Missing, cancelling or rearranging an assessment

4. Preparing for an assessment

Audio recording of your assessment

5. What happens in an assessment

6. After an assessment

Complaints

This chapter covers assessments for personal independence payment, universal credit and employment and support allowance. It does not cover other benefit assessments, such as those for adult disability payment in Scotland, which are expected to be far less common. For information about these other assessments, see the chapter about the relevant benefit in this Handbook. You might also find useful the general tips in this chapter about preparing for an assessment (see here), the questions you might be asked in an assessment (here) and looking after yourself following an assessment (here).

Key facts

•Most people have an assessment with a healthcare professional as part of the process of claiming personal independence payment (PIP), universal credit (UC) or employment and support allowance (ESA).

•An assessment is not always required, but if you are asked to take part in one, you normally must attend. There are important rules about missing, cancelling or rearranging an appointment.

•Your assessment is not always carried out by a mental health professional.

•There are steps that you can take to make your assessment more accessible (eg, requesting it is carried out at home, by telephone, by video call or in a clinic) and steps you can take to help you feel mentally prepared.

•You can ask in advance to have your assessment audio-recorded or about making your own recording. The rules are different for PIP assessments and UC/ESA assessments.

•You can be accompanied in the assessment by an independent adviser or somebody else who is supporting you.

•There are things you can do before, during and after an assessment to help you manage the impact on your mental health.

1. The assessment provider

Most people have an assessment with a healthcare professional as part of the process of claiming personal independence payment (PIP), universal credit (UC) or employment and support allowance (ESA).1UC Reg 44(1) UC Regs
ESA Reg 23(1) ESA Regs; reg 19(1) ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
Assessments are carried out by private companies, often known as ‘assessment providers’, on behalf of the DWP.

Note: assessment providers do not make the decision about your benefit eligibility. They send a report back to the DWP explaining whether they believe you meet the relevant criteria, and the DWP then decides your entitlement.

Assessment providers

UC/ESA work capability assessments

Assessment provider: Maximus

Also known as: Health Assessment Advisory Service/Centre for Health and Disability Assessments

Website:

Telephone: 0800 288 8777

Email: customer-relations@chda.dwp.gov.uk

PIP assessments in Scotland and southern and northern England

Assessment provider: Atos

Also known as: Independent Assessment Services

Website:

Telephone: 0800 188 4880 (north of England and Scotland) or 0800 188 4881 (southern England)

Textphone: 18001 then the contact number for your area

PIP assessments in Wales and central England

Assessment provider: Capita

Website:

Telephone: 0808 1788 114 (England and Wales) or 0808 1788 115 (Welsh line)

Textphone: 0289 032 9675. Text and video relay services available

Email: contactus@capita-pip.co.uk

1 UC Reg 44(1) UC Regs
ESA Reg 23(1) ESA Regs; reg 19(1) ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
»

At what stage are you referred?

For UC and ESA, you are referred to the assessment provider after declaring that you have a disability or illness that affects your ability to work (see here). The assessment provider then issues a UC50 or ESA50 questionnaire before inviting you to an assessment.

For PIP, you are normally referred to the assessment provider only after returning your PIP2 questionnaire to the DWP (see here).

Knowing at what stage you are referred to the assessment provider can help you know whether to contact the assessment provider or the DWP about particular issues. For example, if you have returned a UC50 and are waiting for an assessment, you may be able to speed this process by calling the assessment provider but calling the UC enquiry line might be less productive.

The healthcare professional

Assessments are carried out by healthcare professionals (HCPs) employed and trained by the assessment provider companies. The DWP publishes guides for HCPs on how to carry out assessments.1DWP, Personal Independence Payment (PIP) Assessment Guide for Assessment Providers, 21 July 2022, available at ; DWP, Work Capability Assessment handbook: for healthcare professionals, 10 October 2022, available at

HCPs come from a range of different medical backgrounds and can include doctors, nurses, physiotherapists, occupational therapists and paramedics. At the time of writing, there are plans for some assessment providers to trial employing other professionals, such as pharmacists, speech and language therapists and clinical psychologists. There is no option to request a particular type of professional for your assessment. You might be assessed by someone with no professional experience of mental health problems and fairly limited mental health training.

What advisers say: assessments

‘Many assessments go well and people feel they get a fair and thorough asessment and a good experience. But advisers know that when things do go wrong, the process can feel rushed and people are left unclear as to why a report recommends so few points.’

If you believe that the person assessing you did not fully understand your mental health problem or ask you relevant questions, this is likely to be grounds for challenging a benefit decision (see Chapter 17) and may also be grounds for a complaint (see here).

Jo’s experience

’The person doing my assessment did not have a clue what my conditions were, which was not helpful.’

1 DWP, Personal Independence Payment (PIP) Assessment Guide for Assessment Providers, 21 July 2022, available at ; DWP, Work Capability Assessment handbook: for healthcare professionals, 10 October 2022, available at »

When an assessment might not be required

A HCP looks at the evidence you have provided about your mental health problem, including your completed questionnaire, and decides whether they need more information to produce a report for the DWP on your eligibility. If they believe they already have enough information, the HCP reports back to the DWP without the need for an assessment.1UC Regs 43 and 44 UC Regs
ESA Regs 21 and 23 ESA Regs; regs 17 and 19 ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
This is sometimes called a ‘paper-based review’ and only happens in a minority of cases (see here).

You might increase the chances of a paper-based review if you provide supporting evidence when you return your questionnaire. Chapter 13 has more information about supporting evidence. It is also important when you fill out the questionnaire to provide contact details for the people and professionals who support you, as the HCP might decide to contact them to fill in any gaps (although you should not rely on this happening).

Caroline’s experience

’With PIP I just sent in all the paperwork and they spoke with my CPN [community psychiatric nurse] and I didn’t need a further assessment.’

1 UC Regs 43 and 44 UC Regs
ESA Regs 21 and 23 ESA Regs; regs 17 and 19 ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
»

2. In-person, telephone and video assessments

Note: this chapter covers assessments for personal independence payment (PIP), universal credit (UC) and employment and support allowance (ESA). For information about the types of assessment for adult disability payment in Scotland, see here.

Assessment types

You may be asked to take part in an assessment:1UC Reg 44(2) UC Regs
ESA Reg 23(1) ESA Regs, reg 19(1) ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs

•in an assessment centre (often known as a ‘clinic’ appointment); or

•at home, with a healthcare professional visiting you in person; or

•by telephone; or

•by online video call.

The assessment provider will decide which type of assessment to offer you, although you can make a request for a particular assessment type (see here).

How common are the different assessment types?

At the time of writing, around 75 per cent of people are assessed by telephone or video, with the great majority of these assessments being by telephone. A smaller percentage (around 7.5 per cent for PIP and 15 per cent for UC/ESA) have face-to-face assessments. The remainder are not required to take part in an assessment at all (see here).2House of Commons, Hansard, Written answers, (i) 1 December 2022, UIN 95826, (ii) 7 November 2022, UIN 77643

Of the face-to-face assessments, it is not clear how many are carried out at home. At the time of writing, some assessment providers’ websites still state that home assessments are suspended following the coronavirus pandemic.

1 UC Reg 44(2) UC Regs
ESA Reg 23(1) ESA Regs, reg 19(1) ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
»

2 House of Commons, Hansard, Written answers, (i) 1 December 2022, UIN 95826, (ii) 7 November 2022, UIN 77643 »

Clinic assessments

Venue and travel

If you are asked to attend a clinic assessment, you are not always invited to the assessment centre closest to where you live. However, you should not be asked to travel for more than 90 minutes on public transport to get to an assessment.1UC/ESA Confirmed at at the date of writing
PIP DWP, Personal Independence Payment Handbook, December 2021, available at

It is usually a good idea to arrive 10–15 minutes before your appointment is due to start. Your assessment may last an hour or so, but in practice this varies, so try to allow for this when making travel arrangements.

1 UC/ESA Confirmed at at the date of writing
PIP DWP, Personal Independence Payment Handbook, December 2021, available at
»

Travel expenses

If you are asked to attend to a clinic assessment, you can get help with travel expenses. You need to fill out and submit an expense form. The assessment provider sends you this with your appointment letter or you can ask for one at the assessment centre reception. You are asked for copies of tickets or receipts.

•Public transport costs are reimbursed for the return journey between your address and the assessment centre. Keep your tickets.

•Car travel costs can be reimbursed. You can usually claim 25p per mile, plus parking costs if the assessment centre does not provide free parking. Keep parking receipts.

•Taxi costs are paid on a case-by-case basis. You must usually show either that there is no public transport for your route or that your condition means you cannot reasonably use public transport for the journey. Request help with taxi fares before your appointment by contacting the assessment provider with quotes (see contact details on here). Ask the driver or taxi company for receipts.

•Somebody accompanying you can also have their travel costs reimbursed – eg, if you and they each buy a bus ticket. It is best to request this in advance by contacting the assessment provider (see contact details on here).

Assessments at home

A face-to-face assessment at home is only usually offered if you cannot travel to an assessment centre for health reasons and if a telephone or video assessment is not an effective alternative. You can be accompanied by an independent adviser or somebody else supporting you.

Note: at the time of writing, some assessment providers’ websites still state that home assessments are suspended following the coronavirus pandemic.

Remote assessments

A telephone or video assessment might be more accessible than a face-to-face appointment, depending on your mental health symptoms and how they affect you. You can join at home or somewhere else.

You can have somebody to accompany you in a telephone or video assessment in the same way as for a face-to-face assessment. They can either join you in person or can be added through a ‘conference calling’ facility.

There can be some obvious advantages of remote assessments, depending on your difficulties and needs. These advantages include not having to travel and not having to be in the physical presence of a healthcare professional (HCP).

There can also be some obvious disadvantages to a remote assessment – eg, if you are not confident with technology, or find it difficult to answer the phone.

Some of the pros and cons of remote assessments are less obvious. For example, in a telephone assessment, you cannot be seen. This might be a disadvantage, because if your mental health problem has visible symptoms, the HCP may miss them. You or somebody supporting you may need to try to describe these symptoms throughout the call. On the other hand, if a HCP cannot see you, this removes the risk of them making misleading ‘informal observations’ (see here) about your appearance. You might feel that this is an advantage of a telephone assessment.

While video assessments can seem like the ‘best of both worlds’, one drawback to a video assessment is that it cannot currently be audio recorded by the DWP, and there are rules about making your own recording (see here).

Asking for a particular assessment type

If a mental health problem affects your ability to take part in certain types of assessment, make this clear as early as possible in your claim. You can write something on the UC50, ESA50 or PIP2 questionnaire explaining why certain venues or formats would not be appropriate. Alternatively, contact the assessment provider as soon as possible after being invited to an assessment (see here).

Examples

‘I have explained my difficulties leaving my home on my own. I have provided a report from my consultant which confirms these difficulties. I do not have somebody who can accompany me to a clinic appointment. If an assessment is needed, please offer me a home or video appointment.’

‘Because of my mental health problem I do not always answer the phone when it rings. I also find it difficult to express myself by phone. If an assessment is needed, please offer me a face-to-face assessment.’

‘I am severely unwell and would not be able to participate in any type of assessment. I have provided detailed evidence from my consultant, community psychiatric nurse and family members which gives you a full picture of my difficulties. Please do not require me to take part in an assessment.’

It is not guaranteed that a request will be accepted. You may have a better chance of success if you provide supporting evidence (see Chapter 13), but should not be asked to pay for this evidence.1For PIP, see PIP AG paras 1.6.72-76 For example, if you are asking for a home assessment, you could provide evidence that other professionals visit you at home – eg, your GP, psychiatrist or community mental health team.

If your request for a different format or venue is refused and you do not attend the assessment that is arranged for you, you may receive a negative benefit decision from the DWP (see here).

Assessment types and disability discrimination

Under the Equality Act 2010,2ss20, 21 and 29 EA 2010 (see also s19) the DWP and assessment providers have a duty to make ’reasonable adjustments’ to the way they carry out assessments to avoid disadvantage to people with disabilities. A failure to make these adjustments is discrimination. (See here about the meaning of ‘disability’.)

A reasonable adjustment can include a particular venue or format for your assessment. If your request for a reasonable adjustment is refused, you may be able to bring a legal challenge against this decision. For example, if your request for a home assessment is refused, you may be able to challenge this using one of the template judicial review pre-action letters available at . Contact an independent advice service if you need support with this step.

1 For PIP, see PIP AG paras 1.6.72-76 »

2 ss20, 21 and 29 EA 2010 (see also s19) »

Overcoming barriers to attending an assessment

If you are faced with an assessment type or venue that you know you will find difficult, it can help to talk to somebody who knows you well about your options.

•Could they, or somebody else, accompany you?

•Will requesting a recording (see here) help you feel any more confident?

•Would it make a clinic appointment more accessible if you had a lift or a taxi arranged in advance?

•Would it help you to manage a telephone or video appointment if a friend or family member took charge of the technology?

3. Missing, cancelling or rearranging an assessment

An assessment is not always needed before a decision can be made about your benefit entitlement, but if you are asked to take part in one, you normally must attend. There are important rules about missing, cancelling or rearranging an appointment.1UC Regs 43 and 44 UC Regs
ESA Regs 21 and 23 ESA Regs; regs 17 and 19 ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
(For the rules for adult disability payment in Scotland, see here.)

1 UC Regs 43 and 44 UC Regs
ESA Regs 21 and 23 ESA Regs; regs 17 and 19 ESA Regs 2013
PIP Reg 9(1) SS(PIP) Regs
»

Getting notice of an assessment

You must usually be sent written confirmation of the date, time and location of your assessment at least seven days in advance. This rule does not apply if you accept less notice or notice by telephone.1UC Reg 44(3) UC Regs
ESA Reg 23(3) ESA Regs; reg 19(3) ESA Regs 2013
PIP Reg 9(3)-(4) SS(PIP) Regs
See here if you have an appointee. If you do not get adequate notice, you are not affected by the rules below on missing an appointment.

1 UC Reg 44(3) UC Regs
ESA Reg 23(3) ESA Regs; reg 19(3) ESA Regs 2013
PIP Reg 9(3)-(4) SS(PIP) Regs
»

Cancelling an assessment

If you have been invited to take part in an assessment, but you believe that this is unnecessary or inappropriate (eg, because you have already provided a lot of supporting evidence about your condition or because you are so unwell that you cannot meaningfully participate in any form of assessment), you can make this case to the assessment provider and ask them to complete a ‘paper-based review’ instead (see here). This may only be agreed in exceptional cases.

Rearranging an assessment

You can ask the assessment provider for a different date, time, venue or format for your assessment. Make the request as soon as possible after getting your appointment notification. There is more information about requesting a different venue or format on here.

Assessment providers only reschedule your appointment once. If you are not able to attend the rearranged appointment, your case is returned to the DWP. You can be referred again to the assessment provider if the DWP accepts that you had a good reason (see here) for not attending the second appointment.

Missing an assessment

For universal credit or employment and support allowance

If you are going to miss an assessment for universal credit (UC) or employment and support allowance (ESA), or have missed it already, you should contact the assessment provider as soon as possible to explain why. You are often sent a BF223 form to complete, which asks why you could not take part in the assessment. Unless you are found to have had good reason/cause for missing your assessment, you are likely to be found ‘fit for work’.1UC Reg 44(2) UC Regs
ESA Reg 23(2) ESA Regs; reg 19(2) ESA Regs 2013

Good cause (ESA) and good reason (UC)

When deciding whether you have ‘good cause’ for missing an ESA assessment, the DWP must consider all the circumstances, including your state of health and the nature of your mental health problem.2Reg 24 ESA Regs; reg 20 ESA Regs 2013; interpreted by the DWP at DMG 42500-42543 Good cause may include being too ill or distressed on the day of the assessment – eg, experiencing a panic attack on the way to the assessment centre or being too anxious to leave the house.

There are no equivalent rules for deciding whether you have ‘good reason’ for missing a UC assessment, but in practice the same sort of issues should be considered.3Interpreted by the DWP at ADM G1128-G1140

To help you demonstrate good reason/good cause, it is often useful to provide supporting evidence (see Chapter 13).

If you are found ‘fit for work’ because you are considered not to have good reason/good cause for failing to attend an assessment, it is possible to challenge the decision through mandatory reconsideration and appeal (see Chapter 17). For ESA, you should also get advice about making a new claim in case your challenge is unsuccessful.

1 UC Reg 44(2) UC Regs
ESA Reg 23(2) ESA Regs; reg 19(2) ESA Regs 2013
»

2 Reg 24 ESA Regs; reg 20 ESA Regs 2013; interpreted by the DWP at DMG 42500-42543 »

3 Interpreted by the DWP at ADM G1128-G1140 »

For personal independence payment

If you are going to miss a personal independence payment (PIP) assessment, or have missed it already, you should contact the assessment provider as soon as possible to explain why. If it is decided that you failed to take part in an assessment without good reason, your PIP claim is likely to be refused and/or your existing award ended.1s80(4)-(6) WRA 2012; regs 8(3) and 9(2) SS(PIP) Regs; reg 26(2) UC,PIP,JSA&ESA(DA) Regs; KB v SSWP (PIP) [2016] UKUT 537 (AAC)

Good reason (PIP)

When deciding whether you had ‘good reason’ for missing a PIP assessment, the DWP must consider your state of health and the nature of your mental health problem. The DWP’s guidance on good reason has several examples in which mental health problems cause somebody to miss an appointment with good reason.2Reg 10 SS(PIP) Regs; interpreted by the DWP in Ch P6 ADM You might have good reason for missing an assessment if, for example, you were feeling too unwell to attend or the person who normally supports you was unavailable. Being asked to attend an assessment at an unsuitable location can also be good reason for not attending it.3OM v SSWP (PIP) [2017] UKUT 458 (AAC); TC v SSWP (PIP) (No.2) [2018] UKUT 286 (AAC) To help you demonstrate good reason, it is often useful to provide supporting evidence (see Chapter 13).

If you are refused PIP because you are considered not to have good reason for failing to attend an assessment, it is possible to challenge the decision through mandatory reconsideration and appeal (see Chapter 17). You should also get advice about making a new claim in case your challenge is unsuccessful.

1 s80(4)-(6) WRA 2012; regs 8(3) and 9(2) SS(PIP) Regs; reg 26(2) UC,PIP,JSA&ESA(DA) Regs; KB v SSWP (PIP) [2016] UKUT 537 (AAC) »

2 Reg 10 SS(PIP) Regs; interpreted by the DWP in Ch P6 ADM »

3 OM v SSWP (PIP) [2017] UKUT 458 (AAC); TC v SSWP (PIP) (No.2) [2018] UKUT 286 (AAC) »

If good reason/good cause is accepted

If the DWP accepts that you had good reason/good cause for missing your assessment, it refers your case back to the assessment provider and you are given another appointment. In theory, this can happen multiple times. However, the assessment provider should notice if you are consistently too unwell to attend assessments and might decide to change your assessment venue or format, or to conduct a ‘paper-based review’ instead. Alternatively, the DWP might refuse to accept good reason/good cause after more than one missed assessment, if it does not find the reasons given plausible.

4. Preparing for an assessment

Audio recording of your assessment

Sometimes assessments can be daunting. There are steps that you can take help you feel prepared for an assessment and to help you manage the impact on your mental health. However, preparation itself might also feel overwhelming, particularly when you are faced with lots of information to try and process at once including lots of different ideas about what you ‘should’ do or say in the assessment.

When Mind spoke to people about their experiences, many said that they found it helpful to have another person helping them to prepare for an assessment, whether this was a friend, a family member or someone from an advice or advocacy service (see ).

What to do before the assessment

1. Make sure you know the date and time of your assessment. If it is helpful, set yourself reminders or ask for help remembering the details.

2. If you are having a clinic assessment, make sure you look up the venue in advance and make arrangements for getting there.

3. Check what you need to do to claim your travel expenses (see here).

4. If you are having a telephone or video assessment, make sure you feel prepared and confident about the technology involved. Read any joining instructions on your appointment letter and ask for help if you need it.

5. If you would like to be accompanied, make arrangements (someone can accompany you at a remote assessment as well as at an in-person assessment - see here).

6. Request an audio recording of your assessment if you want one. You must usually ask for this in advance (see here).

7. Consider and request reasonable adjustments - eg, breaks during your appointment, or a particular room layout (see here).

8. Make sure you have a copy of your benefit form to read through before the assessment so that you can remember your answers and how you expressed yourself.

9. You might also want to read through the scoring criteria/descriptors for your benefit (see the relevant chapter of this Handbook) so that you have an idea what the assessor needs to know.

10. You might find it useful to write down one or two key ideas or phrases that you are worried about forgetting in an assessment – eg, ‘what can I do reliably?’ or ‘what help would I have in an ideal world?’ You can take this with you.

11. If you have time, prepare for the assessment with practice questions. See here for the kinds of questions you might be asked in an assessment.

12. If you have suicidal feelings or you self-harm, the assessment might be a triggering experience. If you have somebody supporting you, you might decide to discuss these feelings with them beforehand. It is good to think in advance about how you can take care of yourself before, during and following the assessment to help you manage the impact on your mental health.

Audio recording of your assessment

If you want the assessment provider to make an audio recording of your PIP, ESA or UC assessment you must request this in advance. (For adult disability payment in Scotland, see here.)

Requesting a recording is usually a good idea because it could positively affect how the assessment is conducted and the accuracy of the assessment report. If there are errors in the assessment report, the recording can help you challenge these.

There are different rules about recordings for UC/ESA assessments and for PIP assessments.

For universal credit/employment and support allowance

You must ask the assessment provider in advance if you want a recording of your UC/ESA assessment. The DWP states that this request can not always be accommodated. You cannot make your own recording of an assessment unless you follow strict rules about the type of equipment you use (laptops and smartphones are not allowed) and make copies that you can physically present to the healthcare professional (HCP) at the end of the appointment.1WCAH para 4.1.3

1 WCAH para 4.1.3 »

For personal independence payment

You must ask the assessment provider in advance if you want them to make a recording of your PIP assessment. The DWP states that this request will be accommodated (unless it is a video assessment). You can also make your own audio recording using any equipment you like and do not have to provide a copy to the HCP.1PIP AG paras 1.6.58-64 You may make a recording without telling the HCP, but it will usually be best to tell them you are doing so at the start of the assessment, because it could have a positive impact on how the assessment is conducted and the accuracy of their report.

1 PIP AG paras 1.6.58-64 »

5. What happens in an assessment

An assessment might take between 20 and 60 minutes. The only people present are you, the healthcare professional (HCP – see here) and anyone who is supporting you. You will be asked questions about your health, difficulties and needs.

Being accompanied

It can be helpful to have someone with you for practical and emotional support. They might help you travel to a clinic assessment, help with setting up a video call, or even to give you the confidence to pick up the phone for a telephone assessment.

Sam’s experience

‘It definitely helps to have someone with you before, during and after the assessment. Having someone with you can make it feel less overwhelming and also has the added bonus of showing the assessor that you need help.’

During the appointment, they may be able to help if you are having difficulty answering questions, - eg, by asking the HCP to slow down or repeat a question. If they know you well they might be able give the HCP more information about your difficulties. They can also take notes.

If you are having a telephone or video assessment and the person supporting you cannot join in person, they can be added to the call remotely. It is best to contact the assessment provider in advance to arrange this.

If you have an appointee and have been invited to an assessment, see here.

What advisers say: having someone with you

‘It is important where possible to have someone with you, whether that is a professional or a friend or relative, just to give you some kind of support and to act as a witness. If you are being assessed by phone it is worth doing it on speakerphone and having somebody with you.’

‘Do also get the assessment audio-recorded (see here).’

Questions

In the assessment, you are likely to be asked about your condition, history and treatment, and about particular difficulties that were covered on the benefit form you completed. You are also likely to be asked about the following:

•what you do in a normal day;

•any hobbies and interests you have;

•whether you use a phone or a computer;

•whether you can drive a car;

•your job (or last job);

•any social activities you take part in;

•how you got to the assessment centre (if relevant).

These questions are intended to find more about what you can and cannot do.

The HCP is likely to be typing while you are talking. Some people find this rude or off-putting. It can help to remember that the HCP is probably doing this so that they do not forget or miss anything relevant that you tell them.

What advisers say: giving clear answers

‘Remember, this conversation may be very different from one you might have with your own doctor, CPN or support worker. That person may know you well and you may rely on them to question you a bit more if you say that you can do certain activities “fine”. The danger is than an assessor may not probe that much and take your “fine” as the answer and move on.’

Are there right and wrong answers?

You might have come across various tips about what you ‘should’ say in an assessment. Some of this advice can be confusing and contradictory. For example, you might have been told:

•not to give away too much information about your day-to-day life in case this is used against you; but also

•not to leave gaps in the information you give, in case the person assessing you draws conclusions.

You might have been told:

•to describe your difficulties only as they are on your worst days; but also

•to be honest and transparent about your difficulties and not to exaggerate.

It can be overwhelming trying to say the ‘right’ things in an assessment. Fundamentally, there are no ‘wrong’ answers. The following are some very basic suggestions.

•Take a breath and a bit of time to think about each question.

•Ask the person assessing you to slow down if they are pushing you to respond too quickly.

•Answer questions honestly.

•Do focus on the negative – what you cannot do. This can feel unnatural as many of us are used to trying to focus on the positives and what we can do. But being clear about what you struggle with (and when) is what will help you get the right benefit decision.

•Write down one or two key words or phrases before the assessment and take them with you if you are worried about forgetting to mention something. For example, ‘can I do it all the time?’, ‘is it safe?’, ‘how do I feel afterwards?’, or ‘what help would I get in an ideal world?’

What advisers say: giving honest answers

‘It is normal to feel anxious about being seen as exaggerating your difficulties. Being honest and open is not exaggerating. Spending time talking about the things you find difficult – rather than trying to brush these off and talking about the positives – is not exaggerating.’

Are there inappropriate questions?

Occasionally, the HCP might ask questions insensitively or asks about things that they do not need to know. You might also hear the HCP using incorrect mental health terminology or feel that they are rushing you to answer questions. You or somebody supporting you can challenge this during the appointment. There is more information on here.

If you believe that an assessment has been carried out inappropriately or in a way that put your safety at risk, you can make a complaint (see here).

Self-harm and suicidal feelings

If you have mentioned self-harm (see here) or suicidal feelings (see here) in your benefit application, you may be asked about this during an assessment. Unfortunately, questions are not always be asked sensitively or with your safety in mind. Some people find that after they are asked these questions, suicidal feelings or the urge to self-harm increases. You might also feel these feelings increase before and after an assessment.

You (and anyone supporting you) can ask why certain questions are relevant, and you do not have to answer a question about self-harm or suicidal feelings that is not relevant. While it may be relevant for you to talk about how your suicidal feelings or self-harm affect your daily life, it is rarely relevant for you to:

– explain how you self-harm;

– show any evidence of self-harm on your body;

– explain what your suicidal thoughts are and the specifics of any plans you may have to end your own life;

– answer any questions around why you have not taken your own life yet;

– give specific details of any previous suicide attempts, unless these details include something particularly relevant to the benefit criteria you are being assessed against.

Informal observations

The HCP may record some ‘informal observations’ in the assessment report. These are written observations about how you present at the appointment, and are more extensive if you are having a face-to-face or video assessment. They can include observations about your appearance (eg, how are you dressed, your facial expression), any external signs of distress (eg, sweating, shaking or crying), your ability to make eye contact, the tone of your speech and your ability to ‘build a rapport’ with the HCP. See here for some more information about informal observations.

What advisers say: informal observations

‘It may be that you have gone to extra lengths to try and make yourself as smart and presentable on the day so that you feel more ready. You may have got a friend to help get you ready, got up really early to be ready and overcome difficulties, timed medication for best effects. Do try to explain this to the HCP. Otherwise, it is possible they will assume you look fine and well prepared and not realise just how hard that may have been.’

‘Firm handshakes, quick answers and making some good eye contact can all be informally noted without realising that you might be struggling underneath.’

Participating in the assessment

If you attend an assessment but feel too unwell to participate (eg, because of feelings of anxiety, panic, sadness or anger), you can ask for a short break or if necessary you can ask that the assessment is rescheduled. You can make the request part-way through the assessment if necessary.

What advisers say: asking for a break

‘If you can, explain the difficulties you are experiencing in an assessment, instead of just politely letting things carry on and wishing it could just be over. If you come out and say something, it can be real evidence of difficulties you have that are relevant to the benefit you are claiming.’

If your assessment goes ahead but you do not participate (eg, you do not answer questions, or you behave in a way that means the assessment must end), this can lead to a negative benefit decision. This does not apply if the DWP accepts you had a good reason/good cause for acting as you did because of your state of health or the nature of your mental health problem. There is more information on here about good reason/good cause.1UC Reg 44(2) UC Regs interpreted by the DWP in ADM G1117-1120
ESA Regs 23(2) and 24 ESA Regs; regs 19(2) and 20 ESA Regs 2013 interpreted by the DWP in DMG 42492-42495, ADM G1117-1120
PIP Regs 9(2) and 10 SS(PIP) Regs, interpreted by the DWP in Ch P6 ADM

Panic attacks

Panic attacks (see here) can happen during assessments and interviews. If you believe that a panic attack may be likely, you can inform the interviewer or assessor of this beforehand and request reasonable adjustments (see here).

1 UC Reg 44(2) UC Regs interpreted by the DWP in ADM G1117-1120
ESA Regs 23(2) and 24 ESA Regs; regs 19(2) and 20 ESA Regs 2013 interpreted by the DWP in DMG 42492-42495, ADM G1117-1120
PIP Regs 9(2) and 10 SS(PIP) Regs, interpreted by the DWP in Ch P6 ADM
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6. After an assessment

Complaints

In practice, you might receive a benefit decision between four and eight weeks after having an assessment. See the universal credit, employment and support allowance and personal independence payment chapters of this Handbook for information about what happens next.

If you feel an assessment did not go well or if you were asked questions that you believe were inappropriate, it is common to feel upset, angry or vulnerable. It is important to take care of yourself following the assessment to help you manage the impact on your mental health.

After the assessment

Try to plan something distracting or calming for after the assessment. This could be something small, like taking 10 minutes to focus on your breathing, or a bigger plan for the rest of your day if you feel you can manage this. If you would find it helpful, put aside some time to chat about the assessment with somebody who knows you well.

If you are an advice worker supporting someone through their assessment, set aside some time after the assessment to answer any questions they might have. The best time for this varies depending on who you are supporting. It can take some people a while to process an appointment, so they might not always have the questions they need to ask right away. Explain clearly the next steps in the process – ie, how long it will be before they receive a decision about their benefit and what happens next.

Complaints

It is possible to complain about various aspects of the assessment – eg, if you are asked inappropriate questions, if your appointment is held at an inappropriate venue or if other reasonable adjustments are not made. See here for how to make a complaint and what it can achieve.

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Chapter 14: Assessments

Mental Health and Benefits Handbook 1st edition

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