How do I fill in the health questionnaire?
You have four weeks to fill out the health questionnaire from when the Social Security Agency (SSA) send it to you – the SSA are strict about this. If you need more time, you should tell them as soon as you can, but you will need to explain why you need more time and how much longer you need to finish the form. When you get your health questionnaire, you may want some help filling it in, and a local Citizens Advice or welfare benefits advice service may be able to help you. You can look for contact details in your local telephone book or on the Internet.
The health questionnaire looks at how your mental and physical illnesses affect your ability to work – this section only gives advice on mental illness.
The health questionnaire looks at how your mental and physical illnesses affect your ability to work – this section only gives advice on mental illness. If you need advice about physical illnesses, you should contact another organisation that specialises in this.
Page 2
Page 2 and 3 ask about your GP and any other healthcare professionals you work with, such as a:
- Community psychiatric nurse (CPN),
- Psychologist,
- Psychiatrist, or
- Social Worker.
You should put the contact details of the healthcare professional that knows you best, as they will be able to explain how your condition affects your day-to-day life and your ability to work.
Pages 4 and 5
These pages ask about your condition, how it affects you, and when it started. If your condition changes, or if you have good days and bad days, explain this here.
Page 5 asks about what medication you take and their side effects – you should include the following information in this section:
- Any treatment you are having for your condition.
- The medication you take or are going to start taking.
- Any treatment you are on a waiting list for.
- If you have psychotherapy, counselling or cognitive behavioural therapy (CBT).
- If you get treatment and care from the Community Mental Health Team (CMHT).
- If you have ever been in hospital under the Mental Health Act (‘sectioned’) or as a voluntary patient.
Scoring Points
To score points in the Work Capability Assessment (WCA), you must have a health condition that means you cannot work, and you need to score 15 points in total across the questionnaire to show you have limited capability for work. You can score 6, 9 or 15 points for each question.
The first 10 questions ask about physical health. If you have any physical health problems, make sure you fill these sections in. If you don’t have physical health problems, you should tick the first box for each question, which says you can do the task without any difficulty.
Part 2 of the form asks about your mental health; these questions start on page 13. Mental health problems affect people in different ways. You may find that some questions don’t apply to you, but we have listed some things you may want to think about for each question in the table below. You might also want to think about the following things:
- It may be helpful to write out your answers on a separate piece of paper first and when you’re happy with them, you can write them on the form.
- Take your time filling in the form. You may want to have a break and come back to it later. The more information you give the SSA, the easier it should be for them to make the right decision.
- When explaining how your illness affects you, use examples that make it clear what you mean. You can use the same example more than once if it applies to more than one question.
- When you think about if you can do things, you should think about if you can do them the same way all the time, for example, you may find it easy to go to a meeting once in a while but if you had to do it every week, coping with the meeting and behaving properly with other people could become difficult.
We have listed all of the mental health-related questions you will see on your health questionnaire below and have included some suggestions of things you can think about when filling in your answers.
We have included the descriptors in the Health questionnaire descriptors section. They show you what points the SSA will give you for your answers – it is important to think about this when you are filling in the form.
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The questions on the form |
Tips and suggestions |
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Q11 - Learning how to do tasks Can you learn how to do an everyday task such as setting an alarm clock? Can you learn how to do a more complicated task such as using a washing machine? |
Does your illness or medication make it hard for you to concentrate on everyday tasks? These might be like setting an alarm clock or using the washing machine.
Examples
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The questions on the form |
Tips and suggestions |
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12. Awareness of hazards or danger Do you need someone to stay with you for most of the time to stay safe?
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Sometimes people with mental illness can get easily distracted. This can mean they put themselves or other people in danger.
Possible dangers are:
Examples
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The questions on the form |
Tips and suggestions |
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13. Starting and finishing tasks Can you manage to plan, start and finish daily tasks?
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Think about how your condition changes – what are you like on a ‘bad day’ compared to a ‘good day’? List all the tasks you might not be able to do.
Examples of ‘tasks’.
Examples
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The questions on the form |
Tips and suggestions |
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14. Coping with changes Can you cope with small changes to your routine if you know about them before they happen? Can you cope with small changes to your routine if they are unexpected?
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Examples
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The questions on the form |
Tips and suggestions |
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15. Going out Can you leave home and go out to places you know? Can you leave home and go to places you don’t know?
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Think about how you would cope:
Examples
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The questions on the form |
Tips and suggestions |
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16. Coping with social situations Can you meet people you know without feeling too anxious or scared? Can you meet people you don’t know without feeling too anxious or scared?
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Think about how it would make you feel if you had to socialise with other people. If your ability to deal with social situations can change make it clear about how often and when you would have a problem.
This could include having difficulties:
Examples
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The questions on the form |
Tips and suggestions |
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17. Behaving appropriately How often do you behave in a way that upsets other people?
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Examples
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Part 3
This part of the form asks about eating and drinking. You need to fill in this section if you would not eat or drink and need someone to prompt and encourage you because of your illness.
Page 17
You will probably have to go to an assessment centre for a medical assessment. If you are unable to travel to an assessment centre or it is difficult for you, you can ask for a home visit. You need to put the reasons for this on page 17. More details on home assessments can be found in the Will I have to go for a medical assessment? section.
You can write about any help you would need at a medical assessment on this page, so this may include taking someone with you. For example, you might require help getting out of bed and getting washed and dressed if you are very anxious about the assessment.
Page 17
You can write anything else that you think is relevant and will help the SSA make a decision on this page. You could include information on:
- Other benefits you get, such as Personal Independence Payment (PIP),
- Support groups you go to,
- Community support you get, or
- Any of your health history that you didn’t include in the main part of the form and that you think is important to your Employment and Support Allowance (ESA)
Sending back the health questionnaire
Before you send the form back, you should keep a copy of your completed form. This could help:
- If you disagree with the SSA’s decision,
- If the SSA lose your form, or
- If you need to fill in a new form in the future.
You need to send the form back to the SSA and if you have to send the form back late, there is space on page 1 to explain why. If the reason is linked to your mental health, make sure you put this down on the form.
Supporting evidence
If possible, ask a professional who knows you well for a letter or report about your ability to work. This could be your GP, psychiatrist, Community Psychiatric Nurse or Social Worker. It can also be your Support Worker, Counsellor or Carer, as they can comment on how your mental health makes it hard for you to work – this is called supporting evidence. This evidence may help your claim. Staple it to the health questionnaire when you send it back. You could include medical test results of any physical health conditions, or your current prescription list, but make sure that you keep a copy of any supporting evidence.
Page 3 of the health questionnaire has a full list of what supporting evidence you can include and provides a full list of people that you can ask to give supporting evidence.
Page 3 of the health questionnaire has a full list of what supporting evidence you can include and provides a full list of people that you can ask to give supporting evidence.
A letter that has more than just your diagnosis is better. This is because a diagnosis does not show how your illness affects you in everyday life. You could ask the professional to put the following information in it:
- Explain how your condition affects your ability to work.
- What could happen to your health if you were asked to start looking for work.
- How you meet the specific criteria for the benefit.
You can find a sample letter in the Next Steps section that you can use to send to healthcare professionals when asking for supporting evidence.
