Page 26 - Reforming Benefits Decision-Making

Independent Assessment Services and in central England, Wales and Northern
Ireland by Capita.

The assessment process is as follows:

a) Claimants are sent a questionnaire in which they are asked to explain
how their illness or disability impacts on their ability to work (in the case
of ESA and UC) or carry out everyday tasks and their ability to get
around (in the case of PIP).
b) The questionnaire and any supporting evidence are sent to the assessment
provider (WCA) or returned to the DWP/DfC who then pass them on to
the relevant assessment provider.
c) A healthcare professional (“HCP" or assessor) reviews the questionnaire
and additional evidence. They may also request additional evidence, for
example from a claimant’s GP.
d) The HCP assesses the claimant’s ability to carry out a set of activities as
measured against a standard list of statements describing what a claimant
can or cannot do, called descriptors, each of which has a point weighting.
The assessor can complete their assessment on the basis of the form and
written evidence alone, however, prior to the pandemic, in the vast
majority of cases, the claimant was required to attend a face-to-face
assessment.
42
e) The HCP sends a report to the DWP/DfC recommending the descriptors,
and therefore points, that should be awarded. To qualify for PIP or ESA,
or be placed in the LCW group for UC, claimants must score a minimum
43
number of points.

42 Claimants who are terminally ill and could have six months or less to live can claim PIP, UC and
ESA under the special rules for terminal illness. This means that claims will be fast tracked, and
claimants will not normally have to attend a PIP assessment or WCA. All face-to-face assessments
were suspended in March 2020 due to the pandemic (see paragraph 2.8 further below).
43 For PIP between 8 and 11 points for the standard rate and at least 12 points for the enhanced rate for
either component. For ESA and LCW 15 points. If any one of the limited capability for work related
activity descriptors are met claimants will be placed in the support group for ESA or LCWRA group
for UC. For WCAs even if a claimant does not receive 15 points on the assessment they can still be
treated as having LCW and in some cases LCWRA in certain ‘exceptional circumstances’. These
circumstances are also known as Non Functional Descriptors. They are (a) a claimant is suffers from a
life threatening disease for which there is medical evidence that it is uncontrollable or uncontrolled by a
recognised therapeutic procedure (and in the latter case, there is a reasonable cause for this); or (b) a
claimant suffers from some specific disease or bodily or mental disablement and, by reasons of such

17