Personal Capability Assessment
How we determine if you are incapable of work or not for social security benefits depends on how long you have been claiming benefit for.
Own occupation test
For the first 28 weeks you are normally subject to the own occupation test.You normally need toprovide us with a sick note from your GP or hospital doctor or consultant to show that you are incapable of work under the own occupation test.
Personal capability assessment
After 28 weeks of first being incapable of work (or sooner if, for example, you were unemployed or self-employed immediately before you became sick) we will decide if you are incapable of work or not using the personal capability assessment (PCA). Under the PCA we need information about your capability to perform certain work-related activities which are set out in legislation.
There is a –
a) a series of activities relating to your ability to carry out certain physical and mental functions (e.g., mobility); and
b) a series of descriptors for each activity which most accurately describe your condition (e.g., the distance you can walk without help in relation to the mobility activity).
You score a number of points against the descriptor which applies to you - the more restricted you are in carrying out the activity, the higher number of points.
If you score at least 15 total points in respect of all the descriptors we will treat you as incapable of work under the PCA.
We will send you a questionnaire setting out those activities and descriptors for you to say which descriptor most closely describes your condition. You can also provide any other information you have about your condition you want us to see.
You must complete the questionnaire and return it to us within the required time. If you don’t do so without good reason we may treat you as capable of work and your benefit will stop. But we won’t need you to complete a questionnaire if we feel that we already have enough information to decide if you are incapable of work or not.
When we get your completed questionnaire from you, we will look at what you have said and review any other information we have and consider if we can decide if you are capable of work or not at that stage. We may decide that we need you to undergo a medical examination with a health care professional to decide if you are incapable of work or not.
If you don’t attend a medical examination we need you to have without good reason we may treat you as capable of work and your benefit will stop.
We will treat you as being incapable of work in certain circumstances without needing you to have a PCA (e.g., if you have certain health conditions or are receiving certain types of medical treatment).
In certain exceptional circumstances, we may treat you as being incapable of work even after you have been found capable of work in accordance with the PCA.