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ESA50×012013×006×001_ESA50 11×12/2012 08:59 Page 1Limited capability for work questionnaire This form is available in Welsh from www.gov.uk or by ringing 0845 600 3018. Please complete this questionnaire

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How to fill out limited capability for work

01

Step 1: Start by gathering all the necessary documents and information, such as your personal details, medical history, and any supporting evidence from healthcare professionals.

02

Step 2: Carefully read through the Limited Capability for Work form, understanding each section and question.

03

Step 3: Begin filling out the form by providing accurate and detailed information about your health conditions, disabilities, and how they affect your ability to work.

04

Step 4: Use additional pages if necessary to fully explain your limitations and provide any relevant examples or experiences.

05

Step 5: Make sure to answer all the questions honestly and provide any relevant supporting evidence or medical reports.

06

Step 6: Review the completed form to ensure all information is accurate and complete.

07

Step 7: Submit the form either online or by mail, following the instructions provided by the relevant authority.

08

Step 8: Keep a copy of the filled-out form and any supporting documents for your records.

09

Step 9: If requested, attend any medical examinations or assessments to further evaluate your limitations for work.

10

Step 10: Follow up on the status of your application and provide any additional information if requested.

Who needs limited capability for work?

01

Limited Capability for Work is needed by individuals who have health conditions, disabilities, or impairments that significantly affect their ability to work.

02

This includes people who are unable to perform tasks required for employment due to physical or mental limitations.

03

Those who experience difficulties in sustaining work-related activities or require substantial supervision or support may also be eligible.

04

It is important to note that the specific criteria for limited capability for work may vary based on different countries or benefit systems.

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What is limited capability for work?

Limited capability for work refers to the assessment of an individual's ability to work due to health or disability issues.

Who is required to file limited capability for work?

Individuals who have a health condition or disability that affects their ability to work may be required to file a limited capability for work form.

How to fill out limited capability for work?

To fill out a limited capability for work form, individuals need to provide information about their health condition, how it affects their ability to work, and any supporting evidence from healthcare professionals.

What is the purpose of limited capability for work?

The purpose of limited capability for work assessment is to determine if an individual is eligible for benefits or support due to their health or disability condition.

What information must be reported on limited capability for work?

Information such as details of health conditions, how they affect work ability, and evidence from healthcare professionals must be reported on the limited capability for work form.

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