Accredited official statistics

ESA: Work Capability Assessments, Mandatory Reconsiderations and Appeals: March 2022

Published 10 March 2022

The latest release of these statistics can be found in the collection of ESA: outcomes of Work Capability Assessments statistics.

This is a summary of the National Statistics on the outcomes of completed Employment and Support Allowance (ESA) Work Capability Assessments (WCA). The publication covers information on both initial and repeat ESA assessments in Great Britain.

This release includes:

• Outcomes of initial and repeat ESA WCAs to end of September 2021
• End to end clearance times for initial ESA claims to end of September 2021
• Mandatory Reconsideration (MR) information to end of January 2022:
  • (i) number of MR registrations
  • (ii) number of MR decisions
  • (iii) MR outcomes by type of decision
  • (iv) Median MR clearance time
• Outcomes of completed WCA-related appeals for initial ESA claims with a start date to December 2020

Figures in this release reflect disruptions caused by the Coronavirus (COVID‑19) pandemic. It should also be noted that Universal Credit (UC) has now replaced income-related ESA for most new claimants and this is changing the volume and characteristics of ESA WCAs, MRs and appeals.

1. Main stories

The statistics show:

• in the quarter to September 2021, the number of completed ESA WCAs with a DWP decision is 32,000, a decrease of 7% from the 34,000 in the previous quarter to June 2021
• of the total number of ESA WCAs completed in the quarter to September 2021, 59% were initial WCAs (19,000) and 41% were repeats (13,000)
• in the quarter to September 2021 the majority of DWP decisions for initial WCAs resulted in a Support Group (SG) award (62%)
• the number of monthly registered MRs relating to an ESA WCA decision has remained low, standing at 410 in the month to January 2022
• the median time taken to clear MRs in the month to January 2022 is 15 days
• the median end-to-end clearance time for initial ESA WCAs is 149 working days in September 2021. Between December 2020 (93 days) and July 2021 (231 days) median end-to-end clearance times increased month on month. However, the latest 2 months have shown an improvement: 176 days in August 2021 and 149 days in September 2021

2. What you need to know

The sources of the statistics are:

• DWP’s benefit administration datasets including MR data
• Healthcare provider assessment data
• HM Courts and Tribunals Service (HMCTS) appeals data for completed appeals

Information is only available for claims that began at least 6 months following the assessment date, or 9 months following the date of claim. This is because of the time required for the customer journey to end and for the information recorded to be as complete as possible.

All figures in this release have been rounded according to DWP rounding policy, as detailed in section 11.

COVID-19 operational easements

Figures in this release reflect disruptions caused by the Coronavirus (COVID‑19) pandemic, which led to changes to operational procedures. Such changes were necessary to process claims and ensure people in need of financial help could access benefits, while keeping customers and staff safe.

DWP temporarily suspended face-to-face health assessments from 17 March 2020 while paper-based assessments continued.

Telephone assessments were introduced from 7 May 2020. Initially only SG outcomes were possible, the full range of outcomes were available from February 2021.

Face-to-face assessments were resumed in May 2021 and they now take place alongside telephone assessments and a small number of video assessments. For more information of operational easements see the background information note .

The typical customer journey, prior to the COVID-19 easements, is detailed below:

1. Claimant registers for ESA - payment issued at assessment rate.

2. Claimant referred for WCA and issued the “Capability for Work” questionnaire.

3. Claimant completes and returns questionnaire.

4. Assessment Provider (AP) may conduct telephone, face-to-face or video assessment, or paper-based assessment and provides recommendation to DWP.

5. DWP makes a decision based on all of the available evidence, including the AP recommendation. Those found eligible for ESA are either placed in the WRAG, which offers support in preparing for work, or the SG if they are unable to work or complete work related activity. Those not eligible are found Fit for Work (FfW).

6. If the claimant disagrees with this decision, then depending on the nature of the decision they will either (i) have to request an MR (before they can appeal); or (ii) be able to appeal straightaway.

Note: As a result of High Court decision in July 2020, MR has been discontinued for any claimant who, having been found Fit for Work (FfW) following a WCA would, if they appealed, be paid ESA pending the outcome of that appeal. This is known as Payment Pending Appeal (PPA). Not all claimants qualify, and it applies only to Fit for Work disallowance decisions, not decisions such as disallowance due to Failure to Return a Questionnaire or Failure to Attend a WCA.

3. Volumes of completed initial and repeat Work Capability Assessments

Most individuals who make a claim for ESA will have a Work Capability Assessment (WCA). The WCA should determine whether a person has limited capability for work and eligibility for the benefit. Both new (initial) and existing (repeat) ESA claimants have WCA assessments. Some individuals are not required to have a WCA. Find out more about those who are exempt on the GOV.UK website.

• Initial assessments refer to the first assessment of the ESA claim
• Repeat assessment refer to subsequent assessments after the prognosis period of first/previous assessment of the ESA claim expires

In the quarter to September 2021 the number of initial assessments was 19,000 and the number of repeat assessments was 13,000.

Quarterly volumes of completed assessments by type of assessment, October 2008 to September 2021

Source: Stat-Xplore: ESA Work Capability Assessments under ESA WCA by Completed Assessment

The composition of ESA, numbers and types of assessments has changed over time. The key features are that:

• from 2008, as ESA was a new benefit, many assessments were initial claims, or related to claimants who were migrated from IB

• from January 2014 repeat assessments were supressed in order to manage priorities

• repeat assessments were reintroduced in December 2015

• in March 2017, completed ESA WCAs reached a peak of 270,000

• the introduction of Universal Credit from December 2018 greatly changed volumes and types of ESA

• the suspension of face-to-face assessments in March 2020 in response to the COVID-19 pandemic adversely impacted DWP’s ability to complete assessments

• in the latest quarter to September 2021 32,000 completed assessments were recorded, a slight decrease (7%) when compared to 34,000 in the previous quarter to June 2021.

4. Work Capability Assessment Outcomes

After the work capability assessment, claims can be placed into one of three outcome categories:

1. ESA Work Related Activity Group (claimant has been found to have limited capability for work (LCW) and is required to undertake and participate in work related activity to help them move towards the labour market)
2. ESA Support Group (where claimant has been found to have limited capability for work and work related activity (LCWRA) and is therefore not required to undertake any interviews or work related activity), or
3. Fit for work and therefore no longer entitled to ESA

Assessment outcomes are based on the DWP decision following the Assessment Provider (AP) recommendation.

62% of initial WCA decisions resulted in a Support Group outcome in the quarter to September 2021

Quarterly outcomes of initial WCA assessments November 2008 to September 2021 (percentages)

Source: Stat-Xplore: ESA Work Capability Assessments under ESA WCA by Completed Assessment

Over time, the proportion of ESA WCA assessments with FfW outcomes has been falling and the proportion with a SG outcome has been rising.

In the quarter to September 2021, the percentage of DWP decisions falling into each outcome category was:

• 62% of outcomes for Support Group

• 14% of outcomes were for Work Related Activity Group

• 24% of outcomes were found Fit for Work

62% of decisions on initial assessments resulted in a Support Group outcome in the latest quarter. On repeat assessment decisions 81% resulted in a SG outcome.

Quarterly outcomes for initial and repeat WCAs December 2008 to September 2021

Source: Stat-Xplore: ESA Work Capability Assessments under ESA WCA by Completed Assessment

• Between 2008 and August 2013 FfW was the most common outcome for initial claims. After that, SG outcomes have been more common

• Initially WRAG was the most common outcome for repeat claims, until October 2012. Since then, SG outcomes have been more common

Decisions on WCA outcomes were impacted by the operational changes implemented in response to the COVID-19 pandemic, such as the temporary suspension of face-to-face assessments.

From March 2020 the focus was on initial assessments. Reassessments already present in the system were processed alongside those related to changes in circumstances, where possible.

In May 2020 telephone assessments were introduced, but initially only SG decisions could be made via telephony channels. This was extended to include other decision types from September 2020.

In the quarter to September 2021, the proportion of initial WCAs found FfW decreased from 28% to 24%. The proportions of repeat WCAs found FfW remained low at 4%.

5. ESA WCA Mandatory Reconsideration registrations, clearances, and clearance times

Mandatory Reconsiderations were introduced in 2013 and if customers disagreed with a decision, they could formally ask DWP to look at it again.

The number of monthly MR registrations remains low and stands at 410 in January 2022.

Mandatory Reconsiderations registrations and clearances, October 2013 to January 2022

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations – Registrations and Mandatory Reconsideration – Clearances

By the end of January 2022, a total of 860,000 MRs had been registered. Of these, 99.6% had been cleared. The number of MR registrations and clearances within each month fluctuate over time:

• the number of MR registrations and clearances gradually increased between April 2013 and March 2017 as volumes of ESA claimants increased

• the number of monthly MR registrations peaked in March 2017 at 22,000 but have since followed a downward trend

• since May 2020 the number of MRs registered each month has remained low and has remained below 500

• there were 410 MR registrations and 480 MRs cleared in the latest month, January 2022

The number of ESA WCA MR registrations and clearances should be seen in context. Firstly, a decrease of ESA claims as UC has rolled out. Secondly, the changing composition of assessment outcomes over time. Third, the effect of the COVID-19 pandemic. Finally, in some circumstances, claimants can now make an appeal without applying for an MR beforehand.

In these statistics, all reconsiderations occurring after the WCA are counted as MRs. For more information on the definition of MR see section 11 of this release and the methodology note

In January 2022 the monthly median clearance time for ESA WCA MRs was 15 days.

Mandatory reconsiderations monthly median clearance times (calendar days), October 2013 to January 2022

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsideration – Clearances

MRs were introduced in October 2013. The median average time taken to clear MRs peaked shortly after to stand at 37 calendar days in May 2014. MR clearance times have significantly decreased from their peak, and typically range from 4 to 16 days.

Since January 2020 the monthly median clearance times have fluctuated but have not risen above 15 days. In the month to January 2022, the monthly median clearance times stood at 15 days. It should be noted that clearance times more recently are based on very low numbers of MRs.

The MR average clearance times is derived using calendar days by calculating the median of the time taken from the date the Benefit Centre (BC) has decided the MR to be valid, having considered any new information, until the date the decision is cleared by the decision maker at the Dispute Resolution Team (DRT). These dates are obtained from the DWP Decision Making and Appeals Case Recorder (DMACR) reporting system. The total clearance time therefore includes the time taken to transfer the case to DRT.

6. ESA WCA Mandatory Reconsiderations outcomes

At the MR stage, there are multiple outcomes that refer to whether the Decision Maker (DM) chooses to revise the decision under dispute:

• ‘Not Revised’ – the decision the claimant is questioning has not been changed
• ‘Revised – the DM has changed the decision
• ‘Withdrawn’ – the claimant has chosen to remove their MR request

In the month to January 2022, 51% of the ESA WCA decisions going to MR were revised.

Monthly percentages of ESA WCA Mandatory Reconsideration by outcome, October 2013 to January 2022

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsideration – Clearances

From October 2013 to October 2019, more than half of requests to reconsider ESA WCA outcomes were not revised at MR stage. Since then, the proportion of assessment outcomes where the award changed after the MR gradually increased, with some fluctuation. The proportion of MR decisions resulting in a change in award rose from 53% in February 2020 to 82% in April 2020, reflecting the new operational approaches as well as COVID-19 impact.

Since May 2020 approximately two thirds of MR decisions led to a change in award. In the month to January 2022, 51% of ESA WCA decisions going to MR were consequently revised.

The increase in the proportion of revised decisions since 2019 should be seen in context with the large reduction in MRs, new operational approaches to gather additional oral and written evidence at the MR stage, as well as the changing composition of WCA decisions influenced by a number of factors. These include the COVID-19 pandemic and the introduction of UC replacing most income-related new claims to ESA.

Most ESA WCA MR decisions in the quarter to January 2022 were made on disputes about ESA group allocations.

Mandatory Reconsiderations by reason for dispute for the quarter ending January 2022

Decisions Made	Percentages
Customer failed to attend WCA, provide medical evidence or return questionnaire	10%
Customer disputes FFW decision	33%
Customer disputes ESA group allocations	56%
Others/Unknown	0%

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsiderations – Clearances

Mandatory Reconsiderations outcomes by reason for dispute for the quarter ending January 2022

Decision Outcomes	Revised	Not Revised
Customer failed to attend WCA, provide medical evidence or return questionnaire	64%	36%
Customer disputes FFW decision	28%	72%
Customer disputes ESA group allocations	62%	38%

Source: Stat-Xplore: ESA Work Capability Assessments under Mandatory Reconsideration – Clearances

Note: percentages may not sum to 100% due to rounding.

In the quarter ending January 2022, approximately 56% of MR decisions were made on disputes on ESA group allocation. Out of these, 62% of decisions made were revised in favour of the claimant.

33% of MR decisions were made on disputes against FfW decisions and 10% related to disputes where the claimant had not followed the claim procedures correctly.

7. Appeals clearances and outcomes for initial ESA claims which started up to December 2020

The claimant can dispute a DWP decision by appealing to HMCTS. Since the introduction of MRs in 2013 a claimant would need to ask DWP to look at the decision again unless DWP advised that a MR was not required. Being found FfW at initial assessment is the primary reason for claimants disputing a decision. The figures below focus on FfW appeals for initial assessments.

Appeals outcomes on initial FfW decisions, for claims started December 2008 to December 2020

Source: Stat-Xplore: ESA Work Capability Assessments under Appeal Outcomes by Claim Start

The total number of appeals heard on FfW decisions for initial assessments up to December 2020 is very low compared to pre-2013 figures, when mandatory reconsiderations were introduced.

In the latest period, for claims that started up to December 2020, there were very few appeals outcomes. The low numbers of appeals may be partly due to the decrease in FfW decisions and an increase in MR revision rates since late 2019, which are likely to affect the number of claimants going on to appeal.

Numbers of appeals for recent quarters are too low to make any meaningful comparisons.

Note: The numbers of appeals are by claim start date, therefore numbers could increase as more appeals are completed for claims started in the most recent months.

8. Health conditions and ESA group allocation for initial assessments

The health conditions recorded on the ESA claim form do not themselves grant entitlement to benefit. During the WCA, what is being assessed is the effect of someone’s health condition or disability on their capability for work, not the condition itself.

• The ESA Support Group (SG) is for those who are living with severe disabilities or health conditions which makes it unreasonable to require them to engage in work related activities

• The ESA Work Related Activity Group (WRAG) is for those claimants who the DWP consider will be capable of work at some time in the future and who they consider can take steps immediately towards moving into work (work related activity)

A full list of descriptors for both SG and WRAG groups and a guide to the ESA Work Capability Assessment can be found on the GOV.UK website.

Main reasons for SG decisions for initial assessments by claim start date, December 2008 to June 2021

Source: Stat-Xplore: ESA Work Capability Assessments under ESA WCA by Claim Start

Note: Claimants can have multiple functional impairments, therefore appear in more than one category.

Most claimants assigned to the SG, who started their initial ESA assessment in the quarter to June 2021, were allocated SG due to health conditions linked to ‘Severe functional disability’. This accounts for 4,400 (60%) of all SG allocations this quarter. ’Severe functional disability’ has been the main reason for allocation, being over 50% since January 2016.

There was a notable decrease in allocations to the ‘Physical or mental health’ risk group for claims started from October 2015 onwards. Volumes in this group fell from 28,000 in the quarter to September 2015 to 17,000 in the quarter to December 2015. This should be seen in context with the updated guidance on the application of risk introduced at the start of 2016.

For claims started in the quarter to June 2021, 800 cases were allocated to the SG due to ‘Physical or mental health risk’, while 1,600 were awaiting/recovering from chemotherapy/radiotherapy and 130 were terminally ill.

Since 29 September 2017, claimants in the ESA SG no longer need to be reassessed if they meet the Severe Condition criteria. Information on this can be found on Stat-Xplore.

‘Adapting to change’ and ‘Social interaction’ remain the main reasons for WRAG allocation (with 15 points or more) this quarter.

More information on how assessments are allocated to the WRAG can be found in background information note

Main reasons for WRAG (15+ points) allocations for initial assessments by claim start date (percentages), December 2008 to June 2021

Source: Stat-Xplore: ESA Work Capability Assessments under ESA WCA by Claim Start

Note: Claimants can have multiple functional impairments, therefore appear in more than one category.

For claimants allocated to WRAG with 15 points or more, the most common categories for scoring points this quarter were ‘Adapting to change’ and ‘Social interaction’. Of these claimants, 91% had an ‘Adapting to change’ condition and 88% scored points in the ‘Social interaction’ group.

Alongside these categories, in the latest quarter, claimants with impairments relating to consciousness and understanding accounted for 5% and 3% respectively of allocation to WRAG with 15 points or more.

Other reasons for being assigned to WRAG (with 15 points or more) are: Upper Limb, Sensory, Continence, and Lower Limb.

9. Experimental data: Sankey showing the ESA WCA, MR and appeal process for claims starting October 2013 to June 2021

Numbers of all WCA, MR, appeals at stages in customer journey from October 2013 to June 2021

Source: Data tables: ESA WCA experimental cohort statistics for initial and repeat ESA assessments, by period of claim start, October 2013 to June 2021

Of the 4.9 million ESA claims with a start date between October 2013 and June 2021:

• 66% had a completed assessment; WCAs for the remaining claims are either still in progress or were closed by the claimant

• 400,000 MRs have been registered, following a completed WCA

• 99.7% of these MRs, which were raised after the WCA, have been completed, with the original decision revised 17% of the time

• 26% of claimants who raised an MR after the WCA went on to complete an appeal

• of the 100,000 appeals completed, 34% had the DWP decision upheld at hearing while the remaining 66% were ruled in favour of the claimant

As a result of High Court decision in July 2020, MR has been discontinued for any claimant who, having been found Fit for Work following a WCA would, if they appealed, be paid ESA pending the outcome of that appeal. Not all claimants qualify, and it applies only to Fit for Work disallowance decisions.

10. ESA WCA customer journey clearance times for initial claims (experimental statistics)

The median end-to-end clearance time is a measure from the claim registration date to the final DWP award decision. Claim registration date is the date the claimant has first contact with the department when making a claim to ESA. The DWP decision will include MRs where there is a completed decision.

Median clearance times for initial claims: showing end-to-end clearance times and referral to assessment provider recommendation (days) October 2008 to September 2021

Source: Stat-Xplore: ESA Work Capability Assessments under Clearance Times for Initial Claims

After 2008, the median end-to-end clearance time generally followed an upward trend, reaching a peak of 192 calendar days in August 2014 falling to 70 days in September 2019. Since then, it has steadily increased to 231 days in July 2021, which marks the highest median end-to-end clearance time in any month. The latest 2 months have shown an improvement: 176 days in August 2021 and 149 days in September 2021.

With the suspension of face-to-face assessments, DWP focused on individuals who were more likely to attract a higher benefit award rather than in date order which is usual practice. When face to face assessments resumed in May 2021, DWP was able to revert to prioritising WCAs in date order. This caused a spike in customer journey times in July 2021, when many older cases were assessed.

Median clearance times by stage for completed initial claims since the introduction of COVID-19 operational easements (March 2020), in days, to September 2021

Source: Stat-Xplore: ESA Work Capability Assessments under Clearance Times for Initial Claims

The end to end clearance time is calculated by measuring the time taken for a claim to clear 3 distinct stages:

• Claim registration to WCA referral, where claims are initially processed to the point where a referral for a Work Capability Assessment can be made
• WCA referral to Assessment Provider recommendation, which covers the time taken to make an assessment
• AP recommendation to DWP decision. This reflects the time taken to arrive at a WCA outcome decision following the receipt of an AP recommendation

The majority of time is taken up by the second stage, which usually includes the waiting time for the claimant to return a questionnaire and for the provider to conduct the assessment itself. Multiple referrals are sometimes required before an assessment is completed and a recommendation received.

In September 2021, the median time between referral to the AP and their recommendation was 72 days.

Between December 2011 and July 2020, the monthly median clearance time from claim registration to referral has remained under 10 days. In more recent months, it has steadily increased from 2 days in March 2020 to 25 days in March 2021, increasing to 26 days in the month to September 2021.

11. About these statistics

The UK Statistics Authority has designated these statistics as National Statistics, in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics. This badge does not currently apply to the experimental cohort figures or ESA clearance times.

Key uses of the statistics include:

• providing the evidence base for assessing the potential effect of changes, monitoring and evaluation of DWP policy

• answering Parliamentary Questions and Freedom of Information requests and forecasting benefit expenditure (in conjunction with expenditure statistics)

• policy development and evaluation by local authorities and other welfare to work and pensions stakeholders and providers

This release only includes ESA WCAs.

This release does not capture:

• UC WCAs
• UC MRs
• UC appeals

Recent trends in these ESA WCA statistics will be affected by the roll out of UC.

Terminology

Term	Definition
Registration	Claimant registers an application for a WCA, MR or appeal.
Clearance	DWP decision maker has determined whether the claimant should or should not be entitled to claim ESA.
Mandatory Reconsideration	Claimant wishes to dispute a decision made on their claim and requests DWP to reconsider the decision. Due to operational practices performed within the DMACR system, some MRs are recorded on the source data as ‘reconsiderations’. Therefore, for the purpose of these statistics, all ‘reconsiderations’ occurring after the WCA (for reasons typically associated with MRs) have been included within the total number of MRs.
MR clearance time	The clearance time begins from the point the MR is raised on the DWP administrative system by the Benefit Centre as a valid MR, having considered whether they can initially change the decision in the light of any new information. The total clearance time therefore includes the time taken to transfer the case to the Dispute Resolution Team and the time taken for the decision maker to make a decision.
Repeat assessment	An existing claim that has been reassessed for ESA, as opposed to a new claim. A repeat assessment is the second or subsequent WCA undertaken on an existing, continuous ESA claim, usually between 3 and 24 months after the previous assessment. These claimants will have already been assessed as having a limited capability for work at their initial WCA and the repeat assessment will assess if their capability for work has changed.

Rounding policy

Since March 2017, the following rounding policy has been applied to the statistical release. Please note that percentages shown within the release are calculated using figures prior to rounding.

From	To	Rounded to
0	1,000	10
1,001	10,000	100
10,001	100,000	1,000
100,001	1,000,000	10,000
1,000,001	10,000,000	100,000
10,000,001	100,000,000	1,000,000

IB reassessments information on Stat-Xplore

Information on Incapacity Benefit (IB) reassessments is now published via Stat-Xplore.

Where to find out more

See Stat-Xplore for more detailed breakdowns of the data covering Region, Local Authority and Westminster Parliamentary Constituency breakdowns available for WCA outcomes by claim start date and completed assessment date.

Read the methodology note for more detailed information on these statistics.

Read more about ESA.

Contacts

DWP would like to hear your views on our statistical publications. If you use any of our statistics publications, we would be interested in hearing what you use them for and how well they meet your requirements.

For more information on these statistics, or to provide feedback on our publication, please email [email protected]

For further enquiries, you can contact Press Office: 0203 267 5144

ISBN 978-1-78659-396-2