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  1. #1
    Senior Member nukecad's Avatar
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    Jun 2014
    West Cumbria (Lake District)

    Listing of ESA standard forms.

    Links for fillable forms, clicking on Download takes you to the official page to download a form that you can fill in and send off.

    Where the link says Example then that is all it is, if needed request an official copy from the DWP.

    ESA1 Claim form 'Old Style' ESA Download (you should claim by phone)
    NOTE- Since Jan 2019 this can only be used if you are barred from claiming UC

    NSESAF1 Claim form 'New Style' CB-ESA Download

    JSA NC1 Claim form for NI Credits Only Example

    ESA2 Circumstances review form

    ESA3 Claimant application for reassessment because of C of C Example

    ESA5 Request for pension information
    ESA6 Request for pension & other income information

    JSA/ESA10JP Application for hardship payment Example

    ESA40 General Information leaflet Download

    ESA49 Work Related Activity Plan Example

    ESA50 Capability for Work questionaire Download
    ESA50A Short version, sent when you qualify for WRAG but DM wants to check for SG Example

    ESA-N-50 Capability questionaire, claimant overseas Example
    ESA-N-54B Guidance notes, assessor overseas Example
    ESA-N-54C Medical Report, claimant overseas Example

    ESA51 Info. sent with ESA50.

    ESA55/WCA55 Jacket in which WCA documents are kept Example

    ESA56 Decision Makers points scoresheet Example

    ESA60 DM rejection of paper assessment - (request for F2F assessment) Example

    ESA65 Disallowance notification (Fit for Work) Example
    ESA65B Letter sent to your GP re fit-notes Example

    ESA72 Notification of award after assessment Example
    ESA72SC Notification of SG and 'Severe Condition' Example

    ESA82 Letter advising ESA will not be paid until a decision is made following WCA
    ESA83 Form to report worsening condition after FfW at previous WCA Example

    ESA85 WCA report (f2f)
    ESA85a WCA report (no f2f) Example
    ESA85s Personalised Summary Statement (Extra notes)

    ESA86 Form used to record advice on LCWRA clerical referrals

    ESA113 Form sent to GPs to request information (also see FRR# below) Download

    ESA120 Letter about WFIs when moved from WRAG to SG Example

    ESA124 Details of how your ESA payment was worked out Example

    ESA125 Written details of ESA claim (Proof of receiving ESA benefit) Example

    ESA214 A detailed guide to the WCA Download

    ESAL0001 Letter inviting SG claimant for voluntary WFI Example

    ESAHWC1 Invitation letter to 'Health and Work Conversation' Example

    HWC1 H&W Conversation questionaire Example
    Same but with the Work Coach notes included: Example

    CRMR1 Mandatory Reconsideration Request form Download

    Permitted work forms
    DWPF01 General information leaflet, PW Example
    PW1 Permitted work form (Tell the DWP you are/will be doing PW) Download
    PW8 Letter/form sent to check if you are still doing PW Example
    PW9 Letter/form sent to check you are still doing SUPPORTED PW Example

    Related application forms.
    HC1 Claim Free Health Costs, (Low Income) Order (comes with a prepaid return envelope) or Download (no envelope)

    HCTB1 Housing Benefit claim form Download

    IS10 Application for Severe Disability Premium Example

    SF500 Budgeting Loan application Download

    Other forms related to ESA
    BF223 Good Cause form. Sent if you miss a WCA appointment Example
    DP_Gen Form to give bank details Example
    DS1500 Confirmation of terminal illness
    FRR2 Request for specific ME, sent to GP or another healthcare provider Example
    FRR3 Request for ME, sent to another HealthCare Professional
    FRR4 Recording and/or paper notes of telephone contact between HCP and GP, or HCP and claimant
    LT54 Decision Makers Report Example (part 3 for ESA decisions)

    UC50 Capability for Work questionaire - Universal Credit Download

    SSCS1 Appeal application. -This is now done online Online Application
    Last edited by nukecad; 08-16-2019 at 10:19 AM. Reason: Forms added and updated, Edited to reduce character count.
    I don't know everything. - But I'm good at searching for, and finding, stuff.

    Migration from ESA to Universal Credit- Click here for information.

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