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Thread: Listing of ESA standard forms.

  1. #1
    Senior Member nukecad's Avatar
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    Listing of ESA standard forms.

    Clicking on Download takes you to the official page to download a form that you can fill.
    Clicking on Example gives an example form.

    ESA1 Claim 'Old Style' ESA Download (you should claim by phone)
    Only used if you are barred from claiming UC

    NSESAF1 Claim 'New Style' CB-ESA Download

    JSA NC1 Claim NI Credits Only Example

    ESA2 Circumstances review Example

    ESA3 Apply for reassessment due to C of C Example

    ESA5 Req for pension info Example

    ESA6 Req for pension/other income info Example

    ESA10 Apply for hardship payment Example

    ESA40 General Info leaflet Download

    ESA49 Work Related Activity Plan Example

    ESA50 Capability for Work questionaire Download
    ESA50A Short version, check for SG Example

    ESA-N-50 ESA50, claimant overseas Example
    ESA-N-54B Guidance , assessor overseas Example
    ESA-N-54C Med Report, claimant overseas Example

    ESA51 Info sent with ESA50 Example

    ESA53 Reminder for ESA50 Example

    ESA55/WCA55 Jacket in which WCA docs are kept Example

    ESA56 DMs 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 GP re fit-notes Example

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

    ESA82 Letter saying ESA will not be paid until decision made following WCA Example

    ESA83 Form to report worsening condition after previous FfW Example

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

    ESA86 Used to record advice on LCWRA clerical referrals

    ESA113 Sent to GPs to request info. (also see FRR# below) Download

    ESA120 WFIs when moved from WRAG to SG Example

    ESA124 How your ESA payment is worked out Example

    ESA125 Proof of receiving ESA benefit Example

    ESA214 Detailed guide to the WCA Download

    ESA280 Why you are not entitled to ESA Example

    ESAL0001 Letter inviting SG claimant for voluntary WFI Example

    ESAHWC1 Invite to 'Health & Work Conversation' Example

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

    CRMR1 Request Mandatory Reconsideration Download


    Permitted work
    DWPF01 General info leaflet, PW Example
    PW1 Permitted work form Download
    DLPW1 letter that work is PW Example
    PW8 Sent to check if you are still doing PW Example
    PW9 Sent to check you are still doing SUPPORTED PW Example

    Related 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[B]
    BF223 Good Cause form. Sent if you miss WCA appointment Example
    DP_Gen Form to give bank details Example
    DS1500 Confirmation of terminal illness
    FRR2 Request for specific ME, sent to GP Example
    FRR3 Request for ME, sent to another HCP
    FRR4 Notes of telephone contact between HCP & GP, or HCP & 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
    Last edited by nukecad; 02-06-20 at 14:44. 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.

  2. #2
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    You've left out LT54, Decision Makers explanation/report of ESA Decision. Normally requested in conjunction with ESA85/85a or found in ESA Tribunal Evidence 'bundle'.

  3. #3
    paul446
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    a very usefull thread , i have printed it off for future refference :-)

  4. #4
    Any idea on the following DWP abbreviations / forms please?

    BDC -
    HOTT - i think its a handover term
    DPA1 - (the note just says "DPA1 held")
    DP - Disability Premium???? (note says "DP marker set")
    ESF F- (note says "ESF family support")
    NQF - regarding framework?
    DJ -
    (DJ) IRP -
    IRP ISS EF -
    CFA -
    SAH -
    SCC -
    LR 3207 -
    IC.O/P - re: a claimed overpayment

    If these help the following are:
    PWLL - permitted work lower limit
    PWHL - permitted work higher limit
    WCA - work capability assessment
    WARS or WRAG - work related activity group or support group

  5. #5
    Also
    490 - notes says "arrears issued from (date-date) of (amount) VIA '490'."

  6. #6
    Senior Member nukecad's Avatar
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    Hi penthouse,

    Some of those look like internal jobcentre codes.
    We do have a 'sticky' thread for abbreviations already, I've not checKed but you may find them there:
    http://www.youreable.com/forums/show...t=abbreviation

    JA490 is one of their internal procedures for processing recovery of overpayments.
    It is mentioned, along with other "JA" numbers, in this document:
    https://www.whatdotheyknow.com/reque...%20benefit.pdf
    I do't know exactly what it is but assume the 'JA' stands for Jobseekers allowance.
    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.

  7. #7
    Senior Member nukecad's Avatar
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    29 April 2017.

    Various changes and additions.

    'Clickable' Weblinks added to known downloads and examples.

    Admin have made this thread a 'sticky' (Thanks admin) so it should be easier for people to find in future.
    Last edited by nukecad; 29-04-17 at 14:44.
    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.

  8. #8
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    Thanks for posting this thread Nukecad. Very useful

  9. #9
    Senior Member nukecad's Avatar
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    Permitted Work forms updated following removal of '12 month' rule.
    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.

  10. #10
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    So, I noticed that you said that the ESA56 form is only given when you have no F2F. I did get/ask for the ESA56 when I asked for the LT54, but I had a F2F, so maybe it's generated for all decisions, not just those with no F2F?

    Extremely useful thread though, thank you for posting.

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