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Help filling in your ESA form

This advice applies to Northern Ireland

The ESA50 form is your chance to say how your illness or disability affects your ability to work. You’re being asked to show why Employment and Support Allowance (ESA) is the right benefit for you.

You will already have completed the first ESA form (ESA1) - usually over the phone.

This is a long form, and it can be hard work to fill it in - take a break whenever you need to.

You must send back the form within 28 days of the date you receive it from the Department for Communities (DfC).

Get help with each part of the form

These help pages are to guide you through each question on the form. They will help you to decide if you need to answer each question.

We explain what the questions really mean, and give prompts on what to think about. This should help you to answer the questions and get the benefit.

Help filling in your details

If you’re sending the form back late

Medical evidence Your conditions

Your medication and treatment

Help with part 1: physical capabilities

Question 1: Moving around

Question 2: Standing and sitting

Question 3: Reaching

Question 4: Picking up and moving things

Question 5: Manual dexterity (using your hands)

Question 6: Communicating - speaking, writing and typing

Question 7: Communicating - hearing and reading

Question 8: Getting around safely

Question 9: Controlling your bowels and bladder and using a collecting device

Question 10: Staying conscious when awake

Help with part 2: mental, cognitive and intellectual capabilities

Question 11: Learning how to do tasks

Question 12: Awareness of hazards or danger

Question 13: Starting and finishing tasks

Question 14: Coping with changes

Question 15: Going out

Question 16: Coping with social situations

Question 17: Behaving appropriately

Help with part 3: eating and drinking

Question 18: Eating and drinking

Help with the last section of the form

Face-to-face assessment

Other information

Get extra help with the ESA50 form

If you need extra help filling in your ESA50 form, you can go to your local Citizens Advice - someone will help you fill it in and explain everything to you in person.

You can also get help from your local disability support agency.

If you have cancer

You don’t need to fill this form in if you have cancer and you’re:

  • waiting for chemotherapy or radiotherapy
  • going through chemotherapy or radiotherapy
  • recovering from chemotherapy or radiotherapy

Tick the boxes that apply to you on pages 3 and 4 then skip to page 18 and sign the box - then get a health professional (for example your GP or hospital doctor) to fill in page 20.

For both practical help and emotional support you can call the Macmillan Support Line for free on 0808 808 0000, Monday to Friday, 9am – 8pm.

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