Capability for work questionnaire ESA50

Date published: 23 May 2023

Only fill in this capability for work questionnaire (ESA50) if you’re asked to do so – this is not a claim form.

Details

The answers you give in the questionnaire should explain how your illness or disability affects your ability to complete everyday tasks.

Return this form to:
Medical Support Services,
29-31 Alfred Street,
Belfast,
BT2 8ED.

Documents

Capability for work questionnaire - ESA50 Adobe PDF (1 MB)

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Comments or queries about angling can be emailed to anglingcorrespondence@daera-ni.gov.uk

If you have a comment or query about benefits, you will need to contact the government department or agency which handles that benefit. Contacts for common benefits are listed below.

Employment and Support Allowance

Call 0800 587 1377

Jobseeker’s Allowance

Contact your local Jobs & Benefits office

Personal Independence Payment

Call 0800 587 0932

If your query is about another benefit, select ‘Other’ from the drop-down menu above.

Comments or queries about the Blue Badge scheme can be emailed to bluebadges@infrastructure-ni.gov.uk or you can also call 0300 200 7818.

For queries or advice about careers, contact the Careers Service.

For queries or advice about Child Maintenance, contact the Child Maintenance Service.

For queries or advice about claiming compensation due to a road problem, contact DFI Roads claim unit.

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Restrictions or regulations — contact the Department of Health
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If your query is about another topic, select ‘Other’ from the drop-down menu above.

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For queries or advice about birth, death, marriage and civil partnership certificates and research, contact the General Register Office Northern Ireland (GRONI) by email gro_nisra@finance-ni.gov.uk

For queries about your GRONI account, email gro_nisra@finance-ni.gov.uk.

For queries about the High Street Spend Local Scheme, email HSSS.mail@economy-ni.gov.uk.

For queries about:

Car tax, vehicle registration and SORN
contact the Driver and Vehicle Licensing Agency (DVLA), Swansea
Driver licensing and tests, MOT and vehicle testing
contact the Driver & Vehicle Agency (DVA), Northern Ireland

If your query is about another topic, select ‘Other’ from the drop-down menu above.

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Capability for work questionnaire ESA50

Details

Documents

Help improve this page - send your feedback

Messages

What to do next

Carer's Allowance

Discretionary support / Short-term benefit advance

Disability Living Allowance

Employment and Support Allowance

Jobseeker’s Allowance

Personal Independence Payment