Esa50 1013 2013 form-2026

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37 votes

The document provides guidance on using a PDF claim form for benefits related to limited capability for work. It outlines the requirements for saving and filling out the form, technical support contact information, and instructions for completing a questionnaire about physical and mental health conditions. The document emphasizes the importance of providing detailed information regarding health issues that affect work ability, as well as instructions for submitting the form and additional medical documentation.

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Click ‘Get Form’ to open the esa50 1013 2013 form in the editor.
Begin by filling out your personal information in the 'About You' section, including your surname, other names, title, address, date of birth, and National Insurance number.
Proceed to the 'Face-to-Face Assessment' section. Provide your contact details and indicate if you require an interpreter or have specific needs for the assessment.
In the 'About Your Treatment' section, list your GP's details and any other healthcare professionals involved in your care. Include recent appointment dates.
Answer all questions regarding your illnesses or disabilities in detail. Use the provided spaces to explain how these conditions affect your daily life.
Complete the sections on physical functions and mental health by indicating any difficulties you face with daily tasks. Be honest and thorough in your responses.
Review all entries for accuracy before signing the declaration at the end of the form. Ensure that you have included any necessary medical reports.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (25 Votes)
2019	4.8 Satisfied (86 Votes)
2016	4.1 Satisfied (42 Votes)
2014	4.3 Satisfied (99 Votes)
2013	3.8 Satisfied (37 Votes)
2011	4 Satisfied (54 Votes)

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