Welfare benefits (ESA) I need help filling ESA Triage journey for Welfare Benefits "*" indicates required fields I need help filling in my Employment and Support Allowance (ESA) capability for work questionnaireYou Selected* Employment and Support Allowance (ESA) You Selected* I need help filling in my Employment and Support Allowance (ESA) capability for work questionnaire After you’ve applied for Employment and Support Allowance (ESA), the Department for Work and Pensions (DWP) will usually send you a form called the ‘Capability for Work questionnaire’. It’s also called the ESA50. You will be given one month to complete your form and send it back. The deadline will be on the DWP letter that was sent with your form. If you’re late sending back the form you must still fill it in and send it as soon as you can. We can help you explain to the DWP why it's late.Restart If you need help from an adviser please continue to our callback form, where you will be asked to provide your contact details. An adviser will then call you back at a time that is convenient to you. All information given through the following form(s) is held in accordance with our privacy policy and will not be passed to any third parties without your consent. Any deadlines?Please tell us about any deadlines so we can prioritise your request if needed. Do you have any upcoming deadlines?* Yes No What is your deadline? (optional) DD slash MM slash YYYY If you have more than one upcoming deadline then please input the nearest This field is hidden when viewing the form(CB1 )Request a callbackPlease complete the form below, and we'll call you back in 3-5 working days.Full name*Phone number*Can messages be left on this number?* Yes No Postcode*When is the best time to reach you?Select all that apply. Callbacks will be made between 10am and 4pm Monday to Thursday.Monday AM PM Tuesday AM PM Wednesday AM PM Thursday AM PM Privacy agreementConsent*All information given through this form is held in accordance with our privacy policy and will not be passed to any third parties without your consent. I agree to the privacy policy.*