Regulation 42 When an assessment may be carried out

(1)

The Department may carry out an assessment under this Part where—

(a)

it falls to be determined for the first time whether a claimant has limited capability for work or for work and work-related activity F1or is a severe conditions criteria claimant, or

(b)

there has been a previous determination and the Department wishes to determine whether there has been a relevant change of circumstances in relation to the claimant's physical or mental condition or whether that determination was made in ignorance of, or was based on a mistake as to, some material fact,

but subject to paragraphs (2) to F2(6).

(2)

If the claimant has monthly earnings that are equal to or exceed the relevant threshold, the Department may not carry out an assessment under this Part unless—

(a)

the claimant is entitled to attendance allowance F3, pension age disability payment, disability living allowance F4, Scottish adult disability living allowance F5, child disability payment F6, adult disability payment or personal independence payment, or

(b)

the assessment is for the purposes of reviewing a previous determination

F7(i)

that a claimant has limited capability for work or for work and work-related activity that was made on the basis of an assessment under this Part or under Part 4 or 5 of the ESA Regulations F8, or

(ii)

that a claimant is a severe conditions criteria claimant made on the basis of an assessment under this Part,

and, in a case where F9an assessment for the purposes of determining whether a claimant has limited capability for work and work-related activity may not be carried out by virtue of this paragraph, the claimant is to be treated as not having limited capability for work unless they are treated as having limited capability for work or for work and work-related activity by virtue of regulation 40(6) or 41(5).

(3)

The relevant threshold for the purposes of paragraph (2) is the amount that a person would be paid at the hourly rate set out in regulation 4 of the National Minimum Wage Regulations for 16 hours per week converted to a monthly amount by multiplying by 52 and dividing by 12.

F10(4)

If it has been previously determined—

(a)

on the basis of an assessment under this Part or under Part 4 or 5 of the ESA Regulations that the claimant does not have limited capability for work, or

(b)

on the basis of an assessment under this Part that the claimant is a severe conditions criteria claimant,

no further assessment under this Part is to be carried out unless there is relevant evidence.

(5)

If it has been previously determined—

(a)

on the basis of an assessment under this Part or under Part 4 or 5 of the ESA Regulations that the claimant has limited capability for work, and

(b)

on the basis of an assessment under this Part that the claimant is not a severe conditions criteria claimant,

no further assessment under this Part for the purposes of reviewing the determination that the claimant is not a severe conditions criteria claimant is to be carried out unless there is relevant evidence.

(6)

For the purposes of paragraphs (4) and (5) “relevant evidence”, in relation to a determination, means evidence to suggest that—

(a)

the determination was made in ignorance of, or based on a mistake as to, some material fact, or

(b)

there has been a relevant change of circumstances in relation to the claimant’s physical or mental condition.

Annotations

Textual amendments

F1: Words in reg. 42(1)(a) inserted (6.4.2026 with effect as in relation to assessment periods commencing on or after that date) by Universal Credit Act 2025 (c. 22), Sch. 2 para. 2(7)(a)(i)(10)
F2: Word in reg. 42(1) substituted (6.4.2026 with effect as in relation to assessment periods commencing on or after that date) by Universal Credit Act 2025 (c. 22), Sch. 2 para. 2(7)(a)(ii)(10)
F3: Words in reg. 42(2)(a) inserted (21.10.2024) by The Social Security (Scotland) Act 2018 (Disability Assistance) (Consequential Amendments) Order 2024 (S.I. 2024/919), arts. 1(1), 30(4)
F4: Words in reg. 42(2)(a) inserted (21.3.2025) by The Social Security (Scotland) Act 2018 (Disability Assistance) (Consequential Amendments) Order 2025 (S.I. 2025/227), arts. 1(1), 32(5)
F5: Words in reg. 42(2)(a) inserted (26.7.2021) by The Social Security (Scotland) Act 2018 (Disability Assistance for Children and Young People) (Consequential Modifications) Order 2021 (S.I. 2021/786), art. 1(2), Sch. 12 para. 5
F6: Words in reg. 42(2)(a) inserted (21.3.2022) by The Social Security (Disability Assistance for Working Age People) (Consequential Amendments) Order 2022 (S.I. 2022/177), arts. 1(2), 28(5)
F7: Words in reg. 42(2)(b) renumbered as reg. 42(2)(b)(i) (6.4.2026 with effect as in relation to assessment periods commencing on or after that date) by Universal Credit Act 2025 (c. 22), Sch. 2 para. 2(7)(b)(i)(10)
F8: Reg. 42(2)(b)(ii) and word inserted (6.4.2026 with effect as in relation to assessment periods commencing on or after that date) by Universal Credit Act 2025 (c. 22), Sch. 2 para. 2(7)(b)(ii)(10)
F9: Words in reg. 42(2) substituted (6.4.2026 with effect as in relation to assessment periods commencing on or after that date) by Universal Credit Act 2025 (c. 22), Sch. 2 para. 2(7)(c)(10)
F10: Reg. 42(4)-(6) substituted for reg. 42(4) (6.4.2026 with effect as in relation to assessment periods commencing on or after that date) by Universal Credit Act 2025 (c. 22), Sch. 2 para. 2(7)(d)(10)

Notes on Part 5

Modifications

C1: Pt. 5 excluded (coming into force in accordance with reg.1 of the amending Rule) by The Universal Credit (Transitional Provisions) Regulations (Northern Ireland) 2016 (S.R. 2016/226), regs. 1, 24(2)