I should never read the comments after Guardian articles. They are invariably full of opinionated people, with little knowledge or experience to back up their opinions. Take “We Disabled People aren’t Shirkers” in Sunday’s Comment is Free. Written by the Chair of Scope; Alice Maynard, the article discusses Government cuts to disability benefits, and the Work Capability Assessment (WCA) carried out on behalf of the DWP by a private company; ATOS.
At one point she cites the case of a person who recently had his ATOS WCA. “Another young person, James, is blind, deaf and can’t walk or talk, yet has been deemed “fit for work” by the new system, entitling him to only £53 per week.”
To the average person, with little or no knowledge of ATOS medicals, this claim might seem preposterous. However, you’d think having little or no knowledge of a situation might stop you making comment on it. You’d certainly think that having little or no knowledge of a situation might stop you from accusing the author of an article, a Chair of a national charity, of making up key facts.
The second comment on the article:
“You do your cause no good by making up random stuff and printing it as fact.”
Obviously I don’t know the specifics of James’ situation. But I have talked to many people who have failed ATOS medicals, when they seem unfit for work. And tales of bad experiences and apparent injustice are all over the internet. Accusing Alice of making up stuff is not only libelous rude, but really missing the point.
The WCA is a terrible way to assess fitness for work. Instead of relying on the person’s own medical evidence, from GPs and consultants, a non specialist nurse, doctor or physiotherapist uses a computer generated questionaire to make an assessment.
Huge numbers of people who are unfit for work have been found fit. If they are put onto JSA instead of ESA not only do they have less money to live on, when they have higher costs because of their illness or disability, but they have to attend monthly Work Focussed Interviews (WFIs), which can be exceptionally stressful, painful, or difficult for them. If they are unable to do this, they will face loss of benefit. They also receive much less support in finding work, than those on ESA.
For all new ESA Claims from 27th October 2008 to 30th November 2009, the result of the initial WCA was as follows:
o Support Group – 6%
o Work Related Activity Group -14%
o Fit for Work – 39% (JSA)
o Claim closed before assessment complete – 37% (No further information available)
o Assessment still in progress – 4%
Far fewer people were put into the Support Group than was expected by the DWP. Far more were found fit for work than expected by the DWP. A report in May showed that 1 in 4 WCA decisions were appealed, with 70% of appeals successful.
The DWP has not been tracking those whose claim was closed before assessment, so it is unknown if they found work, claimed another benefit, or decided not to continue with their claim because of other reasons such as the fear or stress of the medical. I have talked to a not unsignificant amount of people who decided not to continue with a claim for that reason, including those with schizophrenia and bipolar disorder (manic depression).
This week the new Incapacity Benefit migrations to Employment and Support Allowance (ESA) are beginning, using the WCA, with trials in Burnley and Aberdeen. The coalition plans to reassess 10,000 claimants a week from spring 2011. Eventually all Incapacity Benefit Claimants will be transferred either onto ESA, or in some (many?) cases onto Jobseekers’ Allowance (JSA). It will be terrifying interesting to see if the recommended amendments to the WCA will actually have any effect on pass rates, especially for those with variable conditions and cancer.
Here are some sites where people have discussed their experience of the DWP and ATOS medicals, both WCA and the previous Personal Capability Assessment (PCA).
why wait forever (many links)
A few quotes from the links above:
“The DWP had my Medical Cert, which was clearly ticked, unfit to work. The DWP canceled my ESA and said that I need to apply for JSA. If my Employer ignored the Med Cert and tried to force me to work, he would be in trouble. So how can the DWP get away with this?”
“Thought I would post this today, as I could not believe what I was hearing from the receptionist at the Carmarthen ATOS office.
My wife had her medical assessment today for ESA. She is suffering from depression as a result of having to be my carer. Because of my problems, I have to use a wheelchair to get around.
So today, my father drove us to Carmarthen for the assessment, and we went up to the office which is located on the 2nd floor of the building. No sooner than we had checked in, the receptionist told me that I was a hazard and had to leave the building. Apparently, the building is not suitable for wheelchair users because of poor fire exits.
I could not believe this. Surely it’s a breach of the Disability Discrimination Act? I ended up having to leave my wife in tears to face the assessment on her own, the one thing that she was dreading the most.”
“Yesterday I ran out of SSP so had to apply for ESA. It had to be done over the phone and took 45 minutes. By the end of it I could barely answer their questions, was shaking and stuttering. I slept all afternoon. Today I am in a lupus flare.
The past 10 days had been better and encouraging. I had managed to get dressed every day, get up and spend time in the lounge. Might not seem like much, but it was progress. Today I am back in bed, unable to move and down to 30 minute bursts of “activity” (eg listening to audiobook or using laptop) before needing to rest or sleep.
Flares are unpreditable. I could be completely better tomorrow or it might last several weeks. I can’t help wondering how the heck I’m going to manage to go to their face to face interviews if this is what a telephone interview does to me.
Incidentally I was told to try not to become an inpatient for the next 12 weeks. Ha bl***dy ha. Like I choose when my illness becomes very serious!””
I am confused,distressed and have become increasinly depressed by the DWP and ATOS. They just seem like Bullies to my,who are wasting my time,their time and my GP’S. I had to give up work in 2004 due to increasinly bad health. I claimed nothing as I did’nt even have a proper Diagnosis. It took me almost 4 years to get one.I was diagnosed, after many tests with a condition called Fibromyalgia/Me (chronic fatigue)
My condition has continued to deteriate. I started to receive Disabilty allowance 2 years ago,and have just been awarded this for a further 3 years,due to the letter my Proffessor wrote to them. He is the top man in my condition and says I will never work again,as my condition will never really improve only get worse and stress is so bad for me and these people continue to harass me and make me sicker. I had a home visit from Atos,and there Dr stated in his opinion I would be fit to resume work in 6 months !!! I now have them on my back again,countless worrying letters.I have had to get another letter just recently from my GP, who throughly backs me to state I will need a home visit again, I practically home bound because of my health.
I actually spoke to Atos today !! about another appointment that they had sent me AFTER receiving my Doctors letter.They told me “their” Dr was looking in to it and I would get an answer shortly, if not I must attend !!! I dont undertand how they operate. I am under the my GP and a Professor of imunology who both agree I am unfit to work ??? yet they keep the pressure on even thoe my GP has told them that this all aids to making my health worse.I feel they are sending me mad,and I dont feel I have anywhere to turn to,and there is nothing I can do about it..
And some findings from a report for the DWP, published this year by the Institute for Employment Studies gives some interesting insights into staff experiences of the WCA, and of DWP advisors trying to assist people on ESA.
Some [advisors] felt that many of these decisions were unduly harsh, and that the majority of customers assigned to the Work Related Activity Group or fit for work groups faced severe barriers to employment. Many customers were reported to be appealing, and there was a large backlog of appeals at the time of the fieldwork. Some … staff were acutely conscious of the additional costs this was creating for the system as a whole:
‘There’s so many like that. It’s really difficult…you’ve got people with multiple health problems… they can hardly walk and breathe but yet they’re in the Work-Related Activity Group. And you do think to yourself, “it’s going to be difficult, this”. Because obviously I’ve got to make sure I’m offering support, but at the same time, sometimes you can see that this person really won’t be able to do many of the things I’ve got on offer…I think all advisers would probably say that, and it’s very difficult.’
They are going to be far removed from the labour market, and probably
never going to work again…but we are calling these people in, because we
don’t have that [the WCA] information, and they’re coming in, sometimes;
it’s appalling, because they’re coming in, in a wheelchair, they’ve got
progressive cancer. I don’t want to see these people.’
Some charities’ feedback on the WCA.
People with serious illnesses and disabilities who could not reasonably be expected to work are being found fit for work. Other people who remain on ESA WRAG might, with considerable support, be helped into work, by moving to JSA they are effectively being “written off” by being found fit for work and therefore ineligible for the more focused work support for people on ESA. Many of these people are too ill to sign on, or are not eligible for any other benefit, and are left with Disability Living Allowance only, or indeed no money or help or support to find work. Furthermore, many of those found ineligible for ESA also lose access to an extremely helpful route into sustainable work through the disability element of tax credits.
Our experience as a support charity is that people with ME/CFS have a great deal of difficulty in obtaining sickness and disability benefits when benefit applications are first assessed, or are later re-assessed – even when they are fully supported by their GP or consultant. Although initial claims are often rejected, there is a high rate of success (around 40%) on appeal – indicating that eligibility criteria and medical assessment procedures are poorly designed for people with this illness. We have repeatedly brought our longstanding concerns about the unsatisfactory way in which people with ME/CFS are being medically assessed for DWP benefits in meetings with both the Rt Hon Yvette Cooper (former Secretary of State at the DWP) and with Dr James Bolton, Deputy Medical Adviser at the DWP – as has the All Party Parliamentary Group (APPG) on ME.
Even if it was accepted that this model of assessment was the best way to proceed with the evaluation of an individual’s ability to work, within these confined parameters the content of the assessment is poor. The descriptors that do specifically deal with mental, cognitive and intellectual functions group together a whole range of different ‘conditions’ including mental health conditions, learning disabilities, dementia and cognitive impairment due to a brain injury. The descriptors and pathway through the assessment (as controlled by the Lima computer system) are too rigid to take account of the idiosyncratic nature of people’s conditions and can result in people scoring few or no points despite substantial barriers to returning to work.
We believe the Work Capability Assessment (WCA) is failing to ascertain disabled people’s needs effectively; is generating costs to Government through high appeal rates (40% of which are successful); is generating avoidable hardship for some disabled people; and requires significant improvement in terms of: the information provided to people undergoing assessments; the descriptors, the requirement for independent medical information; and the timeframes being operated for the WCA and appeals.
The main findings concern problems with each of these aspects of ESA assessment:
Seriously ill people are inappropriately subjected to the WCA. Under IB if someone was seriously ill, information was sought from their own doctor and if the diagnosis was confirmed, they were exempted from the assessment. There are fewer exemptions for ESA, which means that people with debilitating conditions or serious disabilities are being subject to the WCA, and some are found ineligible for the benefit. Others in difficult but shortterm situations are being found ineligible, just when they are most in need of the support of ESA.
The assessment does not effectively measure fitness for work. It does not take sufficient account of variable symptoms. There is little recognition of generalised pain and exhaustion, or the seriousness of an underlying condition. It takes no account of the context of the work environment, including a person’s education, skills and circumstances, or the discrimination they may face in looking for work, all of which can significantly affect the scale of the person’s barriers to work. The guidance for the health care professionals (HCPs) administering the test gives extreme examples, which is likely to lead to very harsh decisions.
Application of the assessment is producing inappropriate outcomes. Citizens Advice and other organisations have been concerned for many years about the quality of medical assessments for benefits. We still hear repeated reports of rushed assessments, assumptions being made without exploration, inaccurate recording and poor recognition of mental health problems. These problems create major difficulties for our clients and undermine the Government’s aims for ESA. People with serious illnesses and disabilities who could not reasonably be expected to work are being found fit for work. Other people who might, with considerable support, be helped into work, are effectively being ‘written off’ by being found fit for work and therefore ineligible for ESA. Many of these people are too ill to sign on, or are not eligible for any other benefit, and so are left with reduced incomes and no help or support to find work. Furthermore, many of those found ineligible for ESA also lose access to an extremely helpful route into sustainable work through the disability element of tax credits. Research shows that claimants who move off benefits and (re-)enter work generally experience improvements in income, socioeconomic status, mental and general health, and well-being. However it also shows that “those who move off benefits but do not enter work are more likely to report a deterioration in health and well-being”