More Disability Tests for Benefits

posted: 08/12/2010

All 3 million people with disabilities and long term conditions such as HIV, including pensioners and children, who are getting Disability Living Allowance will soon be forced to have medical tests.

Ministers announced yesterday plans to end the automatic right to disability living allowance, worth up to £70 a week for care and up to £50 a week for travel needs. This benefit will soon be called the 'personal independence payment'.

Waiting and testing

Claimants will have to wait for a year for the new "personal independence payment" and then face a series of medical and other tests focusing on "an individual's ability to carry out a range of key activities necessary to everyday life".
 

Medical tests already under fire

The existing system of medical tests that are used to judge people claiming sickness and disability benefits (Incapacity Benefit and Employment Support Allowance) is already under review after mounting evidence that people with serious illnesses like HIV are being judged fit to work, when they are not. The tests for the replacement 'personal independence payment' will be based on these.

Many claim that the disadvantages of the medical tests will outweigh any benefits. The medical tests system is often very wrong and very inefficient. 40% of people who appleal the decision win their appeals.

"We have fundamental concerns that the cost of the administration will mean there is no saving here. Claiming these benefits mean at the moment filling out a very long form. I don't think the answer is a whole new process of interviews, which many disabled people may find intimidating," said Guy Parckar of the Leonard Cheshire disability charity.
 

Do what we say

Welfare support will also be conditional on disabled people acting on government instructions to "better manage or improve their situation if appropriate".
 

Behind the changes - cuts of £1 billion from Disability Living Allowance

Charities said they were "deeply concerned" about the proposals – the government plans to save £1bn from DLA in the June budget.
 

"There's no evidence of widespread fraud and no evidence to back up claims that the benefit acts as a barrier to work," said Richard Watts, of the Essex Coalition of Disabled People.
 

Department of Work and Pensions announcement 

Consultation proposals

Consultation on the proposed changes - response deadline 14 February 2011

Source

Better Benefit ‘Work’ Tests

posted: 24/11/2010

The government has said it will overhaul its controversial medical tests to decide whether the seriously ill and disabled can claim long-term sickness benefits. An independent review found they were "impersonal, mechanistic and lacked empathy", leaving many claimants feeling unjustly treated and distressed.
 

The review, conducted by the academic Malcolm Harrington, an occupational health specialist, looked at whether the 'working capability assessment' was a fair system. There is mounting evidence that people with serious illnesses, like HIV, are being judged fit for work, when they are not. 40% of people who appeal, win their appeals.
 

Testing 94,000 people a month
The tests, first introduced in October 2008, mean 53,000 people are assessed a month for 'employment and support allowance'. The numbers being tested will balloon from next April as another 41,000 incapacity benefit recipients are re-assessed under the ‘work capability assessment’ every month.
 

Long-term ill and disabled somehow pass ‘work’ tests
Harrington found that the assessments, run by a French multinational, Atos Origin, which received £54m from the coalition government for the contract, failed people with mental illnesses and long-term disabilities.
 

‘Impossible’ 28 page form
One form which claimants needed to complete is 28 pages long and almost half the people "found the questionnaire difficult or impossible to complete".
 

Another problem is that people’s ability to work is measured by a computer questionnaire that uses "descriptors" - questions that are apparently unrelated to work. One example is that people are asked whether they had "loaded a dishwasher or washing machine" that day. "It does not bother to ask whether the claimant has a dishwasher or washing machine. That is the danger with computer systems and drop-down menus," said Harrington.
 

Another question asks if you sit and watch TV. Say yes and they assume you can sit for long periods in a chair.
 

"We want to rely much more on healthcare professionals and assessments., said Harrison..

He pointed out that 40% of those found fit for work by the system appealed and won – and added that most people who appealed provided "additional medical information".
 

Radical change needed
Harrington called for a radical overhaul, with jobcentre staff having to take into account health records, the Atos assessments and an individual's own testimony before making a decision about whether someone on sickness benefits should be forced back into work.
 

At present benefits staff rarely dissented from Atos's verdict, he said, and "a lack of procedural justice can lead people to feel embittered and for some this can lead to psychological distress with affects on physical and mental health".
 

Champions to help
The report also recommends the appointment of lay "champions" to guide claimants through the process, and detailed explanations of why a benefit has been refused.
 

Welcome for review
Many working with the poor and vulnerable welcomed the report, saying it was a long overdue recognition of the system's problems. Citizens Advice said its surveys showed a 41% increase in complaints from claimants in the past year alone.

NAT, National AIDS Trust welcomed the findings and recommendations. They say ‘we fully support the call for change to ‘improve the fairness and effectiveness of the WCA’ by improving transparency, empathy and communication within the assessment process for Employment Support Allowance (ESA)’. NAT were among the 400 organisations and individuals to contribute to the independent review, based on their research report Unseen disability, Unmet needs – A review of the impact of Work Capability Assessment on people living with HIV. Deborah Jack, Chief Executive of NAT (National AIDS Trust), said: ‘NAT supports the recommendations of the independent review and we were extremely pleased to see some of our concerns included in the final report.

Government to make all the changes

The government said it accepted Harrington's conclusions and would implement them in full. The work and pensions minister Chris Grayling said: "There were no targets or goals to get people off benefits. This is meant to be a fair process … we are dealing with claimants who we have had very little contact with."
 

Reform delay criticised

However, Harrington did criticise the government for failing to implement a key recommendation quickly enough: that of a "personalised summary of assessments in plain English" to be produced by Atos. The government could only promise that ministers "explored the feasibility of providing a summary" by the end of 2011. Given the planned expansion in the scheme next year, Harrington said, this "was just not good enough".
 

Charities said the "review pinpoints what is wrong with the system". Matthew Lester of the Papworth Trust, a disability charity, said the main concern now was how quickly the government would implement the report's main findings. "Even if they get the main points implemented by April that will mean another 250,000 people being assessed by a system that we already know is unfair."

NAT report

Source (adapted)

Failed Work Capability Assessments

posted: 28/10/2010

Tests for the new sickness and incapacity benefit called Employment Support Allowance are wrongly failing people with HIV. The tests, called the Work Capability Assessments, fail to recognise that HIV can prevent and limited people from working, says new research by NAT (National AIDS Trust).

Appeal - 40% Win

The Department of Work and Pensions has revealed that almost 40% of the people who appeal these decisions win. That is a dreadful rate of expensive administrative failure.

NAT’s report Unseen disability, Unmet needs – A review of the impact of Work Capability Assessment on people living with HIV sets out the problems. These start with the design of the assessment test and how it is used in practice.

• For example, the test does not properly allow for illnesses and conditions where symptoms come and go, where fatigue, side-effects of HIV treatment and depression affect our ability to work.
• People going through the medical examination may not have the chance to talk about how HIV affects their physical and mental health in ways that limit the ability to work.
• NAT‘s research finds that continuing ignorance about HIV among the medical assessors and decision makers drastically reduces the likelihood of a fair and accurate assessment and decision about people with HIV’s ability to work and need for sickness and disability-related benefits.

Deborah Jack, Chief Executive of NAT, says:

‘HIV is a disability, and like many other disabilities, people living with HIV can have vastly varying experiences relating to their condition. Whilst some find they can still work, many others find the impact of HIV or their treatment means employment is not an option at the moment and they need to claim disability related benefits.

‘As it currently stands, the WCA is based on an outdated model of disability which only recognises a narrow medically defined set of physical and mental impairments. Also, it does not appropriately acknowledge the fluctuating nature of the condition and the impact that low self esteem due to HIV related stigma can have on a person’s ability to work.

‘NAT has submitted our ongoing concerns to the Independent Review of WCA, lead by Professor Malcolm Harrington, and hopes these will fully considered before any new rules are finalised and come into effect.’

Key findings

• The test ignores key HIV clinical markers, such as CD4 count, in the medical assessment
• WCA decision makers often pay more attention to the company contracted to do the medical assessment than to the person’s own HIV clinician and GP, who know the patient and their needs much better
• A wide range of problems with administration and communication of the tests harm the health and well-being of people with HIV through stress, delays and pressure.

Tim’s tale

Tim is a young man who applied for Employment and Support Allowance (ESA) with the help of his aunt and an HIV specialist benefits adviser. At the time of completing his ESA50 form, Tim’s CD4 count was 19. Medical evidence from his doctor explained that at the time of diagnosis, Tim had a CD4 count of 0 and PCP, a form of pneumonia associated with a low CD4 count.

Despite providing information about his blood test results, these were not discussed during the medical examination. The record of the examination contradicted itself by saying that Tim experienced ‘no side-effects’ but then noted that he had diarrhoea as a side effect of his medication. He was not given any points for his incontinence.

Tim was found fit for work. His doctor submitted further medical evidence but the case still ended up at appeal. Tim’s adviser said that, “on the day, we won that appeal, without me having to say a word or even sit down...The judge looked up and said, “oh – ESA successful, he’s in the support group, that’s not a problem”.’

Tim is now in the support group of ESA.

Grace's grievances

Grace had a CD4 count of 40 when she was refused ESA. She claimed Job Seeker’s Allowance and attended the jobcentre for help to find work, where she was placed in a job as a cleaner. Grace became sick after only a couple of hours work, owing to her compromised immune system. She was ill for a fortnight.

Her HIV-specialist benefits adviser said, ‘me and the social worker went ballistic at her when we found out [that Grace had gone to work] but she said “I wanted to try because I don’t want to claim”. We said “we know darling, but you’re too knackered, so don’t”.’

The adviser took Grace’s case to appeal, and was successful. Grace is now in the support group.

About the tests - the Work Capability Assessment (WCA)
The Work Capability Assessment (WCA) is the medical test used to decide whether a person is eligible for Employment and Support Allowance (ESA). The WCA aims to identify claimants who have ‘limited capacity for work’ or ‘limited capacity for work-related activity’, so that they may receive the right amount of financial and employment advice support to help them live and (where appropriate) return to work. Those who are found ‘fit for work’ are refused ESA. They can then appeal and claim Job Seekers Allowance instead. 40% of people who appeal WCA test decisions win their appeals.
The WCA test contains a series of questions, called ‘descriptors’, which relate to physical and mental functions, and each awards some points. You need to get enough points to get ESA.

The report

NAT’s report Unseen disability, Unmet needs – A review of the impact of Work Capability Assessment on people living with HIV

In October 2008, Employment and Support Allowance (ESA) started to replace Incapacity Benefit and Incapacity-based Income Support as the main benefit for people who are unable to work due to disability or illness. Everyone now on Incapacity Benefit will have to go through the new ESA WCA tests, starting in 2011.

George House Trust helped with this report.
 

Sick Benefit Claims

posted: 27/10/2010

Claims made yesterday by the Department for Work and Pensions that three-quarters of the people applying for the new Employment and Support Allowance (ESA) are fit for work are disputed by leading charities.

The official figures were published as the Government continues its plans to reassess everyone on the old style incapacity benefit (IB), which began in Burnley this month and will cover the rest of the country from early next year.
 

Claims distort reality

Charities say the department is distorting reality. A high proportion of these decisions are wrong and almost 40% of people who appeal win. Citizens Advice Bureau has published three detailed reports on serious failings in the system. We know that many people with HIV are being refused wrongly and winning their appeals. We know that NAT are producing a report on the experience of people with HIV with the new benefit and system.

Citizens Advice argues that instead of improving the lives of ill and disabled people, the “deeply flawed” benefit has brought misery for thousands.

The Department recently ordered an independent review of the assessment process because of the widespread problems and complaints.

In last week’s spending review Chancellor George Osborne announced further benefit cuts: most people will only be allowed to claim ESA for a maximum of a year. It plans to cut the benefit bill by at least £18bn.
 

New sick benefit is 'unfit'

Scotland’s acting chief executive at Citizens Advice, Susan McPhee said: “We said last year that ESA was unfit for purpose and we see no reason to change that view. We are still seeing case after case where people are being found fit for work even though their illness or disability restricts them from any type of work. ESA isn’t working for the most vulnerable. We need to protect people in times of suffering, not cause them further hardship.”
 

ESA has forced thousands of vulnerable people with conditions such as cancer, schizophrenia, HIV and Parkinson’s disease back into the job market after being declared fit for work, despite medical evidence from GPs and consultants saying different.
 

Citizens Advice Bureau evidence shows that the system isn’t working

• for people with cancer
• the assessment process isn’t working properly
• the administration of the benefit is poor

For new ESA claims from October 2008 to February 2010, the department for Work and Pensions says that the three quarters of claims that were refused and unsuccessful were made up of:

• Support Group (people who cannot work now or in the foreseeable future and need unconditional support) – the department nonetheless decided 6% were fit for work
• Work Related Activity Group (people who cannot work now but with the right help could work in the foreseeable future) – the department nonetheless decided 15% were fit for work
• Fit for Work - the department decided 39% of ordinary ESA claimants were fit for work and refused the claim for ESA. People can appeal and claim Job Seekers Allowance. 
• Claim closed before assessment complete, or assessment still in process: 39%

The department is fiddling the figures to say that claims where the assessment is still in progress are among the three quarters of the claims that were refused or abandoned. Any claim still being assessed hasn't been decided yet, it is not refused, abandoned or unsuccessful. Undecided claims could be almost 39% of the 75% that the department's press release claims 'are being found fit for work after undergoing the Work Capability Assessment or stop their claim before they complete their medical assessment'. The true figure for claims that failed might be as low as 36%.

Whatever the rate of refused claims, almost 40% of people who appeal the decision, win. That is a dreadful rate of expensive administrative failure.
 

Reviewing the system

Employment Minister Chris Grayling said:
" I am determined that we get the medical assessment right, which is why Professor Malcolm Harrington is undertaking an independent review in consultation with a number of charities representing disabled people and those with mental health issues. I am more than happy to take onboard any serious suggestions for changing the assessment as I want it to be as near to perfect as we can be. This is not about pushing the sick and disabled into jobs but giving those that can work the help to do so and those that can't more, not less, support."
 

Churches: Don’t blame the poor
Meanwhile, three of Britain's churches accused the chancellor, George Osborne, of exaggerating the scale of benefit fraud in last week's spending review speech, pointing out that official figures were lower than the £5bn claimed by Osborne. The president of the Methodist Conference, Alison Tomlin, said: "Exaggerating benefit fraud points the finger of blame at the poor. Let us be clear this recession was not caused by the poor, those on benefits, or even benefit cheats."

Sources
Guardian Scottish Herald 
Department for Work and Pensions Press Release

Work Incapacity Tests – Have Your Say

posted: 09/08/2010

You can have your say in an independent review of how people’s fitness for work is checked by a medical, when claiming benefits for being too ill or disabled to work. People who claim Employment and Support Allowance have medical assessments as part of their claim. These are called ‘Work Capability Assessments’. The fairness of these is now being checked. We know many people with HIV are having serious problems with these.

Also people in Burnley who are on Incapacity Benefit are being put through these medicals as part of a national pilot. Beginning in February, everyone else on Incapacity Benefit will have to have one of these medicals. Many people living with HIV claim these two benefits.
 

Problems lead to review

The fairness of these medical assessments is being checked by an independent national review, led by Professor Malcolm Harrington, who is an occupational health expert. He will produce a report by the end of the year on whether the assessments are fair and transparent.
 

Have your say

You can have your say, based on your experience by Friday 10 September.

They ask a number of questions, but you don’t even need to answer these – simply say what happened to you, and whether you think the system works for people with HIV, or you could give plain and simple answers to questions 2, 3 4, and 6. Most of the questions are aimed at benefits experts.
 

Email your comments

or post your comments to WCA Independent Review Team, Floor 6, Section B, Caxton House, Tothill Street, London, SW1H 9NA.
 

What benefits and disability experts think
Disability charities say the current assessments tests are inflexible, and fail to take into account how long-term conditions (like HIV) can vary from day to day, or from week to week. George House Trust knows there are serious problems with the way these incapacity assessments are done and that people with HIV face a high rate of wrong refusals.
 

Atos Healthcare (who have the government contract for doing Employment Support Allowance assessments) appear to refuse to record basic HIV information like people’s CD4 count, admit their own ignorance about HIV and unwillingness to learn about HIV, don’t refer people with HIV to doctors for a full medical assessment as they should do, refuse to consider the ‘exceptional circumstances’ rules (regulations 29 and 35), and ignore medical reports from HIV doctors.
 

The advisers at Manchester Advice who specialise in HIV have won appeals before they can even say a word. Independent Tribunals have shown they are disturbed and surprised that plain evidence of obvious incapacity for work due to HIV is ignored, and at the failure to follow the rules.