Along with other members of the group appointed by Professor Malcolm Harrington to advise him on fluctuating medical conditions (eg ME/CFS, HIV/AIDS, MS, arthritis), I have been invited to a seminar on Wednesday this week at DWP HQ to discuss the recommendations relating to WCA that were contained in Professor Harrington's November 2010 report and the further work in progress relating to benefit review that is contained in his May 2011 interim report.
Among the issues for discussion on Wednesday are:
* Face-to-face assessments – better, worse, or no change?
* Decision Making – especially getting and using additional evidence. Better, worse, or no change?
* The Atos IT system (LiMA)
I have already communicated to Professor Harrington the fact that many people with ME/CFS are finding it extremely difficult to qualify for ESA, DLA etc and are only being successful at appeal. And our report into fluctuating conditions has made it clear that the current WCA descriptors are not a satisfactory way of assessing people for fitness to work who have conditions such as ME/CFS.
If anyone has any observations that they wish to make on these specific issues please do so here on the MEA website comment section or on the MEA Facebook page.
Thanks
Dr Charles Shepherd
Hon Medical Adviser, The ME Association
There still seems to be a major problem with decision-makers not putting people into the support group. My husband is housebound (and so can’t get to pathways to work interviews etc), and should qualify for the support group. He has just been transfered from IB in the work-related group. We are appealing, but everytime we talk to someone at the DWP they try and dissuade us, telling us that almost no-one gets in the support group and that when they do it is because they are terminally ill. Anyone who does’t really know how the system works could be really put off appealing.
We have sent in additional evidence and are waiting to hear if the will reconsider or if we need to go to a tribunal.
For many people with ME, the support group is essential as having to attend preparation for work activities will make their health worse. In addition, many people will only be able to claim ESA in the work-related group for one year, yet it is unlikely that they will be recovered enough to work after this time.
1. The DWP do not now request medical information from those you name on the questionnaire.
The onus is on the patient to provide the information and this is too much of a responsibility.
Cost alone is a real issue, as are the deadlines to which doctors etc. cannot always themselves adhere.
If patients are able (this is not always possible) to visit the CAB beforehand (or for an appeal) then legal aid will enable suitable medical evidence to be requested and paid for. But this is an inadequate and unequal system.
If the questionnaire itself is not bad enough to complete in the timeframe when ill, then obtaining medical records most certainly is.
And there is good reason to believe that even the questionnaire – let alone any medical reports – are not taken into account when the assessment is delivered or the subsequent report made.
2. I also have to question (again) the purpose of the assessment itself. At the May meeting of the Work and Pensions Committee http://www.parliamentlive.tv/Main/Player.aspx?meetingId=8433 they met with Atos.
About 10 minutes into the video the meeting turned to the reason why these assessment are referred to as ‘medicals’.
Atos seemed uncomfortable with this term, implying that medical professionals are in charge only to reassure patients.
I have some difficultly in understanding the format of these assessments on that basis, but also because it would seem for other conditions the ‘tests’ and the specialism of the professional leading the session, are geared towards the primary condition itself.
The relevance of the assessments I have attended in recent years to my condition still seems highly questionable as do the conversations that take place.
Either these interviews are about my ability to work (in which case why a medical professional) or they are about my ability to work when considering my disability (in which case structure the meeting around matters that are relevant.
I know there is more but fortunately I can’t think of anything else at this point 😉
The evidence of my own experience with illegitimate disqualification (overturned at appeal) is that the ATOS assessment is a cynical exercise intended to combat a culture of benefits reliance and push people to work.
To this end the ATOS assessment is not currently implemented to achieve a proper assessment, it is implemented to justify the denial of benefits. The evidence for this is the high rate of successful appeals and a long history of disqualifications on spurious and unreasonable grounds. This evidence proves it is not a fair assessment and is a biased assessment which contravenes the human rights act not just in the letter of the law. More worryingly, ATOS are knowingly using this system in a way which contravenes the spirit of the human rights law because it is expedient to the government’s economic objectives and their own objective of realising a profit.
In an attempt to achieve an outcome which can be justified to the public the appeals process is used as part of the assessment process but this is not a legitimate way for ATOS to fulfill their contract to assess claimants.
For people with immunological ME this assessment method is essentially trial by torture akin to the ducking stool, as it does real physical harm because it means they experience high levels of stress over prolonged periods. Stress is highly deleterious to ME patients as it suppresses the immune system, causes overutilisation of physiological energy and activates recurrent viruses, all of which can lead to harmful relapse, and downward spirals of secondary illness. It is not fair to assess ME patients in this way as it is rigged to fail them, along with everyone else and thus oblige them to appeal, repeatedly.
Further to this issue is that of the failure of the assessment to recognise the nature of ME and correctly admit the severely affected to the support group. It is hard to see how this latter issue can be rectified until the former issue of a fundamentally disingenuous and biased unethical assessment method is challenged and put right.
Whilst ESA does work for the majority of claimants, it continues to fail miserably for significant minority.
There has been no improvement in the handling of fluctuating conditions despite the inclusion of “exhaustion” to the criteria. It will be interesting to see how many claimants with ME/CFS FMS, MS, etc. who have failed to score points at the new WCA medical will score 15, 24 or more points at appeal, as they do on the old tests.
The move to phone calls from written communication, rather than “personalising” the experience has left many in fear of picking up the phone. The quality of information has dropped significantly over the last few months, and even worse, the amount of mis-information or simply wrong information been given out has multiplied many fold.
The ESA50 is now even further away from the descriptors than it was before March, with no real explanation of what is being asked and what the answer will be tested against. Take “mobilising” with its virtual wheelchair, or the Standing OR Sitting test which is really standing AND sitting.
The Reconsideration process has improved but this is offset by increased pressure on the Tribunal Service as a result of the IB to ESA transfer, resulting in many claimants waiting 12-15 months for a hearing. Whilst it is too early for the impact of the new tests to be felt, success rates for ESA appeals remain at 39-40%, after two years of reporting.
ATOS medical reports remain poor, and regularly include assumptions not based on any evidence presented. Worse still, too many reports include, being polite, misrepresentations of the facts, clearly aimed at failing the claimant.
The PIP proposals have caused consternation across the whole of the DLA community, with even those on HRC and HRM voicing concerns over whether they will retain their allowances.
Many fear they will lose their mobility allowances and as a result their mobility cars. There has still been no announcement whether PIP will be available to the over 65s who are in receipt of either DLA or PIP before this age.
Finally, despite the protestations of “not us”, the government continues to orchestrate a campaign in the popular press, against the ill and disabled, labelling us as scroungers and wasters.
The following paper from the DWP is interesting.
http://www.dwp.gov.uk/docs/esa-time-limit-wr2011-ia-revised-apr2011.pdf
It shows that the policy objective is purely cost-driven.