Category: WCA

Successful Appeals Against Disability Assessments – It’s As If There’s Something Wrong With The System

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Source: the Independent, written by James Moor.

It’s rapidly becoming clear that Prime Minister Theresa May’s bold pledge to create a Britain that works for everyone should have an asterisk attached to facilitate the addition of “except for those pesky people with disabilities, can’t we pack them off somewhere else?”

In recent days the Government’s plan to cut people with serious mental health conditions out of eligibility for personal independent payments has justifiably come under sustained fire. 

However, the attitude problem displayed by both May’s administration, and that of her predecessor David Cameron, goes beyond that, as a delve into the latest statistics demonstrates.

What they show is that the number of appeals against decisions made by the DWP on the basis of assessments made by the private, profit driven contractors working on its behalf is increasing at a similar speed to that at which Lewis Hamilton exits Silverstone corners. 

They show that there were 60,600 Social Security & Child Support appeals between October and December 2016, an increase of 47 per cent. Even Lewis might think twice about acceleration like that. 

Some 85 per cent of those appeals were accounted for by the Personal Independence Payment (PIP) and the Employment & Support Allowance (ESA).

The rate at which the decisions made by the DWP on the basis of information supplied by the Government’s contractors – Capita and Atos – are overturned is also increasing. 

People started taking notice when it was running at 50 per cent. Now close to two thirds of appeals in the case of the PIP (65 per cent) are successful. The figure is higher still when it comes to ESA (68 per cent). 

I’m given to understand that the people who sit on tribunals have been asked to keep June clear, in an attempt to reduce a growing backlog. So forget about an early summer holiday. 

Needless to say, these people have to be paid, which puts extra cost into the system at a time when the Government says it’s trying to save money. 

Simply applying for either benefit causes a great deal of stress to people with disabilities. Having to go to appeal only exacerbates that. Applicants find themselves in the middle of a process that is humiliating and dehumanising.

That process also seems to throw up scandals with alarming regularity. Channel Four, for example, infamously filmed a Capita assessor saying a claimant had a “disability known as being fat”. Another claimed to have filled out forms before even seeing clients amid pressure to get as many done as quickly as possible. 

Other scandals have involved people with weeks or months to live being told they’re fit for work in the case of ESA, which is paid to people whose fitness to do so is impacted by medical conditions and disabilities. 

Set against that backdrop, is it any wonder that there has been so much criticism of the process, and so many successful appeals? 

If the assessment process worked effectively, and as it should, the number should be limited, and you wouldn’t expect such a large majority to be successful.

Ken Butler, welfare rights advisor at Disability Rights UK, says he is “very worried for all those disabled people who get turned down for benefits and don’t have the time or energy to challenge poor decisions made by the Department for Work and Pensions (DWP)”. 

He adds: “We’d advise all claimants to get benefits advice and, if they are turned down, to use the independent appeals process.”

Butler says that the high success rate of appeals clearly demonstrates that there is something wrong with the system. 

Unless, of course, the system, also savagely criticised by the United Nations, was deliberately set up to be this way. 

Before you suggest that is me indulging in a conspiracy theory, take a moment to think about this. If you make something difficult, stressful and painful, if you litter it with traps, and take the view that everyone getting involved in it is a dirty scrounger until proven otherwise, a lot of people will get put off and won’t apply. Still more won’t appeal when turned down, saving the Government money it can use for things like millionaires tax cuts. 

Dealing with a disability presents enough of a challenge as it is, without having to get to grips with a state that operates in a manner that would have impressed some of George Orwell’s darker characters. Would anyone be terribly surprised to find O’Brien working as a civil servant in the DWP?

The cynicism on display is breathtaking, if my assessment is correct. Alternatively, the situation I’ve discussed could simply have been created by a toxic mix of bureaucratic callousness and incompetence. 

The net effect is the same regardless, which is why there will be peals of bitter laughter emanating from Britain’s disabled community every time those words of Theresa May’s are trotted out. 

You’d be able to hear them if it weren’t for the fact that so many people with disabilities are now trapped in their own homes.  

Terminally ill woman lost her ESA, home and all her belongings after being told she was fit for work

 


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Claire Hardwicke

Claire Hardwicke has stage four thyroid cancer. This means that it has spread to other parts of her body, and sadly, Claire was told that her cancer is terminal. She also has chronic osteoarthritis. Despite taking 80mg of morphine a day to cope, she still experiences considerable pain.

Additionally, Claire already had a life-threatening, acute allergy to latex. This means that she has to carry an EpiPen at all times, which is an epinephrine (adrenaline) injection to treat life-threatening anaphylaxis. Developing a severe allergy to latex unfortunately meant that Claire could no longer continue working as a mental health nurse. 

Claire first became ill 9 years ago with uterine/ovarian cancer, but it was the allergy that made her unemployable and ended her career as a mental-health nurse, her partner, Alan King, told me

Claire’s first bout of cancer was treated and she made a recovery, which lasted only 7 years. Sadly, the diagnosis of her more recent thyroid cancer and metastases wasn’t diagnosed until it was incurable. The tumours had spread throughout her thyroid gland, neck, lymph system and adrenal glands.   

All Claire can hope for now is palliative care, which is alleviatory only, as a cure isn’t possible. 

Unbelievably, Claire was assessed as “fit for work” by the Department for Work and Pensions (DWP) last year. Her Employment and Support Allowance was stopped. All of her financial support ended. This was despite being told by the Capita assessor (for Personal Independence Payments) that the report to the DWP would state that Claire was in need of more support, not less. 

Overnight the couple lost every bit of financial support they had previously been entitled to, so Alan decided to use what little financial resources he had left to help Claire to fulfill some of  her”Bucket List.”

The couple were forced to say goodbye to their rented bungalow and 99% of their possessions because their housing benefit was stopped. They had no income, as Claire’s Disability Living Allowance (DLA) and Employment Support Allowance (ESA) was stopped, and the Carer’s Allowance also ended.

Claire explained to me that when she lost her lifeline support, the wait for appeal hearings was over 18 months. The couple couldn’t afford to wait that long, as they had no income. They also didn’t know if Claire would survive the wait.

Claire and Alan went to visit family members around the UK before setting off, in October 2016, on a Mediterranean cruise for a month, which Alan paid for, using his credit cards. They already owed a lot of money on their credit cards, but with no income at all, the couple were facing destitution.  The incredible distress the couple suffered took its toll on Claire’s already poor health, too.   

On the return journey, both of them realised that coming all the way back to the UK – where they were homeless, with no income, and they no longer even qualified for free prescriptions – would be pointless. So the couple left the cruise when they got to Portugal, where it’s significantly warmer than the UK (and therefore less painful for Claire) – and they’ve been there ever since, living in a very basic, rented room.

Alan told me: “Claire’s cancer hasn’t claimed her life as quickly as we both had imagined, (which is good), but with medications, food and board, we’re now out of funds and out of options unless we can somehow fundraise for some subsistence.”

The couple have paid money in advance for their single room in Portugal, which covers rent until 14th March, after which time they will have absolutely nowhere to go.

Claire says: “There are new trial therapies for extreme cases of thyroid cancer like mine.

 I wish I had a pot of gold to pay for the experimental cancer therapy.
I don’t want to die, but choices and chances aren’t given to the poor people. We need a miracle, a winning lotto ticket. There should be equal opportunities for all patients.”

The treatment would possibly extend Claire’s life and improve the quality of the time she has left. She says: “I could have a chance of a longer, fuller life…. but I don’t have that option open to me….”

Tiffany Williams, a friend of Claire’s in the UK, has set up a crowdfunding page on JustGiving to raise £800 to help pay for her treatment. So far, 53% of the sum has been raised. 

It’s such a modest amount for a treatment that will make a huge difference to Claire and Alan, who have lost their home and everything else they had in the UK. Now they are at risk of losing their room in Portugal, too. 

You can make a donation at:  https://www.justgiving.com/crowdfunding/tiffany-williams

Update

Claire informs me that the gofundme collection has now closed. But for those wishing to help in some way, there is a beautiful painting of Claire by Jason Pearce, which is up for auction with funds going to her medical fees.  

She says many thanks. 

Jason Pearce is an administrator for a very popular political group, and like me, he was originally contacted and asked if a member (Alan) could post a gofundme page to raise money for treatment costs to the group, as his wife, Claire, is seriously ill. Jason agreed, and offered to help. As Jason is an artist, it was suggested that he could paint a portrait of Claire and it could then be auctioned online to help raise some more money towards Claire’s ongoing treatment.

This is Jason’s lovely painting of Claire.

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“Claire”

20″ x 16″ Mixed media on canvas.

 


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Thanks Mr Green, but we want more than token gestures and political opportunism

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The work and pensions secretary, Damian Green, is expected to announce at the Conservative conference that those people with severe, lifelong conditions will no longer face six-monthly reassessments.

Employment and support allowance (a misleading title for sickness and disability support for those people whose doctors say are too unwell to work) will now continue automatically for people who have lifelong, severe health conditions, with no prospect of improvement, according to Green.

However, the retesting of chronically ill or disabled people for another key disability benefit – personal independence payments – is to remain, and thousands with unchanging or degenerative conditions are preparing to be put through that pointless assessment again.

I can’t help wondering how “chronic” and “degenerative” will be defined and how exemption from reassessment will be decided. It’s unclear which medical conditions will be considered grounds for a reprieve from further WCAs, but apparently the criteria will be drawn up by “health professionals. There were no details provided about who these “health professionals” will be. Many people have no faith whatsoever in the medical judgments of the assessors themselves – especially when they have previously been known to ask woefully ignorant questions like “how long are you likely to have Parkinson’s disease?”

It may be the case that those claiming Employment and Support Allowance, placed in the support group will be exempt from the reassessments. However, as Samuel Miller, a human rights specialist and campaigner for disabled people, points out: 

“The Department for Work and Pensions says that it is scraping retesting for people with severe, lifelong conditions at the same time that there has been a sharp drop in Support Group awards and a sharp increase in people placed in the Work Related Activity Group (WRAG). Charities report that 45% of people who put in a claim for Employment Support Allowance (ESA), and had Parkinson’s, Cystic Fibrosis, Multiple Sclerosis, or Rheumatoid Arthritis, were placed in the WRAG.

Disability rights campaigners are concerned that the figures show the government is cutting spending on disability benefits “below the radar”, after being forced to abandon its attempts to reduce expenditure on personal independence payment (PIP) in April.

The Department for Work and Pensions (DWP) statistics, released last month, show the proportion of disabled people applying for ESA who were placed in the support group – for those assessed with “the highest barriers to work” – plunged by 42 per cent in just three months. There are concerns that the Work Capability Assessment has been made even more harsh by stealth.

For assessments completed during November 2015, 57 per cent of claimants were placed in the support group; but by February 2016 that had dropped by 24 percentage points to just 33 per cent. 

Far too little far too late

This small change will not undo the suffering of sick and disabled people who have already been caught in the revolving door of the assessment and reassessment process. It’s not uncommon for people fighting a wrong “fit for work” decision to wait for many months before they win at tribunal, only to find that within three months of their successful appeal, they have another appointment for reassessment.

You would think that if someone has just won an appeal, common sense would prevail – that someone at the DWP would acknowledge that it’s highly unlikely these people have suddenly got better in such a short space of time. The strain of being put through this callous revolving door process has an adverse impact on people with chronic conditions, exacerbating their symptoms. It is profoundly stressful and anxiety-provoking. 

This political token gesture will not undo the profound physical and psychological damage that the WCA has caused some of our most vulnerable citizens. And for many who did not feel vulnerable – those who felt they coped pretty well with their illness ordinarily – the constant strain of having to prove themselves ill and the loss of lifeline income whilst they await mandatory review and appeal, has led to increased vulnerability.

It’s also tragic and painful that it’s far too late to help the people who have died as a consequence of  being told they are fit for work when they are not, and being forced to fight for lifeline social security to meet their basic needs.

I am happy to see the announced decision to stop reassessing chronically sick people every six months, because it’s unlikely they will get better. (The clue was always in the word “chronic,” curiously enough). If that brings about a reduction in the widespread suffering caused by the callous cost-cutting WCA , it’s a small step towards much needed positive change. This move would have been more credible as a signal of good intentions had Green also intended to announce the reversal of the cuts planned for those in the work related activity group, claiming ESA.

That a UK government feels it’s acceptable to financially penalise and punish a previously protected social group – comprised of people judged as too ill to work by doctors – shows how far our society has regressed in terms of equality and human rights. And democracy. 

Labour have already pledged to abolish the Work Capability Assessment

Call me a cynic, but didn’t the Labour party pledge to completely scrap the Work Capability Assessment at their conference? Debbie Abrahams, shadow work and pensions secretary, spoke of strong ethical and empirically evidenced reasons for doing so.

She says: “As ever with this government though, the devil is in the detail. While the end to repeated assessments will be a relief to those that have been affected, this announcement falls far short of the fundamental shift to a more holistic, person-centred approach we so desperately need.

“Too many sick and disabled people will remain subject to this harmful, ineffective assessment. We will continue to push the Tories for a better deal for disabled people.”

After years of people suffering and evidenced feedback from victims of their policies, campaigners and academic researchers, the government decide NOW that chronic actually means “chronic”?

Duncan Smith, whose resignation from the role of work and pensions secretary was seen as an attack on the then leadership of David Cameron and George Osborne, told the Today programme he “completely agreed with the changes.”

“We worked to change this process, it was one we inherited and it just functioned badly on this area,” he said.

That isn’t true.

Some historical context

The Work Capability Assessment was piloted under the last Labour government, but Duncan Smith passed it into law after disregarding the concerns that the Labour party had raised following their review, regarding the assessment process being insensitive to fluctuating conditions and mental health status. In fact Duncan Smith modified the assessment process, making it even less sensitive. In early 2011, the Conservative-Liberal Democrat coalition government initiated the planned expansion of the programme to reassess 1.5 million people whom previous governments had judged to be entitled to Incapacity Benefit.

At the same time the DWP introduced long-planned revisions to the test’s eligibility criteria, which became more stringent overall: most notably, the 03/11 version awarded no points when a claimant who had difficulty walking could overcome the disability by using a wheelchair, if reasonably practicable. When Atos were recontracted in 2010, targets to remove the higher rate benefits from seven out of eight claimants were built into the new contract. Dr Steven Bick reported that “experts” testing Incapacity Benefit claimants were told they should rate only about one in eight as so disabled they will never work. The “quota” was enforced by French firm Atos, paid £100 million a year for the testing, and was revealed by undercover GP Bick on Channel 4’s Dispatches.

In February 2011, Professor Paul Gregg, an economist and one of the original architects of ESA, warned that the WCA was “badly malfunctioning” and urged further pilot studies before the more stringent 03/11 version was used as the default assessment. Nevertheless, the mammoth Incapacity Benefit reassessment programme got under way in the spring of 2011, using the new version of the test.

In January 2016, the National Audit Office (NAO) published its evaluation of the DWP’s health and disability assessment contracts. It said the cost of each WCA had risen from £115 under Atos to £190 under Maximus.

The report went on to say that Maximus was facing “significant challenges with staff failing to complete training requirements” and revealed that in July 2015 – less than six months into the new contract – the DWP had been obliged to draw up a “performance improvement plan” with Maximus because “volume targets were not being met”.

Perhaps the real reasons for stopping the six-monthly assessments are entirely financial – merely cost-cutting measures. As well as the heavy cost of each assessment to the public purse, there is also the considerable cost of many tribunals, because of the many “wrong decisions”. 

Green told the Press Association: “We are building a country that works for everyone – not just the privileged few. A key part of that is making sure that all those who are able to work are given the support and the opportunity to do so. But it also means ensuring that we give full and proper support to those who can’t.”

(You can laugh now. I’m just wondering when an assessment for tax-dodging millionaires who were awarded at least £107,000 each per year in the form of a “tax break” will happen. This was at the same time the first round of welfare cuts were announced. It would be refreshing to see the minority of privileged citizens shouldering some of the burden of austerity and “paying down the the deficit” for a change. It would be fair to expect those who have gained the most from society to put something back, after all.)

He went on to say: “That includes sweeping away any unnecessary stress and bureaucracy – particularly for the most vulnerable in society.

“If someone has a disease which can only get worse then it doesn’t make sense to ask them to turn up for repeated appointments. If their condition is not going to improve, it is not right to ask them to be tested time after time. So we will stop it.”

I find it incredible that it’s taken six years for this “revelation” to hit home. Overwhelming empirical evidence that the assessment process is harming sick and disabled people has been presented to the government on many occasions, only to prompt what is, after all, a very small and inadequate policy change.

Green has almost always voted for a reduction in spending on welfare benefits, generally voted against raising welfare benefits at least in line with prices, almost always voted against paying higher benefits over longer periods for those unable to work due to illness or disability, and almost always voted for reducing housing benefit for social tenants deemed to have excess bedrooms (the “Bedroom Tax”), which has disproportionately affected sick and disabled people and their carers.

Earlier this year, a report for the Social Market Foundation thinktank recommended that the government entirely scrap the work capability assessment. The report also said the government should introduce a properly funded system – making use of trial projects and extensive consultation with benefit claimants – which would identify those disabled people closest to being able to get a job, while those too ill or disabled to work should have a “level of benefit provided … sufficient to allow them to live comfortably and engage fully in society.”

It also recommended that the government abandon the failing benefit sanction system for people with chronic illness or a disability – instead putting an emphasis on support meetings and financial incentives through a “steps to work wage” on top of their unemployment benefit. 

Remarkably, the report was written by Matthew Oakley – a former Treasury adviser who until 2013 was head of economics at the right-of-centre Policy Exchange thinktank. He was also on Iain Duncan Smith’s own social security advisory committee.

What Green has offered falls far short of Oakley’s recommendations.

Let’s not accept politically opportunistic sops and scraps of small comfort.

Sick and disabled people deserve so much better than this. The Work Capability Assessment is not only consistently empirically demonstrated as being unfit for purpose, arbitrary and cruel, but it is also one of the most shocking political betrayals of those most in need that has ever been allowed to go unchecked.

 

Related

Man leaves coroner letter as he fears Work Capability Assessment will kill him

The Tories are epistemological tyrants: about the DWP’s Mortality Statistics release

Labour pledge to scrap punitive Tory sanctions and the Work Capability Assessment

The Government’s brutal cuts to disability support isn’t ‘increasing spending’, Chancellor, but handing out tax cuts to the rich is

Government Finally Reveals That More Than 4,000 Died Within Six Weeks Of Being Deemed ‘Fit For Work’

Research finds strong correlation between Work Capability Assessment and suicide

What you need to know about the Work Capability Assessment

 


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Man leaves coroner letter as he fears Work Capability Assessment will kill him

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The government have persistently denied any “causal relationship” between their welfare reforms and an increase in premature deaths and suicides, despite an existing correlation. Ministers have also denied a link between disability assessments and an increase in mental distress and ill health.

Figures released last year show that between December 2011 to February 2014, 4,010 people died after being told they were fit for work, following a Work Capability Assessment (WCA). 40,680 died within a year of undergoing the WCA, making a bleak mockery of any claim that the WCA is a real and valid “health assessment” of any kind. Or that our welfare system is “supportive” to those in most need, in any real or meaningful sense. Those people were clearly not at all “fit for work.” The figures were only released after the Information Commission overruled a Government decision to block the statistics from the public.

Research last year from Leonard Cheshire, a charity that works with disabled people, also showed that the assessments are making people who are ill more sick. Almost three quarters (72 per cent) said they found the assessment had a negative impact on their mental or physical health, or both. The same number described the face to face appointment as very stressful.

David Sugg would agree with those research findings. David suffered a life threatening subarachnoid haemorrhage (bleeding in the brain) because of an aneurysm (a swollen and very weakened point in a blood vessel) in 2013, and faces more life saving surgery because he has developed two more aneurysms that threatens to rupture, putting him at risk of another catastrophic brain haemorrhage. Whilst he waits for his operation, he has been told that if his blood pressure goes up, he is likely to die.

He had a Work Capability Assessment with Maximus this week. He was so afraid of the adverse health impacts that the strain of the WCA may have on him that he left a letter for the local coroner, to be opened in the event of his sudden death.

The letter said: “You may be looking into the reason for my death. I am hoping I can save you some time. This uncaring and spiteful Tory government killed me.”  

He told me: “My neuro-surgeon says I mustn’t get stressed, but I have been called by the Department for Work and Pensions for an assessment even though I’ve told them about my situation. 

If I don’t go for an assessment my benefits will be stopped. But I fear it may cost me my life.”

Although David survived his appointment, he has been suffering with a violent headache since, and hasn’t been able to eat for a week.

 “That appointment might still kill me. If my blood pressure goes up I could be dead before I hit the floor. I asked the assessor why she was putting my life at risk, but she said it wasn’t her decision,” he said.

Aneurisms are quite often caused by an increase in blood pressure. The majority of people don’t survive a subarachnoid haemorrhage, and those who do are remarkably lucky if they escape without serious disability. Most people don’t survive if they have a second one.

David added that he felt the situation he is in has “Orwellian” parallels. It’s a terrible choice to have to make: he either risks his life and complies with the assessment or loses his lifeline support – his benefit is the only income he has.

David explained to me that like many people needing to claim Employment Support Allowance – which is a very misleading name for a sickness benefit –  he had worked all of his life before becoming ill. He worked in IT and security until a couple of years ago. He became unemployed at that time, and was struggling to find work.

 “I’d paid tax and national insurance all my life – since I was 15,” he said.

“The battle to get Job Seekers Allowance was so stressful I actually think that led me to having the aneurysm in the first place. Then I had to battle to get support. The first work capability assessment I had was just six months after I’d had seven-hour brain surgery.”

He told me that his assessor recognised how inappropriate the appointment was, telling him “you shouldn’t actually be here.”

Despite the fact that David was awaiting life saving surgery, the Department for Work and Pensions (DWP) demanded that he was assessed again. He returned the form, explaining that he was awaiting life saving surgery and must avoid stress, but to his horror, was forced to attend nonetheless.

He said “It’s brutal bullying by the DWP. No wonder people are committing suicide, pushed over the edge. You either die because of your condition or from suicide. All I would have to do is stop taking my pills for a couple of days and I would die.”

Debbie Abrahams, the shadow Work and Pensions Secretary, said that David’s case is far from unique.

She said: “This WCA process, revised by this Government, is not only not fit for purpose, there is growing evidence of the harm it is doing. These assessments need to be completely overhauled. Labour want to see a holistic, person-centred approach, not the dehumanising, harmful, inefficient process we have now.”

David wrote to his own MP, Stephen Metcalfe, outlining his extremely distressing circumstances, and was told that Stephen would contact the Department for Work and Pensions, but did not yet receive a response.

The system is designed to deter successful claims

I co-run a support group on Facebook for sick and disabled people claiming disability benefits. I know from the accounts and everyday experience of many others just how stressful the assessment process is. It’s a terrible state of affairs when people who are already struggling with severe health problems are made even more vulnerable because of callous cost-cutting government policies.

The assessment is not always an end to the stress, either. Quite often, people are forced to challenge wrong decisions, because the WCA is designed to find ways of passing people off as “fit for work” regardless of whether they actually are, cutting their benefit. It’s worth remembering that people needing sickness benefits have already been assessed as unfit for work by their own doctors.

If people need to appeal a wrong decision, they first have to go through a mandatory review  – where the DWP “reconsider” the decision. Sickness benefit is stopped at this stage, leaving people who are often very ill without any lifeline income. Most can’t claim jobseekers allowance because they are too ill to work and so cannot meet the harsh and rigid conditionality requirements of that benefit. There is no set time limit for how long the DWP have to undertake the mandatory review. No-one may appeal until after their review is completed. The appeal process is also very stressful and intimidating, it usually entails another wait of months. 

The revolving door of assessments and psychological distress

David is not the only person to contact me this week.

George Vranjkovic has been extremely anxious and distressed about his Work Capability Assessment, too. He is very afraid at the thought that he may lose his lifeline support.

He told me: “I took 5 days filling out the assessment form by hand and I sent it in 12 days before my deadline. But 5 days before the deadline I got a letter saying it had still not been received, so I rang them, and I got some bloke who chuckled. He said it probably got lost and was there anything else he could do.

I blew my top I’m afraid and said he could effing apologise for losing my form!!! He said he deserved to be treated with respect. I was so upset I shouted not if you sit there laughing at desperate people you don’t . Anyway, I ended up filling in the form on line, printing it off and sending one version by fax, and one version by special delivery, which is what I was instructed to do by them… £22.00 that cost me.”

The form showed up, according to another advisor that George spoke to the next day, but by then he had already paid out for the fax and special delivery and was told the likelihood of getting the £22.00 back was pretty remote. This is someone relying on just a lifeline benefit, calculated to meet only basic living costs – essentials: food, fuel and shelter.

Previously, George has been left without any money to live on by the DWP, without them providing any reason. That’s absolutely unacceptable.

“For 6 months when they cut my money off completely,  I was made to feel like a criminal. I was spoken to so badly on the phone. I wasn’t being sanctioned. They just weren’t paying me.

 This is all just another example of the abject cruelty we, as honest people, are put through,” he said.

Like many other disabled people, George has also worked previously, co-running a photographic service.

George talked to me over a period of 24 hours before his assessment yesterday. He hasn’t slept for weeks. He really needed someone to support him emotionally. He was extremely anxious, agitated and afraid. He knows that the WCA is designed to try and cut costs and take lifeline support from sick and disabled people.

He told me that he is someone who usually copes, and doesn’t like to make a fuss. He said “I try not to fall to pieces in public.” He was in a state of sheer panic, however, when he contacted me.

When he arrived for his appointment, George said that the assessor tried to reschedule the assessment. His distress was so great by this time that he absolutely refused to leave until the assessment was carried out. He simply couldn’t face going through the strain of waiting again.

“He asked me how the rescheduling of the test made me feel.  He told me that it wasn’t the first time today he’d heard that forms had got lost or went missing, he asked me if I’d ever thought about committing suicide. Which I have, the last time being a year and a half ago when the DWP cut off my money for 6 months,” he said.

Like many others, George has had several assessments. It’s fairly common experience to have to go through an appeal, only to get another appointment within three months of a successful outcome.

A study published by the Journal of Epidemiology and Community Health last year, showed a correlation between worsening mental health and assessments under the WCA. The study linked the WCA tests with an additional 590 suicides, increased mental health problems and hundreds of thousands of antidepressant prescriptions

In a letter to the Guardian, the study’s main author, Benjamin Barr, said it was crucial the DWP takes seriously concerns that WCAs are “severely damaging” mental health. He called on the department to release data it holds to researchers to allow further analysis of the health impact of the controversial test.

Calls to scrap the WCA

Earlier this year, a report for the Social Market Foundation thinktank recommended that the government entirely scrap the work capability assessment. The report also said the government should introduce a properly funded system – making use of trial projects and extensive consultation with benefit claimants – which would identify those disabled people closest to being able to get a job, while those too ill or disabled to work should have a “level of benefit provided … sufficient to allow them to live comfortably and engage fully in society.”

It also recommended that the government abandon the failing benefit sanction system for people with chronic illness or a disability – instead putting an emphasis on support meetings and financial incentives through a “steps to work wage” on top of their unemployment benefit.

Remarkably, the report was written by Matthew Oakley – a former Treasury adviser who until 2013 was head of economics at the right-of-centre Policy Exchange thinktank. He was also on Iain Duncan Smith’s own social security advisory committee.

The WCA is not only unfit for purpose, arbitrary and cruel, but it is also one of the most shocking political betrayals of those most in need that has ever been allowed to go unchecked.

 

What you need to know about Atos assessments

 

 

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Secret ‘internal reviews’ show clear link between Tory welfare ‘reforms’ and suicides

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I’ve written more than one lengthy critique of Tory notions of what passes for “research” methods, and often criticised Conservative refusals to accept the research findings of academics regarding, for example, established links between the Work Capability Assessment, increased suicide and mortality, the link between sanctions and increased mortality. The Tory plea for the universal and unqualified dismissal of whatever they deem to be criticism of their policies is often based on the claim that “no causal link has been established.”

As I have pointed out previously, whilst correlation certainly isn’t quite the same thing as cause and effect, it quite often strongly hints at a causal link, and as such, warrants further investigation.

It is inaccurate to say that correlation doesn’t imply causation. It quite often does. Correlation means that an association has been established. The tobacco industry, for example, has historically relied on exactly the same dismissal of correlational evidence to reject the established link between tobacco and lung cancer.

The standard process of research doesn’t entail, at any point, a flat political denial that there is any relationship of significance to concern ourselves with, nor does it involve a systematic and deliberate withholding of relevant data, attempts at censoring democratic dialogue, and a point blank refusal to investigate further. Furthermore, the government claims that there is “no evidence of a causal link ” is unverified. There is no evidence to support government claims that there isn’t such a link, either. In fact empirical evidence strongly refutes the Conservative’s persistent claims of no association between the welfare cuts and an increase in suicide and mortality.

I’ve observed more than once that when it comes to government claims, the same methodological rigour that they advocate for others isn’t applied. Indeed, many policies have clearly been directed by ideology and traditional Tory prejudices, rather than being founded on valid research and empirical evidence. The fact that no cumulative impact assessment has been carried out with regard to the welfare “reforms” indicates a government that is not interested in accountability, and examining the potential negative outcomes of policy-making. Policies are supposed to be about meeting public needs and not about inflicting Conservative dogma and old prejudices in the form of financial punishment on previously protected social groups.

We need to ask why the government has so persistently refused to undertake cumulative impact assessments and conduct open, publicly accessible research into their austerity policies, the impact they are having and the associated deaths and suicides.

Without such research, it isn’t appropriate or legitimate to deny a causal link between what are, after all, extremely punitive, targeted, class-contingent policies and an increase in premature mortality rates.

Government policies are expressed political intentions regarding how our society is organised and governed. They have calculated social and economic aims and consequences. Political denial of responsibility is repressive, it sidesteps democratic accountability and stifles essential debate and obscures evidence. Denial of causality does not reduce the probability of it, especially in cases where a correlation has been well-established and evidenced. Nor does attempting to hide the evidence.

Being civilised, holding values of decency and having legitimate concerns about the welfare and wellbeing of sick and disabled citizens have all been depreciated as mere matters of “subjective interpretation” and not as worthy subjects of political, rational or objective discussion. This isn’t a government prepared to engage in a democratic dialogue with citizens, it is one intent on imposing authoritarianism.

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The following article titled “Suicides of benefit claimants reveal DWP flaws, says inquiry” was written by Patrick Butler and John Pring, for The Guardian on Friday 13th May 2016 22.59 UTC

A series of secret internal inquiries into the deaths of people claiming social security reveal that ministers were repeatedly warned of shortcomings in the treatment of vulnerable claimants facing potentially traumatic cuts to their benefits entitlements.

The conclusions are contained in 49 Department for Work and Pensions (DWP) inquiry reports finally released to campaigners on Friday after a two-year Freedom of Information (FOI) battle. Some 40 of the reports followed a suicide. In 10 cases, the claimant had had their benefits sanctioned.

Although the heavily redacted reports do not draw a direct link between the death of a claimant and problems caused by their dealings with the benefits system, they highlight widespread flaws in the handling by DWP officials of claims by people with mental illness or learning difficulty.

The reports, called “peer reviews,” appear to challenge blanket claims by ministers that there is no connection between government welfare reform policies and the deaths of vulnerable claimants.

Several suggest that claimants who died may not have received adequate support from DWP staff handling their benefit claims. At least five of the reports call for major reviews or substantial changes to procedures on identifying and supporting vulnerable claimants.

Many of them centre on the much-criticised Work Capability Assessment (WCA), the test used to assess whether claimants are fit for work. Campaigners argue the tests are flawed and linked to health relapses, depression, self-harm, and suicides.

Activists have linked the WCA to a string of tragic deaths – including poet Paul Reekie, former sheep farmer Nick Barker and ex-security guard Brian McArdle – all of whom died after being found “fit for work” and told by the DWP that they would lose their out-of-work disability benefits.

Peer reviews are triggered when a claimant death is “associated with a DWP activity”. The reports released on Friday were drawn up between February 2012 and August 2014, when an FOI request was originally submitted.

One report warns that vulnerable claimants risked being overlooked by DWP officials, with potentially harmful consequences, because staff resources were stretched by a ministerial decision to push ahead with the speedy re-assessment of hundreds of thousands of incapacity benefit claimants.

It says: “The risk associated with disregarding the possibility that some of these claimants need more support or a different form of engagement is that we fail to recognise more cases like [name redacted] with consequent potential impact on the claimant.”

The report adds: “We need to ask whether or not in the context of a fast-moving environment of high [claimant re-assessment] volumes and anticipated levels of performance, the current process requires, encourages and supports … colleagues to independently and systematically consider claimant vulnerability.”

Another report suggests that while official written policy demanded vulnerable claimants to be treated appropriately this was not implemented in practice. It says: “This case may highlight a dislocation between policy intent and what actually happens to claimants who are vulnerable.”

Ministers initially denied back in 2014 that they held any records on people whose deaths may have been linked to benefits system. Although they subsequently admitted that so-called “peer-review” investigations had been carried out since 2012, they argued social security laws prevented them from publishing them.

A DWP spokesman said it would be wrong to link benefit claims with deaths. “Any suicide is a tragedy and the reasons for them are complex, however it would be inaccurate and misleading to link it solely to a person’s benefit claim.”

They added that guidance was provided to staff on how best to support vulnerable claimants. Ministers were not routinely shown the reviews, which were undertaken internally help staff to deal with complex and challenging benefit cases.

However, they were unable to say whether ministers or senior officials had acted on any of the recommendations contained in the 49 reviews.

Disability News Service, a specialist press agency which submitted the original FOI request to obtain the reports, asked the Office of the Information Commissioner to review the DWP decision. The ICO ruled in favour of the DWP in July 2014, but a subsequent appeal was upheld in March and ministers ordered to publish the reports.

Officials have removed from the reports any references to the specific events that triggered an investigation, as well as dates, names of claimants or staff and locations. Several of the inquiry reports have been stripped of almost all data.

But a number retain entries under the heading “Lessons learned”. Collectively these show that investigators examining the links between a claimant’s death and their treatment by local DWP officials uncovered persistent problems.

They found frontline officials were often unable to identify potentially vulnerable claimants, failed to deal sensitively or appropriately with them, or anticipated problems they may have negotiating their way around the welfare bureaucracy.

Investigators found, variously, that communication between officials and vulnerable claimants was often poor, that practice guidelines were not followed, and that benefits staff often rigidly adhered to the rulebook rather than using “common sense” in their dealings with claimants.

In two instances, investigators reported that it was difficult to carry out a proper inquiry because DWP records had been purged, or not kept properly. In another instance the investigator concluded that officals precedural actions were followed correctly and could not have prevented the death of the claimant.

Other peer review findings include:

• Local DWP branch officials should be given awareness training to deal with “customers who made suicide/self harm declarations”, one report urges. It concludes: “In learning from this experience it is clear there is work to do”.

• In one local office staff failed to provide adequate support for vulnerable claimants, according to a report. It says: “It is clear that we had several opportunities to identify and address the errors made over the duration of this claim, but we neglected to do so”.

• DWP staff who decide on whether to award or disallow disability benefit claims should always consider the claimants’ full historical case files and medical history, a report concludes, to “minimise the risk of withdrawing benefit inappropriately and placing a vulnerable claimant at risk”.

It is understood nine similar DWP peer reviews have since been undertaken since August 2014 and are subject to further FOI requests.

guardian.co.uk © Guardian News & Media Limited 2010


Sign the petition asking the government to examine the DWP, ATOS & Maximus’s culpability for deaths of benefit claimants

“There’s been a marked increase in the number of deaths & suicides of claimants recently found “fit for work” by work capability assessments, possibly implying those benefits entitlements were removed hastily and that the DWP, ATOS & Maximus failed in its duty of care to vulnerable benefit claimants.”

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Maximus ‘has falsified results of fitness for work tests’, says MP – John Pring

By John Pring

The discredited US outsourcing giant contracted to carry out “fitness for work” tests on behalf of the government has been accused by an MP of “falsifying” the results of assessments.

Labour MP Louise Haigh attacked the track record, ethics and even criminal behaviour of Maximus in delivering public contracts in the US, during a debate on the work capability assessment (WCA).

But she also highlighted what she described as a “disconcerting pattern of behaviour” by Maximus in the UK since taking over the WCA contract from Atos last year.

She said: “There seems to be an alarming trend of cases being rejected based on factual errors or even – I hesitate to say this – falsification.”

Haigh (pictured speaking in the debate), a shadow Cabinet Office minister, also raised concerns that there was no way for the public to check whether targets set for Maximus by the government – such as the number of serious complaints and the payment of travel expenses within nine working days – were being met.

 

You can read the rest of this excellent article here

Related

Doctors bribed with 70-90k salaries to join Maximus and “endorse a political agenda regardless of how it affects patients.”

Benefits Assessor: How Long Are You Likely To Have Parkinson’s?

I was asked in 2011 by an Atos assessor how long I thought I would have a “chronic, progressive illness”.  Medical testing had confirmed I have connective tissue disease (lupus). That was the diagnosis from my rheumatologist, which she read aloud at the assessment, from a correspondence between my consultant and my GP. Dumbfounded, I replied:

“Until I die. The clue is in the words ‘progressive’ and ‘chronic’.”

But an essential failure to grasp what words like “chronic”, “degenerative” and “progressive” actually mean isn’t peculiar to state assessors of illness and disability, who work for the government specifically to reduce the number of people eligible for sickness benefits. Government ministers display the same level of purposive ignorance:

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Hardly  “appropriate” , “reasonable” or taking “circumstances”, or medical diagnoses, for that matter, into account. A degenerative condition is one that DOES deteriorate. That is why it is called  a “degenerative condition.” It is therefore wrong and displays a degree of exceptional ignorance to assume that people WON’T or “may not” deteriorate.

This is why we don’t visit the government rather than a doctor when we become ill, especially when the state thinks it knows best about our medical conditions and how we should address those – and clearly doesn’t. This is about irrational ideology-driven policies aimed at cutting  back the welfare state. Regardless of how unreasonable that is and regardless of the consequences for those needing social security.

Sick and disabled people need support, understanding and medical care, not ignorance, Conservative dogma, vicious stigmatisation and a (neo)liberal re-translation of the words “Arbeit macht frei”.  

The government have conflated human needs with purely dogmatic economic outcomes.

Kitty S Jones.

Same Difference

This paragraph from Frances Ryan’s latest article- an interview with a claimant called Phil Brehaut- just says it all.

“It was very daunting, like being in court,” he says. “The lady on the panel actually asked me, ‘How long are you likely to have Parkinson’s?’” He pauses. “The person next to her quickly whispered in her ear … You would think they’d know a little bit about it.”

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Fit for work assessment was trigger for suicide, coroner says

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A disabled man killed himself as a direct result of being found “fit to work” by the government’s work capability assessment, a coroner has ruled. In a report to the Department of Work and Pensions, the coroner for Inner North London demanded it take action to prevent further deaths.

The coroner’s report on the death of Michael O’Sullivan  warns of the risk of more such deaths. Michael, a 60-year-old father of two from north London, killed himself at his home after being moved from employment support onto jobseekers allowance, despite providing reports from three doctors, including his GP, that he was suffering from long-term depression and agoraphobia and had been certified as unable to work.

The coroner said that Michael’s anxiety and depression were long-term problems, but the intense anxiety that triggered his suicide was caused by his (then) recent assessment by the DWP as being fit for work.

Previously, the loss or reduction of benefits have been cited as a factor in deaths and suicides of claimants by coroners. However it is believed to be the first time the work capacity assessment (WCA) process has been blamed directly for the death of a claimant. Iain Duncan Smith can no longer deny a causal link between benefit cuts and suicide following this landmark verdict.

Michael O’Sullivan died on 24 September 2013, but his case came to light after Disability News Service reported the story.

In a document marked “sensitive”, Mary Hassell, the coroner for Inner North London, told the DWP she concluded the “trigger” for his suicide was his “fit for work” assessment and detailed her concerns over future deaths.

The report, known as a Prevention of Future Deaths or Regulation 28 report, Hassell wrote:

“I found the trigger for Mr O’Sullivan’s suicide was his recent assessment by a DWP doctor as being fit for work. During the course of the inquest, the evidence revealed matters giving rise to concerns. In my opinion, there is a risk that future deaths will occur unless action is taken.”

At an inquest into his death last year, Hassell said that O’ Sullivan was suffering from long-term anxiety and depression “but the intense anxiety which triggered his suicide was caused by his recent assessment by the Department of Work and Pensions [benefits agency] as being fit for work and his view of the likely consequences of that”.

The inquest heard that in his assessment, the Department of Work and Pensions (DWP) assessing doctor, a former orthopaedic surgeon, did not factor in the views of any of the three doctors treating O’Sullivan. She also said that he was never asked about suicidal thoughts, despite writing them down in a DWP questionnaire.

Under a heading marked “matters of concern” in her report to the DWP, Hassell said the assessing doctor did not take into account the view of any of the three doctors who were treating O’Sullivan. She said:

“However, the ultimate decision maker (who is not, I understand, medically qualified) did not request and so did not see any reports or letters from Mr O’Sullivan’s general practitioner (who had assessed him as being unfit for work), his psychiatrist or his clinical psychologist.

In my opinion, action should be taken to prevent future deaths and I believe that you and Jobcentre Plus have the power to take such action.”

In its 16-page response to the coroner’s report, the DWP admitted it had got it wrong. It said that its policy to request further evidence when a claimant mentions suicide on claim forms was “regrettably not followed in this case”.

It also said the WCA process remained under “continual review and development”, including through five independent reviews, and concluded:

“We have noted the issues in this case and will continue to monitor our policies around assessment of people with mental health problems while we await the outcome of related litigation.”

The Department of Work and Pensions has conducted at least 60 internal investigations into suicides linked to benefit changes since 2012. Last month, DWP data showed the equivalent of nearly 90 people died every month after being declared fit for work and losing their benefits between 2011 and 2014.

A Department of Work and Pensions spokesman said last Monday that improvements have been made to the system since the coroner’s report. The spokesman said:

“Following reforms to the work capability assessment, which was introduced in 2008, people are getting more tailored support to return to work instead of being written off on long-term sickness benefits as happened too often in the past.”

People were not dying in their thousands before the introduction of the Tory austerity measures. The so-called “reforms” to the work capability test have been going on according to the DWP for the past five years, yet we see no improvement in outcomes.

Reducing a response regarding a suicide brought about by departmental and wider negligence to petty political point scoring, casualising tragic, needless and premature deaths that are linked with the welfare “reforms” and Conservative small state fetishism, is an outrage. This is not an acceptable or appropriate response from the DWP.

This tragic case along with the recorded, detailed evidence of many others, has been presented to the government by campaigners, opposition MPs, and by the parliamentary work and pensions committee as part of their inquiries related to the reforms, clearly demonstrating that government policies are causing harm to people. This case alone ought to have triggered an independent inquiry regarding the impact of the “reforms”, but instead we are presented with persistent and aggressive denials of a causal link between an increase in premature mortality and Tory policies, such as the non-medical WCA, (which was  re-designed by the Tories when they re-contracted Atos to deny people their entitlement to benefits,) without any grounds for those denials whatsoever.

This is a government that has abdicated its responsibility – its democratic, ethical, moral and legal duties towards those people who need the most support. Furthermore, by modelling such callous indifference towards the social groups that they have also stigmatised and scapegoated, this government are also pushing public moral and rational boundaries, too,  leading to desensitisation, and a normalisation of prejudice, discrimination and of a government’s actions that are designed to intentionally punish and coerce unemployed, sick and disabled people rather than support them.

We must challenge that and keep pushing back, because the alternative –  bystander apathy – is untenable. To do nothing is to give a silent consent to a continuing and devastating cumulative policy impact on the poorest and weakest citizens that is tantamount to eugenics, albeit by stealth.

Kitty

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Pictures courtesy of  Robert Livingstone.

Government fitness for work test is making disabled people more sick

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In January, 2012, I wrote an article: The ESA ‘Revolving Door’ Process, and its Correlation with a Significant Increase in Deaths amongst the Disabled and I discussed the distress and harm that the current government work capability assessment is causing disabled people. I said:

Many claimants have described a “revolving door” process of endless assessment, ceased Employment Support Allowance (ESA) claim, (based on an outcome of almost invariably being wrongly “assessed” as fit for work), appeal, successful appeal outcome, benefit reinstated, only to find just 3 months later another assessment is required. The uncertainty and loss of even basic security that this process creates, leading to constant fear and anxiety, is having a damaging, negative impact on the health and well-being of so many.

A significant proportion of those required to have endless assessments have very obviously serious illnesses such as cancer, kidney failure, lung disease, heart disease, severe and life threatening chronic conditions such as multiple sclerosis, lupus, myalgic encephalomyelitis, rheumatoid arthritis, brain tumours, severe heart conditions, and severe mental health illness, for example. To qualify for ESA, the claimant must provide a note from a doctor stating that the person is unfit for work. There can be no justification for subjecting people who are so ill to further endless assessments, and to treating us as if we have done something wrong.

Marginalising and stigmatising sick and disabled people, amongst whom are some of our most vulnerable citizens, via propaganda in the media, using despiteful and malicious terms such as “workshy” and “feckless” is a major part of the Government’s malevolent “justification” to the public for removing the lifeline of support from the sick and disabled. We are climbing Allport’s Ladder

In addition to very justified anxieties regarding the marked increase in disability hate crime that the Tory-led propaganda campaign has resulted in, many sick and disabled people have also stated that they feel harassed and bullied by the Department of Work and Pensions and Atos. Many talk of the dread they feel when they see the brown Atos envelope containing the ESA50 form arrive through the letter box.

The strain of constantly fighting for ESA entitlement and perpetually having to prove that we are a “deserving” and “genuine” sick and disabled person is clearly taking a toll on so many people’s health and well being. Many families of those who have died have said that the constant strain, anxiety and stress of this revolving door process has contributed significantly to their loved ones’ decline in health and subsequent death. The figures from the DWP, and the marked contrast between the ESA and IB death statistics certainly substantiate these claims.

Leonard Cheshire, a charity that works with disabled people, surveyed 350 people who had been through the workplace capability assessment, which is used to establish whether benefit claimants are well enough to return to work.

More than six in 10 (65 per cent) of those who had gone through the process said they had ended up with more pain afterwards. Almost three quarters (72 per cent) said they found the assessment had a negative impact on their mental or physical health, or both. The same number described the face to face appointment as very stressful.

A teacher who was medically retired in 2011 due to progressive rheumatoid arthritis, said she left her appointment “feeling absolutely awful and suffered a lot of pain in the following days”. She went on to suffer a stroke a few weeks later, and believes the experience of undertaking a work fitness assessment was a contributing factor.

Andy Cole, campaigns director for Leonard Cheshire, said:

“This isn’t acceptable and no test should put someone through something that makes their condition worse.

We have known for a long time that this is an important issue. We had anecdotally hear this information but, [getting] it quantified in this way in quite such significant numbers, we were really surprised to see that it was this sort of figures.”

Harm may be caused by assessors because they did not have sufficient information about patients’ conditions. Less than half (42 per cent) said their assessor had evidence of their condition prior to the meeting. Only 21 per cent agreed with the statement:

“The assessor let me explain how my condition [or] disability affects me differently on different days or at different points during the day.”

Two thirds disagreed with the outcome of their assessment.

Mr Cole added:

“Some of the conditions are well documented through medical data going back decades. If that was used better there wouldn’t be a need for a test in the first place. It’s worth remembering that the test was fundamentally supposed to be about a benefit that helped people back into work. There are lots of issues around the test about whether it’s been able to achieve that.”

The research relates to the period during which the private company Atos was responsible for carrying out the assessments. Its work has ended after it pulled out of a government contract to manage disability claims early, and the American company Maximus has taken over delivery of the assessments from 1 March 2015.

The charity is calling on Maximus to take the findings of its survey into account when redesigning the fitness for work assessment process. It wants to see staff trained in specific medical conditions, (as most Atos assessors are non-specialised nurses or occupational therapists,) physical examinations restricted to cases of absolute necessity and for claimants to be aware they can say no to an examination if it will cause them pain.

However, a spokesman for the Department of Work and Pensions said:

“Healthcare professionals always take consent for any physical examination and ask claimants to tell them if any movement is uncomfortable. Examinations are not completed if they cause pain. Sufficient information is usually obtained through discussion, observation and a limited physical examination to assess the effects of disability.”

We know this to be untrue because of the high numbers of people needing to challenge wrong decisions.

One such person is Sharon Majek, 57, from Rugby, who has been unable to work since her mid-thirties after suffering a serious injury at work. She stopped an elderly patient from falling out of bed badly hurting her back. She was diagnosed with osteoarthritis, degenerative disk disease and fibromyalgia, leaving her in constant joint pain and with limited sensation in her hands.

She described her assessment as “traumatic”. She said:

“The doctor never made eye contact with me once, and that made me feel very uncomfortable. I was awaiting a knee replacement. He asked me to bend my knees. When I said I couldn’t he pushed it back. I was sweating with the pain. It swelled up later that day.”

Ms Majek was found fit for work so she asked to see a copy of her report, which she and her husband described as unrecognisable from the meeting they had attended. The decision was overturned at appeal. This is a very common and unacceptable experience amongst people claiming ESA.

 

Further reading:

What you need to know about Atos assessments.

Black Propaganda

Essential information for ESA claims, assessments and appeals

Clause 99, Catch 22 – State sadism and silencing the vulnerable

 

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Thanks to Robert Livingstone for the memes

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