Tag: DWP

DWP accused of altering disability assessment reports to cut or end successful claims

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Pictured: Gail Ward, who was told that she did not qualify for Personal Independence Payment, despite living with a rare and potentially life-threatening heart condition – Prinzmetal’s angina – attacks can occur even when she is resting. She also had other health problems. Remarkably, Gail was told by the DWP that she doesn’t qualify for PIP. She won her appeal after waiting 15 months for her case to be heard at a social security tribunal.

It has been claimed that officials within the Department for Work and Pensions (DWP) have edited or removed thousands of work capability assessment reports submitted by privately contracted healthcare professionals.

It’s alleged that officials reduced qualifying points awarded during face-to-face assessments, delivered by ‘independent’ private firms, and in some cases disposed of the reports entirely.  

The Daily Record reports that during the last year paperwork was altered or amended in around 1,840 cases, while a further 460 applications were branded ‘unacceptable’ and simply binned.

In 2018, I raised concerns that the DWP were quietly editing people’s assessment reports for Personal Independence Payment (PIP) and Employment and Support Allowance (ESA), to reduce or end claims for disability support. I reported that a man with multiple sclerosis and mental ill health lost his PIP award after his original assessment report was dishonestly edited during a DWP ‘audit.’

Officials had clearly tampered with the assessor’s original report. The man only discovered the ‘audited’ version of his health assessment report when he asked for copies to make an appeal. He had been in receipt of the basic level of support for two years when he was summoned to be re-assessed for PIP, which is non-means tested and designed to help with the extra cost of living with debilitating conditions.

The original assessment document said the man, has “regular specialist input”. The ‘audited’ version says he does not. The report outlines the patient’s MS, depression and anxiety and tells of his difficulties with tasks including cooking, dressing and washing. The nurse noted his clothes were dirty and his top inside-out. The ‘auditor’ had removed the second point.

The ‘auditor’ changed a part which said the man needed supervision or prompting to wash or bathe, and a section on preparing food. The original said he “needs prompting” but the ‘audited’ version said he could prepare and cook a simple meal himself. In every section of the report where the man scored points towards his PIP award, the ‘auditor’ had reduced his score to zero, without contacting him to ask for information. This tampering with the original report was done without informing the claimant, and therefore without giving him an opportunity to clarify the original report or challenge the altered version of his account. 

He was accidentally sent ‘before and after’ audit copies of his assessment, highlighting the DWP editing designed to trivialise the impact of his medical conditions on his day to day living circumstances, and to remove points for his award eligibility. 

The Daily Record reports than an estimated 11,760 assessment reports were secretly graded by DWP officials as acceptable, unacceptable, or amended.

DWP officials graded around 980 health assessments per month, with up to 200 of these being amended every month, while 20 to 50 were deemed “unacceptable” and rejected outright.

However, the number of amended reports is likely to be much higher because the DWP only publishes data from Independent Assessment Service forms (formerly known as Atos).

The Daily Record also says that 33,670 assessments in total were audited from two private companies contracted by the DWP to carry of disability assessments for PIP. 

SNP MP Marion Fellows commented: “It is concerning that thousands of health reports are being tampered with each year by people who weren’t even present for the assessment.

“There must be a complete halt to audits and an inquiry into the UK Government’s rigged health assessments.

“DWP auditors, who aren’t present during assessments, should not be able to mandate changes which could bear heavily on peoples’ lives.

“Changes should not be made by so-called health professionals who didn’t even carry out the original assessment. This is a clear injustice that must be corrected.

“People have spoken to me about how they feel they are degraded in their assessments.

“For the whole process to be a sham and for the assessment to be undermined by auditors is infuriating.”

The DWP said: “We are absolutely committed to ensuring people receive the support they are entitled to.

“That is why assessments are carried out by qualified health professionals and we continue to work with them to ensure quality is continuously improving.

“Sometimes assessment reports are returned to providers to ensure we have as much information as possible to reach an accurate decision.”

That’s clearly untrue. Information is most often actually removed at ‘audit’ by the DWP.  And inaccurate decisions are unacceptably high. The high success rate of claimant appeals indicates that clearly, something is seriously wrong with the system.

Last year, around two thirds of cases heard at tribunal in Great Britain found in favour of the claimant. In Northern Ireland, the figure was around 54% in 2018-19. The rise in the percentage of successful appeals came despite a drop in the overall number of cases being heard at court.

This raises concerns about the overall quality of decision-making in the DWP – both on PIP and ESA, in the apparent push to remove support unlawfully from as many disabled people as possible in the name of austerity.

The hostile environment

The introduction of mandatory reconsiderations in 2013 and cuts to legal aid have deterred many people from appealing. Mandatory Reconsideration don’t seem to function as a genuine check to ensure the original decision is fair and accurate, instead it is an administrative hurdle for claimants to clear, leaving them without any support while the DWP review the original decision. Furthermore, there were targets in place for DWP decision-makers to uphold around 80% of the original DWP decisions.

The DWP have claimed that the largest single reason for the high success rate of those claimants appealing DWP disability benefit adverse decisions. However, the Department has failed to explain why it takes until the appeal stage for evidence to come to light. In almost half of cases the “new evidence” presented was oral (not medical) evidence from claimants, which arose most often during the appeal process. It is difficult to understand why this information was not, or could not have been elicited and reported by the assessor.

The DWP’s attempt at explanation does not absolve the Department of responsibility. It certainly fails to address or explain how a target for upholding original decisions is compatible with ensuring that questionable reports are thoroughly investigated, and clearly flawed, inaccurate decisions identified and corrected.

Government guidelines for assessments are aimed at invalidating disabled peoples’  accounts of their experiences of illness and disability

The government produced guidelines that says assessors must look for ‘inconsistencies’ in disabled people’s accounts. Assessors are told: “All evidence must be interpreted and evaluated using medical reasoning, considering the circumstances of the case and the expected impact on the claimant’s daily living and/or mobility. When weighing up the evidence, it is important to highlight any contradictions and any evidence that does not sufficiently reflect the claimant’s health condition or impairment or the effect on their daily life.”.

This means that rather than focusing on written medical evidence and verbal evidence provided by the claimant, the assessor is looking for any evidence that may be used to discredit the claimant’s account of their disability from the start. 

Disabled peoples’ benefits assessments are carried out on behalf of the Department for Work and Pensions by the private contractors Capita, the Independent Assessment Services (formerly called Atos) and Maximus. However, it is the DWP that makes the decisions regarding a person’s eligibility for social security support.

The government guidance document for PIP assessments (section 3.4 onwards) says that “audit processes are in place for auditing the quality of assessments through:

• DWP Lot-wide audit (random sample); and
The provider – Approval-related audit (for trainees).

And: “Audit has a central role in ensuring that decisions on benefit entitlement, taken by DWP, are correct. It supports this by confirming that independent Health Professional advice complies with the required standards and that it is clear and medically reasonable. It also provides assurance that any approach to assessment and opinion given is consistent so that, irrespective of where or by whom the assessment is carried out, claimants with conditions that have the same functional effect will ultimately receive the same benefit outcome.”

It goes on to say: “The DWP Independent Audit Team carries out lot-wide audit, which is an audit of a controlled random sample from across each contract Lot, feeding in to routine performance reporting for DWP.”

Where a report is deemed ‘unacceptable’: “Any changes made to forms should be justified, signed and dated. It should be made clear that any changes are made as a result of audit activity. Where necessary a new report form should be completed.”

The government guidelines also say that: “Any challenge to the reason DWP has returned a case to the Provider for rework must be made via the nominated rework Single Point of Contact (SPOC).”

In the event of a dispute regarding a request for an assessment report to be changed, “the final decision on whether the case requires rework rests with DWP and not the assessor.” 

So ultimately, an official at the DWP who was not present when a person was assessed, may decide that the assessment report is ‘reworked’, and use non-transparent criteria to change the facts established and recorded during the assessment.

This means that the person making the claim has no opportunity to challenge the changes made to ‘reworked’ reports before the decision is made regarding the claim. 

Over the last few years, evidence has mounted that disability benefits are being reduced or removed from people on fabricated grounds. Disability News Service (DNS) has  carried out an investigation into claims of widespread dishonesty in the disability benefit system. The research found more than 250 PIP claimants who have alleged assessors repeatedly lied, ignored written evidence and dishonestly reported the results of physical examinations. It’s a regular occurrence for disabled readers to read the reports of their benefit assessment, and find a statement of their circumstances, an event or comment that never happened.

For example, one person with a serious spinal injury who is wheelchair-bound was baffled by the comment on her assessment report which said she could bend to feed her dog and could take it out for a walk. She said she doesn’t have a dog, and has never had one. 

The government produced guidelines that says assessors must look for ‘inconsistencies’ in disabled people’s accounts. For example, if a person says they lack dexterity in their hands, but they are wearing jewellery, it will simply be assumed that they can open and close the clasp. They won’t be offered an opportunity to clarify that this is the case. 

In my own PIP assessment report in 2017, it said that the HP had to prompt me several times because of my lack of concentration. She also acknowledged that I needed aids to remember to take my medication. Yet the report is riddled with inconsistencies and inaccuracies. It was concluded that there is no evidence that I have any ‘cognitive difficulties’ because I have a degree (from 1996), and worked as a professional – social work (before I became too ill to work in 2010.) 

It was also mentioned that I had a driving licence as further justification for removing a point, but the report failed to mention I have not been able to drive since 2005 because of flicker-induced seizures, even though I made that clear. I therefore lost one point – which meant I was not awarded the enhanced rate. The reasons provided were not justified, since the assessor referred to events and periods of my life when I was not ill and disabled.

As well as widespread allegations of fabricated reports, secret filming has produced claims of a culture of targets, in which assessors are allegedly monitored to ensure they don’t find excessive numbers of disabled people eligible for benefits, and mounting evidence of toxic punitive measures. As one former jobcentre adviser put it when describing her role with benefit claimants, there were “brownie points for cruelty”.

Consequences of the DWP’s hostile environment

The Conservative’s welfare reforms have led to “grave and systematic violations” of disabled people’s rights, a United Nations (UN) inquiry has concludedChanges to social security “disproportionately affected” disabled people, the United Nations Committee on the Rights of Disabled Persons (CRPD) found.

The UK was the first country to be investigated under a UN convention it has been signed up to since 2007.

However, the government said it “strongly refuted” the committee’s findings and its “offensive” view of disability. Many disabled people, charities and campaigners submitted evidence to the United Nations for the inquiry. The government’s response was offensive.

The committee launched an investigation in 2012 after receiving evidence from individuals (I submitted evidence) and disability organisations about an the adverse impact and harm of government reforms on disabled people. The government have refused to act upon the findings and recommendations of the UN report.

Last year, the DWP disclosed that over 21,000 ill and disabled people died waiting for their PIP assessment to be completed, between April 2013 and 30 April 2018.

Sarah Newton, then Minister of State for Disabled People, published the figures on 11 January following a question raised in parliament by Labour MP Madeleine Moon in December: “How many people have died while waiting for their personal independence payment assessment to be completed; and what were the conditions those people died from?”

Newton responded: “All benefit claims can be made under the special rules for people who are terminally ill which will mean that they are fast tracked. These are currently being cleared within 6 working days for new claimants to PIP. The Department would encourage all claimants with a terminal illness to let the department know and to apply using the special rules.

The cause of death of PIP claimants is not collated centrally by the Department.”

Over 3.6 million applications to PIP were made between April 2013 and 30th April 2018. Of these:

  • 4,760 claimants died between their case being referred to, and returned from, an assessment provider;
  • 73,800 claimants died within 6 months of their claim being registered; and
  • 17,070 claimants died after registering but prior to the DWP making a decision on their claim. Details of the claimant’s primary medical condition, where recorded, are in the accompanying spreadsheet.”

The total number of PIP claimants who died was 95,000. But Newton’s response does not indicate at what stage of their claim the 73,800 people, who died within six months of it being registered, were at. Nor does it indicate what those people who did not have terminal or degenerative illnesses died of – including those with mental illness. For example, 270 of those mortalities are listed as having had anxiety and/or depressive disorders as their primary disorder.

Of those who did have terminal illnesses, we need to ask why these people were  cruelly left waiting so long for their assessment, if, as Newton claims, they are ‘fast tracked’ through the claim and assessment process.

Prior to the introduction of PIP, Esther McVey stated that of the initial 560,000 claimants to be reassessed by October 2015, 330,000 of these are targeted to either lose their benefit altogether or see their payments reduced. Of course the ever-shrinking category of “those with the greatest need” simply reflects a government that has made a partisan political decision to cut disabled people’s essential income to fund a financial gift to the wealthiest citizens. There is no justification for this decision, nor is it remotely “fair”, as the government claims. 

We also need to ask how and why McVey had those figures in advance of the assessments taking place.

It’s become very evident since that ‘those in the greatest need’ are not being served by social security.  Disabled people are suffering distress, harm and some are dying as a consequence of government policy. The DWP end disabled people’s support any way they can, it seems. And when they can’t find a reason, they edit the evidence to attempt to justify their brutal and incoherent decision making.

In August 2013, Mark Wood starved to death at his home in Oxfordshire after his ESA was stopped.

David Barr, from Glenrothes, Fife, also died that month, having taken his own life following an assessment that deemed him “fit for work”, resulting in the withdrawal of his ESA. He had a long history of serious mental health problems. 

On 23 September 2013, a father-of-two, Michael O’Sullivan, took his own life at his flat in north London. He had a long history of significant mental ill-health.

In November 2015, Paul Donnachie killed himself at his home in Glasgow. His ESA was stopped in error, but the letter informing him of the DWP’s mistake arrived too late. His body was found when the council came to evict him.

All of these people had significant mental health problems, and there are countless others, many whose names are never likely to be known, other than by grieving family and friends. These deaths are inextricably linked to decisions and actions taken by Conservative ministers and senior civil servants from the early days of the 2010 coalition government.

Every one of their deaths could and should have been avoided.

The Disability News Service (DNS) reported more recently that Errol Graham weighed just four-and-a-half stone when his body was found by bailiffs who had knocked down his front door to evict him. He had just a couple of out-of-date tins of fish left in his flat, because the DWP had wrongly stopped his ESA. He starved to death, and his rent support had been stopped as a consequence of his ESA claim being ended. The DWP failed to follow safeguarding rules in their haste to end his claim. He was also denied PIP, which left him without any income whatsoever. 

DWP civil servants had failed to seek further medical evidence from his GP, just as in many other tragic cases that have sparked repeated calls for an independent inquiry into links between the deaths of claimants and the actions and failings of the DWP. The government have consistently refused to acknowledge a correlation between their actions and the death of disabled people, so have no intention of investigating the evidence. 

Assistant coroner Dr Elizabeth Didcock, who heard the inquest, was told that the DWP stopped Graham’s ESA entitlement – and backdated that decision to the previous month – after making two unsuccessful visits to his home to ask why he had not attended a face-to-face work capability assessment (WCA) on 31 August 2017. The inquest heard that it was standard DWP procedure to go ahead with stopping the benefits of a claimant marked on the system as vulnerable after two failed safeguarding visits.

However, the DWP (somehow) managed to stop an ESA payment that had been due to be credited to his bank account on 17 October, the same day officials made the second unsuccessful safeguarding visit.

DWP’s own rules state that it should make both safeguarding visits before stopping the benefits of a vulnerable claimant.

Because Errol lost his ESA entitlement, his housing benefit was also stopped. His family says he had also been found ineligible for PIP. Deprived of all financial support, experiencing significant mental distress and unable or unwilling to seek help, he slowly starved to death. He was 57. His body was discovered on 20 June 2018 when bailiffs arrived at his Nottingham council flat to evict him for non-payment of rent. 

His benefits had been stopped even though he had been receiving incapacity benefit, and then ESA, for many years as a result of enduring mental illness and distress that had led to him being sectioned. Errol was clearly extremely vulnerable.

He had also told the DWP on an ESA form three years earlier that he could not cope with “unexpected changes”, adding: “Upsets my life completely. Feel under threat and upset…”

He added: “Cannot deal with social situations. Keep myself to myself. Do not engage with strangers. Have no social life. Feel anxiety and panic in new situations.”

The assistant coroner said: “There simply is not sufficient evidence as to how he was functioning, however, it is likely that his mental health was poor at this time – he does not appear to be having contact with other people, and he did not seek help from his GP or support agencies as he had done previously.”

She concluded in the narrative verdict, delivered last June, that the “safety net that should surround vulnerable people like Errol in our society had holes within it”.

Those ‘holes’ are a consequence of deliberate, ideologically driven anti-welfare policies. They have intended consequences. The government assumes that people treated unfairly will appeal wrong decisions. Firstly, many people are far too ill to cope with the stress of that process. Secondly, it should never be primarily the role of courts to allocate social security fairly. That is the official role and purpose of the DWP.  However, the government department is clearly failing to fulfil its role. This is because the neoliberal ideology that drives austerity policies is incompatible with the central principles of social security. 

She continued: “He needed the DWP to obtain more evidence [from his GP] at the time his ESA was stopped, to make a more informed decision about him, particularly following the failed safeguarding visits.”

She said that a consultant psychiatrist had told the inquest “that Errol was vulnerable to life stressors” and that it was “likely that this loss of income, and housing, were the final and devastating stressors, that had a significant effect on his mental health”.

But she decided not to write a regulation 28 report demanding changes to DWP’s safeguarding procedures to “prevent future deaths” because the department insisted that it was already completing a review of its safeguarding, which was supposed to finish last autumn.

The DWP had promised her it would “listen to clients and to those representing them, and… ensure that the DWP was focused on support and safety for vulnerable people”.

Dr Didcock insisted that this commitment “must be converted into robust policy and guidance for DWP staff” and that the DWP must ensure that “all evidence that can reasonably be gathered is put together about a client, before a benefit is ceased”.

Disability News Service also highlights that the death of Errol Graham closely mirrors other tragedies caused by the DWP’s repeated refusal to make significant improvements to its safeguarding policies and practices.

Denise McKenna, co-founder of the Mental Health Resistance Network (MHRN), said the network was “absolutely devastated and saddened beyond words to hear of the circumstances surrounding the death of Mr Graham”.

She said: “We are enraged that the DWP continues to treat the lives of people who live with mental distress as disposable.

“This level of cruelty is outside of anything that would happen in a civilised society.

“The fact that Mr Graham had not responded to attempts to contact him following his failure to attend the work capability assessment (WCA) should have raised alarm bells over his safety, but instead the DWP took the opportunity to stop his social security entitlements.”

And there’s the truth: the government have created a hostile environment for disabled people that is heavily weighted towards preventing successful claims, taking its lessons from rogue multinational insurance companies such as Unum, who have systematically employed strategies to pay out insurance only as the last resort, rather than on the basis of need. 

And if the evidence doesn’t suit the politically desired outcome – as outlined by the likes of Esther McVey –  it can always be edited or disposed of by the DWP.

Hostile environment McDonnell

 


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Woman with rare heart condition that causes unpredictable multiple health problems is denied PIP

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Gail Ward. Photo: Facebook

A woman with a rare heart condition, which can cause her to collapse unpredictably at any moment, has spoken about her battle with the Department for Work and Pensions (DWP) to get the support she desperately needs.

Gail Ward was told that she did not qualify for Personal Independence Payment (PIP), despite living with the potentially life-threatening heart condition called Prinzmetal’s angina, a rare form of angina where attacks can occur even when she is resting. Remarkably, Gail was told by the DWP that she doesn’t qualify for PIP.

Prinzmetal’s angina can cause arteries in the heart to spasm during times of stress or cold weather, which severely limits a person’s independence and can also be life-threatening. It causes cardiac arrhythmias and can lead to heart attack if the blood flow to the heart deprives the organ of oxygen. The condition may sometimes arise when someone already has a serious form of Raynaud’s phenomemon, where the blood supply to the extremities is closed down because of cold or stress, causing a painful spasm. But it is a relatively rare condition.

Gail, who many of my readers will know, is also a respected disability rights campaigner. She had been claiming Disability Living Allowance for 20 years, but after being ordered to attend a mandatory reassessment for PIP, she was told that her support would stop because she ‘failed to meet the qualifying criteria.’

Gail told the Chronicle Live about her condition: “It occurs when you are resting and you don’t get any warning. It is not like normal angina.

“I can be in the sitting room having a conversation and the next minute I have collapsed.

“I need to wear a pendant bracelet in case I collapse but sometimes I don’t even get to press that.

“It has such an impact on my life. If I have a severe attack I could not even put a sentence together but find that if I rest up it allows the body to repair itself.”

Gail, who also has arthritis and hip dysplasia, among other health problems, say’s that living with the condition leaves her feeling tired and drained and that this has been exacerbated by her battle with the DWP.

She appealed the DWP’s decision. After waiting 15 months for her case to be heard at a social security tribunal, Gail was told that her appeal had been successful and that her benefits would be reinstated.

Commenting on her own experience and that of other people who struggle to get the support they are entitled to, Gail said: “Disabled people are losing their mobility cars, losing disability entitlement when they are moving to PIP.

“It is a different criteria. It is basically about what you can and can’t do. It is a disability analysis, not a medical.”

In 2013, the government began to rollout PIP for adults to replace Disability Living Allowance (DLA). One of the purposes of PIP was to reduce spending, with the intention of costing 20% less. Therefore, the conditions to satisfy in order to be entitled to the support were made stricter.

Gail is right. The assessments are not remotely ‘medical’ in nature, and the evidence from doctors employed within the NHS, including diagnosis and details of symptoms, are often ignored. Instead, the DWP contracted assessments are geared towards “objective” snapshot accounts of how someone’s disability affects their day to day living.

It also emphasises the professional gap between NHS medical professionals and the “health professional” employed by the state to carry out these functional capacity assessments in the context of a neoliberal welfare state, and medical health professionals, whose wider work is generally not directly linked to the politically defined conditionality of welfare support.

That said, PIP is a non-means tested support to help people maintain as much independence as they can, whether in work or not. It stands to reason that someone who is too ill to work will need more support because of their loss of earnings. 

Gail said: “People with severe disabilities are losing their DLA after being on it for 20 or 30 years.”

She added: “I would like the DWP to clarify why they refuse to address poor quality assessor report failings and decision maker decisions, which put disabled people at risk of financial hardship.

“I would like answers as to why the DWP stop the mobility component money from date of applying.

“I applied in July 2018 but the assessment was in October 2018, yet if a claimant is successful the mobility component is paid from decision date.”

A DWP spokesperson said: “We are committed to ensuring that disabled people get the support they’re entitled to.

“Decisions to award PIP are based on all of the evidence available to us at the time.

“Ms Ward has been awarded the enhanced rates to PIP for daily living and mobility after additional evidence was provided.

“She continued to be supported with Employment Support Allowance while awaiting the outcome of her PIP tribunal.”

This standard response doesn’t offer any explanation as to why the DWP decided that someone who they have already deemed more than once as not being well enough to work somehow failed to qualify for Personal Independence Payment.

Gail was subjected to a loss of income, her motability entitlement and high levels of stress for almost a year and a half. It’s a well known fact that stress exacerbates illness, and particularly her heart condition.

Furthermore, it is the decision of the ‘health professional’ (HP) to “determine whether any additional evidence needs to be gathered from health or other professionals supporting the claimant.”

Often at the appeal stage, it turns out HPs frequently decide not to ask for further evidence.  The DWP must take all medical evidence into account when making a decision about PIP claims. Yet the DWP say: “In many cases, appeals are granted because further medical evidence is provided.” 

This indicates that people are having to go to court, often waiting months for their appeal to be heard, because of deliberately under-informed, poorly evidenced DWP decisions. 

Furthermore, it says in the government guidance to GPs: “Your patient should complete the forms to support their [PIP] claim using information that they have to hand, and should not ask you for information to help them do this, or to complete the forms yourself.” “

After all this time, you would expect that this problem would have been addressed, especially given that the person who suffers as a consequence is always the ill and disabled person. 

Anyone would think this is part of a broader enduring government strategy to ensure as few people as possible are awarded the disability support they are entitled to. After all, it takes immense strength for someone who is very ill to fight unfair decisions at tribunal, and not everyone does so.

Many die while awaiting the outcome of their claim for PIP.  Up to January 2019, more than 17,000 people died while waiting to hear whether their claim had been successful, it emerged.

Among those were people with terminal conditions, but who did not meet the government’s strict ‘six month’ rule – people can only be ‘fast tracked’ for support if they are expected to die within six months. However, doctors cannot predict the precise timing of terminally ill people’s demise. Many campaigners have been pushing for this restriction to be lifted, because it’s irrational, inhumane and unreasonable. 

Ministers have been accused of “failing people at the most vulnerable point in their lives” after the figures revealed 17,070 disability claimants have died while waiting for decisions on their PIP claims since 2013.

One in four (4,330) of those who died were suffering from a form of cancer, while 270 had anxiety or depressive disorders. In more than half of cases (9,020), the main disability was not even recorded.

Last year, shadow disabilities Marsha de Cordova accused the government of allowing a “cruel and callous” PIP assessment process to create a “hostile environment for disabled people”.  

She is absolutely right.


 

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DWP stop man’s PIP support after assessor claims amputated foot has ‘healed’

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Tommy Weir says the reference in his Personal Independence Payment (PIP) assessment report to his left foot was either ‘gross incompetence or simply a lie’ because he doesn’t have a left foot.

A man who had his foot amputated because of a health condition has had his social security support cut after an assessor claimed a wound on his non-existent foot had “completely healed”.

Despite the evident error in the Department for Work and Pensions report, Tommy Weir’s £479 a month payments were immediately stopped last month.  

Weir suffered from a bone infection which led to life-threatening sepsis and an eventual amputation of his leg under the knee in October 2017.

He was initially examined at his home and awarded a Personal Independence Payment (PIP) as he cannot walk without the aid of a prosthetic leg. Before becoming too ill to work, Weir was a swimming pool manager.

The assessment was carried out by Independent Assessment Services (IAS), previously known as ATOS.

Weir said, referring to the assessor’s later claim: “The reference to my left foot was either gross incompetence or simply a lie because I don’t have a left foot. 

“I honestly believe I’m yet another case where IAS have quotas to fulfil that rely on refusing people’s applications for PIP or other benefits, no matter what kind of disability is put in front of them.”

In the IAS assessment, it is recorded in a “current symptoms” section that “the wound on his left foot has healed”.

Weir, who has worked at the local authority leisure centre in Renfrew for 35 years, said: “My employers have been great and they have made adaptations at work to allow me to do my job.

“I believe IAS takes the opposite view, that they are set up to take things away, not to help.”

A spokesperson from IAS last night apologised to Weir

The spokesperson said: “We are looking into this, we understand this was an error and would like to apologise to Mr Weir, as the wording should have read that his wound had healed.

“We are unable to say if his PIP will be reinstated as it is the DWP who will make that decision.”

A DWP spokesperson said: “PIP is awarded based on someone’s needs arising from a disability or health condition and those needs can change over time with rehabilitation or, in the case of amputees, with the use of prosthetics.

Decisions are made following consideration of all the information provided, including any assessment report and supporting evidence from a GP or medical specialist. If someone disagrees with the decision, they can of course ask for it to be looked at again.

“Mr Weir has asked us to reconsider our decision and we will contact him as soon as we have looked at his case again.”

Source


 

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Sarah Newton lied to parliament and the public about the DWP’s standardised letter to GPs following ‘fit for work’ assessment

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Sarah Newton, former minister of state for disabled people. However, it’s very evident that neither she nor her party actually support disabled people. They prefer oppressing them.

Last month and previously, I reported about the controversial issues raised by the Department for Work and Pensions’ standard ESA65B GP’s letter template, which was only relatively recently placed on the government site, following a series of probing Parliamentary Written Questions instigated by Emma Dent Coad, addressed to the minister of state for disabled people. Her responses to the questions were repetitive, vague, unevidenced and did not address the questions raised. 

Campaigners and MPs have called for the Department for Work and Pensions’ (DWP) amended letter to GPs to be scrapped after it emerged that ill and disabled people appealing against unfair work capability assessment (WCA) decisions were left in near destitution after their GPs refused to provide further ‘fit notes’, because they were instructed that they did not need to by DWP officials.

It emerged that ministers ordered changes to the standard-issue letter to remove references that made it clear to GPs they may have to issue a medical statement if their patient wished to appeal against a WCA decision. The DWP claims this was not intended to dissuade GPs from issuing fit notes. 

However, it’s highly unlikely that government ministers ordered the amendment to the letter for another purpose, as there are none. This was a calculated strategy to deter people from appealing DWP decisions, by leaving them in severe financial hardship.

The mandatory review was also introduced for similar reasons, since people are left without any income while the DWP reviews its decision, a process which can take longer than six weeks.  

Those people who challenge WCA decisions are entitled to continue to receive employment and support allowance (ESA) at basic rate, worth £73.10 a week while they await their appeal hearing, but to do so they must obtain fit notes from their GPs to provide evidence that they are too ill to work.

They must also first await the outcome of a mandatory review before submitting their appeal. Before a claimant may lodge an appeal, they must first ask the DWP to ‘reconsider’ their original decision. There is no limit on how long the DWP may take to reconsider the original decision about their award. 

The DWP has a stated target of upholding 80% of their original decisions, so the majority of people then have to appeal following the review outcome, since the . The law says that the claimant may claim basic rate ESA following mandatory review if they wish to proceed with an appeal.

So the misleading change to the template letter routinely sent from the DWP to GPs has led to people who have lodged an appeal against an unfair decision being stopped from claiming basic rate ESA while awaiting the appeal hearing. This prevents many low-income disabled people from accessing any financial support while they wait for months on end to go to tribunal. Furthermore, we know that catastrophically inaccurate decisions following the assessments within the DWP are pretty much the norm. Nationally, 72% of people who appeal against their work capability assessment decision are successful.

Entitlement to ESA pending appeal is enshrined in the ESA Regulations to cover the whole of the period leading up the hearing. It is also possible to have the payment backdated to cover the Mandatory Review waiting period too – it can take over six weeks for the DWP to review their original decision, over which time people are left without welfare support.

ESA pending appeal is not paid automatically – people usually have to ask for it, and must provide fit notes from their GP, presenting these along with their appeal acknowledgment letter from the Tribunal Courts to their local Job Centre. The Job Centre should report back to the DWP who will arrange for ESA pending appeal to be paid.

From last year, then minister for disabled people, Sarah Newton, responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an Employment and Support Allowance (ESA) claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008.

That is partly untrue, since the original wording has been amended. 

Newton went on to say: “Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

The decision to change the letter template was made without any scrutiny from or consultation with parliament or the public.

The standard template letter, titled Help us support your patient to return to or start work says: “We assessed [Title] [First name] [Surname] on and decided that [select] is capable of doing some work, but this might not be the same type of work [select] may have done before.

“We know most people are better off in work, so we are encouraging [Title] [First name] [Surname] to find out what type of work [select] may be able to do with [select] health condition or disability through focused support at [select] local Jobcentre Plus.

“In the course of any further consultations with [Title] [First name] [Surname] we hope you will also encourage [select] in [select] efforts to return to, or start, work

“Please do not give [Title] [First name] [Surname] any more fit notes relating to [select] disability/health condition for ESA purposes.

Newton responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an ESA claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008. 

“Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

Professor Helen Stokes-Lampard, the chair of the Royal College of GPs (RCGP), said the lack of clarity over when GPs should issue fit notes could put patients’ finances and health at risk. “No GP wants that, and it only serves to threaten the long-standing trust that patients have in their family doctor.”

Until 2017 the standard letter advised GPs that if their patient appealed against the WCA decision they must continue to provide fit notes.

However, on (undisclosed) ministerial orders, the letter now states that GPs “do not need to provide any more fit notes for ESA purposes”. It does not mention the possibility that the patient may appeal, or that a fit note is needed for the patient to obtain ESA payments until the appeal is heard.

Frank Field, the chair of the work and pensions select committee, also raised the issue with Newton back in January. Newton replied that the wording was amended “to make the letter simpler and clearer”, adding that DWP communications were intended to be “clear, understandable and fit for purpose”.

The purpose appears to be to deter people from appealing unfair DWP decisions concerning the loss of their social security disability award.

Field replied that the wording was “not having the desired effect”, and urged her to revise it to make clear ESA claimants on appeal were entitled to fit notes. “This simple step could greatly ease the stress and worry that people who are awaiting an appeal experience.”

Newton told Field: “We are committed to ensuring our communication is clear, which is why the wording of this letter was cleared by both the British Medical Association and the Royal College of General Practitioners (RCGP). However, we will of course consider feedback when revising the letter.”  Newton tends to stick to a script in her responses, though. She told Emma Coad Dent exactly the same thing, almost word for word last year, in her response to a Written Question.

As I commented in a previous article, it was extremely unclear on what basis the RCGP agreed to the new wording as the change was agreed at a DWP stakeholder meeting for which, according to Newton, there are no formal minutes.

Newton confirmed this in the correspondence between herself and Field, as well as in her responses to Emma Coad Dent’s long series of Written Questions on this issue.

Firstly, on 16 May, last year, Newton says: “The Cabinet Secretary first issued the requirement to revise the ESA65B letter in November 2014.

“The wording of the ESA65B was changed to emphasise the benefits of work and to ask GPs to encourage their patients in their efforts to return to some form of work.”

Then, according to Newton: “The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016.” 

However, in June last year, she also said, in response to a Written Question from Emma Dent Coad: “DWP’s Legal Service cleared the revised wording on 29 July 2016 and the then Secretary of State for Work and Pensions subsequently authorised the changes.”

Yet when asked in November last year what written evidence her Department holds on the British Medical Association and Royal College of General Practitioners agreement to the revised wording of the ESA65B letters sent to claimants’ GPs when they fail the work capability assessment, she replied: “There is no written evidence relating to the agreement obtained from the British Medical Association and the Royal College of General Practitioners on the revised wording of the ESA65B letter.

“In accordance with the Answer of 30 May 2018 to Question 146987, agreement on the final wording of the ESA65B was obtained via the regular meetings DWP holds with both organisations.” 

She was being conservative with the truth. In other words, she was telling lies.

Following a series of distressing reports about people dying as they await the result of the Personal Independent Payment (PIP) and ESA assessments, the Work and Pensions select Committee has published the Royal College of GPs’ (RCGP) and the British Medical Association’s (BMA) views on DWPs controversial advice to doctors on “Fit Notes” for people awaiting the outcome of an ESA appeal.

The Committee asked both  organisations (PDF PDF 163 KB)Opens in a new window  (PDF PDF 163 KB)Opens in a new window for their input, following DWP’s repeated claims that they had approved the advice, given in a letter (form, ESA65B) to the GPs of people who have been denied ESA after assessment: PIP and ESA Assessments.

The Committee has described the assessment processes for disability/incapacity benefits as “gruelling” and “error-ridden”, potentially forcing claimants into DWP’s “arduous, protracted” reconsideration and appeals process. People who have been denied ESA at the assessment stage, but who are awaiting the results of their appeal are entitled to an “assessment rate” of ESA, in recognition of the hardship they may endure during the potentially lengthy wait for their appeal.

However, in recent months the Committee has been investigating concerns (PDF PDF 1.41 MB)Opens in a new window that the advice DWP is giving to doctors about the system and process is causing confusion, leading directly to people being left without the lifeline income they are entitled to.

I have reported previously that people have died soon after being declared ‘fit for work’ by the DWP, after the Department have contacted a patients’ doctor without notifying  them, telling the GP not to issue any more ‘fit’ notes. 

Comments from RCGP and BMA

The Department has claimed in response to the Committee (PDF PDF 219 KB)Opens in a new windowthat Agreement on the final wording of the revised ESA65B was obtained via the regular meetings DWP holds” with both the British Medical Association and Royal College of GPs”, (PDF PDF 84 KB)Opens in a new window and that the wording is the outcome of “close and extensive working between DWP, BMA and RCGP.” (PDF PDF 165 KB)Opens in a new window

Both medical professionals’ associations’ have now written to the Committee – and in the case of the RCGP, directly to the Secretary of State (PDF PDF 199 KB)Opens in a new window – expressing their concerns about both DWP’s advice to GPs and its characterisation of their approval or endorsement. The RCGPs said:

“Without a fit note from their GP, claimants who are awaiting the outcome of their appeal will not be able to receive ESA. They would therefore have to seek Universal Credit or Jobseekers Allowance, and subsequently try and meet the work-seeking requirements of those benefits, potentially endangering their health in the process. As such the College is deeply concerned about the potential impact of this on doctors and their relationships with potentially vulnerable patients.”

As the BMA describes in its response to the Committee (PDF PDF 164 KB)Opens in a new window:  

“By way of background the BMA attends meetings with the RCGP and the DWP where information is shared with the aim of improving working practices between the DWP and clinicians. While the BMA may act in an advisory capacity it does not have the authority to clear, approve or otherwise sign off any DWP correspondence or policies and would see this as being clearly outside of our remit…At a meeting with the DWP and RCGP a BMA representative was given sight of the ESA65B amended letter. The BMA considers that sight of this letter was for the purposes of information sharing and did not agree or otherwise sign off the content of the letter.”

The Royal College of GPs put the same point to the Committee (PDF PDF 197 KB)Opens in a new window:

We are aware that the Department claims that ‘The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016’. However, there is some ambiguity about what was said in the referenced meeting with the DWP. Since the DWP did not keep any written records of what was said at this meeting [as DWP admits in its latest letter to the Committee (PDF PDF 165 KB)Opens in a new window], we are unable to provide further clarity.”

The RCGP statement continues:

“Since these changes were made, significant evidence has come to light about the negative impact that these changes have had in relation to patient care, leading to some patients being denied fit notes by their doctors. We are concerned that the current wording of ESA65B does not sufficiently clearly indicate that there are circumstances in which GPs may need to continue to issue fit notes for their patients. It is essential that communication with GPs is as clear as possible, to uphold the high levels of trust that exist between GPs and their patients. As a minimum we would want to see the wording of the ESA65B letter urgently changed to its previous wording.”  

This means that ministers have once again mislead both parliament and the public in claiming that both medical professional organisations agreed to the wording of a controversial letter which told GPs not to provide benefits officials with proof that seriously ill patients were unfit for work.

I’ve reported on this particular issue more than once, and highlighted the parliamentary dialogue between Newton, who resigned in March, and the DWP, who have said in separate statements that the document wording “was cleared by both the British Medical Association and the Royal College of General Practitioners”.

Both organisations have now dismissed Newton and the DWPs’ claim. In the letter, the BMA,  said that they did not “clear” the wording, they were simply been shown the letter template during a meeting at the DWP.

When the organisation wrote to Frank Field, Pensions select committee, the letter states categorically that: “The BMA considers that sight of this letter was for the purposes of information sharing and did not agree or otherwise sign off the content of the letter.” 

The RCGP has told work and Pensions secretary Amber Rudd  that the letter “does not clearly indicate that there are exceptions to this wording, including if a claimant is appealing against the decision”. 

The Royal College raised fears that vulnerable patients awaiting the outcome of appeals may further harm their health by trying to meet the requirements of other benefits such as Universal Credit or Jobseeker’s Allowance.

However, a DWP spokesperson told me: “We have regular discussions with the BMA and RCGP to ensure we deliver effective support to disabled people and those with health conditions.

“The wording of this letter was discussed as part of these meetings, as both organisations confirm, as was the release of the final letter.

“Of course we recognise the concerns of GPs which is why we are discussing a revised letter with the BMA and RCGP and have issued clear guidance for GPs in the meantime.”

So, not only did the DWP and Conservative ministers lie and get caught out, they have continued to repeat the lie following its exposure.

Meanwhile citizens who are ill and disabled are left in dangerous situations with unacceptable levels of hardship, and some have died as a consequence, yet the government continues to present and mechanically repeat crib sheeted PR and strategic comms responses to limit the political damage of justified concern and criticism of their cruel, miserly, punitive, discriminatory, robotic neoliberalism and authoritarian policies that target those with the least in any way they can to prevent them from accessing the support that their taxes and National Insurance have contributed to creating. 

When David Cameron said the Conservative party was going to address the ‘culture of entitlement’, and ‘change the relationship between citizens and the state’ this is precisely the kind of underhand, targeted discrimination he had in mind. The ‘low tax, low welfare society’ is one where the wealthiest pay very little tax and the poorest citizens – in work and out – simply go without the means of meeting their most fundamental needs. 

The wider political aim is to systematically dismantle every single welfare and public service and to normalise the brutality of this process by almost inscrutable degrees, by telling lies that attempt to neutralise the serious concerns raised by campaigners, opposition MPs, academics, charities and medical professionals. This method of political gaslighting is much worse than lying, because it is a calculated, deliberate method of psychological manipulation and abuse.

 

 


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The government are challenging independent disability assessment appeal decisions

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In 2017, the then minister for disabled people, Sarah Newton, said that the Department for Work and Pensions (DWP) was “recruiting, training and deploying” approximately 150 presenting officers (POs) to attend Personal Independence Payment (PIP) and Employment and Support Allowance (ESA) tribunals “in order to present the Secretary of State’s case and support the first tier tribunal in arriving at the right decision”.

The question is the ‘right decision’ for whom? It’s certainly not disabled people.

Given that, at the point of appeal, the Secretary of State’s case has already been presented twice –  at the first DWP decision following assessment and again during the mandatory review – it seems that the government is using an incredibly oppressive and authoritarian approach to prevent successful appeal outcomes for ill and disabled people trying to access disability-related social security alone, without legal aid and support in the majority of cases. 

Last week I spoke to someone who won her PIP appeal following a reassessment which had resulted in the loss of her PIP award. After waiting two weeks for some communication from the DWP,  she rang to see when her award would be reinstated. She was informed that the DWP had requested the full written reasons for the tribunal’s decision, and that they were considering challenging the court’s decision. If the DWP decide to proceed with their challenge, they must apply for permission to appeal.

The application must be made within one month of the date of the tribunals’ written statement of reasons. So far, the claimant has been left without her award for 13 weeks, and she is very distressed. Having gone through mandatory review and appeal, she is utterly exhausted and the stress of the process has significantly exacerbated her illness – she has multiple sclerosis. Since her assessment, she has also needed treatment for anxiety and depression.

The claim for PIP was in relation to her physical disabilities, but she has become mentally unwell as a direct consequence of her extremely distressing experiences. The DWP will be permitted to appeal the tribunal’s decision only if it is considered that the decision resulted from an error of law. Once the tribunal have received the request the chair of the tribunal will provide a written statement to the claimant and the DWP explaining why they awarded PIP.  It can take up to 12 weeks for the written statement to be sent out.  

I co-run a support group online for people going through ESA and PIP claims, assessments, mandatory review and appeals. We are seeing a rise in the number of cases where the DWP are requesting written reasons for the decision of the tribunal, but quite often, it eventually emerges that they are not proceeding with an appeal. 

This leaves people waiting many months with the fear they may lose their lifeline award, causing a lot of additional and unnecessary distress. Furthermore, the DWP are not keeping people informed of their intentions in a reasonable and timely manner, which adds significantly to the distress and uncertainty that the whole awful process has created.

There are two people who have waited over 12 months after they won their appeal, while being told by the DWP that they are still awaiting the judge’s decision as to whether the DWP can proceed with a challenge. Meanwhile, the DWP refuse to discuss the details of the matter any further when people ask for details and an idea of a timescale.

One person told me he felt that the DWP are “intentionally playing mind games to demoralise and scare people”, and that leaving people feeling precarious was “a deliberate strategy” to undermine people’s expectation of support, and 

Someone else who won their PIP appeal has been left for four months without any payments, the DWP claim he owes them money for an overpayment, and refuse to release the money he is owed. However, he told me that he does not owe any money, and has never been overpaid, as prior to his relatively recent claim for PIP and ESA, he was in work and received no social security. He ahs also been forced to appeal the DWP’s decision not to award him ESA. 

The DWP were allocated £22m of public money to hire the “presenting officers” to “support” the DWP at disability benefit tribunals. Disability campaigners warn that these 180 presenting officers, rather than helping judges to make fair decisions about whether to overturn the DWP’s rejection of someone’s claim for benefits, will inevitably argue as forcibly as possible in the government’s favour. The aim is to cut the number of successful appeal outcomes for claimants. The reality is that PO’s are sent by the DWP to try to discredit claimants’ accounts and to argue forcibly for the DWP’s interpretation of the law to be accepted. 

A freedom of information request by Disability News Service resulted in them being sent forms that have to be completed by presenting officers after each tribunal they attend.

Included in the documents are the following questions for presenting officers attending ESA and PIP tribunals, respectively:

“PO impact – Was SG [support group] award averted”

“PO impact – was enhanced PIP award averted?”

DNS quotes a DWP insider, saying that presenting officers are being given the ‘target’ of stopping enhanced PIP payments and that this was placing ‘immoral pressure’ on presenting officers. (See the full article: ‘Truly appalling’ revelations ‘show DWP is subverting justice’ at appeal tribunals.)

The DWP outline says: “The PO must be confident that the decision is accurate and prepared to lapse appeals where this is not the case. They must highlight inconsistencies and take appropriate action when new evidence comes to light, including making a critical assessment of its validity.

But surely that is the role of an independent court.

At the time, Marsha de Cordova, Labour’s shadow minister for disabled people, described the DWP’s admission as “truly appalling”.

She said: “The idea that the ‘impact’ of DWP staff is being assessed on whether they managed to get ESA support group or enhanced PIP awards ‘averted’ is truly appalling.

“Presenting officers are supposed to be there to provide fair and balanced evidence of a claimant’s needs.

“In May last year [2017], freedom of information requests revealed that the DWP was setting targets to reject 80 per cent of social security appeals at mandatory reconsideration.

“They clearly haven’t changed their approach.”

She added: “The whole system is broken: from assessments where, for example, only eight per cent of claimants think assessors understood their mental health, through to appeals where judges are overturning over 67 per cent of initial ESA and PIP decisions.

“Labour will scrap the current PIP and ESA assessments, bringing an end to the Conservatives’ failed, privatised assessment system.

“Instead of enforcing a culture of distrust and cost-cutting, we will work with disabled people to ensure that they have personalised, holistic support to live full and independent lives.”

The assessment process, from beginning to end, is almost entirely about providing opportunities for assessors and DWP decision makers to manufacture as many far fetched ‘inconsistenciesas they can to prevent awards and deter as any higher rate awards as possible.

This means that PIP is not about meeting the needs of disabled people, it is about how little the state can get away with paying out from public funds, regardless of a person’s needs and entitlement.

It was acknowledged in my own PIP assessment report that I had cognitive difficulties because of my illness. The HCP said that I had difficulty focusing when asked questions and needed prompting. She acknowledged that I rely on a 7 day pill organiser to ensure I take my medication safely and correctly.

However, the report said that I had a degree (I graduated back in 1996), I had worked in a profession – as a social worker (until 2010, when I became too ill to work) and I had a driving licence in 2005 (I haven’t been able to drive since 2005 because of flicker-induced partial seizures). The assessment took place in 2017. I was not awarded a point for cognitive problems, and was just one point short of an enhanced PIP award. The reasoning behind not awarding the one point was unreasonable, irrational pretty thinly stretched, given that I cannot drive, I was forced to give up work in 2010, and I graduated in 1996. The decision at mandatory review was exactly the same, with the same woefully incoherent reasoning presented again.  

In November 2017, POs attended 23% of all first tier PIP tribunals, but the aim back then is to increase this to 50%.

It would seem likely that presenting officers are being used primarily to target claimants who are likely to be seeking enhanced rates of PIP or the support group of ESA. In which case their presence has nothing to do with improving decision making by feeding back to colleagues and everything to do with taking awards from disabled people, regardless of the high price disabled people have to pay in terms of loss of independence, loss of income to meet their basic and additional needs, placing them in unacceptable situations of severe hardship. 

A claimant who secretly recorded his personal independence payment (PIP) assessment and provided a transcript to a tribunal has won his appeal against a disability living allowance (DLA) to PIP transfer decision, the BBC has reported.

Nev Cartwright, 45, received DLA because of breathing difficulties caused by a lung tumour which led to his left lung being removed.

Last year he was told to attend a ‘medical’ to assess him for PIP instead of DLA. Because he had seen a programme the night before questioning the fairness of PIP assessments, Nev decided to secretly record the interview on his mobile phone.

As a result of the assessment Nev lost his higher rate mobility and had to return his Motability car.

When he read the PIP assessors report he realised that there was information missing and other details such as his peak flow reading, had been altered. The effect was to make Nev seem much more mobile than he actually was.

Nev had a professional company write a transcript of his assessment recording and asked to be allowed to submit it as evidence for his appeal.

The DWP tried to prevent the transcript being admitted by the tribunal, but they failed and the transcript was taken into account. As a result Nev won his case and now has his Motability vehicle again.

Given the very costly restrictions attempt to place on openly recording your PIP assessment, it is not surprising that some claimants turn to doing so covertly. Although we have had members who have used relatively inexpensive cassette recorders at their assessment.

It is not illegal to secretly record your assessment.

But if you are caught doing so and refuse to stop, the interview is likely to be ended and you will be held by the DWP to have failed to take part in the assessment with the result that you will not be awarded PIP.

This imbalance of power is most certainly subverting justice for disabled people. We often hear about the outright unfair methods the DWP uses to cut disabled people’s income when they have been held to account. But for every case we hear about where justice prevails in the end, there are many more that slip under the radar, because perhaps some of us are simply too ill, exhausted and disheartened to appeal alone, without any legal support, while the government spends hundreds of thousands of pounds of public funds to prevent us from having a fair and balanced assessment and hearing, and accessing the social security support that most of us have paid towards.

Meanwhile, Atos and Capita have come under fire for the reported mishandling of as many as a third of the PIP assessments they carried out. The firms received a raise for their efforts last year, raking in more than £250 million each for the controversial disability welfare checks, despite Parliament’s Work and Pensions Committee recently suggesting vulnerable people had been “pushed to the brink of destitution” by the contractors’ handling of the scheme.

That’s because the private companies are contracted to do precisely that by the government.

pip-esa inhumane

 


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Misleading DWP letter to GPs is depriving disabled people of lifeline support

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Credit: PA Images

Last month I reported about the issues raised by the Department for Work and Pensions’ ESA65B GP’s letter template, which was only recently placed on the government site, following a series of Parliamentary Written Questions.

Campaigners and MPs have called for the Department for Work and Pensions (DWP) standard letter to GPs to be scrapped after it emerged that ill and disabled appealing against unfair work capability assessment (WCA) decisions were left in near destitution after their GPs refused to provide further ‘fit notes’, because they were advised they did not need to by DWP officials.

It emerged that ministers ordered changes to the standard-issue letter to remove references that made it clear to GPs they may have to issue a medical statement if their patient wished to appeal against a WCA decision. The DWP claims this was not intended to dissuade GPs from issuing fit notes. 

Those people who challenge WCA decisions are entitled to continue to receive employment and support allowance (ESA) at basic rate, worth £73.10 a week while they await their appeal hearing, but to do so they must obtain fit notes from their GPs to prove they are too ill to work.

They must also await the outcome of a mandatory review.  Before a claimant may lodge an appeal, the must first ask the DWP to ‘reconsider’ their original decision. However, the DWP has a stated target of upholding 80% of their original decisions, so the majority of people then have to appeal following the review outcome. The law says that the claimant may claim basic rate ESA following mandatory review if they wish to proceed with an appeal.

So the misleading change to the template letter routinely sent from the DWP to GPs has led to people who have lodged an appeal against an unfair decision being blocked from claiming ESA while awaiting the appeal hearing. This prevents many low-income disabled people from accessing financial support while they wait for months on end to go to tribunal. Furthermore, we know that catastrophically inaccurate assessments within the DWP are pretty much the norm. Nationally, 72% of people who appeal against their work capability assessment decision are successful.

Entitlement to ESA pending appeal is enshrined in the ESA Regulations to cover the whole of the period leading up the hearing. It is also possible to have the payment backdated to cover the Mandatory Review waiting period too – it can take over six weeks for the DWP to review their original decision, over which time people are left without welfare support.

ESA pending appeal is not paid automatically – people usually have to ask for it, and must provide fit notes from their GP, presenting these along with their appeal acknowledgment letter from the Tribunal Courts to their local Job Centre. The Job Centre should report back to the DWP who will arrange for ESA pending appeal to be paid.

From last year, then minister for disabled people, Sarah Newton, responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an Employment and Support Allowance (ESA) claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008. 

“Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

The decision to change the letter template was made without any scrutiny from or consultation with parliament or the public.

The standard letter, titled “Help us support your patient to return to or start work.” says: “We assessed [Title] [First name] [Surname] on and decided that [select] is capable of doing some work, but this might not be the same type of work [select] may have done before.

“We know most people are better off in work, so we are encouraging [Title] [First name] [Surname] to find out what type of work [select] may be able to do with [select] health condition or disability through focused support at [select] local Jobcentre Plus.

“In the course of any further consultations with [Title] [First name] [Surname] we hope you will also encourage [select] in [select] efforts to return to, or start, work

“Please do not give [Title] [First name] [Surname] any more fit notes relating to [select] disability/health condition for ESA purposes.

Minister for disabled people, Sarah Newton, responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an ESA claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008. 

“Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

Professor Helen Stokes-Lampard, the chair of the Royal College of GPs (RCGP), said the lack of clarity over when GPs should issue fit notes could put patients’ finances and health at risk. “No GP wants that, and it only serves to threaten the long-standing trust that patients have in their family doctor.”

Until 2017 the standard letter advised GPs that if their patient appealed against the WCA decision they must continue to provide fit notes.

However, on (undisclosed) ministerial orders, the letter now states that GPs “do not need to provide any more fit notes for ESA purposes”. It does not mention the possibility that the patient may appeal, or that a fit note is needed for the patient to obtain ESA payments until the appeal is heard.

Frank Field, the chair of the work and pensions select committee, has also raised the issue with the then disability minister Sarah Newton back in January. Newton replied that the wording was amended “to make the letter simpler and clearer”, adding that DWP communications were intended to be “clear, understandable and fit for purpose”.

Field replied that the wording was “not having the desired effect”, and urged her to revise it to make clear ESA claimants on appeal were entitled to fit notes. “This simple step could greatly ease the stress and worry that people who are awaiting an appeal experience.”

A DWP spokesperson said: “These letters simply inform GPs when a claimant has been found fit for work and are not intended to dissuade them from issuing fit notes for ESA appeal purposes, to claim otherwise is inaccurate.”

However, there is a hint the letter may be changed. Newton told Field: “We are committed to ensuring our communication is clear, which is why the wording of this letter was cleared by both the British Medical Association and the Royal College of General Practitioners (RCGP). However, we will of course consider feedback when revising the letter.”  Newton tends to stick to a script in her responses, though. She told Emma Coad Dent exactly the same thing, almost word for word last year, in her response to a Written Question.

It remains very unclear on what basis the RCGP agreed to the new wording as the change was agreed at a DWP stakeholder meeting for which, according to Newton, there are no formal minutes. Newton confirmed this in the correspondence between herself and Field, as well as in her responses to Emma Coad Dent’s long series of Written Questions on this issue.

Firstly, on 16 May, last year, Newton says: “The Cabinet Secretary first issued the requirement to revise the ESA65B letter in November 2014.

“The wording of the ESA65B was changed to emphasise the benefits of work and to ask GPs to encourage their patients in their efforts to return to some form of work.”

Then, according to Newton: “The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016.” 

However, in June last year, she also said, in response to a Written Question from Emma Dent Coad: “DWP’s Legal Service cleared the revised wording on 29 July 2016 and the then Secretary of State for Work and Pensions subsequently authorised the changes.”

Yet when asked in November last year what written evidence her Department holds on the British Medical Association and Royal College of General Practitioners agreement to the revised wording of the ESA65B letters sent to claimants’ GPs when they fail the work capability assessment, she replied: “There is no written evidence relating to the agreement obtained from the British Medical Association and the Royal College of General Practitioners on the revised wording of the ESA65B letter.

“In accordance with the Answer of 30 May 2018 to Question 146987, agreement on the final wording of the ESA65B was obtained via the regular meetings DWP holds with both organisations.” 

Newton had previously also said: “In accordance with the Answer of 3 July 2018 to Question 155402, the information is not available as there is no written minute of the meeting between officials from this Department and representatives from the British Medical Association and the Royal College of General Practitioners on the revised wording of the ESA65B letter.” 

In June last year, Dent Coad asked Newton who attended the meetings between officials in her Department and the (a) British Medical Association and (b) Royal College of General Practitioners on the revised wording of the ESA65B; and if she would place in the Library a copy of the minutes of those meetings. Newton responded on 03 July 2018:  

“The names of the participants representing the British Medical Association and the Royal College of General Practitioners who attended the meetings referred to constitute their personal data and in accordance with data protection principles, they will not be disclosed without informed consent. DWP officials did not take minutes of these meetings.”

And: “No other external stakeholders were consulted on the development of the revised ESA65B letter.”

Newton has also said in response to Written Questions: “The Department is committed to ensuring all of its communications are clear, accurate and understandable and we continuously improve our letters. We engage regularly with the welfare benefits advice sector and disability charities and take into account all of the feedback we receive.”

“We have received comments from a number of sources including MPs, stakeholder organisations and GPs on the current version of the ESA65B letter and will take all of their feedback into account when revising it.”

I should hope so. The idea of the state persuading doctors and other professionals to “sing from the same [political] hymn sheet”, by promoting work outcomes in social and health care settings is more than a little Orwellian. Co-opting professionals to police the welfare system is very dangerous. 

In linking receipt of welfare with health services and “state therapy,” with the single intended outcome explicitly expressed as employment, the government is purposefully conflating citizen’s widely varied needs with economic outcomes and diktats, isolating people from traditionally non-partisan networks of relatively unconditional support, such as the health service, social services, community services and mental health services.

Public services “speaking with one voice” as the government are urging, will invariably make accessing support conditional, and further isolate already marginalised social groups. Citizens’ safe spaces for genuine and objective support is shrinking as the state encroaches with strategies to micromanage those using public services. This encroachment will damage trust between people needing support and professionals who are meant to deliver essential public services, rather than simply extending government dogma, prejudices and discrimination.

 

Related

Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died.

GPs told to consider making fit notes conditional on patients having appointment with work coach

Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

 


 

I don’t make any money from my work. I’m disabled through illness and on a very low income. But you can make a donation to help me continue to research and write free, informative, insightful and independent articles, and to provide support to others going through Universal Credit, PIP and ESA assessment, mandatory review and appeal. The smallest amount is much appreciated – thank you.

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Former DWP boss tells how Tory policies pushed her to quit her job

Doyle

Mhairi Doyle with her grandson Isaac supporting junior doctors at Southport Hospital. Picture courtesy of the Liverpool Echo.

A Merseyside councillor has spoken out about why she retired from the Department for Work and Pensions (DWP) after 25 years. She says it’s because she “refused to be complicit in how the Tories treat vulnerable people.”

Mhairi Doyle, Labour councillor for Norwood ward in Southport, was also the social inclusion manager for Merseyside in the Department of Work and Pensions until 2012. She moved to Southport in 1988, having been born and raised in Edinburgh.

Doyle received an MBE for her work with disadvantaged people, especially her work with Street Sex Workers in Liverpool, and has worked at local, regional and national levels developing policy to help change lives.

She said: “I was working with heroin users, sufferers of domestic violence, people who were in and out of prison, homeless people… with some funding we managed to create networks to support people and help them out of horrendous situations.

“We were getting about 80% of people back into work.

“It took time and energy but we had a really good thing going. And then the coalition government came in and everything was cut, gone in an instant.

“Everyone was shocked when I said I was retiring; they used to joke that I’d have to be carried out, I loved my job so much. But I could not be complicit in the way the Tories think it’s acceptable to treat vulnerable people.”

Doyle said that there have been abrupt changes in the ethos of job centres since 2012. She said: “We used to be there to help and advise, but it’s gone from being a service about people to a service about numbers.

“The benefit regime is so harsh. They say people don’t have targets on benefit sanctions but it’s all semantics – there is an expectation on staff to cut benefits.

“I’m not having a go at anybody who works at job centres. It’s a difficult job and it’s not well-paid, it’s the system. Workers are expected to get people out the door quickly and get them to do it online, but not everyone is computer literate or has internet access.”

She added: “The bulk of my caseload is people struggling to get the benefits they need to live on, and a lot of these people work.”

She continued: “When I moved here I was told, as many of us were, that a vote for Labour was a wasted vote. So, to keep the Tories out I voted Lib Dem until 2010, when I voted Lib Dem and still got the Tories.

“Even worse, they took part in and enabled all the devastating cuts still affecting us today.

“I don’t think it is fair that our NHS is being sold off piece by piece or that my grandson when he gets out of university, will leave with over £50,000 of debt.

“And I don’t think it is fair that the Tories and Lib Dems have starved our local council of money, forcing them into such difficult decisions over services and amenities and then stand back and blithely criticise when they are the very reason it is happening.”

In a completely meaningless response, a DWP spokesman reading from the DWP crib sheet, said: “Finding work is the best route towards prosperity and Universal Credit is a force for good, providing tailored support for over 1.6 million people as they find jobs faster and stay working longer.

“Extra digital help and budgeting support are also available.”

The comment doesn’t address the issues raised by Doyle at all, nor do the political platitudes mitigate the hostile environment that has been engineered by successive Conservative-led governments, which is having dire consequences for many people, both in and out of work.

Doyle 2

Mhairi Doyle, pictured here alongside Bootle MP Peter Dowd and Southport Labour members, won her seat in 2018.  Picture courtesy of the Liverpool Echo.

 


I don’t make any money from my work. I’m disabled through illness and on a very low income. But you can make a donation to help me continue to research and write free, informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

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