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Harrington review of ESA - here's an excellent draft.

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Please adjust and send this. (I stole it, though the Guardian journalist who composed it won't mind at all if we use it)

ESA is causing great distress to our members and we are very glad you are undertaking this enquiry. This is our representation to your enquiry.

There is especially a great deal of concern about the Work Capability Assessment (WCA) and we will discuss the details of this test with you at length.


The most worrying aspect of the WCA, and consequent distribution between the ESA groups, is that the ‘health professionals’ who conduct these assessments are not necessarily medically qualified as doctors. The Incapacity Benefit caseload, who will all have to undergo WCA, includes a number of people who are severely ill or disabled. These disabilities may well be hidden, ranging from those diagnosed with cancer to sufferers of ME. Such people may experience different symptoms from day-to-day, and on a case-by-case basis. These people cannot be deemed fit for work by anyone except their own doctors and consultants, or another expert in their particular illness.

This expertise is missing from the WCA, which has led to well-reported cases of seriously ill people being found fit to work. Further, 40% of appeals against WCA decisions are upheld, rising to 70% when the claimant has representation. That such a high proportion of appeals is successful is not only a worrying indicator that the WCA as not fit for purpose, but also that the seriously ill, or less articulate and forthright, who are less likely to appeal, may have genuine cases that are not brought to appeal. Further, people who are not able to call on representation have their chances of success at appeal almost halved, suggesting grave problems for poorer claimants.

Before expanding on problems with the WCA, there are issues that must be considered regarding the “approved” healthcare professionals conducting the WCA and the conditions faced by the claimant, including:

i) lack of provision for audio recording of the assessment by the ESA claimant

ii) lack of specific public information on the medical knowledge that approved healthcare professionals will need to demonstrate. It is nearly impossible for any doctor or nurse to be au fait with all possible medical conditions, meaning that some healthcare professionals would be unsuitable to conduct a WCA for certain people with rare and complex disorders.

iii) lack of publication of the criteria by which healthcare professionals will be 0assessed other than medical knowledge (practical training, appraisal of casework).

iv) lack of requirement for healthcare professionals to demonstrate understanding of the effects of disability and illness when seeking approval (Chapter 42 of DMG:pages 4-6)

Specific weaknesses in the WCA include:

a) The insistence (Chapter 42 of DMG: page 12) that “No customer will be found not to have limited capability for work without either having a medical examination or having been offered one.” This suggests that expert evidence from the relevant medical professionals will be discounted during the questionnaire stage.

b) lack of information on what the medical assessment will entail.

c) lack of clarity regarding the consideration of written medical evidence from GPs, hospital consultants and other medical professionals during the medical assessment.

d) the scheduling of the work-focused health-related assessment on the same day as the medical assessment, without consideration for conditions causing fatigue

e) lack of clarity regarding the scoring system for the work-focused health –related assessment. Various activities have descriptor “marks” up to 15. To be considered to have limited work capability requires the claimant to have one 15 point disability, or a range totaling above 15 points. The DMG does not provide the justification or reasoning for the assignation of scores to specific disabilities. Thus a number of issues with no direct comparison, either medically or in terms of work, are arbitrarily awarded the same score.

f) the further scoriing scheme to prove limited capability for work-related activity is redundant as all these disabilities would be flagged up in written medical evideence.

Another worry is the status of those waiting for the result of their appeal, as there exists a notable lack of clarity on this issue. As 70% of appeals made with representation are successful, this is especially worrying, with the possibility of people being wrongly assessed and then placed on an interim benefit whilst awaiting appeal.

The above problems with the WCA raises the issue of the fitness-for-purpose of the ESA Work-Related Activity Group and Support Group. Given the list of problems mentioned above, the assumption that claimants have been distributed to the right groups seems tenuous.

The WRAG in particular seems spectacularly unfit for purpose, as the group is dependent on work-related activity being available for its members. Given that these claimants will have limited capability for work, it seems unlikely that potential employers will be convinced by their capability. Thus the conditionality imposed in this case is not suitable, especially for those with variable conditions.

The WRAG Group also covers too narrow a criteria. Most IB claimants will have a real illness or disability, even if the WCA “proves” that they are capable of work. Shifting such people onto JSA, alongside healthy JSA claimants, is deeply unfair, given that employers will choose the healthy worker over the ill or disabled. In this case, a person deemed fit to work by the WCA will become trapped by the conditionality of the JSA.

As an example of the fear and stress caused by ESA we would like to cite the case of trickle who posts on our site about his condition as follows -

You can use as many sticks as you want but until you remove discrimination from the employer I’m not going to have any hope – and I only have a physical condition. At the moment the sticks are all aimed at the wrong people – where are the sticks for those who are expected to employ us. Until we balance this properly nothing wll happen.

I am 27 – I finished working when I was 24 – I certainly havn’t given up, I’ve tried retraining a number of times – and it has always failed as what is required is always more than my body can handle.

At present I’m stuck in bed – possibly for longer than two weeks. I can still type (though i have to be careful about how much I do this) I could do any ammount of paper work at home utilising email and voice/type software – in fact I am about to dissect information for personal budgets to be given to service users. I’m doing this for free to try to enable other people to use personal budgets with confidence. I’m in a good position to do this, I have a physical disability, I’ve suffered chronic depression, I have family with varying levels of severe mental illness and I have worked with adults with learning disabilities. I have some experience of disabled children and their parents. I also have dyslexia. All this means I am quite disability aware – and I can use this knowledge to make the information as accessible as possible. I’m quite valued (though not in monetary terms) for this – but there is no money to employ me.

I’m just never going to be as productive as an able bodied person – and I’m always going to have weeks at a time where I cannot leave my home. I’m always going to get so fatigued I can’t think and must sleep – from sitting for too long.

I’ve a horrible feeling that it is the whole system thaty would have to change to accomodate someone like me. An allowance that the money made from me as a productive unit will always be less. That is a lot to ask of an employer – to expect to get less in return than they would usually expect – I think it may be a step too far in all honesty. However if it is a step to far for our present economy – how do you justify placing any sanctions on me as a round peg cannot fit into a square hole no matter how many times you whack it.

It seems to us that Trickle is always going to need a safe place to operate from so that he can face these challenges. This means a safe place where he will not be threatened with conditionality and sanctions.

He needs to be able to access all the back to work help in a voluntary way without fear of being moved up the ladder and ending up on JSA or being asked to do more than he feels able to face.

Carer Watch do not consider that conditionality and sanctions should be applied to people with enduring illness or disability. Carer Watch believe that every one no matter how severe the disability should be able to access full back to work help when they want it. However, people with enduring disability already face daily battles with their illness / disability and the difficulties of the competitive job market and that is enough pressure. They should be able to make their own decisions, freely without sanctions, as to how they deal with these challenges.

So unless the ‘support’ group is adapted to be a safe place for all people with severe and enduring illness/disability where they are entitled to remain and receive back to work help freely without sanctions – there is no safe place for these people to go.

So sadly changing the test will not help.

We feel the test is being asked to make an unrealistic and artificial allocation and that is why it isn’t working.

I'm not a qualified welfare rights adviser, but I'm planning on becoming one. I'm no substitute for more competent advice from trained CAB and welfare rights workers - [URL="http://www.consumeractiongroup.co.uk/forum/benefits-tax-credits-minimum/127741-benefits-advice.html"]see this post[/URL] by Joa, great advice and links! I've been running a Crisis Loan campaign and help since Jan 2007 . See my annotations c/o "theyworkforyou". I'm also currently interested by the recent DWP Medical Services reform and the effect this is having on valid claims, seriously - someone needs to be keeping a suicide count.

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