Dying man deemed fit to work - an omen for incapacity benefit cuts?

A couple of years ago I went on a date with a guy who declared over dinner that:
"As long as you've got both legs there is no reason why anyone can't run the marathon".
Before we'd even chosen dessert, I realised this wasn't the man for me - he wasn't really going to 'get' the whole Cystic Fibrosis thing.

Yesterday the Government announced further measures against disability benefits, looking to cut back on those who receive Incapacity benefit, or the Employment Support Allowance (ESA) that has replaced it, and move them back into work. My concern is that those who reassess claimants may well turn out to be like my 'Marathon man' date - and just not get the huge impact hidden illnesses have on a person's everyday capacity to function. Lord knows, I never thought there would come a day when I looked at a single flight of stairs with such trepidation, but what is easy for the well person can literally feel like a mountain to climb for the ill.


The Citizens advice bureau released a report in March this year, outlining their concerns surrounding the ESA Work Capability Assessment that assesses what work new claimants of ESA can actually do. It found that a man with Parkinson's who couldn't stand for more than ten minutes, slurred his speech and has significant short-term memory loss was deemed able to work.  A man who had incurable stomach and bowel cancer had been found fit to work as he'd mentioned in his medical that he does try to go for a short walk once a day. He successfully appealed the decision, but he should never have had to go through the stress of needing to do so in the first place.

Both these cases deal with 'hidden' disabilities, where the claimant has all their limbs and can move around, albeit with incredible discomfort. I've talked before about the ESA form in a previous blog, but its over-simplistic form and the short WCA medical assessment seem to place too much focus on whether someone's body can mechanically move, not asking questions on the time involved in medical routines (3-4 hours a day for me), extreme fatigue and pace of deterioration that's at the crux of most 'hidden' illnesses.

David Harker, Chief Executive at Citizens Advice said: "The current test to determine eligibility for ESA isn’t working. Seriously ill and disabled people are being severely let down by the crude approach of the Work Capability Assessment. A much more sophisticated approach is needed, that not only looks at a person’s ability to undertake a certain task on the day of the test, but considers supporting medical evidence and other aspects, such as the variability of a person’s condition and the external barriers they face in finding work."

A report by the Depart of Work and Pensions, found that over a two month period, 68 per cent of new claimants for ESA were found fit to work. Such a high percentage makes me fear that ESA is a benefit that the UK government (past and present) is increasingly loath to support.

Talking about the need to reduce Icapacity benefit in the drive to cut the UK's deficit, George Osbourne said: "It's a choice we all face. It is not a choice we can duck". I'd like to add nor should it be a choice between saving money and forcing seriously ill people back to work due to ill-thought through assessments.

Budget reaction - disabled benefits overhaul must recognise the unpredicability of serious illness

I'm sure we're all paying attention to the budget, listening out for the sections that will directly affect our lives and those of our families. For those ill enough to be in need of benefits, there may well have been a sense of trepidation ahead of what some of the media is calling the 'Bloodbath Budget'.

So I turn my initial reaction to Disability Living Allowance, a benefit for those with significant disabilities to help them with the extra costs of living and care that their health requires. Chancellor George Osbourne has just announced that by 2013 all those in receipt of DLA will need a medical assessment to determine their continued need for such a benefit.

This sounds positive in some regards. Osbourne claims that the introduction of a medical assessment will make the process of claiming simpler - the current forms to claim disabled benefits are hard to understand and do not show an understanding of how long-term illnesses can affect someone's life. For example the new Employers Support Allowance, replacing Incapacity Benefit, has many tick boxes about whether you can stand up, raise your arm and walk. It fails to ask a single question about the time it takes every day to do medicine, how much extra rest an ill person needs, and the fact that someone's health can dramatically vary from day to day, meaning fixed working hours might be untenable. It is such a complicated form it puts the more vulnerable members of society at risk: those who struggle to read; who don't know how to access the support of charities to help understand the form; who aren't used to writing lengthy arguments at the end of the form to support their claim.

But a word of warning to a Government that wants to introduce medical assessments to long-term illnesses - living with uncertainty is something disabled people learn to do from a young age, and my guess is that MP's will soon learn that an illness is very hard to comprehend in a half hour assessment by a doctor that doesn't know the patient.

For those with degenerative illnesses like CF, diabetes, MS and Parkinson's there is no clear timeline of how long your health can continue to hold out, and your health varies massively from day to day, let alone month to month. For someone with CF, an over-simple doctor's assessment in winter rather than summer could result in a different decision to award DLA. Plus continuing to work might literally put some sufferers in an early grave, when being allowed to 'retire' could dramatically improve a disabled person's quality, and could extend it by years.

So MPs, in advance of 2013 please talk in depth to the disabled and medical community first to get a true understanding of long-term illnesses and how they affect day-to-day life and life expectancy. Ensure that the medical assessors have a deep knowledge of the condition they are assessing (perhaps ask doctors from one specialised medical centre to assess patients from another) and keep in mind that everyone should have a right to protect their long-term health.

If an overhaul of the disabled benefits system weeds out the minority of claimants who are unfairly claiming DLA then it can only be a good thing - as long as it doesn't jeopardise a single claim from someone who truly needs help.