Will new Government occupational health assessments result in benefit disqualification?

This week the Government announced the creation of a new Health and Work service. Once set-up, anyone off sick for more than four weeks will be offered a work-focused occupational health assessment to help them get back to work more quickly.

It is unclear at the moment how this will play out in practice. The service is intended to be non-compulsory, but so was the DWP's Universal job match service. However as of March last year, the Government announced that Jobseeker Allowance claimants could be mandated to use the service or risk losing their benefits. It isn't inconceivable either that an employer will coerce an employee to take part in an assessment with the implicit threat that failure to do so would be seen as proof that they aren't as ill as they say they are. With legal aid for work disputes now cut, an ill person may feel obliged to go through an assessment for fear of being sacked without financial recourse to appeal.

But my concern is that anyone who willingly agrees to a Health and Service review may well find the results come back to bite them. Someone sick for more than four weeks may well have applied, or be about to apply, for Employment and Support Allowance. This is paid out at the same rate as Job Seeker's Allowance, and is only increased to the higher amount after a person has been claiming for more than three months and once further information has been given to the DWP.

As it stands, in June last year the DWP introduced new rules as to who is eligible for ESA. These include harsh rules for disqualification for misconduct which state that the benefit can be withdrawn for up to six weeks if the claimant:

"fail without good cause to attend for or submit to medical or other treatment (excluding vaccination, inoculation or major surgery) recommended by a doctor with whom, or a hospital or similar institution with which, the claimant is undergoing medical treatment, which would be likely to remove the limitation on the claimant’s capability for work."

If a claimant has willingly attended an occupational review and has not implemented its suggestions because they do not agree with them, then it is conceivable that this refusal may well harm the person's right to access higher-rate ESA. And given the Government's track record with hiring companies like Atos who don't appear to understand the real nature of disability, it is conceivable that a person rejects the advice purely on the grounds that it conflicts with that given by their own GP or the self-knowledge they have built up over the years of managing a long-term condition.

Remember, 40% of people with long-term incurable illnesses have been told by Atos after an assessment that they are expected to recover.

It is also easily conceivable that a business will use the assessment, whether it is accurate or not, to claim that the person is well enough to return to work immediately, and if they do not do so will be at risk of being fired.

These are my early concerns and will hopefully not come to fruition. But as always with policies imposed upon disabled people rather than created through discussion with them, it will be disabled people who will have to bear the pain of this new policy if it does turn out to be another 'tool' to push people off benefits or back into work before they are well enough.

What practical changes to Atos's WCA would you recommend to the Government?

The 'Responsible Reform' Spartacus report revealed the power of social media in helping to raise awareness to the cuts faced by disabled people in the UK. It got the House of Lords to listen to disabled people. If it wasn't for a the Government utilising the Commons 'financial privilege' in a way that has seen no precedent, significant changes would have been made to the Welfare Bill that would have protected disabled people from some of its worst 'reforms'.

So thinking about this success, and following on from the brilliant article written by Amelia Gentleman in the Guardian earlier this week, I thought it would be great to capture people's experiences of Atos's Working Capability Assessment (WCA) to pull together recommendations for the Government to help make the process fairer.

As much as many people reading this will say the WCA shouldn't exist, my main focus is to work within the system that has been imposed on us (and which no political party has recommended repealing) to think of practical changes that the Government could implement immediately and at no cost. Listed below are my initial thoughts. Please do comment and add your thoughts too.

1. DWP should give doctors' reports equal weight as Atos's WCA medical test
Although Atos conduct the 'independent' medical test it is the DWP who have the final decision about who does and doesn't receive ESA. It is widely felt amongst the disabled community that in reality the DWP are just rubber stamping the decision made by Atos's medical test, at it is the company's system of awarding points to a claimant's illness that decides if someone reaches the threshold of eligibility. A simple change would be to give equal weight to the reports given to the DWP by the claimant's own doctors and to the report provided by Atos. Where there is a clear discrepancy in the perceived ability of a claimant the DWP could step in early to demand more informationn from both parties, hopefully reducing the number of mistakes made and the huge cost to the Government of managing appeals against DWP's ESA decisions.

2. Stop the continual cycle of re-testing
One of the shocking problems within the ESA system, is that once a claimant has waited up to nine months to have his or her case heard at the court of appeal and finally been awarded ESA, they can be recalled for another medical within months of the appeal being heard. This second medical then strips the claimant of ESA forcing them back into the stressful and lengthy appeal process. This makes no sense to either the claimant who is struggling to regain their health or to the tax payer which is paying £50 million a year for this appeals merry-go-round. At each appeal hearing, each claimant should be given a date before which they cannot be called back for another medical and the DWP must be made to honour this date. I suggest a year before retests but opinions are welcome on this.

3. Impose financial penalties on Atos for incorrect decisions
A Commons select committee report last year highlighted that Atos may be driven by a profit motive to, in their words, "get the assessments done, but not necessarily to get the assessments right". The Government should treat Atos like any other private contractor and impose financial penalties for incorrect decisions. Clearly a margin of error may be acceptable but decisions in which a claimant has been awarded 0 points by Atos to then be awarded 15 points on appeal cannot be justified. It isn't in the taxpayers interest to fund an appeal process worth £50 million a year while letting Atos retain all of its £100 million annual fee.


Please do let me know what you think - it would be great to work together as a social media community to create key recommendations from those who have been through the WCA process to try and make a difference to those who have to endure it in the future.

The Government is implicated in creating negative attitudes to disabled

It is the 40 years since the first Disability Act was enacted and to mark the occasion the BBC commissioned a survey into the public's attitude to disabled people. Interestingly 90% of people thought the Government should do more to help disabled people into work. I found this outlook really refreshing as I recently wrote a piece for the Guardian discussing the need for the Government to recognise that disabled employment must be a two-way conversation: disabled people must be willing to work but employers must be willing to hire. Despite the Government refusing to discuss the fact that it is harder for disabled people to find work, it was great that the average person recognises it as a problem.

Where the BBC survey results were less positive, were in its findings that 40% of people think disabled people would "refuse work even when they have been found capable of doing it". This figure rose to over 50% amongst young respondents and those on low incomes.

Clearly there is a negative perception of disabled people in the UK, which can undoubtedly be attributed in part to right-wing media representation of the disabled. The Daily Mail is notorious for this. A recent front page screamed,  "75% of claimants are fit to work", and carried on: "Tough new benefits test weed out the workshy".

You expect this kind of thing from the Daily Mail. But what shocked me is that the 75% figure came from a press release from the Department of Work and Pensions. And the figure is wrong. So it amounts to blatant Government propaganda. 

The Government has reached its 75% figure by adding together the 39% of people found 'fit to work' and the 36% of people who have removed their claim during the assessment process. This 36% figure is problematic as there is much anecdotal evidence that those withdrawing their claims are those suffering from mental illness who found the process too frustrating and had a negative impact upon their health condition. So the truth is that the Government has no idea what happens to these 36% of people, as it doesn't track those who withdraw their claim. Which also means that the Government has no idea why they stop the claims process, although of course the Mail is quick to claim its because they were merely 'trying it on'.

But let's turn our attention to the number of successful appeals against ATOS's 'fit to work' decisions. When you follow the 'Notes to editors' link on the DWP's very own press release it reveals a more in-depth report which shows that every month on average 40% of appeals against ATOS are upheld and the appellant is awarded ESA. On average, one third of claimants found 'fit to work' appealed against their decision and 40% were successful with their appeal. So if you do the math, once the whole process including appeals is complete, the DWP is wrong to say 39% are fit to work. In fact, 34% are found fit to work. So overall, at best 70% of ESA claimants are 'fit to work' although my guess is that this would be lower still if those 36% who dropped out of the process were given the right initial support to continue with their claim.

Let me remind you that the Government has access to this data, I've taken it directly from its own report. Yet although the release quotes Grayling saying he is "determined to get the medical test right" the successful appeals against the test are entirely omitted from his ESA headline statistics. 5% may be a small difference, but it is a difference none-the-less when you think that this current Government is so focused on transparency and providing accurate information to its citizens.

So it is seems that the Government has decided to spin the statistics associated with who is and isn't fit to work. Perhaps it suits its current agenda for the public to think that the majority of ESA claimants are 'scroungers'? Perhaps ministers realise they can only get the public to accept their massive welfare cuts if the public think the money is going to the undeserving. 

And this might explain why, in today's BBC survey, the number of people who think disabled people choose not to work rises amongst those people who are most struggling to get by in life or get a job. So the Government at least seems to be doing well at one thing: pitting one set of welfare cut losers against another.

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.