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Work Capability Assessment Under Attack in Emotional House of Commons: ME Comments

Discussion in 'General ME/CFS News' started by Firestormm, Jan 18, 2013.

  1. Sasha

    Sasha Fine, thank you

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    I realise I'm sounding rather bitter! :eek:
  2. In Vitro Infidelium

    In Vitro Infidelium Guest

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    Yes, it's tempting to place all the problem with ESA - and accept the explantion that is convenient for the Government - that is that all the faults lie with the under contract ATOS, when actually the fundamental problems are with the DWP over which the Government has direct control (though no doubt additional outsourcing there is under active consideration).

    However we shouldn't be seduced by ideas of 'the past was better'. Under the pre 1980s system, the intimidatory role was primarily applied within the harsh medical examinations carried out in Government run facilities - some of the abuses from back then make ATOS seem positively customer friendly. Change to this 'trial by medical examination' was gradual and happened in response to a number of conflicting influences. A growing independent advice sector began to provide a voice for people who were being appalling treated*, the increased level of community care, the success of which depended upon disabled people having adequate personal finance, plus the the cynical use of Invalidity Benfit by the successive Governments led by Margerate Thatcher as a means of massaging high unemployment caused by Government policy, all contributed to change in the Medical Assessment process.

    Through the 1980s the harshness and unfairness of the system was shifted from Medical Assessment to the adjudication process, which was deliberately altered to reflect commercial insurance practice - that is the presumption of the administrators shifted from acceptance to refusal of any claim. The result was that the adjudication process became ever more litigious and welfare rights advice became an essential element of maintaining a modicum of fairness. Being informed, assertive, educated and articulate (being well ?) or having acces to someone who had those qialities, remained a key qualification in getting a just award under Invalidity Benefit, and subsequently awards of DLA and Incapacity Benefit. There seems little change under ESA and the forthcoming PIP, except that access to advice has been drastically cut due to reduction of the funding Goverment provides for independant agencies or (heaven help us), lawyers.

    *(examinations in unheated rooms in winter, people with obvious mobility impairments forced to walk in public corridors in their underclothes to demonstrate levels of disability etc were just some of the lesser degradations)

    IVI
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  3. Firestormm

    Firestormm Guest

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    I think, further, that one issue has become the 'indefinite' awards for incapacity benefit (as was) and Disability Benefit for that matter: and the need (now) for all sickness/disabled benefits to be regularly reviewed. This might seem to us as an unnecessary additional cost but it does at face value seem reasonable...

    Ha! Got you going!

    My point would be that 'indefinite' awards should be made but under specific circumstances (circumstances that previous changes to the system - and non-uniform application of the rules have been seen to render arbitrary perhaps). So, I would venture that an 'indefinite' award was made for terminal, progressive (where the claimant was assessed initially as warranted the benefit and could subsequently apply for increases as and when necessary; and for those disabilities whereby the claimant's functional state is unlikely to change and/or will decrease.

    What to do with 'fluctuating' or conditions whose aetiology and nature is not understood? Well here's where any system is likely to fall down because you can't base a system on any single (or mulitple) actual diagnoses. It has to be on the individual's functional capacity and their need for help/care. And that need will be assessed based on some set of measures, and on various opinions - a la what we have now.

    Of course all of these reforms (little 'r') are ideologically motivated with a further view towards the [warped sounding trumpet blast] Universal Credit :) Another 'great' idea but hells bells if they pull it off I will eat my shorts!

    I can only shudder at the thought of what bureaucratic nightmare this will be. The 'good news' is that this will potentially screw up so many (working) and able people's benefits (and tax returns possibly) - that the country might be energised enough to demand it's withdrawal. But I won't be holding my breath.

    We are an apathetic nation at the best of times.
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  4. In Vitro Infidelium

    In Vitro Infidelium Guest

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    DLA was actually designed to be an annually awarded benfit, so that each 12 month award was treated as a seperate claim from what went before. This actually led to some 'interesting' interpretations of what 'consistency' meant in terms of administration, with utterly perverse reversals of award from one year to the next. I rather lost track of what the circumstances of the slippage of annual awards of DLA actually were but I'm fairly certain there were no provisions for 'indefinite' awards in the initial legislation. Invalidity Benefit and its successor Incapacity Benefit were one off awards that could be withdrawn on the basis of new information - i.e someone got better - but of course these were both recognised as long term benefits because an award of the short term Sickness Benefit would have to have run out before IB and ICB could be claimed. I can't recall what the review period for IB or ICB was, although my impression is that there was no standard period and that it was very much a function of Regional Departmental workload and particular condition, with Doctor's letters, particularly Consultant opinion, playing a large role in the judgement made about whether to bring someone in for a medical review.
    Terminal illnesses are of course dealt with separately under ESA, although the DWP doesn't always seem able to recognise what constitutes - 'likely to be dead in six months'. But you are quite right - there are other circumstances where an annual cycle of reapplying and ATOS testing makes no sense for either the claimant or tax payer. Even with M.E/CFS perpetual annual reviews may make little sense, given that where disability is significant and has been present for a number of years, substantial and sustained improvement is rare, and the age profile of the patient population (lots of 45 plus) militates against re-achievement of employability.

    The irony with ESA, is that by setting the bar for qualification very high, benefit award in the case of chronic illness is strongly aligned with the likelihood of permanent unemployability. ESA Work Group transfer to employment is less than 0.5% in any one year, about a fifth of what even the long term unemployed are achieving. There aren't seperate figures for chronic illnesses but the rate for movement from ESA to employment is likely vanishingly small. Even with some magic economic revival, unemployment rates in the UK are going to remain high for at least another decade, to spend £00 millions perpetually chasing seriously ill people in case they show improved capacity is beyond absurd, except perhaps in some conservative functionalist fantasy of 'instilling a work ethic back in to the country'. The 0.5% rate doesn't even exceed the incidence rate of disabling conditions, so the Government would be reliant on a high death rate amongst disabled and chronically ill people to show improvement in the figures, if ATOS and the DWP don't keep up their wrongful denial of benefit work. Oh dear, am I demon eyesing the system ?

    IVI
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  5. Firestormm

    Firestormm Guest

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    Have often pondered what the number of people found 'fit to work' actually found sufficient work to enable them to achieve and maintain a basic standard of living. You are right. This hasn't made it's way into the figures. Once out of ESA you are 'lost' to the system. And what do they care? You go from what, £90 a week on ESA to £70 on Job Seekers Allowance. As far as they are concerned the economy (and you) are 'better off'. You because 'it's better for you to be working' ;)

    And what about the number of reapplications? And how long do people struggle on JSA before reapplying? And what about the Support Group element of ESA. Are they 'safe'? What are the entry requirements - I never did discover? And if in the Work Related Activity Group - where are the figures showing what/how much job retraining is taking place?

    You are meant to receive help accessing/returning to the workplace taking into account your disability - where are the data for that little ideology? I've been here for nearly 4 years and haven't heard from the Jobby Centre once!! Couldn't face another appeal and I don't benefit in terms of cash - only NI contributions - as I have a private disability pension from my previous employer.

    Hurrah! Up zee revolution amigo's :)
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  6. Sasha

    Sasha Fine, thank you

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    I expect to have to go to appeal as standard these days - I have become so practised at putting applications in over the years that I no longer find them very distressing (they used to really upset me in the early years). I'm pleasantly surprised if I get a benefit without a fight.

    Watch out for those NI contributions, Firestormm - did you hear the news about the new flat-rate State Pension of £144 a week for people getting it from 2017 if you've got 35 years' worth of NI contributions (or credited contributions)?
  7. Firestormm

    Firestormm Guest

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    From 20 January 2013 Vox Political a blog written about this OP debate in Parliament:

    Not endorsing the blog - I ain't red it all yet ;)
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  8. In Vitro Infidelium

    In Vitro Infidelium Guest

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    There are some statistics, but I can't find the data online now - the Guardian has a load of figures but they are almost as mangled as the Government's own. Private Eye drilled down on disability issue revealling that less than 0.5% of ESA claimants go work in a 14 month period. This statement from the PAC gives a flavour of what is going on: http://www.parliament.uk/business/c...c-chair-on-work-programme-outcome-statistics/

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  9. Firestormm

    Firestormm Guest

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    Thanks IVI. Methinks the minister (who the heck had ever heard of him and why wasn't a more senior bod in that debate?), was full of excuses and bereft of detail. Hoban. What a sad excuse. Farcical performance. I am quite saddened (though not surprised given the focus elsewhere) that this debate did not raise even the eyebrows of the BBC let alone other news agencies. Missed the radar completely. The focus turned - conveniently and understandably to the Algerian fundamentalists it would seem.
  10. Valentijn

    Valentijn Activity Level: 3

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    British benefits systems make my head spin ... am I correct in thinking that ESA is only for ill and disabled people who are unable to work, either due to disability alone (support group) or due to needing retraining resulting from disability (work related activity group)? And if in the work related activity group, benefits can be reduced if not "cooperating", whereas in the support group, you're not expected to be able to work and don't have to go to interviews, etc.

    And it's ATOS employees that are deciding which group applicants go into, if any? The assessment guide seems to suggest that getting more than 15 points (guide page 17) on the questionnaire means the applicant gets on ESA. Based on careful (re)reading of the guide, the applicant has to show "limited capability for work-related activity" to be in the support group, which requires them to be is the most severe categories (guide page 24) - cannot repeatedly move 50 or more meters, can't move to another seat, can't raise arms, can't pick up half a liter, and/or can't press a button or turn a page are the physical requirements. The only activity that has "repeatedly" as a qualifier (and only in the guide, not the questionnaire) is moving 50, 100, or 200 meters.

    So a few things seem weird. The only points awarded seem to be 6, 9, or 15 per disability. It seems a rather arbitrary amount. Why not 2, 3, and 5 points per disability? Or even 1, 1.5, and 3? Or something else entirely? Why is being unable to sit up for half an hour less disabling than being unable to walk 50 meters repeatedly - are there jobs available where we can lie down most of the day? And why bother adding points up at all - why does being unable to reach above your head + being unable to move a liter of liquid around make you disabled enough for ESA when either disability on its own is insuffucient?

    The amount of disability required to qualify for the support group versus the work related activity group seems ridiculously high. I can see why people at death's door are told to go to job interviews, based on those criteria. Aside from having literal paralysis, I'm not sure what other physiological disease or illness would generally be sufficient, even in severe cases.

    What is the rationale behind having a group that is disabled enough to get assistance, but healthy and capable enough to go to training and go to work? It almost seems like they are combining two very different concepts, disability and job training, into one, and suggesting that job training can usually overcome disability. It gets even more bizarre when you factor in ongoing illness (which it explicitly covers in addition to disability), and seems to suggest that job training can overcome illness-induced limitations.

    The lack of a "repeatable" qualification for all activities except for moving however many meters, means that the only physical limitation they're really respecting (but not enough to put it on the actual questionnaire) is mobility. They'd might as well get rid of most of the questions and replace it with "Can you eventually get to work without much assistance if work is located on the same block that you live on? If so, get to work you lazy git!"

    The whole thing is insane. It might be amusing to see how the points would add up for variously absurd groups - for example, a toddler, a trained monkey, someone with a bad case of pneumonia, and someone severely injured in a recent car accident.
  11. In Vitro Infidelium

    In Vitro Infidelium Guest

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    That's more or less correct - however the issue of 'retraining' overstates what is on offer. The UK used to have a rather good, if some what limited range of retraining following injury or acute health impact, this has been gradually diminished over the years and now barely exists. All that is really on offer to those put in the 'work group' are insultingly banal 'skills help' suchas 'how o write a cv', plus unpaid placements in the private sector so that people can 'get used to working again'. Punitive measures for non compliance can be applied although compliance may mean no more than attending a monthly meeting with an advisor. A much more serious problem exists for people who have a level of disability which doesn't qualify them for ESA - their disablement is treated as non existent by the benefits systm and withdrawl of benefit fr sustained periods can be imposed for no compliance.

    The work group has lower rates of benefit than the support group, and crucially is only payable for one year before it becomes means tested - in effect it means that if you are ill/disabled and not in the support group, then if you have a partner who is working then they are expected to support you.
    ATOS is only responsible for operating the capacity tests. All decisions on actual award of benefit lies with Civil Servants in the Department of Work and Pensions - they use the reports they get from ATOS too come to thir decisions.
    There is some logic within the system though I doubt any of it is realy defencible. In the case of sitting versus lying - this would differentiate between someone whose only disability was in mobility, and someone whose disablement is more complex. For example not being able to walk may not amount to qualifying for the support group if the claimant could use a wheel chair.[/quote]

    Yes, those are all fair observations. ESA was sold (under the previous Government and pre economic crash) as an empowering move - "no one to be excluded from society/work" and the theory could have worked to a degree if the training, inwork support and jobs were there. What we have now is just another 'cut Government spending' process and to hell with the social costs.

    IVI
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  12. Valentijn

    Valentijn Activity Level: 3

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    It still seems very weird to act as though almost all people with disabilities should be able to get a job if they learn how to write a CV, etc. In the US I think you're either too disabled to work or you aren't, and job retraining and job finding skills are something you'd only find potentially required in other sorts of non-disability assistance programs, such as if getting welfare payments due to being unemployed.

    There's no logical connection in the ESA system. Job finding skills (and most retraining) do not overcome disability. Especially when there's no shortage of able-bodied workers for the few jobs that the moderately or severely disabled could perform. Why does the government offer the benefits at all if most of the people supposedly intended to benefit from them can't really access them?

    The entire system seems like an excuse to reduce benefits without cause. You mentioned that work group becomes means tested after a year... would this mean that a single disabled person in the work group would stay in the work group indefinitely and receive the regular rate? Could/Do some disabled people with partners making money move onto Jobseekers Allowance instead to receive that benefit?

    Did ESA always work this way, or did the punitive Work Group aspects get added later? And why are benefits so much lower for the first 13 weeks of ESA?

    I suppose it just all seems perverse. "Look at all these amazing benefits we offer everyone that needs them. Oh, no, you can't actually have them after all. But don't they look so wonderful?" At least in the US everyone knows they'll get the "bugger off" as soon as they walk in the door, instead of being led on and messed around with for a while first :p
  13. Sasha

    Sasha Fine, thank you

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    Hi Valentijn - unfortunately that is exactly what it is and it's very widely recognised to be so in the UK. You're trying to make sense of a system that doesn't make sense and we all know it doesn't.

    We're in a recession and the government is pushing a rhetoric of 'benefit cheats and scroungers' to try to justify benefit cuts not just for the disabled but for everyone. Recently a backlash has been growing but there is no sign of it affecting the government's actions.
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  14. Firestormm

    Firestormm Guest

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    Next Monday Panorama at 20.30:

  15. Sasha

    Sasha Fine, thank you

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    Thanks, Firestormm, I'll watch this.

    There are two failures going on - the failure to support those disable people who could work, and the failure to accurately identify those who can't. I think the second failure more often has been overlooked lately.
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  16. barbc56

    barbc56 Senior Member

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    I did go through the Department of Disability for a job at home. All they had were jobs cold calling people to sell something. Just the thought of doing that could put someone in a flare.
    Barb

    ETA I am in the states as well as being in a state of illness.:rolleyes:
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  17. Firestormm

    Firestormm Guest

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    Am just getting around to looking at what my Cornish MPs who took part in the debate had to say about things. The first comment is from my own (Liberal) MP Dan Rogerson and comes not from the debate but from his regular article in the local Cornish Guardian:

    Ok. So pretty mild really - although interesting that he refers to 'the Government' when he's a part of it. I've been in touch with Dan on several occasions drawing his attention to my own 'journey' through the system and the appeals and the delays and the 'wins' etc.

    I find it 'odd' that he considers people with "serious health conditions" to be fine if found fit for work. And this this notion of support back to work has become something of a meme. If I didn't think it would cause me hassle I'd go back to him and alert him to the fact that in 4 years of WRAG I have had no contact from the Job Centre - so no support.

    This situation even with support is starkly underlined by the link that IVI provided above. I think it is about time - beyond time - that the WRAG was exposed. Let's see what actually happens in WRAG and what support is afforded. Let's see them blow the belief I have that WRAG is merely an excuse to pay claimants less money, out of the water.

    I also - while on the subject - find it 'odd' that WRAG gets support (allegedly) and yet the 'Support Group' doesn't. Presumably that 'support' is financial i.e. £20 extra a week and 'only' an annual review to look forward to.

    Back to the Cornish-contribution to last Thursday's debate. Just for my benefit and purposes (hope y'all don't mind):

    I thought this comment was especially pertinent to what we were talking about previously (not from one of my lot unfortunately):

    This strikes me as 'odd':

    Now I know they did/do this in respect of the Disability Living Allowance; but I didn't think they did for ESA. I can't remember but I'm fairly sure that my doctors were not asked by the DWP to provide evidence - I had to ask them myself and was initially going to be charged by my GP for the privilege at one point. Maybe they are/were asked and simply hadn't returned the forms? I wish this was certain - it would save patients one hell of a job. But then how would we know if they'd asked all the medical professionals we see? I suppose the medical professionals would tell us but as they never have I have to conclude that the Minister is out of touch and indeed, incorrect. I don't believe the DWP asks for evidence directly from medical professionals. I certainly couldn't afford to rely on his assumption.
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  18. Valentijn

    Valentijn Activity Level: 3

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    Lumping in the physically ill (serious health conditions?) with the physically disabled seems like a huge mistake. If you've got the flu, you're ill and you should stay home until you recover. Why is it different with longer term illness? You're still in a fluctuating state where you're mostly non-functional and activities, especially employment, are a constant exhausting struggle. It's generally acknowledged that you should rest and not push yourself when ill - why does that advice change when the illness is incurable and not going away after a respectable amount of time?

    I think you could have two people with a similar level of physical disability, one ill and one not. And sending the ill one off to work on the basis that he's just as able-bodied as the non-ill disabled person seems ludicrous and cruel. Physically ill people are in a relatively vulnerable and fragile state, and putting that sort of demand on them is not going to benefit them - to the contrary, it is very likely to make them even more ill.

    Yes, it sounds like the WRAG support is mostly fictitious and inappropriate - these are physically disabled (and ill) people, not punks just out of high school with no job-seeking skills. If the WRAG was intended to help them, it would be aimed at ergonomics therapy, teaching disabled people to cope with their limitations, especially in the work place.

    But that is individualized and time-consuming, hence pretending the problem is CV-writing is much cheaper. This illustrates that the bottom line really is about saving money, and that helping people to cope with their disabilities does not save enough money by finding them jobs to justify the expenditure. Which in turn suggests that the entire WRAG program is doomed to failure, especially with the dismal statistics IVI found, showing something like 0.2% of ESA participants get a job.

    And Firestormm's quote of some politician suggest that 74% of ESA beneficiaries are in the WRAG group, and it used to be 89%. So a very very tiny amount of people labeled fit to work are actually getting work. It would seem that the fit to work label is very inappropriately over-used, and/or "fit to work" disabled people are still far too undesirable/unreliable for potential employers to make the WRAG program at all practical.

    To reiterate what someone else said - they should be making their decisions based on whether anyone would actually be interested in employing these ill and/or disabled people, rather than on whether these ill and/or disabled people could theoretically perform an uncommonly accomodative job under ideal conditions.
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  19. Sasha

    Sasha Fine, thank you

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    I've applied for both ESA and DLA this year. They did ask my GP for a report for my ESA application and he promptly filled in the form on the basis of ancient and currently incorrect information which I had to get him to write a letter about during the appeal process. For my DLA application, it was stated on the form that I had to get the info from him and I had to pay him a fee for it.

    I actually preferred the latter situation (not the fee, obviously) because it meant I could have a conversation with my GP about what my life is like in the kind of detail necessary to provide the info needed. I don't normally have that kind of conversation with him because it's distressing and he can't do anything about my condition that he hasn't already - normally, there's no point going into the details for clinical purposes.

    I'd recommend anyone applying for these benefits to go to their doctor as soon as they get their application sent off and explain in detail how their illness affects them. I gave my GP written notes on what I can't do in terms of daily living for the DLA application and was awarded it at the highest mobility rate and middle personal care rate just on paper, with no Atos medical exam.
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  20. Sasha

    Sasha Fine, thank you

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    I had a long period of remission, which I and my doctors thought was recovery, and worked during that time. I had a serious relapse, went on long-term sickness absence from my job, which obviously cost my employer in sick pay and disruption before I was let go, and have been unable to work for six years now. At this point, even if I 'recovered' I wouldn't have any faith that I wouldn't at some point relapse and I wouldn't want to burden an employer with me. I don't think it would be fair to an employer. I realise people might not have much of a choice but if I could go self-employed I'd try to go that route rather than make someone else carry the risk. It's unfair of the government, both on the sick and their potential employers, to make employers carry the risk of employing someone who isn't really fit for work.
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