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PIP medical assessments and CAPITA - Meeting at the House of Lords

JohnM

Senior Member
Messages
117
Location
West Yorkshire

JohnM

Senior Member
Messages
117
Location
West Yorkshire
The DWP Training Guidelines on CFS continue: “At one end of the scale are the (uncommon) cases where there is a very clear history of the sudden onset of fatigue after a proven viral infection, such as Epstein Barr virus; at the other, cases strongly associated with current or pre-existing psychiatric disorder. In fact, most patients with CFS will also meet the criteria for a current psychiatric disorder

@slysaint
Do you have a link or copy of The DWP Training Guidelines on CFS? Thanks in advance :)
 

JohnM

Senior Member
Messages
117
Location
West Yorkshire

snowathlete

Senior Member
Messages
5,374
Location
UK
The DWP Training Guidelines on CFS continue: “At one end of the scale are the (uncommon) cases where there is a very clear history of the sudden onset of fatigue after a proven viral infection, such as Epstein Barr virus; at the other, cases strongly associated with current or pre-existing psychiatric disorder. In fact, most patients with CFS will also meet the criteria for a current psychiatric disorder

wow, that last part is astonishing. On what evidence is this guidance based exactly??
 

snowathlete

Senior Member
Messages
5,374
Location
UK
It's worth noting that although officially Capita and Atos do not make the decision, they do make a recommended decision (a score for each component, as the decision maker does). My bet is that in the vast majority of cases the DWP decision maker just copies that. I'd love to see data which shows how often the DWP deviate from the score as recommended by their contractor.
 

JohnM

Senior Member
Messages
117
Location
West Yorkshire
It's worth noting that although officially Capita and Atos do not make the decision, they do make a recommended decision (a score for each component, as the decision maker does). My bet is that in the vast majority of cases the DWP decision maker just copies that. I'd love to see data which shows how often the DWP deviate from the score as recommended by their contractor.

I seem to recall in times past - highlighted in disability advice circles - DWP guidance was such that DM's should give HA reports precedence over further medical evidence, if indeed sought and/or provided. So a 30-40 minute subjective assessment process, undertaken by the HA, could be used to override/ignore the evidence of your GP/Consultant and the like.

I also recall that an ESA report could be used by the DM to inform a decision on DLA and visa versa, even though the benefits serve a different purpose. A subject access request did demonstrate that this did happen in my case; though without going through my documents, I cannot remember which report was used to inform the other report.

I do not know if the supposed improvements to assessment process(es) undertaken in the last couple of years, address any of these issues, and/or apply to PIP? Given Capita are mainly employing nurses, physios and the like ..?
And if HA's/DM's are still being signposted to documents as outlined in earlier posts .. (add your own expletives here if needs be)
 

slysaint

Senior Member
Messages
2,125
@slysaint
Do you have a link or copy of The DWP Training Guidelines on CFS? Thanks in advance :)
no sorry I don't.
There's more
"
The DWP Guidelines continue:

“It will almost always be appropriate to assess the claimant’s mental state, and in the case of IB PCA (Incapacity Benefit Personal Capability Assessment) and ESA (Employment and Support Allowance), to complete a mental health/function assessment”.

“The combination of cognitive behavioural therapy (citing Wessely and Chalder) and graduated exercise (citing Peter White) is at present the mainstay of treatment”, “treatments” which have been shown to be ineffective in numerous international reports and in surveys carried out by ME/CFS charities, as well as in the UK FINE and PACE Trials themselves.

The Training Programme then instructs DWP assessors to read only a heavily psychiatrically biased reading list (with no mention of any of the biomedical evidence on ME/CFS), including “Occupational aspects of the management of Chronic Fatigue Syndrome: A National Guideline” (2006) in which Professors White, Sharpe and Chalder were instrumental; the NICE Guideline CG53 (2007) which recommends only CBT/GET as the primary intervention, and the 1996 report on CFS of the DWP Chief Medical Adviser’s “Expert Group” which included Dr John LoCascio (Medical Director of UNUMProvident insurance company), Professor Anthony Pinching, Dr Peter White, and Dr Charles Shepherd, (Medical Adviser, ME Association)."
 
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JohnM

Senior Member
Messages
117
Location
West Yorkshire
@slysaint
Thank you for the above updates .. my weekly online visit to Disability News Service has jolted my memory about the DWP Work Capability Assessment Handbook used to inform Healthcare professionals carrying out benefit assessment work with regards to the ESA/UC (latest version July 2016).

I realise ESA and/or UC is likely off topic for this thread, but I am reasonably sure that these assessments can also be used to inform the PIP assessment for those who claim either ESA or UC, together with DLA or PIP.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
This is the official guidance from Capita on medical assessment procedures for PIP:

http://www.capita-pip.co.uk/en/assessment-process.html

Did Dr Ian Gargan advice on processes to follow when the practise by the people employed by Capita is very different from what he said "should" happen? Eg is there a policy for disciplinary action? Likewise when people win on appeal, is there feedback into the system applied by Capita to see what went wrong?
 

Daisymay

Senior Member
Messages
754
I would think they are entitled to take whatever stance they want in terms of their organizations official and unofficial viewpoint. But that isn't the issue in my mind. I would be very surprised if a contractors opinion, if it conflicts with the DWP's position, was allowed to override the official position of the DWP when it comes to work these organizations do under contract from the DWP. It might be worth asking the DWP to confirm that.

Quite, and critically the scientific evidence proves ME/CFS is a serious organic multi system disease (IOM P2P) so it is completely unacceptable for them to adhere to a scientifically invalid point of view. This should simply no longer be allowed.

Can Forward ME petition Capita and all the authors of that awful report you posted with the IOM findings.

Where does Capita stand if they have failed to ensure their staff think a disease is behavioural when it is physical. Of course such an error will make a big difference in how someone is assessed.

A client would surely have a strong case to appeal if Capita staff are basing their decisions from such fundamental misconceptions.
 

JohnM

Senior Member
Messages
117
Location
West Yorkshire
Quite, and critically the scientific evidence proves ME/CFS is a serious organic multi system disease (IOM P2P) so it is completely unacceptable for them to adhere to a scientifically invalid point of view. This should simply no longer be allowed.

Can Forward ME petition Capita and all the authors of that awful report you posted with the IOM findings.

Where does Capita stand if they have failed to ensure their staff think a disease is behavioural when it is physical. Of course such an error will make a big difference in how someone is assessed.

A client would surely have a strong case to appeal if Capita staff are basing their decisions from such fundamental misconceptions.

I would recommend that anyone undertaking an assessment, provide copies (of any or all) of IOM, ICC and CDC documents as part of their evidence submission. It would be useful on three counts:

1) You can use the diagnostic criteria, outlined in these documents, to help you to organise your thoughts more clearly as you complete the assessment questionnaire, and to reference ALL your symptoms as they affect you.

Note:
- Always bear in mind that you should be able to complete any activity safely, reliably and repeatedly, when completing your questionnaire, during your assessment, or on appeal.

2) The criteria will also help to remind you to obtain any relevant medical records, and/or letters from friends and family, in support of your lived experience with this awful disease. For example, I provided GP summary notes which referenced my losses of power and reflexes under examination, my own 'poor man's table tilt test' results together with my 24 BP test results confirming OI, and consultant reports.

Note:
- Use a highlighter pen and references to help 'signpost' the HA and/or the DWP DM to the additional information provided in any appendices, and/or additional documents in support of your claim.
- Do not expect the HA or DM to request additional medical evidence as they should do. They only need request additional medical information if they believe it will help inform the decision process if memory serves?

3) The HA should have copies of all your submission evidence prior to the assessment, and are obliged to consider all evidence submitted, and not just rely on the assessment itself. Whether this happens or not is for another thread I suspect.

Note:
- During the assessment, where appropriate, I would always try to refer back to my submission evidence - along the lines of "As I stated in ..."; easier said than done when the brain fog kicks in, and why you should have someone with you in support if possible.
- If you need to go to appeal, it is always useful to be able to refer back to your supporting evidence if you believe the HA/DM did not take all your evidence into account when arriving at their decision.

Attached some files should anyone need/find useful?
 

Attachments

  • CDC_diagnostic_criteria_2010.pdf
    156.3 KB · Views: 3
  • ICC_diagnostic_criteria_2014.pdf
    400.5 KB · Views: 4
  • ICC_diagnostic_criteria_short_version.pdf
    112.3 KB · Views: 3
  • IOC_MECFS_report_brief_0215.pdf
    373.6 KB · Views: 3