Fears over DLA reform and the new medical assessment

Disabled people are anxious about losing access to disability living allowance because of the government's cost-cutting plan to introduce mandatory medical tests. Gordon Carson reports

Disabled people are anxious about losing access to disability living allowance because of the government’s cost-cutting plan to introduce mandatory medical tests. Gordon Carson reports

The Apple iPhone represents substance over style for Robyn Steward (pictured). The 24-year-old, who has Asperger’s syndrome and cerebral palsy, says the device offers crucial support when she becomes anxious, enabling her to locate her position via GPS if she is lost, and listen to music when she gets sensory overload.

However, she is worried that she would no longer be able to afford her iPhone, among other things, if she were to lose her disability living allowance under government reform plans, affecting her ability to live an independent life (see case study).

Disability campaigners share Steward’s concern over the future of DLA. In June, chancellor George Osborne announced plans to phase in a new medical assessment for new and existing DLA claimants of working age from 2013, to help slash the country’s £180bn annual benefits bill (see box). In time this would be extended to new and existing child claimants and pensioners who receive DLA.

similar process

This test, states the Budget 2010 policy costings report, will “follow a similar process” to the work capability assessment (WCA), which determines eligibility for employment and support allowance (ESA), with a “points-based system to assess eligibility”.

WCA, introduced in October 2008, has been accused by campaigners of wrongly identifying large numbers of disabled people as fit to work and thus ineligible for ESA, thereby reducing the level of benefit they can receive.

However, there is no detail as yet on how the new DLA assessment will work, and a Department for Work and Pensions spokesperson says it will not be exactly the same as the WCA.

DLA, introduced in 1992, is a tax-free, non-means tested benefit that helps 3.1 million children and adults meet the extra costs of disability. It is divided into two components; care, with three levels of payment, ranging from £18.95 to £71.40 per week; and mobility, with a lower weekly rate of £18.95 and higher rate of £47.80.

There is some agreement that reforms to DLA are needed, particularly to the complicated application process and its 59-page form. But charities say there is little evidence that DLA is being fraudulently claimed, and that the government’s main motive is to cut costs.

Neil Coyle, director of policy at the Disability Alliance, points out that the existing DLA system includes provisions for claimants to undergo medical assessments, if more information is needed to support a claim. He says introducing a completely new system with all the associated costs of contracting and staff training could conflict with the government’s desire to save money.

Then there is the cost and time taken up by appeals. For example, 29% of the 97,000 medical assessments from October 2008 to March 2009 that declared claimants for ESA “fit to work” were appealed, and the DWP’s initial decision was overturned in 39% of cases.

David Congdon, head of campaigns and policy at Mencap, says the medical assessment must be designed in a way that “ensures it is absolutely fair”. But, he says this was not the case when the WCA was introduced, especially for the mental health test used.

There is also a wider concern about how a focus on medical assessments could herald a return to the medical model of disability, and how it will affect those disabled people who don’t have obvious, physical conditions – for example, people with mental health problems or learning disabilities.

Professor Roy Sainsbury, a research director at York University’s Social Policy Research Unit, points out that DLA is “not a medical benefit” and is instead “designed to meet the extra costs of disability, which can be social”.

A DWP-commissioned report on the impact of DLA by Sainsbury and York colleagues, published this month, found that DLA helped adult recipients meet the expenses of needs ranging from personal and health care to transport, social activities and gifts.

Without DLA, some said they would not be able to pay their bills.

other entitlements

As well as the direct impact on income, the crackdown could have a severe knock-on effect on other entitlements. For example, carers of working-age people can only claim carer’s allowance if they care for a person who receives DLA at the middle or highest care rate.

Then there is the potential impact on the adult social care budget, including a reduction in councils’ ability to recoup costs through user charges.

“If there was to be a reduction in DLA, there would have to be some impact on social care,” says John Nawrockyi, co-chair of the Association of Directors of Adult Social Services’ physical disabilities network. “People who receive DLA are not fully independent of the social care system and our charging policies can take DLA into account.”

For this reason, Nawrockyi is keen for discussions about the future of DLA to be included in the government’s commission on the long-term funding of social care.

However, the government announced the DLA restrictions a month after it said it would set up the commission. This suggests it sees reform of the benefits system as a standalone task for the time being.

This may satisfy some of the more hawkish champions of a crackdown on “scroungers” and “benefit cheats”, but will do little to ease the fears of disabled people whose quality of life may be seriously affected by the loss of DLA money.

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Case study


‘DLA allowed me to start out in self-employment’

obyn Steward became self-employed last year after struggling to stay in work due to a lack of support. Although she is now earning fairly regular income, she says her DLA, amounting to £264 a month, provides vital support. Her mental health needs have increased so she has also been allocated an individual budget and receives housing benefit, and has recently moved into her own flat.

Steward works as an Asperger’s trainer, advising professionals in the education and charity sectors on how to work with people with the condition. She says starting out on her own would have been much harder without the DLA. “I needed money and time to start things up,” she says. “Being self-employed isn’t something that happens overnight.”

Eligibility for DLA is also crucial in enabling her to maintain her independence. For example, it qualifies Steward for a Freedom Pass, which provides free travel on public transport for disabled Londoners. “I know I can get on any bus that goes past, I will never run out of money [for travel], and I can always get home,” she says.

In addition, the DLA helps her to pay for her iPhone, which fulfils a number of roles. For example, it enables her to track her British Gas meter readings in real time through an uploaded application, reducing anxiety about bills.

She is worried about the impact of the government’s proposed medical assessments on disabled people, particularly those on the autistic spectrum. “Disability is social as well as medical,” she says. “When I was in work, I got so tired by the end of the day that I needed another day off. Assessors aren’t going to see things like that.”

Medical assessments

By introducing medical assessments, the government aims to cut the DLA caseload and expenditure by 20% for people of working age once fully rolled out. This would lead to savings of £360m in 2013-14 and £1.075bn in 2014-15. The number of recipients in this group has risen by more than 40% since 1997 to hit 1.8 million in 2009-10, while the bill increased from £3.9bn to £6.2bn during the same period (both at 2009-10 prices).

Published in the 22 July 2010 edition of Community Care under the heading ‘An assessment to be feared’

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