Assessment that fails its own test

(pictured: MS sufferer Andy Grantham, who won an appeal against his work capability assessment)

The government has started reassessing sickness benefit claimants on their fitness to work in order to boost job prospects. But campaigners say the assessment process ignores crucial factors and will lead to poverty and stress for service users. Vern Pitt reports

Earlier this month the government started piloting the reassessment of long-term sickness benefit claimants on their fitness to work. The pilots in Burnley and Aberdeen will be followed, from 2011 to 2014, by the nationwide reassessment of 1.5 million people receiving incapacity benefit or income support due to ill health.

But the work capability assessment (WCA) that will be used continues to face criticism, particularly for its treatment of people with fluctuating conditions such as multiple sclerosis, Parkinson’s disease and mental illness (see case studies). For this reason, the government has announced an independent review of the WCA, which is due to report before the end of the year.

Deeper poverty

The assessment was introduced in October 2008 to test eligibility for employment and support allowance, which replaced incapacity benefit for new claimants in order to improve disabled people’s job prospects.

Campaigners have since argued that many people have been wrongly deemed fit for work, and fear this will now affect existing IB claimants, driving them into deeper poverty.

Long-term IB pays £91.40 a week. Those assessed as eligible for ESA will receive a similar sum if they are found to have some prospect of returning to work, or more (£96.85) if they are deemed unable to work.

However, the WCA will move many on to jobseeker’s allowance if they are found to be fit to work, paying only £65.45 a week.

The stress of a low income and the pressure to find work are known to have a detrimental effect on people’s mental health.

Mind policy officer Tom Pollard says the charity is already taking calls from people on incapacity benefit whose worries about the impending reassessment are damaging their mental health. “People feel threatened by the process. Some people are talking about the possibility of suicide,” he warns.

One reason people are worried is because the WCA asks only 10 questions about mental health and cognitive ability. Pollard says this is not enough to accurately assess how a person will function in the workplace.

Clients are also asked about their physical health, with each question carrying multiple answers. Each answer carries a score and claimants must exceed 15 points to be eligible for ESA. For instance, if you “cannot cope with minor, unforeseen changes in routine” or “cannot walk more than 200 metres on level ground without stopping” you score six points.

Perform tasks

However, the WCA ignores how a person’s ability to perform tasks changes over time, a crucial factor for those with fluctuating conditions.

Anjuli Veall, social policy manager at Parkinson’s UK, believes this can be overcome: “We suggest that the person does a diary over seven or 14 days to be submitted as part of the evidence.”

Campaigners also say health professionals conducting the assessment have little understanding of how conditions affect people’s work, despite all being subject to an approval process to test their skills.

To fix this, Hayley Jordan, policy researcher at the MS Society, recommends more involvement from other professionals, including social workers. “We have suggested that when someone applies for ESA they should be asked to name a professional who could be asked to give supplementary evidence and support them,” she says.

There should be greater information-sharing between assessments conducted for social care and those for benefits, says Jordan. This would make the assessment process less stressful for claimants and may increase the quality of the WCA decisions, which have a high appeal rate of 29%, 39% of which succeed.

Ideas for reform

Letters are already sent by doctors, psychiatrists, nurses or other professionals involved in a person’s care but Veall says Parkinson’s UK members report these are ignored.

The charities have fed their ideas for reform into the independent review, which is being carried out by Professor Malcolm Harrington. We will soon know whether they have been heard.

Read more about the WCA 

Case study: ‘ESA has given me my independence back’

When Andy Grantham was turned down for employment and support allowance it wasn’t just money he lost but his relationship, independence and health.

Grantham has multiple sclerosis, a degenerative neurological condition that is affected by stress. It’s that stress that he says caused the breakdown of his relationship with his girlfriend. She also has MS and they split up just four weeks after they were both turned down for the benefit.

Worse was to come. “I had two relapses. Because of those I have had to use a wheelchair to get out and about because I can’t walk any more,” says Grantham.

Grantham was one of the first to be assessed for ESA in November 2008 but feels the work capability assessment was rushed and weighted against him. “Doctors ask how things are at home and your inclination is to say, ‘OK,’ when you should say ‘these are all the problems I have at home’,” he says.

When his claim was rejected Grantham says he was blown away by the decision.

He appealed at a tribunal where his own conclusions were confirmed. He can still recall the judge’s words when he told him the disability benefits he already received: “Mr Grantham, we are going to be able to considerably shorten proceedings.” Within an hour he was certified eligible for ESA’s higher rate.

Without ESA, Grantham relied on disability living allowance but now he can afford a car through the national Motability scheme. “I couldn’t afford to lose the money before,” he says. “It has given me my independence back.”

Case study: ‘You need to be assessed by someone who understands’

Derek Poole had held down a job since he was nine. As an adult, he spent 22 years driving taxis, coaches and buses but a diagnosis of Parkinson’s in April 2009 changed all that.

“My arms and legs were locking up and I wasn’t getting full movement,” he says of the first symptoms. “I consider myself driving as a danger to myself and other people.”

In June he applied for employment and support allowance but he was taken aback by the first interview in the work capability assessment. “The doctor said, ‘right Mr Poole, I want you to sit there and answer yes or no and I don’t want to know anything else’,” he recalls.

Poole says nearly 80% of the questions he was asked didn’t have a simple yes or no answer. When asked whether he could wash himself he was denied the chance to explain that he had difficulty washing his back because of his decreased dexterity.

The work-focused interview followed in a similar fashion. The interviewer was unaware that Poole’s fatigue was a direct result of his Parkinson’s and recommended he could continue to drive with an automatic car, a suggestion Poole found incredible.

Although denied ESA initially, Poole was persuaded to appeal by his job centre officer who recognised that work would be difficult for him. He now receives the higher rate of ESA.

Despite the wranglings, he still supports the principle behind the assessment. “It’s a good way of whittling down the number of people who shouldn’t be [receiving it],” he says. “But when you get people who have genuine illnesses they need to be assessed by someone who knows what they are talking about.”

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