A Tale of Two Assessments

Anne Killeen, Senior Caseworker at Z2K, shows how two assessments can lead to very different outcomes.

Normally in Z2K blogs we focus on cases when things have gone either extremely well for a client or extremely wrong for a client.  However, in this blog I will focus on how two medical assessments by the Department of Work and Pensions produced two opposite decisions. One led to the client having to go to appeal to obtain Employment and Support Allowance (ESA) while the other led to Personal Independence Payment (PIP) being awarded immediately.

I understand the requirements are different for the two benefits – ESA is about your ability to function in a work environment while PIP is about the impact the disability has on your daily life – but often the need for one suggests a need for the other.

Jack attended one of our outreach sessions in the south of the borough of Westminster in May 2017. He had approached the service, which also has a foodbank, after accessing his GP to request a foodbank voucher.

His GP was later to say that when Jack approached him he was in a state of starvation.

I have worked in the advice sector for many years and this is one of the worst cases I have encountered. It’s hard to believe that someone with this level vulnerability could get to the stage of starvation whilst living in one of the wealthiest boroughs in London. What could have been a tragic event was only averted by building a relationship of trust over a period of time to allow intervention.

Jack completed his ESA form himself; this must have caused him great distress and taken days to complete. He attended the medical assessment and was awarded 0 points. Jack said the Healthcare Professional would not listen to his answers and the report did not reflect what he said. This assessment had a profound effect on him. A mandatory reconsideration was requested and the decision was upheld. An appeal was lodged by someone Jack met at the launderette which he used to sit in – credit has to go to this person who intervened on his behalf to lodge the out-of-time appeal.

At the initial approach to our service in May 2017 to get a foodbank voucher we advised Jack to apply for Personal Independent Payment, and when the form was received he was assisted under the Z2k form filling service. We would like to offer this service more often – however, we frequently have to use our resources to challenge negative decisions. At this appointment it was discovered Jack was not receiving ESA pending appeal which he was entitled to at the point the appeal was lodged. To remedy this it involved going to his GP to obtain duplicate sick notes and going to the Job Centre to get the sick notes and confirmation of appeal scanned to the DWP quickly. Jack has said he would not approach the Job Centre again as when he tried before he felt the staff laughed at him. My own experience of attending the Job Centre to advocate on his behalf was not pleasant, in fact it was somewhat hostile. Eventually at the end of August Jack received his ESA pending appeal.

He had had no income from February 2017 apart from foodbank vouchers and a small amount of money from a relief from poverty fund.

Jack had decided he could not face going to another medical assessment for his PIP. I agreed to attend with Jack and on a few occasions had to intervene in the assessment in order that Jack was given the opportunity to respond to questions in his own time. Post assessment Jack had mentioned that this was a very different experience to his ESA assessments. The outcome of the PIP application was enhanced daily living and enhanced mobility. I could be cynical and say that the award was made because we assisted in completing the form or attending the assessment with him, however, I believe it was made because Jack’s health conditions warranted the award.

Submissions for his ESA appeal were submitted and directions were made by HMCTS (the courts and tribunals service) for Jack’s medical records to be provided. On receipt of the medical records the tribunal made reasonable adjustments and listed it for hearing without the need for Jack to attend. At the tribunal, Jack was placed in the support group with a recommendation that “in view of the degree of disability found by the tribunal and unless the regulations change, the tribunal would recommend that the appellant is not re-assessed.”

 Having been awarded 0 points at the initial assessment, Jack was awarded 42 at tribunal. This clearly shows he should have been awarded ESA at the first assessment stage, as he was with PIP.

 Whilst Jack’s benefit issues have been resolved I fear that in a few years’ time the same cycle will occur again. Hopefully Jack will access Z2K services again if the need arises. In the meantime I will be liaising with other services to make sure Jack has access to the immediate support he needs.

PIP waiting times come down

dwpThis morning Mark Harper MP, the Minister for Disabled People, gave evidence to the Work and Pensions Select Committee on a number of issues, including the problems with the roll out of Personal Independence Payment (PIP). At the same time ad hoc statistic on PIP were released by the DWP.

The statistics make for interesting reading. Since it started to replace DLA in April 2013 to December 2014 there have been 625,000 claims new claims. Of those where a decision has been reached 49% have been awarded PIP while 32% were disallowed following an assessment and 14% were disallowed prior to an assessment.  However as of 25th January there is a still backlog of 110,000 claimants awaiting a decision.

PIP has mostly been in the news due to the extraordinary delays claimants have experienced awaiting a decision. The DWP has set a target of 16 weeks for a decision to be reached, yet last year the median waiting time reached 30 week in June and July. Fortunately it appears that this was a peak and waiting times have slowly decreased, reaching a median of 14 weeks in January this year (the first time the median has been at or under the target). Continue reading

The PIP assessment nightmare

dwpThe process of applying for PIP has been a long one for most of our clients, with some waiting up to a year for their application to be considered and to be invited to attend a medical assessment. Many of our clients report this time to be highly stressful and difficult for them, some due to a lack of money, others due to the uncertainty the wait brings.

However for those that have finally been asked to attend a medical assessment with ATOS the struggle is not yet over, as many of our clients are being asked to travel to assessment centres far away from their home. This often means a long and painful journey, or having to find the money to pay for a taxi, both of which extremely difficult for our clients and add to the stress and turmoil. Continue reading

Personal Independence Payment assessment chaos recalls the WCA scandal

atos-killsThe first independent review of the Personal Independence Payment assessment process is underway and Z2K has submitted evidence based on our experience supporting claimants. You can read our submission here.

PIP is the new benefit that began to replace Disability Living Allowance (DLA) from April 2013. Like Employment and Support Allowance claimants must undergo an assessment to see if they qualify, but that’s not where the similarities end because in large parts of the country these assessments are also carried out by the notorious ATOS Healthcare. As if that wasn’t enough to set alarm bells ringing, the government has made clear that they expect PIP expenditure to be 20% less than DLA, leaving many concerned that eligible claimants may be denied the benefit in order to meet savings targets.

The experience of our clients thus far has left us concerned that many of the problems with the Work Capability Assessment that we documented are being repeated with PIP. Just like ESA there are huge delays in the process with many claimants waiting upwards of 6 months for an assessment, meaning they experience severe impoverishment and in some cases a worsening of their conditions.

Those of our clients ‘lucky’ enough to have received an assessment aren’t necessarily better off as they have been left in tears having felt they were ‘interrogated’, while invariably receiving an incorrect decision.

That the government has manifestly failed to learn the lessons of the WCA disaster is a scandal and urgent action is required to prevent PIP going the same way.