The role of incapacity benefit reassessment in helping claimants into employment - Work and Pensions Committee Contents

Written evidence submitted by Samantha Fulstow

I am writing to give my personal experiences of the Work Capability Assessment (WCA), Atos and the way my claim was proceed by the DWP Jobcentre plus.

1.  I have now undergone two WCA, the first in 2009 and the second in November 2010. Both were carried out by nurses who I feel did not have adequate knowledge and understanding of mental health difficulties.

—  (i)  The first assessment lasted approximately 20 minutes and I was asked questions about my physical ability to perform tasks, I was also asked about any emotional, cognitive or behavioural difficulties. I answered the questions in as much detail as possible while showing the assessor documentation to back up what I was saying. I found a lot of the questions to be very misleading, ie I was asked if I had an active bank account in which my benefits were paid in to, I answered yes to this question as my money went in to my account rather than receiving a giro as I am not very good at managing my money. My answer to this question was used against me to say that I had no difficulties managing my finances.

—     I received my results of the WCA and scored zero points, I then went to appeal and within approximately 15 minutes I was awarded 15 points and was then awarded the full benefit.

—  (ii)  My second WCA took place in November 2010, the assessor was a nurse and the assessment took approximately 30 minutes. I was asked the same questions relating to physical and mental ability for completion of tasks and again many misleading question. For example, I was asked if I see my GP for any treatment, I said that I saw my GP twice weekly to pick up persecutions and to review my progress as my GP was in the process of changing my antidepressants as my old ones had been discontinued. This was used as evidence that I could cope with social situations as I left the house to do this. I was asked if I had any contact with friends or family, I said that my dad came to see me once a week make sure I was generally ok. This was used against me to show that I could cope with social situations. I was also asked if I had a bank account and if I had an address where I received post, this was used as evidence that I had no difficulties managing my affairs. As I did last time, I provided evidence to support my claim. The assessor refused to look at it saying that it wasn't important. This has been used against me stating that I did not provide supporting evidence.

—     From the line of questioning in the WCA I feel it is impossible to get any points for the descriptors because when you try to answer a question the assessor scrutinises your answers. For example, when I was asked if I could prepare a meal for myself I explained about my paranoia with using the cooker and fear of forgetting it is on and burning food or myself. I added that I used microwave meals and get take out. The assessor questioned me saying things like "but you are physically capable aren't you and I'm sure you could make a sandwich if you really needed to?" I had to answer yes to this because I am physically capable; it is mental health reasons that stop me. I scored zero points for this assessment and I am currently waiting for appeal. I have been told that I might not be seen until August but my representative is going to see if I can get seen sooner. I honestly don't know what I would do if I didn't have help, this has already caused me a huge amount of stress.

—  (iii)  I found the attitude to the assessor from Atos to be very confusing. On one hand, when I was giving my history my condition and what caused it, she was very sympathetic, saying that she was very sorry to hear what I had been through. When I told her that I was really worried about the outcome of the assessment because I had failed the last one and had to go to tribunal, she was sympathetic and said that she understood how traumatic the experience can be for people with mental health problems but that there was nothing she could do about it as she is in no way involved in the process. On other occasions I found her to be very uncaring and felt that she didn't understand me. I was feeling very nervous at the assessment and very self conscious so had my hood up, she asked me to take it down and I explained how I was feeling and that I was sorry, she was very sharp with me and it upset me. She hardly looked at me throughout the whole assessment and even provided a description of me in the written assessment that was inaccurate, in my opinion, proving that she wasn't paying attention. I explained to her at the beginning of the assessment that I get very flustered and find it difficult to put what I mean in to words when I am under pressure, even after telling her this she was very pushy when asking questions and seemed to just want to get it done as soon as possible without taking my needs in to consideration. I would have appreciated it if she had taken her time more and let me put more time in to my answers so she could get a better picture. I have a lot of phobias and beliefs that many people would find strange when I am having a really bad time, for example, I have a fear of vomit that stops me being around anyone who might be sick, I also have a problem with thinking that people are angry with me so avoid speaking to people on the phone. I felt that the assessor didn't take these things seriously and many weren't included in the written assessment. I think things like that should be looked in to because they do impact my ability to work and engage in social situations.

—  (iv)  My overall experience of the process has and still is very bad. I strongly feel that the WCA is not fit for purpose and is letting a lot of people down. This whole thing is causing me a huge amount of stress which is making my condition worse and as a result I worry that it will take longer for me to be in a position where I could get a full time job. Like many people who suffer from mental health problems and physical problems I want to work, it's just that at this moment in time I am not ready. I have pushed myself too hard in the past and kept going with a job when everyone around me new I was too ill to work just so I didn't have to go through the system again. Each time I do this I end up in a much worse position, having a breakdown and having to try and build myself back up again. Each time I fail a WCA and have to go through the appeals process it knocks me back further from my goal of being fit enough to find work in the future. The WCA needs a serious overhaul, I can only speak from my experiences of going through it with a mental health problem (GP thinks I have BPD) and it is not a nice one. My problems are fluctuating, I might be really happy and hyper one day, not really looking out for myself and doing stupid things that might get me in to trouble, another day I might be so low that I can't move and want to kill myself, another day I might be slightly psychotic and want to hurt myself in strange ways, it is very rare that I have a day when I am completely ok and "sane". The WCA needs to take this in to account, it is not fare if my assessment happens to fall on a day when I am coping relatively ok and how I feel other times is not taken into account. I also think that evidence provided by GPs and other health professionals should be taken in to account. My GP knows a lot more about what I go through on a regular basis that a nurse who sees me for 30 minutes. I think it is important for the assessors to have some background knowledge of the conditions affecting the claimant they are assessing. It is like getting a random person off the street to assess someone with a complex neurological condition, the results aren't going to be accurate. I also think that the time between assessments needs to change. I had my previous tribunal in March 2010, I was then called in for another assessment in November. If the DWP had looked at my records they would have seen that it would have taken a miracle drug for my condition to have got better in that time and there are some people who are being reassessed every three months. This practice wastes tax payers money, it would be far more efficient for someone from the DWP to look over the claimants file and assess whether or not their condition is likely to have changed, for example, if a claimant has MS or an inoperable brain tumour, the likelihood of their condition getting better is very slim.

2.  From my experience, the decision making process is not adequate. The decision is only made from the Atos assessment which is not accurate and the questionnaire that the claimant has filled in. You should be allowed to submit evidence from medical professionals to back up your claim. I think the thing that frustrates me the most is that once a decision has been made that isn't in your favour, you are told you can submit supporting evidence to show why you think the decision is wrong but the DWP do not send you a copy of the report, so you don't know what questions you are challenging. When I submitted my appeal to be looked at again I requested a copy of the assessment so I could put together some good supporting evidence, but after a month I received a letter saying the decision could not be changes and that I did not send in any supporting evidence. I had not received a copy of the report so I feel this was very unfair. It would be nice to at least be given a chance to defend ourselves. I think it is wrong that if you request information from the DWP they do not have to send it to you, how is anyone suppose to put forward a case when they are not allowed to see what they are challenging. What I would like to see in the way decisions are made is:

—  (i)  A questionnaire that is suitable for all types of illness and disability. The questions need to be more rounded so that you are not excluded if your condition doesn't fit a question 100% you are not excluded. For example: Part one question 11 Staying conscious when awake: I suffer from dizzy spells and vertigo caused by anxiety so most of the time when I stand up I get a white fuzz over my eyes and nearly fall over, this can be hazardous when crossing roads etc. I had to answer no to this question because it says that it is specifically for conditions like epilepsy where you have a fit or blackout or go in to diabetic shock, what I experience is not on the list. Part two question 18 Going out: In the second part of this question it asks if you feel you cannot go out even if someone is with you, you can only answer yes or no. I had to answer no to this question as I do not feel like that all the time; my condition varies so there are many times when I feel I cannot go out without another person with me. The way this question is worded means that if you have a condition that varies you have to answer no and therefore, loose points. There are also any questions that are very misleading, I had someone fill in the questionnaire for me and they were confused. For example, in part two of the questionnaire, the questions start off asking if you can do things with the options usually, it varies from "not" to "very often", then on question 15 the wording suddenly changes, asking if you have difficulty doing things with the same options. For someone who has difficulties filling in forms this tactic of changing the wording for the question is very unfair and may lead to any people ticking the wrong box. I am dyslexic so if it wasn't for the person helping me reread the question just to make sure, I would have picked the wrong box. There are also only 10 sections for mental health which quite frankly is not enough, mental health is very complex and cannot be assessed with such few questions.

—  (ii)  I think the WCA needs to be more thorough. People are different and a condition is not going to affect two different people in the same way. Some ailments are quite easy to assess, like if someone is a quadriplegic or is blind, but others are far more complex and would need a more in-depth assessment. From the side of mental health I think more time should be given to gain an accurate history and understanding, also claimants should be given more time to explain how being in a working environment would affect them. Variations in mood and behaviour should be looked at more thoroughly and on an individual basis rather that asking set questions. I know that the whole thing is done via a computer program and that is going to be difficult to change but I think a lot can be done with choosing the right person to carry out the assessment. If an assessor has got good training with a variety of mental health conditions, having a good amount of time with the claimant to properly discuss the way their condition affects them should aid them in filling in the questions on the system adequately. From my experience there have been a lot of problems with the assessor not fully understanding what the claimant is trying to say and this is worsened with the feeling of being rushed.

—     I don't really want to muddy this up but I truly think that the assessments need to be carried out by professionals who are unbiased and are carrying out the assessments to gain an accurate account of how a claimant is affected by their condition and not more concerned about numbers and deadlines, as I truly feel that that is Atos's main focus. I find it very disheartening that Atos healthcare are using methods for assessment brought forward by Prof Mansel Aylward, head of research at Unum Provident in Cardiff. This is the same company that was sued in America in 2002 for $31.7 million for running "disability denial factories". Again, I am sorry for bringing this up but it just worries me a lot.

3.  I have been through the appeals process twice now, the first time I was successful and the second is ongoing. The first time I was quite happy with the way things were run, I waited about three months for my appeal to be heard and even when I had difficulties the staff were very helpful and supportive. I received all the information I asked for in good time and when my appeal was heard a decision was made very quickly. The people who heard my appeal were patient and listened to what I had to say.

The appeal I am going through currently is unfortunately taking a lot longer; I have been told that this is due to a high number of appeals being heard at the moment. Although I am having to wait they were very prompt in sending me all the relevant information and including details of organisation who I could contact for help and advice. In all I am happy with the way this is run.

March 2011

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