Written evidence submitted by Independent
Resource Centre, Clydebank |
We provide welfare rights and debt/money advice to
all sections of the community. We are currently overwhelmed with
appeals against ESA Work Capability Assessment decisions to decline
We will outline here our three main concerns with
the ESA assessment process, each of which will be illustrated
by way of a case study. We would like to point out, from the outset,
that these case studies are by no means unusual, but actually
represent the experiences of a disturbing proportion of our clients.
Our concerns are as follows:
experiences and their GPs' medical evidence are being ignored
at the WCA. Clients have to go through the ordeal of an appeal
before this "evidence" is taken into account. WCA's
should begin with this evidence, not ignore it until the final
stage of appeal.
WCA itself and the process of appeal is seriously damaging to
clients' health, particularly where the symptoms of their health
condition fluctuate and they are wrongly assessed as fit for work.
The case we will describe here is not the only one we have dealt
with in which a client has died whilst waiting for their appeal
to be heard.
of the lower scoring descriptors have been removed from the ESA
WCA criteria as of 28th March 2011. We believe that this will
substantially and disproportionately affect those with complex/multiple
illnesses, and those with an accumulation of what would individually
be considered to be "minor" illnesses but cumulatively
have a substantial impact on daily life and ability to work. We
are seeing that this particularly affects those with complex mental
Mr W is a 35 year old with moved discs in his back
and neck, nerve damage and inflammation. At the time of the examination
he was prescribed an array of strong pain killers and wrist splints
and was undergoing a series of tests by a specialist, including
MRI scans. After attending his medical and failing to score any
points at all, he appealed. He was concerned that the medical
examiner had not actually carried out any physical tests on him,
using only his brief description of his day to day activities
as "evidence" that he was fully mobile and capable of
work. Mr W was also confused as to why his current medical treatment,
medical tests and the fact that he lost his last job due to his
ill health were not taken into account.
The WCA report described disturbed sleep, inability
to dress and crippling pain but found that Mr W did not satisfy
the criteria for physical disability because he "stands in
the shower for a few minutes", "was able to sit in a
chair with a back for 28 minutes", "stood independently
for one minute without difficulty" and "walked 20 meters
normally". The examiner found that "although a typical
day suggests a high level of limited activity, this was not evident
from observations. This indicates that the client does not have
a severe disability".
At his appeal tribunal, Mr W was awarded 54 points,
for difficulty with walking (six), standing (six), bending (six),
reaching (15), moving objects (nine) and manual dexterity (nine).
The tribunal judge stated in his decision letter: "In light
of what this claimant has described, and the findings actually
made, this tribunal finds it difficult to understand how the HCP
could have awarded no points at all".
The details of the medical treatment that Mr W was
receiving at the time should have been enough for the assessor
to find him incapable of work. Mr W's descriptions of his daily
life, both on the application form and in the WCA should have
been more than sufficient. Instead, the medical assessment that
he underwent at the hands of Atos Healthcare was inappropriate,
unnecessary, unprofessional and damaging.
Mr C was a 59 year old who suffered from severe anxiety
and depression, as well as an eating disorder, all of which began
when he was made redundant some years earlier. He also suffered
from nerve damage, which affected his mobility. At his medical
examination he described severe mobility problems, including regular
falls, problems with washing, housework and eating, severe problems
sleeping, poor concentration and visual hallucinations.
The examiner found him to have no physical disability
because he "was able to sit on a chair with a back for 31
minutes", "stood independently for one minute"
and "walked 15 meters normally". The examiner considered
his nerve damage to be "mild" as he had not seen a specialist
for this condition, only his GP, and that his mental health condition
was "moderate", as he was "pleasant and co-operative"
at the examination.
In the five months between his medical assessment
and his appeal hearing, Mr C died. He may have seemed, during
the examiner's brief meeting with him, to be able to cope with
social interaction, self maintenance and his difficulties with
mobility, but the examiner took no heed of the variability of
either his mental health or physical condition. Mr C was far from
fit for work and we feel that this stressful process contributed
to his declining health and eventual death.
Ms M is a 52 year old experiencing poor mental health,
including depression, tearfulness, anxiety, poor concentration
and severe difficulty with social interaction, all of which stemmed
from her childhood experiences of abuse. She had been prescribed
pain killers and anti-depressants at the time of her examination
but described continuing emotional distress, including an inability
to bring herself to wash and dress on some days and a lack of
motivation to do housework, as well as substantial panic attacks
when leaving the house and suicidal thoughts.
As she did not see a specialist for her mental health
problems and she was able to shop for food, alone, on a weekly
basis, the examiner found that "whilst the client has some
impairment of their mental function, overall they are unlikely
to have significant disability" and "despite wishing
to avoid people, the client will go out when she has to".
She was awarded no points at her examination, which was overturned
at appeal, where she was awarded 18 points, from three separate
This again raises the issue of the variability of
a person's condition, as covered in Case two. It also raises the
issue of complex and cumulative conditions. Ms M's depression
and tearfulness may have been moderate, her panic attacks and
anxiety may also have moderate, but in combination they were severely
prohibitive of a normal and enjoyable life and entering employment
was not a viable option for her.
Ms M won her appeal under the old ESA descriptors
but the amended WCA points system is proving largely unworkable
in such cases. Under the new descriptors, which have substantially
reduced the number of points available to those with anything
less than very severe mental health conditions, Ms M would struggle
to attain 12 points. This brings us to the third and final issue
with this case: the medical examiner recognised that "the
client will go out when she has to", a comment which was
made in reference to her weekly food shopping. Ms M had already
described how these outings made her feel: anxious, frightened,
panicky, tearful and, at times, suicidal. Yet, the examiner saw
fit to declare her fit for work, to create more situations in
which she would be confronted by these overwhelmingly unpleasant
feelings. We feel that this decision and the system that encourages
examiners to make such decisions every day, is thoroughly inhumane.