2 ESA claims process and outcomes
10. To claim ESA, an individual must
first contact Jobcentre Plus (JCP), either by telephone or by
submitting a form (ESA1), and provide some basic information.
Once the claimant has provided a medical certificate or Fit Note
(issued by a GP), then ESA is paid to them at an initial assessment
rate, which is equivalent to the amount paid to people claiming
Jobseekers Allowance (JSA). At this stage, all cases are referred
to Atos Healthcare, which then sends claimants a Limited Capability
for Work Questionnaire (ESA50). In completing this form, claimants
are asked to provide information about their health conditions
or their disability, and their physical and mental, cognitive
and intellectual functions. Claimants can also submit additional
information that they wish to be taken into account in their claim.
Once this form has been submitted, Atos makes a decision on whether,
on the basis of the information provided, the claimant can be
placed in the Support Group, or whether a WCA is necessary.[10]
11. Those invited to undergo a WCA are
required to attend an Atos assessment centre. A Health Care Professional
(HCP) employed by Atos will assess the person making a claim.
The assessment is based on points being awarded against a number
of measures of functionality, based on a set of "descriptors".
The assessor will then pass on a report, along with an overall
recommended "score", to a DWP decision-maker (DM).[11]
12. The DM decides whether the claimant
is fit for work, or is to be placed in the WRAG or the Support
Group. They make this decision by taking account of the Atos report
and the recommended score, alongside the ESA50 and any other supporting
evidence provided. If the claimant has reached the 15-point threshold
required to be placed in the WRAG, the DM will also consider whether
the claimant meets one of the 16 further criteria to be placed
in the Support Group. Claimants not assigned to either the WRAG
or Support Group are considered to be fit for work and are not
awarded ESA.[12]
Trends in ESA outcomes
13. DWP's commentary on the latest ESA
outcome statistics refers to "the bedding down of the benefit,
with distinct growth in the Support Group and decline in the WRAG
from April 2011".[13]
Statistics for each of the outcome groups are shown below.
FIT FOR WORK CLAIMANTS
27% of new claimants were found fit
for work in the period July to September 2013. This compares with
64% when ESA was introduced in 2008.[14]
For migrated IB claimants, the figure was 11%, down from 27% in
the second quarter of 2012.[15]
WORK-RELATED ACTIVITY GROUP (WRAG)
The proportion of new ESA claimants
placed in the WRAG rose from 24% when the benefit was introduced
in 2008 to a high point of 30% at the end of 2010, but has fallen
steadily since to 16% in the third quarter of 2013. This is in
the context of an overall increase in the numbers eligible for
ESA, from 36% in 2008 to 73% in 2013. For reassessed IB claimants,
the latest figures show that the percentage of claimants placed
in the WRAG fell from 22% to 17% compared to the previous quarter.[16]
In the second quarter of 2012, the comparable figure was 38%.[17]
SUPPORT GROUP
The latest ESA statistics covering the
period July to September 2013 show that the proportion of new
claimants assigned to the Support Group increased from 49% to
57% compared to the previous quarter. In the same period 72% of
IB claimants being migrated to ESA were placed in the Support
Group, an increase of 6 percentage points. [18]
In the first 18 months of ESA, only 6% of new claimants were assigned
to the Support Group.[19]
At the start of the IB reassessment process the Government estimated
that 20% of claimants would be assigned to the Support Group.[20]
14. The Secretary of State has referred
to claimants "languishing" on IB.[21]
Figures for the latest quarter show that, rather than "languishing"
inappropriately on IB, 89% of IB claimants who were reassessed
were entitled to ESA, with the vast majority being placed in the
Support Group.[22]
The claimant experience
15. Throughout this inquiry, we have
heard from a large number of claimants, and their relatives and
support workers, who shared with us their experiences of claiming
ESA, and particularly in going through the WCA. Some of these
people wrote to us; others came along and described their experiences
at the public meeting we held in Newcastle. Many reported feeling
dehumanised, ignored or questioned inappropriately. Some felt
that the progress they were making towards recovery, and then
moving back into work, was hampered rather than aided by the anxiety
caused in facing the WCA. While it might be expected that those
who believed that they were placed in the wrong group felt aggrieved,
we also heard from those who felt that they were placed in the
most appropriate group in the end, but who also felt that the
process had still been a harrowing and stressful ordeal for them.
16. It
is too early to predict whether the current trends in ESA outcomes
will stabilise. However, we note the recognition within the ESA
system that a higher proportion of claimants than initially expected
are not fit for work and are therefore eligible for ESA, and that,
of these, many need the higher level of benefit and absence of
work-related conditionality which the Support Group provides.
Nevertheless, it is clear that many claimants still find the process
very stressful. Many find themselves in an outcome group which
does not reflect their health barriers to employment, because
the current system is not sufficiently sophisticated to cope with
the wide variety in prognosis and impact which arises from the
huge range of conditions which claimants present with.
17. In the next chapters, we
raise concerns about the current system and set out a number of
shorter-term changes which we believe will help ameliorate some
of its most egregious flaws. However, our overall conclusion is
that the design of the ESA benefit and assessment process is so
problematic, particularly in relation to the confusion and limitations
of the outcome groups, that its inefficiencies and the detriment
inappropriate decisions cause to claimants can only be resolved
in a fundamental redesign of the ESA claims process over the next
few years. Our views on what
this redesign process should consider are set out in Chapter 8.
10 Dr Litchfield, An Independent Review of the Work Capability Assessment - year four,
December 2013, Chapter 1, paras 8-16; Gov.uk webpage, accessed
7 July 2014 Back
11
DWP, A guide to Employment and Support Allowance - the Work Capability Assessment,
January 2013, pp 8-16; Dr Litchfield, An Independent Review of the Work Capability Assessment - year four,
December 2013, Chapter 1, para 11 Back
12
Dr Litchfield, An Independent Review of the Work Capability Assessment - year four,
December 2013, Chapter 1, paras 12-16 Back
13
DWP, ESA: outcomes of WCAs, Great Britain, Quarterly official
statistics bulletin, 12 June 2014, Results, p 6. The outcome of
appeals is likely to increase percentages in both the WRAG and
the Support Group. Back
14
DWP, ESA: outcomes of WCAs, Great Britain, Quarterly official
statistics bulletin, 12 June 2014, Results, p 2 Back
15
DWP, ESA: outcomes of WCAs, Great Britain, Quarterly official
statistics bulletin, 12 June 2014, Results, p 12; DWP, ESA: outcomes of WCAs, Great Britain,
Quarterly officials statistics bulletin, April 2013, p 4 Back
16
DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials
statistics bulletin, 12 June 2014, Results, pp 2 and 12 Back
17
DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials
statistics bulletin, April 2013, p 4 Back
18
DWP, ESA: outcomes of WCAs, Great Britain, Quarterly officials
statistics bulletin, 12 June 2014, Results, pp 2 and 12 Back
19
DWP, Employment and Support Allowance: Work Capability Assessment by health condition and functional impairment: Official Statistics,
October 2010, Executive Summary Back
20
See Work and Pensions Committee, The role of incapacity benefit reassessment in helping claimants into employment,
para 154 Back
21
Speech of the Secretary of State for Work and Pensions to the Ways and Means Committee, House of Congress,
27 June 2012, accessed 09 July 2014 Back
22
DWP. ESA: outcomes of WCAs, Great Britain - tables, 12 June 2014,
table 10 Back
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