Summary of the work we are doing with DWP re benefits - DLA, ESA, PIP etc:
WP BENEFITS AND WELFARE REFORM: DLA, ESA and PIP
Trustees reviewed the current MEA strategy regarding various benefit reforms that are taking place, or are due to take place.
Changeover from ICB to ESA. This process continues to cause great difficulty for many people with ME/CFS who are currently claiming ICB when they are re-assessed for ESA.
DLA and the replacement with a Personal Independence Payment (PIP)
The changeover from Disability Living Allowance (DLA) to Personal Independence Payments (PIP) has now taken place for all new claimants in two stages – depending on where you live in the UK. The first stage was in April; the second stage was in June. CS previously reported on a meeting held at the DWP to discuss the new criteria for claiming PIP – in particular the inclusion of the words reliably, repeatedly and safely in the assessment process. CS has prepared a new MEA information sheet on PIP. This was included in the Summer 2013 issue of ME Essential. The new MEA information leaflet on PIP is now available on the literature order form and trustees agreed to prepare a guide to filling in the PIP application forms. Updated information on the changeover, including the call for comment on the mobility question, is being provided on the MEA website and on MEA Facebook.
Professor Malcolm Harrington’s Independent Review of the Work Capability Assessment.
A copy of the MEA submission to this review is on the MEA website:
http://www.meassociation.org.uk/?p=1639.
CS is a member of the group appointed by Professor Harrington that has reviewed the WCA descriptors that apply to people with fluctuating medical conditions. The FCG report on fluctuating conditions and the WCA, which contains some very useful information in relation to ESA applications and appeals, can be downloaded on the MEA website:
http://www.meassociation.org.uk/wp-cont ... INAL-1.pdf ?
Fluctuating conditions report and ESA
As noted above, representatives from five charities – Forward ME Group, Arthritis Care, MS Society, National AIDS Trust, and Parkinson’s disease – have been working with Professor Malcolm Harrington on his independent review of the Work Capability Assessment descriptors. The group’s report on fluctuating medical conditions and the WCA descriptors was completed in April 2011 and was very well received by Professor Harrington. As a result, the charities spent the rest of 2011 with a Scrutiny Group appointed by the DWP in order to reach agreement on a final set of conclusions and recommendations, This work was completed in November 2011 and was then forwarded to Professor Harrington and the DWP so that it could be included in Professor Harrington’s report on year two of his review.
Testing the recommendations in the Fluctuating Conditions Report
Having received the FCG recommendations the DWP took their time in deciding how our revised WCA descriptors – which are also intended to assess severity and fluctuation in relation to all the tasks that are included in the WCA – could be objectively tested against the current WCA descriptors. We also proposed two new descriptors covering fatigue and pain.
At the end of June 2012, the group was called to a meeting at the DWP where we were informed that an evidence based review (EBR) of our work will now take place. This involved an intense period of further work over during the summer of 2012 in order reach agreement with the DWP on how our proposals should be objectively tested against the current descriptors.
CS reported that testing is now taking place in Manchester and Newcastle to compare the existing and proposed WCA descriptors:
* A total sample of around 1000 ESA applicants who are due to undergo a WCA with Atos Healthcare will be asked if they will participate in an additional assessment on the same day as part of the EBR. This is a purely voluntary process but we hope that people with ME/CFS will take part if invited to do so.
* Two healthcare professionals will be involved in the initial (and current WCA) assessment. Following this a second assessment will take place that will involve asking additional questions and gathering additional information that is needed for the charities version of the assessment to be completed.
* The raw data will also be passed to an Expert Panel for their assessment of fitness for work and the DWP are in the process of recruiting people to form 30 to 40 Expert Panels. Members of the Expert Panels will have backgrounds in occupational health, general practice, occupational therapy, and physiotherapy.
* Expert Panel decisions on fitness to work will be quality assured by a small number of quality assurance panels with more work related or condition specific expertise.
* Analysis of the results will take place during the late summer/autumn of 2013 with the aim of producing an interim report for discussion in mid August. An independent scrutiny group, chaired by Professor Harrington, is overseeing this work.
Benefit review seminar meetings and seminars
Key points to emerge from charity representatives during the course of previous joint discussions include:
* Overall, there is still very little noticeable change taking place to the way in which people are being dealt with by the DWP and Atos
* There is very little evidence of medical reports from claimant’s health professionals being obtained or taken notice of – even when they have been obtained
* Claimants on low incomes cannot afford to pay for medical reports – which places them at a significant disadvantage
* Those living in areas with no access to specialist referral services are also being disadvantaged when it comes to obtaining supportive medical evidence
* People are still being rushed through Atos interviews without being listened to.
* Atos reports are still being reported as factually incorrect
* The Lima computer programme used by Atos during medical examinations is more concerned with functional assessment and describing a typical day at home and not fitness for work.
* People with fluctuating medical conditions do not have ‘typical days’
* Information provided to medical examiners by Atos is in some cases out of date and inaccurate
* The CAB representative pointed out that 60% of successful ESA appeals came from claims that had originally been awarded zero points – this indicates a major flaw in the ESA decision making process
* The DWP needs to define what it means by meaningful work
* Assessments for patient groups for whom the current WCA process is acknowledged to be flawed (eg ME/CFS) should be suspended until suitable descriptors have been put in place.
ESA feedback to The MEA
Feedback to The MEA indicates that people are often finding it very difficult to obtain ESA. However, a significant proportion are being successful if they go to appeal. If anyone is applying for ESA, or is involved in the transfer from ICB to ESA, please read our updated guidance leaflet on how to fill in the complex paperwork and the fully updated 10 ‘top tips’ on ESA. It is also worth obtaining the fluctuating conditions report – this can be downloaded free from the MEA website.
CS reported that he will be submitting further evidence on how the WCA is working for people with ME/CFS to Dr Paul Litchfield, who has been appointed by the DWP to produce the 4th and 5th annual reviews, following the retirement of Professor Harrington at the end of 2012.
The decision to bring in changes to the WCA descriptors as from 28th March 2011.
Motions in the House of Lords to try to annul the Statutory Instrument that brought in the new WCA descriptors were tabled by both Lord Kirkwood of Kirkhope and the Countess of Mar. This led to a House of Lords debate on Wednesday 16th March 2011. A television recording, and Hansard transcript of the debate, can be found on the MEA website:
http://www.meassociation.org.uk/ ?p=5180 During the debate, Lord Freud made a very important statement about ESA eligibility criteria in a response to an intervention from the Countess of Mar:
“It must be possible for all the descriptors to be completed reliably, repeatedly and safely, otherwise the individual is considered unable to complete the activity.’
Atos medical assessments
As part of Professor Harrington’s on-going review of DWP benefits, CS has visited an Atos assessment centre in London on to see how the much criticised LiMA computerised medical assessment system works. A summary of his visit was sent to the DWP and Professor Harrington.
ESA 50 form and ESA paperwork
The ESA50 form has been revised, taking note of some (but not all) of the recommendations put forward by the fluctuating conditions group. A copy of the new form, along with background information, can be found in the news archive for January 2013 on the MEA website.
The MEA information leaflet which explains how to fill in the complicated ESA paperwork has ben fully revised and updated – as has our leaflet covering 10 key points relating to ESA applications and appeals.
Disabled Facilities Grant
A new MEA information sheet covering the Disabled Facilities Grant has been prepared and added to the MEA literature list.
Meeting with Mark Hoban MP, Minister of State at the DWP
CS attended a meeting with DWP Minister of State Mark Hoban MP at DWP HQ on Tuesday 30th April to discuss benefit issues. This included the evidence-based review into changes that have been recommended by the fluctuating conditions group and mental health groups into the way in which the WCA assesses fitness for work.
Meeting with Dr James Bolton at DWP
CS reported on a very useful meeting with Dr James Bolton, Deputy Chief Medical Adviser at the DWP, on Friday 12 July. Various benefit matters were discussed including the ESA Amendment Regulations (and the continuing uncertainty as to the way in which people with physical conditions can also score in the mental health descriptors section), the ESA Evidence-Based Review (where we have a meeting in mid August to discuss progress/preliminary results) and the recent announcement regarding a pilot scheme to offer mandatory health advice to people in the ESA WRAG Group (where we have offered to take part in the consultation process for this pilot study).