Written evidence submitted by Mrs Janet Hassall (HAB0004)


I was invited to apply for PIP nearly 4 years ago. I had been on DLA for several years because I have a mental health condition which significantly affects my daily life. This is not something I will ever recover from. At the time I was 66 years old and receiving state pension but even though I was never going to return to work, I was not old enough to stay on DLA and had to apply for PIP. I am now 71.

My assessment was paper only, not face-to-face. This was because I had been diagnosed with Social Anxiety Disorder which meant interacting with other people made me so anxious that I became unwell. My Psychiatric Case Worker supported me in arranging this. The assessment went to Tribunal which found in my favour. The whole process took a nightmare-ish 8 months. I attempted suicide because I couldn’t bear the anxiety and was hospitalised.

The quality of assessments for health-related benefits would be vastly improved if highly trained professionals such as my GP and my Consultant Psychiatrist were given greater importance in the process. They have known me for several years and, over many meetings, have in-depth knowledge of how my mental illness affects my day-to-day life, far more knowledge than is possible for a less trained individual to acquire in a one-off meeting. Those who are applying for PIP because of mental health issues will always have regular meetings with their Consultant Psychiatrist. I had been seeing mine monthly for years. Whilst the assessors are described as “health professionals” they are asked to assess the impact of health conditions that are outside their field of knowledge.

I provided my GP and my Consultant Psychiatrist with a copy of the PIP descriptors. I only gave them the descriptors. I had no further input into their responses.  My application included five letters from my GP and Consultant Psychiatrist. There were so many because their letters early in the process were ignored by Asos in my application and so they kindly wrote more. Greater significance given to the opinion of professionals in Primary and Secondary care, in the context of the PIP descriptors, would improve the quality of the assessment and reduce stress on applicants.

Relying mostly on clinician input would have the advantage of -

The disadvantage is that clinicians do not have the time for any addition to their workload. They struggle with what they already have. This is an obstacle that would have to be sensitively handled. If they are asked to input into the assessment, the form of their input would have to be carefully considered. I think that there will be resistance if this adds to their workload.

Face to face assessments, with a contractor like Asos, are an exercise in communication between the applicant and the assessor. The assessor is working to a framework. The applicant may have no knowledge of this framework and even if they do, the process relies on the communication skills of someone who is not very well. There are also unacceptable assessments built in to the current process.The notion that the assessor can determine the applicant’s health and ability to work based on clues like how they got to the appointment, how they’re dressed, their manner or their body language, is not sensible, fair or just.

The descriptors in the PIP assessment are very weighted against invisible or intermittent disabilities. Perhaps if, as I suggest above, medical professionals, who have known the applicant over a significant period of time and are familiar with the fluctuating nature of illnesses, were given more weight in the assessment process, then this would go some way to ameliorating this discrimination.

With regard to the high percentage of successful Tribunal Appeals again, I think that the quality of the assessors and the process is at the root of the problem. In what was, in effect, my third application, having gone through first application, Mandatory Appeal and Tribunal, it was obvious that whoever was reading my paper application was not able to appreciate the evidential nature of  letters from my GP, my Psychiatrist, my Pharmacist, my Mental Health Crisis Team Worker and my family.  Their responses were as if they had not read them. To try and help them, and because the whole thing was literally driving me mad, I wrote a precis of their letters against the reasons they gave for refusing my application, underlining in red, showing where there was clear evidence supporting my claim which contradicted their judgements.

I think that 76% of Tribunal appeals are successful because the people who conduct Tribunals are experienced and skilled in working with evidence. They understand what constitutes valid evidence. That these cases go to Tribunal and are successful indicates that contractors such as Asos do not understand the evidential process.

The descriptors are clunky. I suspect that they are an old assessment form from the last century with some add-ons attempting to bring it up to date. I prefer not to look at the descriptors ever again so I won’t comment in detail.  However, the descriptor about the ability to walk should be changed. The assessment is of how the illness affects everyday life. I now have ME as well as a mental health condition. I can walk the distances in the descriptors – 50 yards, 200 yards etc - but I cannot walk to the local corner shop, my doctor’s surgery or the local pharmacy, all of which are within a 5 minute walk. This means I am effectively housebound yet I fail the walking descriptor test. There is no need for the walking distance descriptor as well as the mobility component. I was awarded the mobility component at the Standard Rate. Now that I have ME as well as a mental health condition, I could probably get the Enhanced Rate. This would enable me to get a car through the Motability scheme, but there is no way I’m going to endanger my mental health by applying for a change to my benefit.

With regard to assessing the ability to work. This is particularly difficult around mental illnesses, invisible illnesses and fluctuating illnesses. Whoever makes assessments needs to understand these difficult  illnesses. They need to understand why, for example, someone with severe Social Anxiety would find work or benefit assessment very difficult, or how someone with ME/CFS may sometimes be bedbound and sometimes not. As I think I’ve made clear above, I don’t think that current assessment contractors have the knowledge or ability at a high enough level to make these sort of judgements. And physiotherapists, who I believe are often employed by contractors like Asos, don’t have any professional knowledge of these conditions. They are medical professionals, but it’s outside their area of expertise.

I’ve read Justin Tomlinson’s statement and I still don’t know what a “Health Transformation Programme” actually means. As well as talking about “transformation” he also talks about procurement contracts being extended with the same companies whose incompetence at assessing has directly led to claimant success at Tribunal. I can’t see how transformation is possible in these circumstances. If the assessments were “in house” I am sceptical about there being an improvement in the quality of assessments. DWP staff are no more able to understand the evidential process than the current contractors and they will have the same poor medical knowledge and limited training. The DWP don’t have the staff to do this. Contractors such as Asos would presumably make many staff redundant and they would probably be recruited by the DWP. Hence nothing would change.

Third party participants such as patient groups, charities and CAB should be recognised and have more support. The application process was directly responsible for a catastrophic deterioration in my mental health. Unsurprisingly. At one point I was hospitalised. I was not competent to make the application properly and was brilliantly supported by CAB when it went to Tribunal. I noticed that the CAB worker who helped me used legalise, specialised language, in my application. She referred to previous judgements by their case number. She took account of what I had written in my application but presented it very differently. Very sick applicants can’t do this. The process should be as simple and user friendly as possible, and it is currently the opposite.

If a clinician states that the applicant’s illness is lifelong then their successful claim should not be reviewed. It is unnecessary, cruel and stressful for the applicant, and costly for the state. My claim was due for review this year. I am 71. I have a mental health condition that will not go away. You cannot understand the level of dread I felt. It took me 3 years to recover from the mental breakdown caused by the first application. Dread of the review was constantly at the back of my mind for nearly 4 years.  I was joyous when I got a letter saying that they were not going to review it for 7 years.

Mine is not the only tale of woe. I read terrible stories of other people’s experience of applying for PIP every day on online forums. I think I’ve made it clear how the current system is unfit for purpose and, in many cases, makes people more ill. It expects too much of sick people. It takes too long. It’s too complex. It is inefficient, incompetent and costly. It fails to give important, relevant, professional medical opinion proper weight. The assessment contractors are not fit for purpose and that is the main problem. Fiddling with the descriptors may make some difference, but addressing the problems around the assessors would make more. I would strongly support a paper only or digital assessment based mainly on a clinician’s assessment.


October 2021