Written evidence from Veronica O'Donohue (HAB0044)

 

  1. How could DWP improve the quality of assessments for health-related benefits?

 

I do not believe that assessments are necessary.  The only reason they exist is to check the validity of a claim.  What happens, in fact, is that assessors routinely minimise or deny difficulties, alter statements made by the claimant or type responses without having asked the question to which they relate.

A diagnosis of a condition or multiple conditions should suffice.  It is extremely easy to source information on the affect/s they have, should the Department wish to confirm the client’s word.

Both PIP and ESA assessments are more like police interviews with the assessor attempting to addle the client into making a statement that the assessor can use against them when reframed.  If you require clarifications on lies and reframing, please let me know. The attitude towards citizens who become sick or disabled, temporarily or permanently is hostile.

Venues are most often a long distance from the client’s home resulting in considerable expense, only payed to the client some weeks later.

The venues are unpleasant and intimidating.  The reception staff all wear security uniforms and are often gruff and intimidating.  In Brighton, in the corner of the waiting room, is a cubicle fabricated from something flimsy, such as plasterboard or plywood.  This houses the toilet and every sound can be heard by those in the waiting area, which proved particularly difficult for all when one poor lady was violently sick. I felt so sorry for her having to emerge and face us all.  It is very humiliating.

One of the questions the assessors ask is how long we are able to sit.  If we normally need to move every fifteen minutes or so to relieve pain and discomfort, we are then asked how we travelled to the centre and how long it took.  Obviously, for most of us, that is for much longer than fifteen minutes.  One assessor said “Well, you managed to sit for over an hour in a car to travel here so I will not count what you told me previously,”  I can only imagine that she expected me to stop the taxi every few miles and take three hours to reach the centre.  The fact that travelling for that time causes severe discomfort was of no interest to her.

We are then asked to perform various demonstrations of our inabilities which is also a humiliating process – even our consultants do not ask us to do that – and the ease with which we perform for them, if we manage to perform at all, is often exaggerated.  If we refuse to do or answer anything the assessors instruct us to do or ask, it is marked as a refusal to the whole process and so we lose our means of support. Also, for the E.S.A. assessment, we can be asked to strip to our underwear.  I am not sure what purpose this serves but, thank God, I have not suffered that particular humiliation, yet.

We can only change the date of an assessment once, regardless of the reason, even hospital admissions. We must maintain a calm demeanour no matter how distressed we feel otherwise we are labelled as aggressive and intimidating and the assessment is stopped which has the same result as not going at all.

 

 

The whole process is based on the assumption that clients are untrustworthy and seeking help fraudulently. It is very difficult to have an assessment at home and it was necessary for me to contact my M.P. to secure one.  When one is reliant on this financial support simply to survive, the threat that it might be reduced or denied is, obviously, extremely distressing.

Considering the small percentage of the welfare costs made up of Sickness and Disability costs it seems a very expensive and wasteful way to discourage citizens from making a claim or depriving many of what they were previously awarded, especially when one includes the cost of mandatory reconsiderations and the use of the Tribunal Service. 

The percentage of fraudulent claims is minute and, bizarrely, includes the figures for The Department’s own errors.

  1. Have you seen any specific improvements in the process since the Committee last reported on PIP and ESA assessments, in 2018?

None.

3. Do the descriptors for PIP accurately assess functional impairment? If not, how should they be changed?

No. Nowhere in the descriptors or during assessments is the phrase, “…repeatedly, safely and in a timely manner…” used or given any consideration by assessors or decision makers. There is no mention of an activity taking a reasonable time, nor what is considered a reasonable time for each activity yet, in government guidance, particularly with regard to walking, the time taken is very important as the distance managed is then disregarded. In addition, at no point does The Department consider the pain and discomfort suffered during an activity.  A client might be able to walk more than 500 yards but need to stop frequently for various reasons and might be in extreme pain whilst walking yet neither of these issues are addressed. Most of us try and maintain a modicum of fitness by walking each day when we are able to leave our homes but the cost can be huge resulting in enormous fatigue, pain, discomfort, risk of stumbling and falling.  Also the Government disregards the added difficulties of walking in a hilly environment, negotiating kerbs, uneven pavements, potholes and so on, which is extremely unfair and does not relate to real life.

 

4. Do the descriptors for ESA accurately assess claimants’ ability to work? If not, how should they be changed?

The decisions made overall are also subjective for ESA and PIP.  With regard to ESA, a member of my family has exactly the same conditions as I have and is younger.  This person was immediately and correctly placed in the Support Group.  I was placed in WRAG which placed considerable stress on me and huge anxiety each time I was made to reapply and have an assessment as I knew that I would be unable to work and so could be made destitute on the subjective opinion of a member of The Department. I was finally placed in The Support Group after assistance from a mental health professional who provided a letter of support but it should not have been necessary as my conditions speak for themselves.  Also, prior to my mobility issues worsening, I have always managed to find my own jobs without any “nudging” from any Government and, in two roles, I was involved in recruiting staff and I would not have employed me as my conditions make it impossible to say what I can manage from hour to hour, let alone week to week.

The term reasonable time is frequently used throughout yet it is left as a subjective.  This needs to be made objective, if it is to be used at all and clients must be made aware of this as well as assessors. 

With regard to mobilising, the word stopping is frequently used but does this mean stopping completely or pausing?

Sitting and standing – as previously explained, assessors regularly respond that a client must be able to manage sitting for a long time because of the time that it has taken to travel to the centre and a client’s word is overruled.

The descriptors for Reaching are ridiculous.  In what way does reaching a breast pocket or the top of one’s head relate to work? Again, repeatedly, safely and in a timely manner is not included.  As for reaching above the head this would be a pointless action unless the client was reaching for something and if so what, how heavy, how large, how repeatedly? Even people who are bed bound can usually manage to reach to a top pocket, their head, his or her face and to reach for a call button.  Does that make them able to work?

Activity 4 also neglects to include repeatedly, safely and in a timely manner and does not mention any pain, discomfort or fatigue.  If one’s job included such an activity it would not only be required once a day so being able to manage these movements once in front of an assessor does not accurately reflect what would be required when, for example, working on a packing line or replenishing shop shelves and is slanted towards excluding as many clients as possible from the support they need.

Activity 5 is again skewed towards denying support as it does not take into account how much pain and fatigue is caused using our hands in those ways.  What is the use of a meaningful mark if a client is only able to make one or two before needing to stop? 

With regard to the abilities in communication, the effects of conditions which cause extreme fatigue should be considered.

Activity 11 surprises me in that it is only concerned with manual activities and does not consider any difficulties in learning procedures, rules and any abstract concepts in a role.

Activity 15 should also include those who sometimes cannot perform these tasks due to overwhelming anxiety or sensory overload.

a. Before PIP replaced DLA for adults, DLA was also assessed using a paper-based system. What were the benefits and drawbacks of this approach?

There was no more fraud without assessments and the process was much less stressful and prejudicial.

6. How practical would it be for DWP’s decision makers to rely on clinician input, without a separate assessment, to make decisions on benefit entitlement? What are the benefits and the drawbacks of such an approach?

The client’s own input should be considered the most reliable source of information as even clinicians do not necessarily know how a condition affects an individual and, as they have their own specialist areas, they are often unaware of the combined effects of several conditions.  That said, their input is likely to be more accurate than that of assessors has proved to be. The Department must bear in mind that clinicians are busy diagnosing and treating citizens and so letters simply confirming diagnosis should suffice and with chronic conditions the date of the letter should not matter.

7. Appeals data shows that, for some health-related benefits, up to 76% of tribunals find in favour of the claimant. Why is that?

Assessors and decision makers lie, manipulate and reframe information in their reports .  As an example the most recent decision maker regarding my PIP award said that he read the report from the PIP assessment and the ESA assessment.  I did not have an ESA assessment last year as they made the decision to move me into the Support Group without one.  I have not appealed the decision because I just cannot cope, either mentally or emotionally with that ordeal again and there is no organization that has enough staff to fully support me through this.  I just cannot cope with going through all that for what would be the third or fourth time. 

  1. What could DWP change earlier in the process to ensure that fewer cases go to appeal?

They could stop approaching the process as though citizens are guilty before being proved innocent.  They could stop aiming to slash the number of claimants by any means necessary.  They could stop lying.  They could stop repeatedly assessing us and they could stop viewing us as though we are a strain on “The British Taxpayer”.  What do we pay taxes for if not to provide for our needs and I wish that parliamentarians would remember that all adults pay tax? If V.A.T. is not important enough to be included in their rhetoric they should abolish it.

8. Is there a case for combining the assessment processes for different benefits? If not, how else could the Department streamline the application processes for people claiming more than one benefit (eg. PIP and ESA)?

As it is assessments are extremely long and unpleasant and the thought of them being even longer with even more performance of disabilities required in one go is an absolute nightmare. It should not be necessary to assess if a confirmation of diagnosis is supplied.

9. What are your views on the Department’s “Health Transformation Programme”? What changes would you like to see under the programme?

From the little information I have been able to find it does not give me any hope of the process being less horrific for clients than it is at present. The Department and The Government must stop seeing their sick and disabled citizens as liars and shirkers ( yes, we all remember Cameron repeatedly talking about workers and shirkers, as though they are the only two categories which exist in our society).  As stated before, I would like all assessments stopped and those in need properly supported. This would also save The Department a lot of money.

  1. (For people claiming) Would you like to be able to manage your benefit claim online?

Paper and online claims should be available.

 

  1. What would be the benefits and drawbacks of DWP bringing assessments “in house”, rather than contracting them to external organisations (Capita, Atos and Maximus)? In particular, would this help to increase trust in the process?The impact of the pandemic

The benefit would be, I imagine, that it would cost less.  What is important is what would be expected of assessors.  Are they expected to refuse support to a certain number of people each week?  It does not increase trust in the process as The Department and The Government still see sick and disabled citizens in the same light as they have since 2010.

10. What lessons should the Department learn from the way that it handled claims for health-related benefit claims during the pandemic: for example, relying to a greater extent on paper-based assessments, or using remote/telephone assessments?

The Department can learn that, if assessments can be carried out over the telephone there is no need for clients to perform their disabilities in a face-to-face assessment. The Department can learn that the vast majority of clients are honest and deserve support, so a paper-based claim should suffice.

  1. Is there a case for making some of the changes permanent?

That depends upon what The Department is trying to achieve.  From my point of view, we should only have to submit the paper-based claim and, if our conditions are chronic, there should be no need to be asked to reapply every few years.  Also, for those of us who were previously in receipt of Indefinite DLA, we should have the indefinite award restored and receive the higher rate of both PIP components if we had the higher rates previously.  The only time that it should be necessary to submit a new form is if/when our conditions change, whether they improve or worsen.

12. DWP believes that applications for some benefits dropped sharply at the start of the pandemic because claimants weren’t able to access support (for example, from third sector organisations) to complete their applications. What are the implications of this for how the Department ensures people are able to access health-related benefits consistently?

It indicates how difficult the process is, showing that most of us require professional help to negotiate the applications. The Department could make the application process much simpler, geared towards helping citizens in need rather than obstructing them from gaining the financial support they need.

  1. How can the Department best help the third sector to support claimants in their applications?

 

Start by restoring Government funding to these organisations and making the application process less deliberately obstructive.

The impact of assessment/application on claimants

13. DWP recently published research on the impact of applying for PIP or ESA on claimants’ mental and physical health. What would be the best way of addressing this?

Again, The Department should stop approaching clients as though they are underserving of help and should stop the loss of benefits whilst the claim is going through the appeals process.

The lack of independence is a bad enough experience yet the threat, which is often carried out, of losing one’s financial support is an immense strain and it is of little surprise that it has led to suicides, homelessness and deaths due to lack of nutrition.

Waits for assessments

14. What could the Department to do to shorten waits for health-related benefit assessments—especially for ESA/UC?

Stop assessing citizens.  Instead believe that their conditions have the effect on them that they state.

  1. How effectively does the “assessment rate” for ESA cover disabled peoples’ living costs while they wait for an assessment? Is there a case for introducing an assessment rate for other health-related benefits?

I cannot remember what the rate is but, as even the full rate benefits barely cover our needs, the assessment rate obviously does not.  Again, if you stopped assessing citizens there would be much less of a wait.

Policy development

16. How effectively does DWP work with stakeholders—including disabled people—to develop policy and monitor operational concerns about health-related benefits?

a. What steps could the Department take to improve its engagement with stakeholders?

I have never been asked to contribute and found this call for evidence by accident after searching “Have your say” online, which produced a number of results and I am glad that I found this.

As I do not know who the other stakeholders are and cannot imagine who they are I cannot comment on them.  I am unaware of The Department working with those effected by its decisions to develop policy at all and am not sure how much heed would be paid to any input that did not fit-in with The Government’s plans.

 

 

November 2021