Decision Maker ‘statements’

I’m sure we’ve all seen the following statements in ESA Appeal packs.

‘although the GP might believe that he is unfit for work, the determination of having limited capability for work is based on satisfying a rigorous assessment process which a GP does not routinely consider when treating and diagnosing a patient’.

This is just one of many ‘statements’ Decision Makers make that get’s on my nerves!

I feel i should put a counter statement in all my ESA submissions. Does anyone bother with this or am i just getting too paranoid.

Cheers

I put in equally routine counter statements as a matter of course. The wording and tone varies with the level of outrage I’m feeling at the time.

I usually do something along the lines of this:

The Respondent avers that

‘although the GP might believe that he is unfit for work, the determination of having limited capability for work is based on satisfying a rigorous assessment process which a GP does not routinely consider when treating and diagnosing a patient’

The above seems inconsistent with the long standing requirement for medical evidence in Regulation 32A and in the Social Security (Medical Evidence) Regulations 1976, and that this has always been part of the NHS contract.

The Respondent’s assertions have arguably little or no credibility in the light of the House of Commons Work and Pensions Committee’s report “PIP and ESA Assessments” (published on 7 February 2018).  That report concluded inter alia:

“Ultimately, while the Department sets quality standards, it is up to contractors to meet them. The Department’s existing standards set a low bar for what is considered acceptable. Despite this, all three contractors have failed to meet key targets on levels of unacceptable reports in any single period. In Capita’s case, as many as 56% of reports were found to be unacceptable during the contract. The Department’s use of financial penalties to bring reports up to standard has not had a consistent effect. Both Capita and Atos have seen increases in the proportion of reports graded “unacceptable” in recent months. Large sums of money have been paid to contractors despite quality targets having been universally missed. The Government has also spent hundreds of millions of pounds more checking and defending the Department’s decisions”

I therefore ask the Tribunal to look on the Respondent’s assertions and the HCP report with great scepticism

This also helps in certain circumstances.

This one made me smile (or rather scream in disbelief).
For background purposes my client was originally awarded 4pts mobility component PIP based in such HCP gems as he was observed leaning against the wall without his walking stick having a cigarette therefore can walk 200m. The tribunal awarded him enhanced rate mobility on grounds he could not walk 20m.
On renewal, his mobility component was reduced on the grounds of him now being able to walk 20-50m. The appeal submission writer has produced the following to support this:
“Current evidence would indicate that [his] mobility has deteriorated from the findings at the previous assessment in 2014, however not to the extent of the decision made by the Tribunal at that time”
and
“the panel awarded them… the enhanced rate of the Mobility component based on the appellant’s oral evidence at the tribunal. The reasoning for the award was not made available to the DWP.”
and
“As the award by the tribunal and the findings of the original Health Professional were so different, I have used the findings of the latest assessment as they are a more up to date reflection of the appellant’s current needs”
This is the same health professional who observed him walking 6m at a slow pace in pain and then recorded he vomited as the condition history was being obtained but that he “coped well at interview” and “behaved normally”.
I think the tribunal may be interested to find out that their unchallenged decision has been overturned on the basis of a deterioration which is in actual fact treated as an improvement and that their reasoning based on his oral testimony was not available to the DWP despite the feeling that it was “so different” from their original opinion that they did not challenge it nor ask for said reasoning.
Good to see that DM’s logic has not improved!

and even more entertaining if the tribunal hearing the new appeal is the same people as the previous one - anything’s possible, after all, and that would be more fun…..

I’ll be stealing this :)

Stainsby - 18 June 2018 12:51 PM

I usually do something along the lines of this:

The Respondent avers that

‘although the GP might believe that he is unfit for work, the determination of having limited capability for work is based on satisfying a rigorous assessment process which a GP does not routinely consider when treating and diagnosing a patient’

The above seems inconsistent with the long standing requirement for medical evidence in Regulation 32A and in the Social Security (Medical Evidence) Regulations 1976, and that this has always been part of the NHS contract.

The Respondent’s assertions have arguably little or no credibility in the light of the House of Commons Work and Pensions Committee’s report “PIP and ESA Assessments” (published on 7 February 2018).  That report concluded inter alia:

“Ultimately, while the Department sets quality standards, it is up to contractors to meet them. The Department’s existing standards set a low bar for what is considered acceptable. Despite this, all three contractors have failed to meet key targets on levels of unacceptable reports in any single period. In Capita’s case, as many as 56% of reports were found to be unacceptable during the contract. The Department’s use of financial penalties to bring reports up to standard has not had a consistent effect. Both Capita and Atos have seen increases in the proportion of reports graded “unacceptable” in recent months. Large sums of money have been paid to contractors despite quality targets having been universally missed. The Government has also spent hundreds of millions of pounds more checking and defending the Department’s decisions”

I therefore ask the Tribunal to look on the Respondent’s assertions and the HCP report with great scepticism

If ever I find that you have used my “stolen” submission over the Xmas period, I will take advice with a view to seeking similar royalties to Noddy Holder.

It should become my pension since IDS and co conspired to make me wait for my state pension until March 2020