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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

IB65 wording; is this misleading?

efloyd
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Financial & social inclusion officer - Isos Housing, Newcastle

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Hi,

I’m working on an IB decision at the moment. Gentleman receives 8 points for mental health; however, there are wider issues here and these have prompted a complaint-  I’ll quote my complaint letter here. What do you think?

“.... I am extremely concerned about the wording contained in document IB65 01/09 that was sent to my client on 14th October 2010. The appeal in question has reference number XXXXXXXXX, and relates to XXXXXX.

XXXX was awarded 8 points from the Personal Capability Assessment in respect of his mental health. The decision letter, IB65 01/09, contains a section entitled ‘More information about the Personal Capability Assessment’ (copy enclosed). The section begins with the words, ‘The Personal Capabilty Assessment looks at how any physical or mental condition affects your ability to carry out a range of everyday activities which are relevant to the ability to do any work’. It goes on to say that ‘If more than one descriptor in each category describes how your illness or disability affects you, we use the descriptor with the highest points. We cannot add the points for descriptors in the same category together’.

This guidance is contrary to Reg 26 (4) SS (IFW) Regs.  A claimant can score points in respect of one descriptor within each physical activity (the one scored highest), but a claimant can score points for every mental descriptor he or she satisfies, regardless of whether they relate to the same activity.

This is not made clear in the decision letter in question. Indeed, a claimant attempting to add the highest points awarded from each daily activity category for the mental health assessment would quickly conclude that there is no hope of an appeal succeeding given that there are only 4 categories, with 2 points being the highest points possible to claim in each….”

What do you think? The decision maker in this particular case has actually followed this guidance, and seems to think that my client only scored 4 points. Apart from this, I feel that, at worse, the wording in this decision potentially has the effect of discouraging appeals as it misleads claimants into thinking that the decision is sound ‘we cannot add the points for descriptors in the same category together’.

I’d love your thoughts on this.

Thanks

Lee

[ Edited: 13 May 2011 at 01:45 pm by efloyd ]

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rwils
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Newcastle Welfare Rights Service, Newcastle City Council

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I agree the wording is far from ideal but is it a bit academic now that PCAs are a thing of the past? Unless you are thinking of trying to identify claimants who did not pursue appeals because of the wording? Which I guess would be a difficult exercise.

efloyd
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Financial & social inclusion officer - Isos Housing, Newcastle

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Thanks for replying- PCA’s aren’t strictly a thing of the past yet, though…..

nevip
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Welfare rights adviser - Sefton Council, Liverpool

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Please, oh please, tell me that a decision maker did not deliberately disregard points awarded under the same mental health descriptor?  If so, I thought I’d seen and heard everything by now.  Obviously not.

efloyd
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nevip - 13 May 2011 12:22 PM

Please, oh please, tell me that a decision maker did not deliberately disregard points awarded under the same mental health descriptor?  If so, I thought I’d seen and heard everything by now.  Obviously not.


Yes, this is exactly what happened in this case. In fact, when I queried it with the benefit delivery centre, the advisor I spoke to confidently told me that only the highest points in the mental health daily activity categories are added together. In this case the medical examiner awarded 8 points between 3 daily activities- the decision maker awarded 4 points (2, 1 and 1).

Worse than the wording in the decision being less than ideal, I believe that the wording is wrong and misleading, and that any claimant who has received such a letter should receive a new decision with the correct information included, and that the appeal rights should be reinstated. I may be going too far for some tastes, but my sense of justice has been upset…..!

nevip
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“Worse than the wording in the decision being less than ideal, I believe that the wording is wrong and misleading, and that any claimant who has received such a letter should receive a new decision with the correct information included, and that the appeal rights should be reinstated”.

I agree, absolutely.

efloyd
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nevip - 13 May 2011 12:35 PM

“Worse than the wording in the decision being less than ideal, I believe that the wording is wrong and misleading, and that any claimant who has received such a letter should receive a new decision with the correct information included, and that the appeal rights should be reinstated”.

I agree, absolutely.

Thanks. We’re looking through other decisions at the moment.

[ Edited: 17 May 2011 at 02:30 pm by efloyd ]
efloyd
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My colleague and I suspect that this may be due to the rules for ESA (adding up the highest descriptor points from every activity) being applied to the Personal Capability Assessment. At the very least, clients are being misinformed. Please check your PCA decisions.

Lee Forrest
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Hello again,

Just to let you know that I have sent a complaint to JC+, and asked for it to be dealt with in accordance to the official complaints procedure. I’m aware that this may be construed as splitting hairs, but I’ve argued less clear cut points…. It’s surely a question of what it would be reasonable to conclude from the information given…. Certainly, the decision maker in this case has concluded incorrectly; what chance the claimant?

I’ll let you know how it progresses.

[ Edited: 16 May 2011 at 05:32 pm by Lee Forrest ]
Ariadne
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Regulation 26 of the Incapacity for Work (General) Regs is the authority. It makes it quite clear that
“(3) In determining a person’s score in respect of descriptors specified in Part I, where more than one descriptor specified for any activity applies to him, only one descriptor shall be counted and that shall be the descriptor with the highest scroe in respect of each activity which applies to him.
(4) In determining a person’s score in respect of descriptors specified in Part II the score in respect of each descriptor which applies to him shall be counted”
The Schedule is the details of the PCA and Parts I and II are the physical and mental descriptors respectively.

Lee Forrest
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Thanks Ariadne. The question, ultimately, is whether the paragraph in question misrepresents this law. At the very least, I think that it needs to be rewritten- whether or not it could be shown to have affected the reasoning of a claimant deciding whether or not to appeal a decision is another matter. Whether the paragraph constitutes guidance in the tradition of a ‘written statement of reasons’ and could therefore be construed as an error in law is another matter altogether. Too much for little ol’ me- I just had a hunch and ran with it.

When you spend a fair proportion of your working life trying to figure out ways to challenge decisions, and something like this pops into your mind it can seem blindingly obvious and it rouses the emotions somewhat. It’s worth challenging and pointing out, although my expectation for the effect of the challenge has reduced over the weekend….

[ Edited: 17 May 2011 at 11:04 am by Lee Forrest ]
CMILKCAB
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efloyd - 13 May 2011 12:51 PM

My colleague and I suspect that this may be due to the rules for ESA (adding up the highest descriptor points from every activity) being applied to the Personal Capability Assessment. At the very least, clients are being misinformed. Please check your PCA decisions.

Was always only a matter of time :(

Lee Forrest
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neilcoll - 17 May 2011 10:41 AM
efloyd - 13 May 2011 12:51 PM

My colleague and I suspect that this may be due to the rules for ESA (adding up the highest descriptor points from every activity) being applied to the Personal Capability Assessment. At the very least, clients are being misinformed. Please check your PCA decisions.

Was always only a matter of time :(

In the case of my client, the front page of of IB65 correctly states the points gained (8). It also states that a claimant needs 10 points under the mental health descriptors. It goes on to say that the decision maker can only add up the highest point from each daily activity, and follows on with the Secretary of State’s submission, which states that the claimant achieved 4 points (the highest points 2, 1, 1 achieved from each descriptor).

Aside from all of this, it would be reasonable to assume that there exists a new generation of DM’s used to writing only LCW decisions and submissions, and some are bound to slip up when faced with a PCA….. Well, I have evidence that this happened once…..

[ Edited: 17 May 2011 at 02:58 pm by Lee Forrest ]