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Assessment Reports Research.
A claimant in Lanarkshire lost his PIP after an assessment. He requested the AR. However, two reports were included, both in respect of the same assessment for the same person! However, one report scored him 0 points, the other 8 points. The former was followed by the DM, the latter ignored. No explanation was given by the DM for preferring the report with 0 points.
Marion Fellows, the Lanarkshire’s MP has raised this in Parliament. To date the DWP has prevaricated. The DWP blame IAS with IAS blaming the DWP.
Obviously, nefarious activity by one of the parties has taken place. I believe this is not a one off by IAS and/or the DWP but which one?
Also, I have flimsy evidence that parts of AR are being amended. However, I cannot narrow this down to the guilty party IAS or the DWP. I am researching the quality of reports, when compared to private medical reports obtained by my clients.
If you can anonymise the section in the AR of your clients, which refers to the MSE/MSO, please scan them in and pm them to me. I intend to publsih the results of this research on Rightsnet.
Please note, at this stage I am only interested in the page in the AR, which refers to the MSE, especially for clients who allege no MSE took place for whatever reason.
Thank you in anticipation of your help in this matter.
Some assessment reports should be filed under fiction.
Like everyone else, I’ve had reports giving indoor walking distances which are greater than the external dimensions of the building, incorrect descriptions of clothing and appearance, tearful and distressed clients being described as coping well, MSEs done when no such MSE was done, serious, life threatening conditions like cirrhosis of the liver described as “liver problem”, etc, etc.
We should keep a log on Rightsnet of all the inaccuracies we see.
Adding to that list I have seen assessment reports where it was stated that the claimant regularly drove the family to the local supermarket when he did not possess (and never had possessed) a driving licence, much less a car…..
That said, I am not entirely convinced that the “no MSE” was done argument will very often succeed. It is clear that 95% and upward of such an examination is carried out by ‘informal observation’ - so I can well imagine a significant number of claimants being convinced there was no MSE when in fact there was.
What I think might be a much more productive approach* is an FOI request that asks for;
- the training materials used by assessment providers in respect of the MSE
- the medical/scientific research that supports a conclusion that such ‘informal observation’ is likely to provide an accurate reflection of a person’s mental state and functional ability.
I strongly suspect the results of that would seriously undermine the value of such informal MSE.
* But as has been discussed many times on here, if the intention is to win a particular appeal, there is little to be gained by rubbishing the assessment report. Even if you succeed, all you have done is to establish that the report is of little or no evidential value. And that comes nowhere near achieving what you need to achieve - which is to establish that the appellant does actually meet the qualifying criteria. And that is done by;
- being clear yourself as to what those criteria are.
- taking clear instructions from the client that show those criteria are met
- where necessary, obtaining evidence from support workers, social workers and those involved in the claimant’s treatment that goes to support the credibility of the claimant’s statements.
The vast majority of tribunals know the assessment reports are, at their best, no more than a snapshot and,, in the vast majority of cases, of little evidential value. Without wanting to big myself up, it is well over 10 years since I represented in a sickness or disability benefit appeal which was dismissed (and only then because the client made statements in the hearing that were totally at odds with what he had told me up to that point) and I can think of only one occasion where I have felt the need to make anything more than passing reference to the assessment report - and that was an ESA appeal where the DWP’s sub actually included the paperwork upholding the appellant’s complaint about the ESA85 report (i.e. entirely unreliable).
If this is being pursued from a policy point of view (i.e. in order to improve the quality of assessments with the hope that more claims are successful at first instance) well there may be more mileage in it…..
[ Edited: 13 Mar 2019 at 11:03 am by past caring ]I will echo past caring with a small number of additional comments:
1 - “the medical/scientific research that supports a conclusion that such ‘informal observation’ is likely to provide an accurate reflection of a person’s mental state and functional ability.”. I’m not as confident this would be fall the way you think. Medical training increasingly involves clinical skills training and that in turn involves being able to do much more than just doing a clinical assessment. For example, there is positive encouragement to hear the patient’s story as not doing so means you could well miss something clinical and there is equal encouragement to focus on informal observation. They are absolutely part of the toolkit and bad decisions get made when they’re not. As far as APs are concerned the issue is not, for me, informal observation per se. It’s that informal observation should lead to further questions but usually doesn’t.
2 - I cannot imagine I would be half as capable of doing my job if I didn’t use informal observation skills e.g. noting that my VI client who says she’s no problem with fine detail has scratches around her front door where she has obviously struggled to insert a key.
3 - The assumption behind this research, or at least the case upon which it seems to be founded, strikes me as debatable at minimum. What evidence is there of something nefarious has taken place at all? I’ve spoken to multiple clients where a report with points was audited and subsequently redone with an outcome of both more or less points. How would this specific case be different?
Mike - we are on the same page with this. You’ve managed to express what I was struggling with. I think it’s apparent in the vast majority of assessment reports that informal observation hasn’t led to any further questioning. Couple that with the research/theoretical underpinning of what should occur and you can hole the MSE below the water line.
I think we are all saying the same thing.
Of course Tribunals view assessment reports with a degree of scepticism and rely heavily on evidence from appellants, their doctors, carers, care professionals, etc and just slagging off the assessment report will rarely win a case.
That said, it is always important to address the other side’s evidence in any litigation and to try to undermine its credibility and/or probative value as well as accept there will be times when the evidence is damaging.
Therefore, I always point out the facile nature of the standard MSE, and MSO, any clear errors based on clients’ instructions, etc and deal with unhelpful points which are in reports such as driving, going shopping, going to visit friends, etc. I also check the Health Professional’s registration status - for example, a psychiatric nurse is unlikely to be knowledgeable about many physical conditions and therefore less likely to know what to observe and/or comment about and good clinical knowledge of a condition is pretty fundamental to recommending the length of an award.
It would be helpful from a policy point of view for a body to collate examples of clearly erroneous reports and perhaps CIT A or Disability Rights UK could do this?
Unfortunately, DWP adopt these reports’ findings in over 90% of cases and it’s still a small minority of people who seek advice and/or appeal, so there is value in doing this.
IUnfortunately, DWP adopt these reports’ findings in over 90% of cases and it’s still a small minority of people who seek advice and/or appeal, so there is value in doing this.
This is the problem here - it’s all well and good saying that tribunals know these reports are rubbish and unrepresentative but for the majority of people affected, I suspect they never get near a tribunal in the first place.
I tend to do an abridged version. Highlight 2 to 3 clearly ludicrous aspects of the AR and that’s usually enough to kick open a fairly open door in terms of giving less weight to what’s been said by a HCP. Can then spend the rest of the appeal focusing on what matters. As much as anything I find this helpful because appellants, wholly understandably, want to pick apart HCP reports line by line and being able to steer them away from that early on makes for a better experience for them and all parties.
I actually don’t focus on the registration aspect at all. As much as anything this is because assessing functional ability is not, in my view, about clinical knowledge so much as asking the right questions and filling in gaps. With a medical professional on the panel who is very often involved in adjudicating on something most likely outside their main area of expertise I have found that those occasions when my apparently open door has been kicked shut in my face have very much been when the medical professional on the panel was willing to entertain errors in the HCP evidence but unwilling to accept the argument that by default their specific professional training would limit their ability to assess functional capacity.
IUnfortunately, DWP adopt these reports’ findings in over 90% of cases and it’s still a small minority of people who seek advice and/or appeal, so there is value in doing this.
This is the problem here - it’s all well and good saying that tribunals know these reports are rubbish and unrepresentative but for the majority of people affected, I suspect they never get near a tribunal in the first place.
The fundamental issue is cultural and it starts and ends with DWP. Competent assessment of evidence as opposed to “accept this because we pay for it” solves this issue as a significant proportion of such reports would simply fall apart as they do at appeals.
Some assessment reports should be filed under fiction.
Like everyone else, I’ve had reports giving indoor walking distances which are greater than the external dimensions of the building, incorrect descriptions of clothing and appearance, tearful and distressed clients being described as coping well, MSEs done when no such MSE was done, serious, life threatening conditions like cirrhosis of the liver described as “liver problem”, etc, etc.
We should keep a log on Rightsnet of all the inaccuracies we see.
Would you be able to pm with a copy of the page, which refers to the. MSE’s.