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Changes to ESA50
Hi all,
As part of our work on the WCA descriptors that Professor Harrington asked Mind, Mencap and the National Autistic Society to undertake, the DWP has asked us to look at whether there are any specific changes we would like to see to the ESA50 form (particularly in relation to the mental/cognitive section).
The key priorities from our perspective are to try and ensure that people provide any additional evidence available and that they put down as much information as possible to help their claim. We have a few ideas about how to do this but we’re keen to get the input of others into this.
Does anyone have any specific proposals for improving the form that we could consider?
Thanks.
Put the points down?
Or perhaps the DWP think it better to ask questions the significance of the answers to which a claimant does not understand…..
The mental health descriptors should be reassessed anyway as they are simply impractical and in my opinion just plainly wrong.
For example Client A has issues that mean : “engagement in social contact with someone unfamiliar to the claimant is not possible for the majority of the time due to ... significant stress experienced by the individual” combined with “is unable to get to a specified place with which the claimant is unfamiliar without being accompanied by another person” will only score 6 points each, meaning they should be on JSA as they will not score the 15 points needed. How can such a person fulfil their JSA agreement if they cant leave the house alone to attend an interview or deal with people when they get there? Reg 29 may apply but its not a given.
I would like to see something about inability to engage with routine indoors. This could include following a programme, opening post, answering the telephone or front door. These are all relevant points that someone with a mental health problem is likely to fail to do in the way of communication. Even if worth 6 points it would capture a large part of deppressive illness.
It is true that the questionnaire is vague and does not reflect the law, but this is not the main problem. The existing law is too harsh and designed to cut benefits from seriously ill or impaired people, obliging them to go on JSA and compete on the labour market with healthy job seekers. My suggestions:
Physical and mental
* In general, the old WCA was fairer. The new WCA should return to its old form. In particular:
Physical
* Functional Areas 2 (Standing and Sitting), 4 (Picking up and moving), 6 and 7 (Making yourself understood and Understanding Communication), should return to their old form. It is important that sitting, standing, seeing, hearing and speaking are tested separately. According to the existing descriptors someone who cannot even stand or sit a minute each, but can ‘remain at a workstation’ by intermittently and continually standing and sitting will be told to be on JSA. Yet I wonder what kind of work he/she is supposed to be fit to do! People who cannot speak, hear, see or use their hands will be told to be on JSA.
* Bending and kneeling should be reintroduced. Most jobs require bending or kneeling.
* Functional Area 8 (navigation using a guide dog or other aid). This shameless Functional Area should be scrapped and replaced by Functional Area 9 (vision…) of the previous WCA. ‘Navigation’ is not the only problem that blind people have in a work place!
Mental:
* Functional Area 11 (Learning Tasks) should return to its old form. It was fairer, as it allowed people who take long time to learn to score points.
* Functional Area 12 (Awareness of everyday hazard). An element of unpredictability for risk of hazard should explicitly score 15 points. Someone who can cause hazard unpredictably should not be allowed in a work place due to health and safety reasons.
* Functional Area 17 (Appropriateness of Behaviour). ‘Aggressive or disinhibited’ should be changed into ‘aggressive, disinhibited or disruptive’ .
* Functional Areas 6 and 7 (making oneself understood and understanding) should appear in the mental health part with a ‘due to mental impairment’ added in them. People who cannot communicate due to mental health problems are as unemployable as people who cannot communicate due to physical problems.
I hope Professor Harrington is able to make the WCA really fairer.
[ Edited: 25 Oct 2011 at 11:57 am by Josephina ]Chris Grayling told MPs yesterday that Professor Harrington’s suggestions for mental health descriptors represent a ‘substantial departure’ from current assessment and involve complete change of WCA, for physical as well as mental health issues -
see rightsnet news story -
Thanks for all your comments.
I’m aware that there are bigger problems with the process than the application form, and we are trying to change these too. However, we have an opportunity to improve the ESA50 right now, so if there are specific concerns about the structure or wording of the form that you can suggest, that would be great.
Thanks.
To be honest i see little point in completing an ESA50 as it is largely ignored by the HCP as they persist in asking shallow questions and judging that if a person can follow the plot in Eastenders and make a cup of tea then they MUST be able to work. Atos Origin’s contract should be scrapped and the claimants GP or relevant Consultant should be paid to undertake the assessment on their patient.
Maybe the ESA50 could ask the typical questions found in the typical day? Would save time for a start and perhaps focus the HCP’s mind on the ‘careful assessment.’
The ESA50 is hardly worth reading unless completed by someone with an inkling as to what’s to be considered as little factual information is requested. It’s rather more a case of “In your opinion” can you….
So questions like do you go to the shop? if so by yourself? Do you shop mainly for bread and milk? Do you have pets? How many units of alcohol do you drink? (or do it by glass/type) Do you watch TV? Listen to Radio? What programmes? Phone? Mobile? Model? Can you get washed and dressed by yourself? Do you have children?
All these answers in the typical day/claimant states bit of the Lima led ESA85.
If all that ‘factual’ stuff can be put in the ESA50 the HCP can move on to the more important part of the assessment.
WCA Handbook
3.1.3.8 Clinical History. It is important to fully explore psychiatric symptoms in claimants with mental health problems, including suicidal ideation if relevant.
3.1.3.2 Interview Technique
It is important that the interview is carried out in a friendly, professional and non-confrontational way, in keeping with good customer service and in line with the approved practitioner professional standards. In keeping with the intention of ESA, it is also essential that the practitioner identifyi(es) the claimant’s capabilities rather than ... identifying their restrictions.
Surprisingly the WCA Handbook confirms that the ESA50 must be read….
3.1.2 In preparation for the interview, you should read carefully the documents in the file /on MSRS. All the medical evidence should be considered, including any medical certification, Factual Reports, previous papers and other documents, including Tribunal documents. Particular attention must be paid to the current claimant questionnaire [ESA50] and all areas where the claimant indicates that there may be a problem must be fully explored.
Note the words “...previous papers…” ??? and ‘...particular attention MUST be paid to the… ESA50…” ?!
[ Edited: 25 Oct 2011 at 04:25 pm by John Birks ]In my experience some of the HCPs do consider, to some extent, the ESA50s, but they have no choice but the use of LiMA. LiMA is a real problem. It is not the law, it is LiMA that decides that someone is fit for work because he is able to ‘make snacks’ or ‘cold drinks’, etc.
A fair medical assessment should not be done through LiMA, it should be done by professionals using their own brains and knowledge. LiMA is an insult, first of all, to those who use it, and to their professionalism.
My Centre has sent detailed criticism of LiMA to professor Harrington, but I feel that he is NOT interested in upsetting the contract between the DWP and Atos. I also think that he has no power to dictate any re-programming of LiMA by Atos. I am pessimistic but I think that, after five years of reviews and consultations, LiMA will stay as it is, with all its ‘cold drinks’ and ‘light snacks’ - but it will have a nice final hand written box, which will give it a more ‘human’ look but will not change its basic functioning.
In my experience some of the HCPs do consider, to some extent, the ESA50s, but they have no choice but the use of LiMA. LiMA is a real problem. It is not the law, it is LiMA that decides that someone is fit for work because he is able to ‘make snacks’ or ‘cold drinks’, etc.
A fair medical assessment should not be done through LiMA, it should be done by professionals using their own brains and knowledge. LiMA is an insult, first of all, to those who use it, and to their professionalism.
My Centre has sent detailed criticism of LiMA to professor Harrington, but I feel that he is NOT interested in upsetting the contract between the DWP and Atos. I also think that he has no power to dictate any re-programming of LiMA by Atos. I am pessimistic but I think that, after five years of reviews and consultations, LiMA will stay as it is, with all its ‘cold drinks’ and ‘light snacks’ - but it will have a nice final hand written box, which will give it a more ‘human’ look but will not change its basic functioning.
Not sure that “LiMA is an insult, first of all, to those who use it, and to their professionalism” , asking one of my client who has until she became sick been a carer for 2 people for several years “so when did you last have a proper job?” isn’t professionalism. Most of the HCP seem to have had a “pep talk” that they should treat all clients as lying scrougers and then wait until proved wrong. LiMA allows HCP’s to free type and alter the opinion of the programme-they just arent doing it and they dont care as long as they are getting paid for what they do.
Returning to the original topic; how about a clearly stated question that asks how often the claimant is or is not able to do things rather that the vague assertion that ‘it varies’. currently used. This is completely routine on DLA forms and I cant see why it shouldn’t be on ESA 50s as well.
While I am on my soapbox how about giving Tribunals jurisdiction over the length of ESA awards, again its common practice in DLA and I can’t see why it shouldn’t be applied to ESA as well.It might reduce the seemingly endless cycle of medical -appeal- medical -appeal etc etc.
Returning to the original topic; how about a clearly stated question that asks how often the claimant is or is not able to do things rather that the vague assertion that ‘it varies’. currently used. This is completely routine on DLA forms and I cant see why it shouldn’t be on ESA 50s as well.
While I am on my soapbox how about giving Tribunals jurisdiction over the length of ESA awards, again its common practice in DLA and I can’t see why it shouldn’t be applied to ESA as well.It might reduce the seemingly endless cycle of medical -appeal- medical -appeal etc etc.
Yes, I agree. the Tribunal should recommend the length of time to reassessment for ESA, bacause currently its a joke.
I agree about the length of time for reassessment. This appears in the medical report but not in any DWP’s decisions. An officer from Worthing BDC said to me that she could not access it. In practice a private provider has a right to decide this length without being subject to any scrutiny from any Decision Maker, and its decision carries no right of appeal. It’s a scandal.
I agree about the length of time for reassessment. This appears in the medical report but not in any DWP’s decisions. An officer from Worthing BDC said to me that she could not access it. In practice a private provider has a right to decide this length without being subject to any scrutiny from any Decision Maker, and its decision carries no right of appeal. It’s a scandal.
I hadn’t thought of it in quite those terms but when you put it that way it is actually a far more serious matter, it could be seen as a fundamental removal of a right which is given without question in other benefits (DLA in particular) I realise that DLA is not the same as ESA (yet??) but is it close enough for it to be reasonable to say that the sme rights to determine length of award should be given to Tribunals?
Returning to the original topic; how about a clearly stated question that asks how often the claimant is or is not able to do things rather that the vague assertion that ‘it varies’. currently used. This is completely routine on DLA forms and I cant see why it shouldn’t be on ESA 50s as well.
While I am on my soapbox how about giving Tribunals jurisdiction over the length of ESA awards, again its common practice in DLA and I can’t see why it shouldn’t be applied to ESA as well.It might reduce the seemingly endless cycle of medical -appeal- medical -appeal etc etc.
Yes, I agree. the Tribunal should recommend the length of time to reassessment for ESA, bacause currently its a joke.
I’d have to disagree. It’s not a joke but a ‘good earner.’
Frequent assessments = £‘s for ATOS.
Given that public spending is at the forfront maybe a case could be made for unecassary spending?