Re: PIP / ESA Assessments ? Sanctions / Guardian / Private Eye & Other Articles
Posted: Sat Jun 08, 2019 4:13 pm
Epilepsy patients left high and dry following PIP benefit reform.
More than half of existing epilepsy patients and two-thirds of new claimants are being denied disability benefits.
Helen Purdon’s life was turned upside down in September 2017 when her application for personal independence payment (PIP) benefit was rejected. Purdon, 47, had been on disability living allowance (DLA) for 10 years, following a diagnosis of epilepsy, which means she has seizures every 10 to 15 days.
She is unable to work and assumed her transfer to PIP would be seamless. But she was wrong. “It was unreal. My DLA stopped, which was around £400 a month. I didn’t get any money at all for months,” she says. “We couldn’t afford to put petrol in the car, we were living off pasta and beans.” Purdon, who is from Irvine in North Ayrshire, decided to appeal against the PIP decision.
It took more than a year, but in October 2018 a tribunal found that Purdon was entitled to PIP, awarding her £119.90 a week and backdated payments of £5,700.
Purdon’s case is all too common. According to the latest figures from the Department for Work and Pensions, more than half of existing epilepsy patients and two-thirds of new claimants are being denied disability benefits.
PIP was introduced in England, Scotland and Wales in 2013, replacing DLA. The benefit is supposed to cover some of the additional costs of having a long-term health condition, and is available to people in or out of work. It is worth up to £87.65 a week to meet daily living needs, plus up to £61.20 a week for the mobility element, depending on assessment.
But since PIP was introduced, 65% of claims from people with epilepsy who did not have DLA were rejected, while 54% of those in receipt of DLA were turned down for PIP, the second-highest refusal rate of all health conditions and double the national average. Of those who challenged the decision 78% won on appeal.
According to Epilepsy Scotland, which obtained the figures, the benefit assessment system is flawed because it fails to take account of fluctuating conditions like epilepsy. Claims assessors focus too heavily on the type and number of seizures a person has, while ignoring other symptoms like memory impairment, confusion, anxiety and depression.
Frances Brown, Epilepsy Scotland’s welfare rights officer, says: “About 70% of my work is PIP-related. Since 2017 we have had to double our workforce to cope with demand and have recovered £1m in unpaid benefits, including PIP.”
Being denied PIP brings financial hardship but also damages mental health. “We’ve had numerous people tell us that they don’t want to be here any more – that they have had enough,” says Brown. “It’s that feeling of not being believed – of not being listened to.”
Epilepsy charities in England and Wales are also reporting soaring demand for help. Daniel Jennings, senior policy and campaigns officer at Epilepsy Action, says the number of people contacting their helpline about PIP rocketed by 123% between 2016 and 2017. “Many people use that benefit to travel to work on public transport, as a lot of people with epilepsy can’t drive. If people lose that money, they lose the one thing that might give them their one bit of independence,” he says.
An early-day motion, signed by 34 MPs, expresses “serious concern” at the number of people with epilepsy being denied PIP, and “alarm” at rejection rates. They want the government to make the system fairer for people with epilepsy.
The figures are just the latest in a litany of problems with PIP. Disability rights organisations and patient groups have widely campaigned against the PIP process, which a former top civil servant described as Kafka-esque in its complexity when his own application was rejected. Last year a cross-party committee of MPs concluded the system was failing a “substantial minority” of claimants; the process was undermined by basic errors, insensitivity and ignorance about people’s conditions. The criticisms prompted key changes to PIP guidance.
In November 2017 and again in June 2018 the DWP issued amended guidance, following a successful legal challenge, which found that government policy had been “blatantly discriminatory” against people with mental health conditions. This has resulted in an increase in the mobility element of the benefit for some epilepsy claimants. Even so, nearly half of claims since November 2017 were still turned down.
In theory, things should improve for epilepsy patients in Scotland, as the Scottish government intends to reform PIP when responsibility for the benefit is devolved next year, with changes coming in 2021. Scotland’s social security secretary, Shirley-Anne Somerville, says: “We will be replacing PIP with disability assistance for working-age people, a new person-centred benefit.
We will be working to get decisions right first time, supported by a reformed assessment process, delivered by Social Security Scotland, not the private sector. We will reduce the need for face-to-face assessments, but, where these are necessary, we will provide people with choice and flexibility over their appointment. Our new system will also provide for the needs of people with fluctuating conditions like epilepsy.”
PIP has not been devolved in Wales but the Welsh government has repeatedly called for the system to be overhauled. A government spokesman says: “We will be carrying out research into the implications of devolving parts of the benefits system to Wales. This will include looking at the Scottish model.”
Charities in England also want a reformed system. Phil Lee, chair of Epilepsy Action, says: “We are looking at what’s happening in Scotland very closely; it’s an opportunity to learn from mistakes and put them right. Hopefully, we will see a better system in place in Scotland which the rest of the UK can model – Scotland is leading on this.”
In a statement, the DWP said 27% of people with epilepsy get the higher level of PIP support compared with 6% under DLA. “In November 2017 we updated our guidance, which will increase entitlement for a number of claimants, particularly those with conditions such as epilepsy.” It is now identifying existing claimants who may be entitled to more PIP support.
Back in Irvine, Purdon is finally getting her life back on track. “I feel a lot less stressed. We’ve got money for the house and we don’t have to worry about food bills. It also means I can give my daughter pocket money again – having to say ‘no’ to her for all those months was heartbreaking.”
Case study – Murray Goulder
HR professional Murray Goulder, 39, from Crawley, West Sussex, knows firsthand just how difficult it is to qualify for PIP if you have epilepsy. Goulder takes 20 tablets a day to reduce the risk of seizures, which come without warning and bring mental “absences”. Each episode can last from a few seconds to three minutes. He has four or five seizures a month, but they are unpredictable – one weekend he had 90.
“I have almost walked off train platforms before, without knowing,” he says. “I get tired very easily and terribly forgetful – my memory is in tatters – and my mood can be drastically effected. I also have constant headaches.”
Goulder applied for PIP when his DLA – worth £174 a month, typically spent on public transport and medication – ended in November 2017. His application was rejected but was finally granted this February on appeal: he was awarded £468 a month with £6,608 in back claims. He says: “It caused a lot of stress and made me feel like I was a liar. It meant I didn’t have enough money for pursuing my hobbies like going to concerts and the theatre.”
DWP followed policy in denying dying man benefits, review finds.
Stephen Smith, 64, from Liverpool, weighed 38kg and was gravely ill at time of death.
An investigation into the treatment of a man who was denied benefits despite being seriously ill and weighing 38kg (6st) before his death has found the Department for Work and Pensions “followed policy”.
The internal DWP review ordered by Amber Rudd found that the department missed “crucial safeguarding opportunities” but that “policy guidance was followed” in Stephen Smith’s case.
Smith, 64, from Liverpool, had a range of debilitating illnesses including chronic obstructive pulmonary disease, osteoarthritis and an enlarged prostate, and used a colostomy bag.
His death was reported in April, months after he was forced to get a pass to leave hospital to fight a decision by the department to deny him of crucial benefits.
Smith, who could barely walk, was deemed fit for work after a work capability assessment in 2017, which meant his employment support allowance (ESA) payments were stopped.
In February the government overturned the decision and agreed to pay back about £4,000 in wrongly denied benefits to Smith. However, he died before he could spend the money and it was used instead to pay for his funeral.
After his death, the Liverpool Echo published two letters from two different doctors that had been ignored by the DWP.
One note, written by Dr Terence Crowley, stated that Smith “could not mobilise a distance of 20 metres repeatedly without needing to stop due to pain and breathlessness”.
Amid widespread condemnation of the department’s treatment of Smith, the MP for Birkenhead, Frank Field, wrote in April to Rudd, the work and pensions secretary, to call for an official inquiry into the case. Rudd refused to grant a full inquiry and instead ordered the internal review.
Writing to Field to reveal its results, Rudd said: “Whilst the policy guidance was followed in Mr Smith’s case, there were crucial safeguarding opportunities which were missed by the department. The review has identified areas where we need to change our policy and we will be implementing these changes to ensure our most vulnerable claimants are protected.
“The department will be working at pace to ensure that these are embedded and that vulnerable claimants are receiving the best possible support from the department. I am adamant that we will learn important lessons from this tragic case and make changes to protect people like Mr Smith in future.”
Among the jargon-heavy changes Rudd outlined were improving awareness of how changes to benefit entitlement could affect other benefits in payment or under appeal and “identifying other trigger points for information sharing between benefit lines to improve, join up and provide more holistic support”.
A DWP spokesman described the missed safeguarding opportunities surrounding Smith’s case as “failings”. He said the changes would ensure that if someone’s condition deteriorated while they were appealing against the result of a work capability assessment, they would be able to access the benefit support they needed, and greater links between the department and authorities such as social services would be established.
In response to the letter, Field said: “What kind of policy guidance is it that fails to recognise that somebody is seriously ill and dying? This letter heavily disguises the fact that we’re talking about a man who lost his life, not a package that got lost within the DWP. It sums up much of what’s wrong with the DWP, which is apparently very short on human sympathy.”
Terminally ill " Denied lifeline " as they are forced to go through " Burdensome " benefits process, finds report.
Government definition called " Outdated, arbitrary and not based on clinical reality. "
Terminally ill people are being denied the “lifeline they need” because they are forced them to go through a “burdensome” process to access benefits, MP's have warned.
The government's definition of terminal illness states that a person's death can be reasonably expected within six months.
But this was described as “outdated, arbitrary and not based on clinical reality” by the All-Party Parliamentary Group for Terminal Illness (APPG).
The six-month rule, introduced into law 30 years ago, means terminally ill people expected to live longer than half a year are missing out on being able to have their benefits claims fast-tracked and simplified under special rules for those given a short time to live, a report from the MPs said.
In cases where patients were supported in their claims by doctors, assessors from the Department for Work and Pensions (DWP) with no first-hand knowledge of the case were challenging their judgments in a “wholly inappropriate way”, it added.
The report comes after The Independent revealed more than 17,000 died between 2013 and 2018 while waiting to hear whether their claim for disability benefit had been successful.
As a result ministers were accused of “failing people at the most vulnerable point in their lives”.
Official figures showed one in four (4,330) of those who died were suffering from a form of cancer, while 270 had anxiety or depressive disorders. In more than half of cases (9,020), the main disability was not recorded.
"Forcing somebody living with terminal illness to go through an intrusive face to-face assessment process is unfair and undignified - unbelievably, this can even include asking people with months to live to attend work capability assessments," said Drew Hendry, who set up the APPG in 2018.
”This is to say nothing of the weeks-long delays and significant financial burdens families face getting the support they need if their doctor is unable to say with confidence that they will die within six months.“
Charities said the current system was not fit for purpose and was making people's lives a ”total misery“.
Matthew Reed, chief executive of Marie Curie, said: ”The inquiry's findings are clear - the current system is not fit for purpose and the 'six-month rule' does not make sense. Yet, every day it is making terminally ill people's lives a total misery, when they should be focused on living well for as long as they can.
“Whether somebody with a terminal illness has six months to live or longer, their needs are the same - it cannot be right to deny them access to the financial support they need based on a 'made-up policy fudge' invented decades ago.”
Researchers at the Marie Curie Palliative Care Research Department at University College London found that clinicians are frequently inaccurate when predicting how long those living with terminal illnesses will survive.
They found that one in four cases saw doctors give inaccurate prognoses when using the question: “Would you be surprised if this patient died within the next x months?”
Doctors meanwhile told the APPG it is “very difficult” to estimate how long someone with a non-cancer condition has to live.
A DWP spokesperson said: “Terminal illness is devastating and our priority is dealing with people’s claims quickly and compassionately. That’s why terminally ill people can get their claims fast-tracked and access benefits without a face-to-face assessment. We’re looking at how we can improve our processes and in the meantime we continue to work with charities to help terminally ill people access the support they need.”
War veteran takes DWP to court over benefit cuts.
The Department for Work and Pensions (DWP) will defend its controversial decision to strip benefits from a disabled war veteran at a tribunal tomorrow in Newport, south Wales.
The embarrassing courtroom showdown comes less than a week after Armed Forces Day, during which Work and Pensions Secretary Amber Rudd called on people to support “the men and women who serve Britain with such distinction.”
The DWP is being taken to court by 56-year-old Royal Air Force veteran Jonathan Williams, who lost his £100-a-week employment and support allowance (ESA) just days before Christmas.
The hearing will take place in his absence because uncertainty over his future has left him too anxious and unwell to attend in person.
Mr Williams, a Morning Star reader, served with the UN in Bosnia where he was trapped under fire in the siege of Sarajevo. The events left him with post-traumatic stress disorder (PTSD).
He also served several tours of duty in Northern Ireland during the Troubles and was injured on exercise in the Arctic Circle when a helicopter landed on him.
The RAF veteran received incapacity benefits from 2001 until an agency worker declared him fit to work last year despite medical evidence to the contrary.
He told the Morning Star that his case demonstrates the “sheer hypocrisy of Armed Forces Day,” an annual jamboree to promote the military.
His case also highlights a chaotic approach between government departments towards veterans.
“I receive a 60 per cent war pension from the MoD and a specific supplement from them in recognition of my inability to work, but the DWP appears to have disregarded this and does not want to support me at all.”
Last month a charity published damning research into the government’s wider treatment of ex-military personnel.
A report commissioned by the Forces in Mind Trust warned that benefit sanctions should not be applied to veterans experiencing mental or physical health issues.
They interviewed 120 veterans and found that the benefits system was “baffling,” “unfair” and “bewildering.”
Some participants in the study said they had resorted to using foodbanks or “going through the bins” in order to survive.
One ESA claimant was told by an assessor, who had no medical training: “To be honest, all you veterans that say you’ve got PTSD and everything, it’s just a crock of shit.”
Mr Williams’s local Labour MP, Nick Thomas-Symonds, told the Morning Star: “The assessment system created by the Tory government has led to great injustices.
“It too often fails to take into account the nature of fluctuating and variable conditions, and too often fails to take into account the particular needs and experiences of specific groups of people.
“Our veterans, who have done so much for us, deserve fairness like everyone else. It is high time the government gave them that.”
A DWP spokesperson said: “We cannot comment on an ongoing tribunal case, but decisions for ESA are made by medical professionals based on all the information that’s available to us at the time and we will help any claimant who is not found eligible with access to other benefits and support.
“Armed Forces Champions are based in every jobcentre to provide specialist support to veterans to access benefits and employment, and work with charities like the Royal British Legion.
“We deeply value the service of our armed forces and, as the Forces in Mind Trust report recognises, the majority of people are able to make a successful transition to life outside the armed forces, with 82 per cent of veterans employed within six months.”
But Mr Williams pointed out: “Many veterans only develop their PTSD several years after leaving the forces.
“Jobcentres should not be pushing veterans into applying for jobs when the MoD pension scheme has already recognised they are unfit to work.”
The MoD was also approached for comment.
Disabled mum left in tears after DWP wrongly stopped all her benefits.
Nicole De Rafael was stripped of her benefits in 2017 but it took her two years and legal support before the DWP admitted she should actually have the maximum allowance.
A mum who suffers from heart diseases and diabetes was left in tears as she battled to get back the benefits she was wrongly stripped of.
Nicole De Rafael, 50, saw her income support reduced to nothing after she was moved onto Personal Independence Payment (PIP) - and incorrectly scored zero on a health assessment.
The mum, whose daughter Lexi is her primary carer, was left having to appeal the decision and she said the "hugely stressful" experience only made her more ill.
But, with Legal Aid support, she took the case to Tribunal eventually winning her benefits back and now says she wants to give "others the courage to fight".
Research from the Department for Work and Pensions shows just 9% of claims are appealed, but almost two out of every appeal (65%) succeed.
But that doesn't mean it was an easy process.
“This has been a hugely stressful time that has only made me more ill," Nicole, who is from Fulham, said.
"It has become clear to me that the rules are written to confuse ordinary people and ultimately try and cut social security spending, irrespective of an individual’s needs or how much damage it does."
She added: “The irony should be lost on no one that it took Government money from the legal aid pot to ensure that I received what I need to live on from the social security pot.
Under PIP, you need to score at least eight points to get the standard benefit, and 12 or more to claim the enhanced benefit.
Those points are based on how much help someone needs to take part in everyday life and with getting around as a result of long-term ill-health or a disability.
But Nicole, who suffers from diabetes, depression, severe anxiety and heart disease as well as dissociative fugue, was initially scored zero points.
Although she appealed the decision, she became tearful at her first-tier Tribunal, as her dissociative fugue saw her temporarily lose her sense of her personal identity.
However, some good news came out of the attempt - as the Legal Aid Agency granted her exceptional case funding afterwards.
As a result Desmond Rutledge of Garden Court Chambers could appear in the tribunals on her behalf, while social care specialist Arjun Jethwa from from Osborne's Law became her solicitor.
It's help that was greatly appreciated, given the complexity of the rules around PIP payments and assessments.
“The DWP publishes social security legislation in 13 volumes, and a decision maker’s guide in 14 volumes – it is not an easy task to get to grips with, particularly if you’re ill," Arjun explained.
“Had we not been able to convince the Legal Aid Agency to fund her case, Nicole – a woman recognised by all her medical professionals to be highly vulnerable – would have been left in the impossible position of trying to navigate the system herself."
With legal support in place, the First-tier Tribunal next awarded Nicole six points for daily living and 14 points for mobility.
This decision was then set aside by the Upper Tribunal, which found errors in the assessments and ordered a new tribunal undertake the process again.
The final tribunal awarded her 13 points for daily living and 14 points for mobility - up from the original 0.
That was enough to ensure Nicole, finally, received the maximum PIP award.
But while the right result in the end, it took two years of stress and worry to reach it.
"It is shameful how many hoops she has had to jump through. It took two years to prove her entitlement," Arjun said.
"This all had a direct impact on her health and wellbeing to reach what should have been clear from the start the right outcome.
"It is clear that the initial assessments require changing to avoid this sort of situation recurring.”
But the case, however many mistakes were made along the way, does at least show they can be corrected.
“The good news, however, is that Nicole’s case shows how bad decisions can be challenged and overturned," Arjun said.
The DWP said they are spending £55 billion - more than ever before - on benefits to support disabled people and those with health conditions.
A DWP spokesman told Mirror Money: “We want people to get the full support they are entitled to and are improving the assessment process, gathering more information earlier to aid decision-making.
"Decisions are often revised because more evidence is provided at a later stage and of the 3.3million PIP decisions made, only 5% have been overturned at appeal.”