Month: June 2016

This is the third of three posts covering the training.

This first post is the background and purpose.

The second and third posts are by Alex Williams who has written about both days – both the experience and the information.

Account of the RITB Welfare Benefits training delivered by Tom Messere and Yvonne Bennett by RITB member Alex Williams
Disclaimer: these are notes from the training days and don’t replace individual benefits advice and reading through the Big Book of Benefits and Mental Health.

“the trainers were brilliant, so knowledgeable, clear and pro-claimant”

More ESA

The trainers explained that they were behind schedule due to the amount of questions generated by the subject on day 1 of the training. The approach used on the second day was to work through topics and allow questions at the end of each section. There would then be time for questions at the end of the day.

There was more discussion about the Support Group component of ESA and the limited capability for work test. Page 63 of the Big Book of Benefits and Mental Health outlines the descriptors for the support group. One of the useful, though often overlooked, descriptors for mental health is ‘conveying food or drink to mouth (without regular prompting)’. If this descriptor is satisfied then the claimant should qualify for the support group even if they have not scored sufficient points on the main test for ESA.

The group worked through a case study, introduced yesterday as a conjurer called Merlin who had fallen out of work and needed benefits help. This exercise led to discussion about the wording used for descriptors, for instance what it means to not be able to set an alarm clock or washing machine. Yvonne explained that she often encourages claimants to think about how they would cope with a new washing machine rather than one they had become used to. This can lead to questions about how easily someone would find it to pick up the instructions, change the settings and use the machine for the first time.

With ESA there is a need to give answers on the basis of how things are for the claimant for the ‘majority of the time.’ This view does allow for a good day but the answer needs to give a realistic, overall, picture for most of the time. It is helpful to back up answers on the form with examples eg whether when doing this activity the person found things went wrong, how many times this has happened, consequences of it going wrong etc. In the case of coping with unexpected change, it would be helpful to state for how long the claimant felt affected by the change afterwards.

It was pointed out how ‘getting about’ wasn’t one of the support group criteria yet could be the most debilitating feature of someone’s mental health in the case of agoraphobia.

The word ‘disinhibited’ was discussed in relation to coping ‘in the workplace’ descriptor 17. This word could apply to uncontrollable crying if emotions were close to the surface as well as behaving in an ‘inappropriate’ way. It is necessary for descriptor 17 to imagine how someone would react in a workplace rather than in safe, known surroundings like the day centre.

There is an ESA50A which is sometimes sent instead of the ESA50. This is a shorter form and just includes the support group descriptors.

When filling out the ESA50 it is best to keep the list of health problems, tablets and treatments very brief. The way that health problems affect the claimant should be completed within the main questions in relation to the descriptors and at the back of the form where there is more space. In mental health cases, payments of ESA should not be stopped if someone doesn’t complete the form. It is though very important to return the form in line with the four week time limit. The trainers encouraged participants to complete their forms in stages, allowing themselves a treat after each section. If a support group descriptor applies then this should be made clear on the form. The claimant needs to keep ‘reasonable, reliable, repeatedly’ in mind when considering how they could perform an activity.

Many participants reported having fluctuating conditions and relapses that would last for a few weeks or months before easing. The trainers urged people to be honest on the form and explain how things vary for them. Both Tom and Yvonne said that it would be wrong and bad advice to fill out the form as though on your worst day ever. This way of filling out the form may weaken someone’s credibility if they needed to go to a tribunal and explain how they were affected by their difficulties.

The face to face medical assessment is requested of around 93% of claimants of ESA. Maximus now have this contract after ATOS pulled out of its delivery. The medical assessor produces an ESA85 report which is considered by the decision maker along with evidence and the ESA50 form. There is a second part of the medical assessment called the ‘work focused health related assessment’ but this is currently suspended.

Several participants said that it would be a personal risk for them to attend a medical. The trainers said that a home visit could be requested, as could being seen by a professional of the same sex. The claimant can request in advance for the medical to be tape recorded. It would be good advice to go accompanied to the medical. The companion can offer moral support and take notes of discussions for the claimant. The assessor will still want to hear from the claimant rather than for the companion to speak for them. It was felt by participants that going to a medical alone could well lead to assumptions being made by the assessor about their capability. The medical could possibly be waived in some cases if medical evidence was very strong, eg a psychiatrist’s letter stating that the medical would lead to a psychotic episode which may result in hospitalisation.

The tape recording would need to be requested from Maximus. It would be risky for the claimant to refuse to take part if the tape recording equipment wasn’t available on the day since this could be seen as non compliance. Recording the medical covertly or openly on a mobile phone would not be acceptable to the DWP or the provider.

Several participants were anxious about completely dissociating during the medical. The trainers recommended having someone with them who could observe the onset of dissociation and point this out to the medical assessor. One participant had dissociated at their medical and the doctor had asked for her permission to end the appointment.

A question likely to be asked by the assessor would be to talk about a ‘typical day.’ It would be helpful for a claimant to have the descriptor activities in their mind or written down so that these were included in their account. The medical is really only a snapshot of the person on the day and not a true mental health assessment.

Following a medical, the claimant can request a copy of the medical report. It would also be helpful to make notes afterwards about how long the medical was, and anything that felt wrong. If there are concerns about the way the medical was conducted then a complaint should be made by the claimant to Maximus as the provider and copied to the DWP.

If the outcome of the ESA assessment (including consideration of the evidence, any medical and the ESA50) is that the person is found fit for work then they should request a mandatory reconsideration straight away. The trainers advised against rushing into a claim for JSA, particularly if living in areas where UC is being rolled out. It is important at this stage to seek advice, get the mandatory reconsideration over quickly then to lodge an appeal if the decision remains unchanged. Once making an appeal the claimant can go back to ESA at the assessment rate, or has the option of claiming JSA. Gathering evidence for a mandatory consideration could lengthen the process in an unhelpful way, so it is best initially to let the reconsideration be determined on what material has already been submitted. There are rules on repeat claims which mean that unless someone has a new or worse condition from the time when the fit for work decision was made, then they wouldn’t be paid ESA until they had another Work Capability Assessment. It is important to appeal decisions about ESA refusals in case repeat claims are made in future.

If the claimant is placed in the WRAG rather than the Support Group they will also need to consider appealing. The WRAG does entail claimants participating in work focused interviews and work related activity which could include mandatory training or work placements, or permitted work. Unlimited sanctions do apply to those in the WRAG and these have become tougher under the new health and work programme.

A claimant applying for JSA while appealing the ESA decision doesn’t amount to a self declaration of being fit for work. The Jobcentre will need to take into account the jobseeker’s health issues. It is possible to apply for an extended period of sickness up to 13 weeks when on JSA.

It was agreed that it was useful to obtain proof of posting for benefits claims though possibly not worth sending them by recorded delivery. All post is directed to a sorting office in Wolverhampton. In future the claiming method is expected to be online by default.

“the Big Benefits Book, a superb resource”

Disability benefits and mental health

DLA and AA were introduced in 1992. These disability benefits were based on the social model of disability with an emphasis on the claimant being listened to about the impact of their health difficulties. The success for mental health claims was limited to begin with but over time caselaw defined attention needs, cooking and supervision in a way that fitted with mental health issues.

PIP has been devised as a replacement to DLA for working age adults. PIP isn’t all bad but it is undermined by the government’s intention to cut 30% from the DLA bill. DLA and PIP are payable to those in and out of work; 20% of people on DLA are in full-time work. It is though essential to inform the DWP if starting work, otherwise it could be that the claimant would have to defend a fraud allegation if reported by a third party. Starting work could potentially lead to an increase in care needs if the person needs more support to be in a workplace.

DLA, PIP and AA can lead to carers being able to claim Carers Allowance or for claimants who work to get a disability element of Working Tax Credit.

There is a qualifying test to DLA/PIP where difficulties must have been present for three months and to be expected to last for a further six months (though this doesn’t apply to DLA to PIP migrations). AA has no mobility component though this does seem to be discriminatory on the basis of age.

With PIP there is no equivalent of lower rate care of DLA. However, this doesn’t mean that those on this lower rate of care will be excluded from PIP. Some in this group will be able to qualify for standard rate of daily living component for PIP.

With PIP it is true that ‘points make prizes’ as qualifying scores come from meeting the descriptors. There are points for both daily living and mobility activities. Unfortunately, the daily living test doesn’t cover all difficulties and so the claimant needs to be aware of the descriptors so that they can focus on the most relevant points. Getting out of bed isn’t anywhere in the form as it was for DLA. Night time needs aren’t referred to either. Many people on DLA with mental health issues qualified on the grounds of needing continual supervision; this doesn’t feature in PIP in the same way. The closest aspect to this continual supervision is one point for monitoring a health condition (activity 3b). The highest scoring of the descriptors applies where more than one answer may describe someone’s difficulties with an activity.

The mobility component criteria could lead to people with mental health issues being awarded the highest rate which was rare with DLA (except for those with a severe learning difficulty). There are only 4 points available for ‘needs prompting to undertake any journey to avoid overwhelming psychological distress to self.’ The higher number of points to qualify – 8 – applies instead to ‘cannot plan a route of a journey.’

Unlike with ESA, whether the cause of difficulties is mental health or physical doesn’t matter.

“knowledgable, approachable and very friendly trainers”

The use of aids and appliances can mean that the claimant qualifies for 2 points in some descriptors. While this feature is positive, claimants should also take care not to miss the higher points available in the descriptor if other responses are true. Regulations for PIP emphasise the need for an ability to perform tasks reliably, safely, to necessary and appropriate standards, repeatedly and in a timely manner. If the claimant cannot do an activity reliably then they should be counted as not able to do that descriptor at all. If a descriptor applies at any time of day during a 24 hour period then it is considered to apply for the entire day.

As with DLA, the claimant doesn’t have to be receiving the support to have an underlying need for that support. There are specific meanings for wording of the descriptors which can again be found in the Big Book of Benefits and Mental Health. There are rules around variability which can be helpful. For PIP the claimant does need to think about how they are throughout the whole year.

There was a discussion about what counted as a meal, it was agreed that this would be a simple meal for instance chicken and vegetables. It wouldn’t amount to frozen food which is simply heated up rather than prepared. There is also a descriptor about ‘taking in nutrition’ which is about whether the claimant manages to eat and drink.

Page 322 of The Big Book of Benefits and Mental Health refers to PIP mobility and planning and following a journey. This change in policy from DLA means that many people with mental health issues may lose lower rate mobility. If someone has a person accompanying them then they would need to be there not simply for reassurance but to actively help the claimant to follow the route. Yvonne said it may be helpful for someone to imagine what happened when they had a panic attack and whether during this state they could work out how to get to somewhere safe, what would another person need to do in those circumstances. Case law does concentrate on navigation and not support. There is also a higher descriptor which could apply if the person cannot go out for the majority of days. If PIP mobility is refused but the daily living component is granted, then the claimant would need to think carefully about appealing since there would be a risk to the daily living award.

If claimants do need to go to tribunals then representation definitely helps. Participants had heard of a case where a tribunal had used the claimant’s social media profile against him. The trainers said that research on social media was more likely to apply to ‘living together’ cases but all users of the internet should still be cautious and use privacy settings.

A participant asked whether savings always needed to be declared. The trainers were clear that savings above the thresholds (please refer to the Big Book of Benefits and Mental Health) should definitely be declared and not doing so does amount to fraud. Claimants who have savings are allowed to spend them but not with the intention of depriving themselves of capital in order to qualify for benefits.

A participant asked how to notify the DWP if moving home. The trainers recommended doing this in writing. Someone else asked whether they needed to notify the DWP if they had more conditions diagnosed; the response was this would depend on whether there was a change in the amount of care/attention/prompting required.

Several participants were concerned about prejudice against PD and asked whether benefit awards were more likely to be made for other mental health conditions. The trainers suggested that diagnoses such as schizophrenia could be taken more seriously than anxiety and depression. However, for the purposes of completing the form, it is helpful to forget the diagnosis and focus on what are the effects of the health conditions on that person’s daily life.

Future training days?

• Appeals and Tribunals
• Universal Credit and tax credits
• Means testing and the benefits system

Suggestions

A private Facebook group be formed for those who have been on the training so that they can support each other while helping other survivors with their benefits claims.

This is the second of three posts covering the training.

This first post is the background and purpose.

The second and third posts are by Alex Williams who has written about both days – both the experience and the information.

Account of the RITB Welfare Benefits training delivered by Tom Messere and Yvonne Bennett by RITB member Alex Williams.

Disclaimer: these are notes from the training days and don’t replace individual benefits advice and reading through the Big Book of Benefits and Mental Health.
Introductions

Fourteen participants attended both sessions on the 1st and 2nd June. All participants had before signing up to the training agreed to use the learning to benefit other survivors. One participant is going to support members of the hearing voices group which she facilitates on a weekly basis, while another learner plans to set up a free workshop. Other people taking part were in a position to support peers with their claim forms and accompany them at medicals. This training model can lead to the creation of a ripple effect lasting far beyond the two days. Participants can feedback to Maddog the ways in which they have assisted other claimants, whether that is an individual or multiple people with mental health issues who really need benefits advice, advocacy and representation.

“I learned so much, how to help someone else”

The first day served as an introduction to the welfare benefits system and made reference throughout to The Big Book of Benefits and Mental Health. This book is an amazing resource which was created by Tom’s late wife, Judy Stenger, and is now in its 16th edition. Tom updates the book on an annual basis and new content is co-authored by Yvonne.

Tom and Yvonne are welfare rights advisers and trainers with vast experience of assisting claimants and health professionals, doing all levels of benefits casework from completing forms to taking cases to Upper Tribunals.

The Big Book of Benefits and Mental Health
All of the 14 people taking part in the training were given a copy of The Big Book of Benefits and Mental Health and guided on how to dip in and out of this resource to find examples, suggestions, descriptors and case law.

“the Big Book of Benefits is going to be my bible”

The Big Book of Benefits and Mental Health may seem both welcoming and scary due to its scope and size at 411 pages. The book is a practical walk through the world of benefits and includes examples of claim forms as filled in by composite clients with different mental health issues. The written examples always help claimants and advisers filling in forms to tell their story when it fulfils descriptors and underlying legislation. The reader can find toolkits and explanations which aid their claim and its likely success. The book originally came from course notes from training done by Judy at Neath Mind about benefits and mental health. The first publication was made possible by lottery funding.

The first message of the day was that there is a huge amount of unclaimed benefits out there even though there are cuts to the budget for welfare benefits. Tom and Yvonne understand well that living on basic benefits is a struggle and the premiums/top ups gained from disability benefits can make the difference between someone living and existing.

“user friendly, dispelling the jargon, I liked the examples, and it helped me to think about the varied approaches one can take. I now feel more able, with less fear, to tackle these forms, BTW lunch was spot on”

Barriers

There are many barriers to claiming benefits when the individual has mental health problems. Examples of these barriers are the complicated nature of the benefits system, the online claim form, (Universal Credit is to all be done online), the need to keep appointments and deadlines and staff attitudes which may seem unsympathetic. Letters about benefit entitlement will sometimes not even make sense to experienced advisers! People with mental health issues may feel wary and exposed by giving out their personal details as part of an application. Some people may worry that revealing they are not coping within a claim form could lead to intervention from child protection or mental health social services, though the trainers confirmed that in practice this doesn’t happen since the content of claims is between the applicant and the DWP rather than shared with care agencies.

The government is placing more emphasis on claimant responsibility which doesn’t consider how the nature of anxiety may mean that some claimants can’t open their post or turn up to appointments on time. Applying for benefits relies on telephone or online channels which cause difficulties for people who struggle to communicate with the authorities. Several participants felt anxiety about being wrongly judged by medical assessors on the basis of their appearance when ‘high functioning’ , able to apply makeup or well dressed. The benefits system does make people ‘jump through hoops’ to get the benefits that they are entitled to often.

Questions about accessing benefits

There were many questions asked on the first day about benefits and dealing with the system. One participant asked whether the social fund still existed and it was explained that in England social welfare assistance had been devolved to local authorities. This localisation means that councils operate different schemes with varying levels of support, for instance in some places a referral to a foodbank is offered rather than financial assistance. Wales and Scotland still have Social Fund schemes; the one in Scotland is particularly successful and well promoted.

Another participant was concerned about whether a claimant could be forced onto Universal Credit. At present, Universal Credit applies only to straightforward jobseeking claims though a gradual roll out will take place over the next two – three years. Universal Credit was feared by some survivors due to any ongoing contact with the Jobcentre which may expect additional hours to be worked to reduce the amount of UC paid out. Tom explained that under UC everyone is a jobseeker until they reach full time work but then the claimant would need to agree with the Jobcentre where full time hours weren’t suitable due to health reasons.

Sanctions – an unnecessary ‘last resort’

The issue of sanctions was raised frequently as a social injustice and punitive measure against the vulnerable. It is now known that 49 claimants have died while subjected to sanctions.

Sanctions will still apply under UC due to its greater conditionality. Housing costs are still paid under a sanction with UC. There has been a disproportionate use of sanctions against claimants with mental health issues. Jobcentre offices deny the use of league tables and incentives for staff to sanction, but staff may have ‘personal improvement plans’ which review their own rates and question their performance. Tom and Yvonne would encourage any claimants affected by sanctions to challenge them since over 50% are reconsidered this way.

Several participants had been rejected for disability benefits in the past and had not been in a position to appeal the decisions. In the case of unclaimed benefits there is scope to request backdating. This backdating is for three months with ESA but can extend to up to 13 months dependent on the reason given for the claim not being made in time. While most sanctions are applied to those on JSA, people in the work related activity group of ESA are subject to sanctions.

Tom drew attention to pages 374 and 375 of the Big Book of Benefits which is a form created by welfare rights advisers in Greenwich. This form can be completed by the claimant and given to the DWP to make them aware of their mental health issues and a professional they wish to nominate as a contact. If the DWP apply a sanction they could be reminded of their ‘safeguarding procedures’ and where information about the claimant’s mental health is on file the sanction should be overturned. The form would also help in the case of people who don’t attend a medical. Anyone can complete the form as a way of making the DWP aware that they are vulnerable. A good time to submit the safeguarding form could be at the start of an ESA claim or during Jobcentre contacts for those in the WRAG.

“lots of information, opportunities to ask questions, patient and helpful trainers, nice venue”

Migrations from old to new benefits

Concerns were expressed by participants over the DLA to PIP migration and how people with mental health issues would fare. The trainers made clear that the government’s position is that DLA and PIP are different benefits, and what a claimant qualified for under DLA has no bearing on what they may get for PIP. With ESA the migration was different and claimants of older sickness benefits (Severe Disablement Allowance, Income Support, and Incapacity Benefit) had some transitional protection where they would have otherwise ended up with less money. With DLA to PIP, the DWP will not refer to old evidence/papers for DLA and it will be down to the claimant to make a fresh claim and submit relevant evidence. There will be claimants who are over 65 who are caught up in the DLA to PIP migration since they were not yet 65 in April 2013 when legislation came into effect. Participants and the trainers were aware of people who had been on both rates of DLA who lost the mobility component under PIP even if they did get an award for standard daily living component.

More people with significant mental health problems have needed to become involved in the ESA assessment process whereas they had been exempt under past sickness benefits rules. For instance, Incapacity Benefit reviews were not necessary for those on the highest rate of care in DLA or anyone with a severe mental illness. There are no exemptions for ESA and all claims are subject to regular review except for terminal illness which is a different benefits track.

One participant was concerned about someone she supports whose DLA has suddenly been suspended without reason. Other participants and the trainers suggested that this may be because she had been ‘invited’ to apply for PIP but had not done so. In these circumstances, DLA is stopped after four weeks of no contact from the claimant. The action to be taken would be to contact the DWP asking why DLA had been stopped. If the reason was a failure to apply for PIP then it should be explained that the letter had not been received. The DWP could then choose to reinstate DLA while the PIP application was done and a decision made.

The migration from older sickness benefits to ESA has taken longer than planned by the government. This process was meant to have been completed by April 2014 but there are still some remaining claimants on SDA who still have yet to transfer. The way that ATOS bought themselves out of the ESA assessment contract did affect reassessments of new and existing ESA claimants. Now that Maximus are operating this contract the regular assessment regime has restarted.

“the spoken expertise brought the subject to life”

Medical support

There was a discussion about health professionals and the way that their evidence may not act in favour of benefits claims. People with mental health issues labelled as having a ‘personality disorder’ may fear their medical notes suggesting they are ‘malingering.’ One participant recommended anyone diagnosed with PD make a request under the Freedom of Information Act to look at their notes. There was agreement that PD was not seen as a severe mental illness and many CMHTs did not offer regular contact as they deem these conditions to be ‘untreatable.’ The trainers explained that claimants should think carefully before submitting medical evidence and that there was no obligation for them to give the names of unhelpful health professionals or those who didn’t know them. It is possible to nominate other supporters eg a carer, friend or GP, as well as a CPN or psychiatrist.

Medical assessments

There was a lack of faith in the medical assessment process. Reference was made to the recent Dispatches channel 4 undercover filming which showed a judgemental assessor who boasted of the money he made from the job. Tom is going to meet with Capita to discuss the culture in the office shown on this programme. He asks for any negative experiences of medical assessments so that he can feed these back to the provider. Tom also stressed that there were some good assessors and reports to come out of them.

Steps to entitlement

The trainers explained the meaning of means tested benefits which are calculated on the basis of existing income and savings, creating a top up where these fell short of set levels. Student loans are counted as income as well as income from work earnings or savings interest. Examples of a means tested benefits are Council tax reduction scheme (which varies between local councils who administer this), Tax Credits (child tax credit and working tax credit) income based ESA and pension credit. UC will be entirely means tested.

Housing Benefit is the means tested benefit which covers part or all of a household’s rent. Local Housing Allowance is the term used to indicate the limit of what can be paid for a rent in the local area, this rate is determined by local councils. The ‘bedroom tax’ has hit a disproportionate number of disabled people who may be ‘under occupying’ their homes due to having more bedrooms than their recognised household need. Councils administer discretionary housing allowance which can be applied for where there is a shortfall in rent available through Housing Benefit and the actual rent, this is usually a temporary measure.

Contributory benefits require someone to have made National Insurance contributions in order to qualify. Examples of these benefits would be contributory based ESA (which is limited to one year when in the WRAG) and contributory based JSA. These benefits will sit outside of UC which rolls various means tested earnings replacement benefits and housing costs into a single monthly payment in arrears. Contributory benefits are often missed, and it was recommended by the trainers that claimants should ask the DWP to check their contribution record since the income based benefit is conditional on circumstances remaining the same. If a partner went out to work for 24 hours a week then the claimant’s eligibility for a benefit such as income related ESA would end unless they were on a contributory benefit.

Non means tested non contributory benefits include disability benefits. These benefits do not take account of income/savings or contribution record. DLA, Attendance Allowance and PIP are in this category. Some benefits such as ESA and JSA can be received on a contributory or means tested basis or as both. Child Benefit is also paid to those with earnings and savings, though there are rules affecting higher earners (ie £50,000 and above) and from 2017 there will be a cap on two children who can be claimed for where it’s a new claim.

There are also overlapping benefits where only one (that pays the most) is paid but the underlying entitlement can still lead to additional means tested benefits/premiums. An example is where someone may apply for Carers Allowance since they are providing more than 35 hours of care per week for someone in receipt of AA, PIP or DLA at the middle rate of care. If that person was receiving a state pension then the Carers Allowance would not be paid in cash but could lead to premiums within Pension Credit, Housing Benefit and Council Tax Reduction schemes.

Where someone does not qualify for an earnings replacement means-tested benefit since their partner is in work then they should still claim National Insurance credits only. This step will help to protect their National Insurance contribution record, which matters for future state pension entitlement.

Where DLA and PIP have increased the amount of means tested benefits that have been paid in the past, when the claim changes or is lost then there will be a reduction or loss of those additional top up benefits. It is important for the claimant to inform all departments of the authorities (DWP and council) which are paying their benefits otherwise this ‘change in circumstances’ could lead to an overpayment in benefit which the claimant would have to pay back.

Means tested benefits in some cases act as a passport to free prescriptions though there is a low income scheme exemption which can be applied for. Fines are made by the NHS Prescriptions /Business Services Authority if prescriptions are collected for free without the correct confirmed entitlement in place.

“The Big book of Benefits is an amazing resource and I now feel confident to utilise it fully”

Council Tax

There was a discussion about Council Tax. One participant was keen to raise awareness of the Severe Mental ‘Impairment’ exemption for council tax. This exemption is administered by local authorities and would require approval by a doctor. Someone with dementia or learning difficulties may qualify, but there are also cases where people with severe mental health issues of a psychotic nature could be entitled to this and council tax liability would be removed (information about this is on page 201 of The Big Book of Benefits and Mental Health).

In most local authorities claimants are required to make a contribution to their council tax with the reduction scheme only covering a proportion of the total liability. This change in the system due to the government’s ‘localisation’ agenda, has created inequity between councils. Policies are different from one local authority to the next so claimants’ charges depend on their address not the affordability or circumstances.

Changes

Another key message of the course was to tell any authorities paying benefits about changes. It is wrong to assume that the departments’ systems ‘talk’ to each other. Examples of changes to report would be:

• A partner moving in
• A change in benefits (see above)
• A change in health condition where this would affect the claim.

Participants expressed fears that changing their address could trigger a benefits review/invitation to claim PIP. The trainers didn’t think this was the case since the roll out of PIP is being done for indefinite awards in a random way. The only people who may be able to know their approximate date of transfer would be where they have fixed term awards which are due to end before October 2017.

Working on sickness benefits

There was an interest in permitted work from participants together with a concern that doing any work would ‘prove’ they were fit to work. The trainers considered that permitted work could be done by those on ESA as a way of trying out whether working was a possibility. It would be important to remember that work done as a volunteer or for pay could be taken in account at the next medical. Working should be declared to the DWP before a claimant starts this. The trainers didn’t think that this declaration should necessarily trigger a review unless one was already due.

ESA refers to ‘limited capability for work’ or ‘work related activity’ but does not preclude someone working, especially if they are trying this as a route out of benefits. Advice should be sought on this area if the claimant needs help to weigh up this decision against any risk to longer-term entitlement.

Claimants can receive payment for working which is:

• £20 for an unlimited time
• £115.50 or less, up to 16 hours – if done for one year, or thereafter if done under supervision from a medical or employment adviser (supported permitted work). With this route it may be important for the professional completing the form to phrase work being therapeutic and part of a programme. The claimant would also need to explain how they could manage this limited work rather than more hours or duties.

There is a 12 week time limit for returning to ESA linked to a previous claim. After this 12 weeks the claimant would need to make a new claim, returning to the basic rate of ESA (£73.10 per week), often beyond the 13 week ‘assessment phase.’ Anyone who has left ESA to start work should be aware of this time limit especially if the job isn’t working out and health problems return in the workplace. It may be better in these circumstances to reclaim ESA than to do this later on.

Welfare reform

Disabled people are aware of the significant cuts to welfare as part of the government’s reform agenda. Benefits have been increased by CPI, a less generous measure than RPI since 2013. There is now a freeze on annual increases to benefits which in real terms is a 5% cut to incomes. The government has imposed a benefits cap which mostly hits those with families. There is a housing crisis and while the government claims that Housing Benefit is out of control there is an underlying lack of affordable housing provision. While the government did a ‘U-turn’ on the proposed cuts to Working Tax Credits, those same claimants will suffer a drop in income when they eventually migrate to UC. Disabled workers will experience less generous support from UC than Working Tax Credit. New ESA claimants in the WRAG will not receive any more than JSA from next year, a loss of £29.05 per week.

Appeals against benefit decisions are only allowed after a ‘mandatory reconsideration’ which typically takes 4-5 weeks to determine.

Universal Credit – is it coming?

Universal Credit now exists in most areas, initially affecting jobseekers with simple claims. This is due to change with a ‘managed migration’ starting from 2018. Most people on ESA will experience a natural migration, transferring to UC as their circumstances change rather than being expected to apply for this sooner. Anyone who works will be eligible for UC on a means tested basis though will need to supply their earnings each month. The idea is that the HMRC system will receive ‘real time’ information from employers about salaries and tax, and that in time this will be communicated to DWP systems. Self-employed people will need to do an online declaration of monthly earnings.

ESA

The route to claiming ESA is to get a medical certificate from a GP confirming being unfit for work. There is a 13 week assessment period during which the claimant is paid for £73.10 per week. The claimant will be sent an ESA50 form (medical questionnaire) and in 93% of cases will be required to attend a face to face medical. The outcome of the ESA claim will be one of these three:

1. Claimant has limited capability for work (goes into WRAG)
2. Claimant has limited capability for work related activity (Support group)
3. Claimant is fit for work.

Around one third of claimants are placed in the support group. Passing the ESA test to enter the WRAG depends on scoring 15 points. The ESA descriptors are on pages 64 and 65 of The Big Book of Benefits and Mental Health. On page 64 the descriptors 1-10 need to be met due to a physical health impairment rather than for mental health reasons. There are grey areas where mental health may result in physical symptoms in line with these descriptors.

“think about where difficulties can fit descriptors, often it’s not obvious”

For anyone completing the ESA50 they would need to emphasise how something may physically happen (e.g. IBS causes me to physically lose control of my bowels.’) Points gained in the physical health descriptors can be added to those in the mental health directed ones (11-17). The ESA50 contains boxes for the claimant to explain how problems affect them and it is advisable to give more details and examples relating to the descriptors. The questions on the ESA50 do not reference the actual descriptors so it is best to cross check these and to amend the form if necessary to give additional information.

Medical evidence can be sent in with the ESA50 and may mean that the claimant isn’t called for a medical assessment .

There was a question about descriptor 10 over altered consciousness. This descriptor tends to apply to those who have diabetic hypoglycaemic episodes or seizures. In the mental health descriptors there would be scope to refer to dissociation or self harm (12 awareness of everyday hazards; 14 coping with change; 15 getting about).

The trainers explained that there are regulations 29 and 35 about exceptional circumstances. If there is a ‘substantial risk to mental health or physical health if not so treated’ as having limited capability for work related activity then this could be argued as part of a challenge to a decision. There is information in The Big Book of Benefits and Mental Health about using these regulations to protect someone at risk of relapse if put through being found fit for work or fit for work related activity (see page 115).

This is the end of the account for Day 1 – you’ll find out about Day 2 here. LINK

 

This is the first of three posts covering the Welfare Rights training we crowdfunded.

This first post is about why we ran it.

The second and third posts are by Alex Williams who has written about both days – both the experience and the information.

Why did we run this 2 day training course?
Because the odds are stacked against benefits claimants, in particular those with mental health problems. The DWP have £22 million to represent themselves in Personal Independent Payments (PIP) and Employment and Support Allowance (ESA) tribunals (source: Benefits and Work) but since 2013, people challenging benefit decisions are no longer allowed to get legal aid. This saved the Ministry of Justice – wait for it – £22 million. (source: CPAG)

On our Facebook group and in our personal lives, we keep hearing how stressful applying for ESA and PIP is and how hard it is to get support and good advice.

“weapons grade evidence is crucial”

The Work Capability Assessment for ESA is directly discriminatory and biased against mental health claimants and the Work Related Activity (WRAG) of ESA is going to be reduced to the same level as Job Seekers Allowance (JSA).

The impact of assessments are having a negative impact on our mental health – an article in the Journal of Epidemiology and Community Health in November 2015 links WCA tests for ESA with possible additional 590 suicides, increased mental health problems and hundreds of thousands of antidepressant prescriptions. This is all due to the pressure of receiving the forms, how difficult they are to fill in, the prospect of an assessment, and what is at stake i.e. losing the ability to live practically or work. (PIP is not means tested and can be claimed by disabled people in employment.)

The critieria ESA and PIP are more focused on more physical impairments and learning disabilities and this makes it more difficult for people with mental health problems to successfully claim.

Many people have been discharged from secondary mental health services because of cuts despite ongoing or enduring needs, and they cannot always access medical evidence from their former service.

GP’s may not be familiar with their difficulties and needs, and some surgeries charge fees for a letter to accompany a form, or won’t write it anything till the claim is in appeal. GP’s (and mental health professionals) need to understand that a succinct letter accompanying a form could help to prevent weeks/months of loss of income and having to go through a tribunal. It helps with ESA claims if professional supporters can make it clear that their patient is not fit for assessment, attendance at a JCP for training, work placements or employment, and to outline why and what risks this presents. Many do not know that they can do this.

So with critieria not designed for mental health problems and the difficulties in getting useful medical information from secondary or primary care, people with mental health problems are really up against it. At the same time, advice services are being cut.

That’s why we decided to run this training. We hope to encourage and inspire other groups to do similar things.

The training 

We wanted to equip ex/current mental health service users (all with previous/current experience of being a claimant) with the skills to: teach others how to fill in forms and gather evidence and to fill in or review forms with people online, by phone, or face to face, or accompany to assessments.

Often people with mental health problems feel more comfortable taking support from fellow survivors who understand the specific discrimination inherent within these processes.

14 people from RITB and across the UK attended our two day training course focusing on ESA and PIP.

“first public group situation I haven’t left in first couple of hours and didn’t feel completely out of place”

We asked everyone to pledge to pass on their skills – to learn and ‘pass the parcel’, so that 14 people with knowledge became 28 and so on, a ‘ripple out’ cascade effect of teaching and peer support.

RITB are very grateful to the following:

“there are people who actually care”

• Everyone who donated money to make this happen
• MHRN for use of their bank account
• Rethink who offered us hospitality and a free room for both days
• Our trainer Tom Messere and co-trainer Yvonne, author of The Big Book of Benefits 
• RITB member Alex Williams for taking amazingly comprehensive notes
• Everyone for taking part
• And the biggest thanks to Maddog who was both driving force and organiser extraordinaire for this training:

It was personally a pleasure to organise and see people come together in solidarity and share a lot themselves, to put some faces to names and we had some lighter moments along the way too, with the occasional bark. Maddog