‘John’, schizophrenia and his debts: The DWP can’t abdicate responsibility

It’s emerging that the Department for Work and Pensions (DWP) has carried out what the Disability News Service (DNS) says were ’60 secret reviews into benefit-related deaths in less than three years’. The excellent DNS obtained the figures from the DWP in response to a series of Freedom of Information Act (FoI) requests. The DWP has always rejected any connection between the coalition’s welfare reforms and cuts and the deaths of claimants.

Additionally, the DWP has now released guidance to staff saying that peer reviews might also be considered in cases involving ‘customers with additional needs/vulnerable customers’.

The vulnerability of many benefits claimants is illustrated by the case of ‘John’, who came into the London food bank with a voucher on Friday. He’s 33 and explained to me that he’s in debt. He still owes well over £2,000 to ‘payday’ or short term loan companies. These include Cash Generators, TextLoanUK (offering up to £100 for seven days at APR of 894%) and Miniloanshop. The repayments are coming directly out of his bank account and are causing him to incur bank charges.

‘John’ is on employment and support allowance (ESA) – a UK benefit paid to people whose illness or disability affects their ability to work. He has also only just started receiving personal independence payment (PIP) – a non means tested benefit that offers help with some of the extra costs caused by long-term ill-health and disability.

He  has serious long-standing mental health issues – he lives with schizophrenia and depression. The very strong anti-depression and anti-psychotic medication he’s on ‘makes you drowsy and you forget a lot of things’, he says. He adds that he ‘ends up paying money back, but getting new loans’.

I wasn’t able to establish how much he’s currently having to repay per week to meet the horrendously high APRs on his loans. Neither was he able to tell me the rate of PIP that he receives: The level of PIP varies hugely from £21.55 to £138.05 a week, depending on the outcome of the assessment process. I was however able to advise him to immediately contact Christians Against Poverty – a debt counselling charity. He promised that he would indeed get in touch with them urgently.

'John' has been referred to CAP for advice
‘John’ has been referred to CAP for advice

He lives in a hostel, but it does not seem to offer much if anything in the way of personal support or advocacy. His health is deteriorating and he is losing large amounts of weight. ‘I’ve lost two stones in two months and my nutrition is up and down’, he says. When he goes to the GP, he sees a ‘different doctor each time’. He’s started having blackouts, at which point a GP referred him to the hospital. He still doesn’t know what’s wrong with him. He sees a psychiatrist once every three months, and has no community psychiatric nurse.

He’s been told by the DWP that he is due to have a work capability assessment (WCA) for his ESA, and has been waiting for this since January this year. No doubt this process will do nothing but add to the stress he is under.

Given his deteriorating health, fast weight loss, lack of day-to-day support with his mental health issues and debt problems, in my lay view any future decision by the DWP to endorse a withdrawal of his ESA following WCA would pose a real risk to him.

Has the DWP got any risk assessment procedures in place for individuals awaiting WCA? The effect on people who are already vulnerable of long waits for assessments that may result in removal or refusal of benefit is a matter of huge concern.

I’ll be contacting the DWP to let them know of ‘John’s’ situation. Many thanks to him for talking about his circumstances.

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The wait for disability benefit and the impact of being declined: Tales from the London foodbank and beyond

The existence of  a massive  waiting list for decisions on Personal Independence Payments (PIP) and accounts of long waits faced by individuals is becoming better known. The Department for Work and Pensions (DWP) says this social security payment is designed to ‘help with some of the extra costs caused by long-term ill-health or a disability’ for those aged between 16 and 64. According to DWP figures, of the 529,400 cases registered for PIP between April 2013 and the end of July this year,  just over 206,000 have been cleared (awarded, declined or withdrawn).

Yesterday in the House of Commons Mark Harper the current Minster of State for Disabled People said that by the end of the year no-one would be waiting for longer than 16 weeks for a PIP decision.

How deliverable is this, given the scale of the fiasco?

Statistics capture one aspect of  the saga, of course. But they do not show how long people are waiting within this 16 month period. Mark Harper has said: ‘The delays faced by some people are unacceptable and we are committed to putting that right’. According to an article in the Guardian here, the figures show that 51 per cent of new claimants had been awarded PIP, and it had been granted in 72 per cent of reassessment cases to people previously in receipt of Disability Living Allowance (the benefit that has been replaced by PIP for all new claimants).

But what about the day-to-day lives and feelings of the people caught up in this catastrophe, many of whom have been waiting eight months and longer for that life-changing letter to drop through the post? Also, what happens when that long-awaited decision turns out to be a ‘no’?

One of the worst cases – reported on the Same Difference blog and elsewhere –  involved Lyn Ward, who applied for PIP after she was diagnosed with breast cancer. In March this year she was still waiting for help  – 11 months after applying for this help and having undergone an operation to remove the tumour, her lymph nodes, a mastectomy, chemotherapy and radiotherapy. While PIP itself is not a means-tested benefit, finances were so tight that the delay forced Lyn to go back to work just days after completing her radiotherapy.

It’s worth stating the unavoidably obvious fact that people who apply for PIP are some of the poorest people in society – those with long-term ill-health and disabilities that more often than not impact on their ability to work. The ill-health can be physical, mental or a combination of both. Richard Hawkes, the chief executive of disability charity Scope, is quoted in the Guardian article saying that ‘Scope’s helpline has been inundated with disabled people phoning for advice on their PIP claim, and many are facing extreme delays of well over six months’.

Recently at this London food bank, I spoke to Theresa (not her real name),  who has recently been diagnosed with borderline personality disorder (BPD), which can make people at risk of self harm and suicidal behaviour. Theresa, a single person,  told me that her experiences while on Workfare – working for no pay while in receipt of jobseeker’s allowance (JSA) – had driven her to take an overdose. Now on the waiting list for specialist counselling, she has just filled in the forms to apply for PIP. But she has no idea at this stage how long it will be before she hears if her application has been successful. Even if it is successful she has no idea how much she’s likely to receive. Applicants could get between £21.55 and £138.05 a week, depending on how their health needs have been assessed – ie how many points they accrue. If she’s turned down for the payment she faces the decision of whether to go down the route of a mandatory reconsideration and if that’s not successful then an appeal to an independent panel. This would  – and again it merits hammering home  –  be particularly stressful in her circumstances.

I’ll be keeping in touch with Theresa to find the outcome of the decision and to keep track of how long it takes to come through. In the meantime, she is trying to survive and pay all bills including rent on her employment and support allowance (ESA) payment of £140.80 a fortnight – a challenge that has driven her to ask for support from the food bank.

Amy (not her real name) is 29 and lives in Sheffield. She’s had an extended wait for a decision on a PIP application. Her circumstances are slightly different to Theresa’s – but she like Theresa is struggling daily with the impact of  serious mental health issues. She lives with her 35-year-old partner in a rented flat, and her mental health issues include, but are not limited to, anxiety, agoraphobia and hearing voices. She has previously had to spend time in hospital. Amy’s partner had been a full-time student, but ended up working during the day and staying up all night to finish his dissertation. Her partner currently earns £16,000 a  year, and they both depend on his income. He is hoping that his contract-based job is extended from this December. Their rent of £440 a month is paid to a private landlord. She says their situation, though hard, would be worse if they lived somewhere like London where private rents are much higher. The couple, who have no children, receive no benefits. I’ve suggested she and her partner immediately get some advice on whether he can apply for Working Tax Credit – worth up to £1,940 a year –  based on the level of  his income. A useful benefits calculator is here.

She applied for PIP in March, and she was helped to do this by her mental health home treatment team, whom she says give her good support. She also has a social worker. She supplied medical evidence, including a report from her psychiatrist. There was an eight month wait, then the decision came two weeks ago – her application was turned down. Her mental health team had thought that she might only get the lowest rate of just over £20 a week – but even that lowest level of PIP would have covered her food bill of £15 to £20  for the week. Amy eats a vegan diet and is skilled at making a little bit of food go a long way. Her partner has a lot of food allergies, so she uses a lot of tinned vegetables and cooks from fresh when she feels able enough to do that. They couldn’t afford ready meals, even if he was able to eat them.

But the decision to reject her application was devastating. She says that if she’d got the money – and particularly if it had been backdated – she could have used it to pay for the tiny extras for herself or someone else that might make the occasional difference between existing and living. Not that she goes out much, being agoraphobic. But the extra bit of cash might have paid for the odd trip to swim at the local leisure centre – which she used to find relaxing. It might also pay for a birthday present or a card for someone. She likes cooking and said a few extra pounds a week might also give her the chance to risk trying out one or two different things. She can’t risk experimenting when she cooks at the moment, because when you’re on the sort of budget she’s on, you can’t afford even one mistake.

Before she got ill, Amy worked as a cleaner. She had been able to put aside some savings during that time, but by the start of this year that money had run out. ‘I thought – I don’t want to be a burden. I think it precipitated me into being very unwell, which is why mental health services helped me apply for PIP. They recognised that the financial worries were making me more unwell. I think they (the DWP) do want to put people off applying by making people wait too long.’

I asked her if she’s going to request a mandatory reconsideration of the decision, which would potentially lead her to an independent panel appeal. But she says that she won’t do this. ‘Most claims go to appeal and I can’t face the stress of  it being turned down. My partner says he’d rather we scraped through than for me to get ill again. I feel the risk wouldn’t be worth it. I know that I do very badly under stress. The worry about going back to hospital outweighs any benefit that money would bring.’

She added: ‘The system can make you more unwell. What they try to save by not giving me £20 a week makes me ill and anxious. They are not saving any money overall. Social care costs more than benefits would cost.’

 

Life after #Atos: Good news for Deborah

Life after #Atos: Good news for Deborah
Deborah successfully challenges the decision by #Atos to deem her 'fit for work'.
Deborah successfully challenges the decision by #Atos to deem her ‘fit for work’.

What a difference a couple of days can make. Last week Deborah came into this London Trussell Trust food bank in despair . She ‘d had  a face-to-face Atos work capability assessment (WCA) back in June, and despite her multiple chronic health problems, she was awarded zero points. This meant that from July 24 this year, she lost her employment and support allowance (ESA). This single parent of 51 – with one of her four children still at school and a dependent – was forced to accept a voucher for the food bank from a social worker.

By last Friday, things had improved massively. Deborah came into the Greenwich food bank to tell us that her application for a mandatory reconsideration has been successful. Following this review of  her health issues and the original assessment, she’s now been awarded 18 points (she needed 15 to remain entitled to ESA).  Deborah believes that an intervention made by an NHS psychologist  who became aware of her difficulties has made a difference. That person  worked with her GP to supply more information about the impact of her many health difficulties on her ability to work.

This is of course a very positive development. But a key puzzle remains unanswered. How did Deborah end up with no points first time round, given the range and complexity of her health conditions? These include arthritis in the lower spine, hips, neck and knees, congenital heart problems, Irritable Bowel Syndrome and long-term depression. Deborah described being having to be helped on and off the couch at the WCA by a health service professional that she assumed was a doctor. She says she was in pain throughout the assessment. In the written assessment that person claimed Deborah had no problems getting on and off the couch and wasn’t in pain. There was also the strange matter of the coat. Deborah says her assessment referred to her being able to take her coat on and off. But she insists she was not wearing a coat that day.

Isn’t Deborah’s case an example if one more were needed of just how slapdash (at best) and unfit for purpose the WCA process has become? Yes, the original decision may have been revised. She will now get ESA again, but she is waiting to see if that will be backdated from late July. She has been placed in the Work Related Activity Group (WRAG) for 18 months from 24 July 2014. Deborah was ‘luckier’ than some – she still had some money coming in during this time – her disability living allowance (DLA). Her sister was also able to keep an eye on her for a few weeks.

But this wasn’t enough of a safety net to stop her from needing emergency food aid, with all that this involves for someone with depression and in  poor  physical health.

The new system of mandatory reconsideration before appeals introduced in October 2013 seemed to pick up the flaws in Deborah’s assessment. It may be the case that the drop by 92% in ESA appeals in April to June 2014 is mostly down to changes of decision in favour of  prospective appellants. But we don’t yet have the figures to show how many reconsiderations result in changed decisions.

People like Deborah appear to be having to wait for six to eight weeks – maybe this is ‘fast’ – do you know better? – for the outcome of mandatory reviews. If the review outcome leads to the decision being overturned,  it looks like they spend a minimum of  six to eight weeks without the benefit they depend on. If the review is unsuccessful then how long they are languishing and at what cost? We know only too well what can happen when the benefits of the chronically ill are stopped. In Deborah’s case she lost her benefit because of a failed ‘fit for work’ test. David Clapson, a former soldier, died after he lost his JSA as a result of a sanction. But the effect on people’s lives is the same – access to the means of survival is vastly reduced temporarily or completely blocked permanently. ‘Lucky’ Deborah had a social work who became involved and offered a food bank voucher. The psychologist and Deborah’s GP liaised to provide health information that appears to have made the difference. However the evidence suggests that many others are too vulnerable by this stage to fight on for their benefits or to access basic means of survival – such as a food bank voucher .

As the author of this Guardian article about David Clapson points out, ‘I’ll resist calling Clapson’s death a tragedy. Tragedy suggests a one-off incident, a rarity that couldn’t be prevented. What was done to Clapson – and it was done, not something that simply happened – is a particularly horrific example of what has, almost silently, turned into a widespread crisis. More than a million people in this country have had their benefits stopped over the past year. Sanctions against chronically ill and disabled people have risen by 580% in a year. This is a system out of control.’

Some advice on WCA assessments has been offered by readers. Welfare rights consultant Jim Strang reminds those going through the process that they can inform the assessor that they would like their assessment recorded. This should be requested in advance. He adds that anyone whose ESA is stopped can also make a fresh claim for housing benefit, based on income.

Paul Trembath says that those who go ahead with an ESA appeal following mandatory reconsideration (and the Department for Work and Pensions have had confirmation from the Tribunals Service) can ask for ESA to be paid again even if they are claiming JSA – ‘they have to ask, the DWP will not suggest’.

Many thanks to Jim and Paul for their advice – and a big thanks to Deborah for speaking out.