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.