16 October 2006
The chances of being found incapable of work on physical health grounds have been dramatically cut under a revised test being piloted by the DWP.

Altogether, 280 points - over one third of the total - have been slashed from the proposed new Personal Capability Assessment (PCA). Astonishingly, Child Poverty Action Group (CPAG), Ciitizens Advice and Disability Alliance all sat on the consultative committee which assisted in drawing up the new test.

Meanwhile, the mental health test has been completely transformed, with a complex new system allowing claimants to score sufficient points from just one descriptor. However, the DWP have stressed that the wording of the new mental health test has yet to be considered and revised by their legal department

The new tests will apply to claimants of the planned Employment and Support Allowance but and is also likely to apply to existing Incapacity Benefit claimants from April 2008 at the latest.

The revised PCA is detailed in a document released by the DWP last week: Transformation of the Personal Capability Assessment. The work has been carried out by two committees, the Physical Function and the Mental Health Technical Working Groups. (See: US medical scandal company at heart of UK welfare reform). The DWP say pilots are already being run, with claimants being assessed under both the current PCA to decide whether they are legally capable of work, and the revised PCA to see how it compares. The Department claims it is aiming for 'a fairer, more accurate and more robust' assessment system.

Physical test
There can be little doubt that the DWP will be satisfied with the 'robust' nature of the new physical test - the changes are almost uniformly for the worse as far as claimants are concerned.

Some descriptors which currently score 15 points - enough to be found incapable of work - now score no points at all. Cannot put either arm behind back as if to put on a coat or jacket, for example, scores 15 points now but has simply been deleted from the new test.

In addition, every one of the seven descriptors for which it is possible to score three points, such as 'Cannot walk more than 400 metres without stopping or severe discomfort' have also been cut from the test.

Other descriptors are still present, but have had their scores dramatically reduced. Being unable to bend, kneel or squat to pick a piece of paper up from the floor has had its points reduced from 15 to 6, for example. In addition, the descriptor has been reworded to make it harder to gain the points.

Similarly, in the current test, someone who cannot walk more than 50 metres scores the 15 points needed to be found incapable of work. In the new test, however, this is reduced to 9 points, with 15 points being reserved for those who cannot walk more than 30 metres.

A number of activities have been amalgamated into a single activity. For example, all the descriptors relating to the current activities of standing, sitting and rising from sitting have been amalgamated into the single activity of:

Standing in one place, unassisted by another person, or sitting in a chair with a high back and arms.

The number of points available has been cut from 127 to 72. In the same way, all of the descriptors relating to walking and walking up and down stairs have been joined into a single walking activity. The 5 scoring stair related descriptors have been cut and replaced with a single descriptor:

Cannot walk up or down two steps even with the support of a handrail. 15 points

The total points available has been cut from 98 to 45.

Some new descriptors have been introduced, such as 'Cannot use a conventional keyboard or mouse' which scores 9 points.

But overall, with the total number of points reduced from 778 down to 498, the new physical test will unquestionably have the effect of reducing the proportion of claimants who score the 15 points required to be found incapable of work.

Mental health
The mental health test is a different, and less clear cut issue. Under the current system, most claimants with severe mental health conditions and learning disabilities are exempt from the PCA. Under the Employment and Support Allowance there will be no exemptions. This means that a way has to be found to ensure that people with severe conditions can still be found incapable of work.

So the current test, under which claimants have to score 10 points from a minimum of 5 descriptors, is to be scrapped. Instead, claimants will have to score a minimum of 15 points from a range of 15 activities such as: initiation of tasks; forming relationships with other people; coping with change; appropriate behaviour with other people; emotional resilience and panic attacks.

So, for example, 'Cannot cope with very minor changes in routine even if pre-planned' scores 15 points, as does 'Frequently has difficulty in understanding and carrying out simple instructions'.

It is clear from the notes accompanying each activity that many are intended to address conditions largely ignored by the current points system, including brain injuries, learning disabilities, obsessive compulsive disorder and autistic spectrum disorders.

In addition, it is intended that the questionnaire given to claimants will in the future offer more scope for people with mental health conditions to provide pertinent evidence.

However, the complexity and intangibility of some of the descriptors seems certain to cause enormous difficulties for everyone involved in the process. For example:

'Has significant difficulty in initiating and sustaining personal action (planning, or organisation, or problem solving, or prioritising, or switching tasks) without support by frequent external prompts.'

This scores 15 points, whilst 'moderate difficulty' without 'regular' external prompts scores 9 points and 'some difficulty' without 'intermittent' external prompts scores 6 points.

The complex wording and introduction of two not easily defined variables in the same descriptor seem certain to lead to many disputes ending up at Commissioners hearings, unless the DWP's legal department defines terms such as 'significant', 'moderate', 'frequent' and 'regular' in the legislation. If, however, very restrictive definitions are attached, then what appears to be a reasonable test may quietly be transformed into one which fewer claimants will be able to satisfy.

Descriptors such as 'Takes twice as long as would reasonably be expected to perform and accurately complete a task' also look certain to lead to many disputes.

Does a claimant who only has difficulty with one task, such as washing, because of their condition, qualify? Or does it need to be many tasks or the majority of tasks? If a claimant can manage relatively simple tasks, such as dressing, at a normal pace but struggles with ones that require greater concentration, such as cooking a meal, would they score points? And will there be queues of claimants applying to the commissioners for a ruling on what is a reasonable time to take preparing eggs, beans and chips or typing 200 words on a computer?

Finally, there is a concern that the new test will be heavily biased towards more severe, and much less common, conditions. The notes that accompany each activity refer to brain injury being relevant to 8 activities, psychotic illness being relevant to 6 activities, autism being relevant to 5 activities, and depression being relevant to just 3 activities. Yet depression is currently by far the most common causes of claimants being found incapable of work on mental health grounds.

With both Unum Provident and Atos Origin having seats on the working group which drew up the new test, many claimants will expect the legal drafting of the new activities to reveal serious restrictions in who they can be applied to.

Watch this space
We hope to look at both the physical and mental health test in more detail over the coming months and keep members informed of any changes to them. We also hope to provide you with answers to many as yet unanswered questions, such as whether the current 'safety net' regulations will be kept in place, whether mental and physical points can be combined and how claimants with more severe conditions will qualify for the 'support' element under the new PCA.

Usual suspects
Meanwhile, whilst the presence of the usual private sector suspects on the working groups drawing up the new test will have come as no surprise, many will be shocked at the role being played by Citizens Advice, CPAG and Disability Alliance. The fact that the DWP has been able to proudly list them as members of the Overarching Consultative Group involved in creating the revised PCA is bad enough. But if they do not now speak out loudly against such savage points reductions, then the chance of preventing them passing into law is zero.

So far, their silence speaks volumes.


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