Posted on 28 October 2010.
WORK CAPABILITY ASSESSMENT WCA fails to recognise the impact of HIV on the ability to work, according to a new research carried out by National AIDS Trust NAT.
The test was brought in to determine whether a person is eligible for Employment Support Allowance ESA and has caused a rift between the government disability charities
Chris Grayling, employment minister commented this week that, three out of four people applying for ESA were fit for to work. But charities say that the assessment will force sick people back into the work-force before they are ready.
NAT’s report Unseen disability, Unmet needs found that the WCA does not reflect the impact of fluctuating symptoms such as fatigue, depression and drug side-effects.
The report also found that there was a continued ignorance about HIV amongst medical assessors and decision makers, reducing the likelihood of a fair and accurate assessment on a claimant’s ability to work and need for disability-related benefits.
Figures show that as many as 68 per cent have failed the assessment. However, 40 per cent have had ESA granted after appeal, highlighting the poor standard of the assessments.
Deborah Jack, NAT, CEO, said: “HIV is a disability, and like many other disabilities, people living with HIV can have vastly varying experiences relating to their condition. Whilst some find they can still work, many others find the impact of HIV or their treatment means employment is not an option at the moment and they need to claim disability related benefits.
‘As it currently stands, the WCA is based on an outdated model of disability which only recognises a narrow medically defined set of physical and mental impairments. Also, it does not appropriately acknowledge the fluctuating nature of the condition and the impact that low self esteem – due to HIV related stigma – can have on a person’s ability to work.”
Lizzie Iron, Citizens Advice head of welfare policy warned:”Seriously ill and disabled people are being severely let down by the crude approach of the Work Capability Assessment.
“The government urgently needs to address the problems with the test for ESA which are causing hardship to seriously ill people at a time when they most need support.”
NAT has submitted their finding to the Independent Review of WCA. It is hoped that they will be fully considered before any new rules are finalised and come into effect.
To download the NAT report go: www.nat.org.uk
Key findings from the report include:
- The WCA does not take into consideration key HIV clinical markers, such as CD4 count.
- WCA decision makers often give greater weight to the opinions of those contracted to make the medical assessment, rather than HIV clinicians and other specialists.
- A wide range of problems with administration and communication of the WCA process materially disadvantage claimants, and the stress and pressure of the process impacts negatively on their health.
- Claimants going through the medical examination do not always have the opportunity to discuss the important issues around how their HIV affects their physical and mental health.
Case Study – Tim
Tim is a young man who applied for Employment and Support Allowance (ESA) with the help of his aunt and an HIV specialist benefits adviser. At the time of completing his ESA50 form, Tim’s CD4 count was 19. Medical evidence from his doctor explained that at the time of diagnosis, Tim had a CD4 count of 0 and PCP, a form of pneumonia associated with a low CD4 count.
Despite providing information about his blood test results, these were not discussed at the medial examination. The HCP’s record of the examination noticed, contradictorily, that Tim experienced ‘no side-effects’ but that he experienced diarrhoea as a result of his medication. The HCP also concluded that Tim did not score any points under the incontinence descriptor.
Tim was found fit for work. His doctor submitted further medical evidence but the case still ended up at appeal. Tim’s adviser said that, “on the day, we won that appeal, without me having to say a word or even sit down…The judge looked up and said, “oh – ESA successful, he’s in the support group, that’s not a problem.”
Tim is now in the support group of ESA.