Explaining an invisible illness to someone isn't easy at the best of times. When you suffer from a mental health condition, it can be difficult and traumatic to translate the troublesome thoughts and feelings running through your head into words. People tend to be alarmed by behaviour and ideas that they can't relate to themselves and you soon learn that it's probably better to keep your personal horrors hidden from your friends and family and make up more acceptable excuses for yourself when you don't feel well. Mental health professionals generally know that people feel stigmatised and frightened to open up. That they're scared of speaking out because it can be confusing and upsetting and there are no simple solutions. They tread carefully at first on tip-toes around you. Little by little they build a professional relationship based upon the solid foundations of your trust. A good therapist offers a sensitive ear to your troubles and waits patiently until you feel stable, comfortable and ready to share your inner depths. They listen and put you at your ease....
...which is far from the reality of the work capability assessment. The face-to-face assessment has all the sensitivity of a blunt lump hammer bashed against your skull to knock the answers they demand right out of you with thumping great whacks. No moment is given to recover from your upset here my friends. Your time is their money.
The face-to-face assessment was scheduled to be done at my home because of the nature of my illness. It was a huge relief that they had accepted and believed my difficulties demanded it. My last assessment was just twelve months ago and despite having a long-term history of chronic anxiety conditions, more therapy than Ruby Wax (not possible) and a poor prognosis, following a fit to work decision and a battle, I was placed in the work related activity group. Thank the Holy Lord and mother nature herself that no one from the jobcentre has ever contacted me. I could not have coped if they had.
The Atos health care professional was not the person named on the letter. When he arrived my heart sank. It was the same man as last time. The same man who twisted and manipulated my answers and wrote a work of fiction about me on his report. I hadn't been expecting a fair or reasonable assessment however. At least this time I knew not to trust. I had been dreading it. Effectively two months had been wiped from my life with worry and stress. I couldn't think of anything else. The apprehension grabs you by the guts and twists them until you're curled up in a quivering foetal ball. I could barely function for fear of what was going to happen next. Suffice to say the night before sleep had eluded me. By the time he arrived in the morning I was ragged and a little bit delirious.
Ten whole minutes of rapid fire questions followed. Barely time to catch my breath, yet alone my composure, which crumbled when he asked me to describe a panic attack. Despite enduring possibly thousands of panic attacks, right there and then under this pressure my mind was a blank vacuum of emptiness. I just couldn't think and hot tears swelled in my eyes so I had to cover my face with my hands. My thoughts dried up, my throat constricted, my voice cracked and words would not come. He was perched on the end of the settee tapping his pen. I noticed him turn his wrist to look at his watch.
"Did I take medication?" I shook my head and told him, no. His scribbled with his pen and I hastily added that I didn't take medication because the side effects had been intolerable and in the past had made my condition significantly worse. I noticed that the pen didn't write this clarification down on paper.
"Did I ring the doctors myself?" I had to think for a moment, "sometimes" I said. I'm familiar with my GPs surgery and it's probably the one place on this earth that I'm not too afraid to ring. Had he asked if I rang the hairdressers, or the dentists, or the DWP, I would have said no, never, because I am too anxious.
"Do I go there by myself?" I do yes, because it's literally around the corner, takes less than a minute to reach by car and you can park right outside the door. "So you walk to the doctors yourself?" he enquired and started to write the answer down before I had started to speak. "No! I am taken there!" because I can't walk that far without panicking. Once again, his pen lay still in his hand.
Two sheets of A4 paper were completed, and with that he opened his briefcase, placed the forms inside and clipped it shut. He said that I didn't need to see him out, and with that, he was through the door and gone, leaving me huddled on the chair feeling stunned and bewildered, as if I'd just been violated in some way. It was over so quickly I didn't really know what to feel. Certainly I was relieved that it was done and dusted, but if that was a credible and fair assessment to reflect a fifteen year history of a crippling mental health condition, I am very worried. I have no idea if he's read my detailed forms and the assessment was a mere formality, or if he's made up his mind already to find me fit to work.
Once the dreaded (white) envelope of doom arrives, you have exactly four weeks from the date it was issued to complete and return the ESA50 forms contained inside. What these forms fail to mention is that for each question you complete, you will awarded a set amount of points from zero to fifteen. You need at least 15 to "pass". However which way you finally get to the stage where you're given the benefit you are legally entitled to, be that as a direct result of the assessment, by a reconsideration of a fit to work decision, or at an independent tribunal, it is extremely disconcerting to feel that you have succeeded in "passing the exam" because someone with no medical training acknowledged the severity of your illness. It really does feel as if your illness is on trial.
How Atos will interpret your answers is something of a mystery. The questions are vague and ambiguous and perhaps in the majority of cases, bear no relation to the real life limitations to work your condition poses. People who are mostly housebound and need someone to support them to go outside cannot score enough points on that particular activity to be awarded the benefit. People who are not aggressive or violent every day, but only some days, cannot score enough points to be awarded the benefit. Okay, so there is a clause which states that if work will cause you or others harm there is some discretion in the decision making process. The problem in reality, is proving to them that is the case. In order to try and understand what was actually being asked of me, it took me almost the whole month to complete the few answers I believe might possibly be relevant to my mental health condition. It is a miserable experience, and utterly demoralising and soul destroying to have to go over and over the very worst aspects of your ill health. By the end of the process you're emotionally battered and more unwell than when you started.
Mark Hoban, the minister for Work and Pensions would have you think the reason why at least 40% of fit to work decisions are overturned at appeal is because additional medical evidence was presented to back up the claims. I challenge the minister to obtain his medical history within this narrow time frame and see if he can do it without having to pay. The maximum your GP surgery can charge for copying your medical records is £50, which is precisely the sum that I was charged. I contacted the GP surgery the day I received the forms. I was told to put my request in writing. That letter was delivered to them within hours. It took six weeks to get hold of some of the documents, but they had missed off everything from 2005 to date. That afternoon, I confess, I cried.
I hope that the clerk at the DWP who makes the final decision does read the two inches thick paper documentation to support my claim. Frankly, I couldn't flip a coin one way or the other to tell you what their decision will be. The major problem with the work capability assessment is that the outcome is so completely uncertain. People keep telling me that they have their fingers crossed. Some have their toes crossed for me too. Isn't that the point after all? No one can second guess what the decision will be. It's a test based not on facts, or evidence. It's more a game of chance which gambles with your sanity and your desperate need for support and a subsistence income. I wait anxiously to learn if they pull my ticket out of their tombola machine. Wish me luck?
If anyone is feeling alone and worried about their own assessment please contact Jane on twitter @WOWpetitionchat
There is an excellent interactive guide to the complex work capability assessment written by a specialist benefits advisor at http://ilegal.org.uk/thread/7049/mlinteractive-guide-completion-esa-50
If you would like to share your own experience please contact us. We will be delighted to hear from you.
Above all, we demand that this degrading and unfair assessment process is stopped as soon as possible. Please give your support by signing and sharing the petition...
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