Too Sick to Work? Attend the Work Programme or Face Sanctions!

On the 3rd December 2012 the DWP announced that people who had been through the exceptionally tough Atos work capability assessment and found to be not fit for work could be mandated indefinitely onto the work programme or have their income sanctioned. This new rule applied to people in the work related activity group. People, who according to the government, should be expected to recover within twelve months. This group includes the greatest proportion of sick and disabled people receiving ESA. The support group is so difficult to get into that it excludes many of those with degenerative and fluctuating illnesses, chronic conditions that have gone on for years and cases of terminal illness when they are expected to live longer than six months. Of course you'd want to spend your final months doing some work experience to improve your future job prospects wouldn't you?

It's plain to see that the work related activity group is fast becoming indistinguishable from job seekers allowance. Coalition politicians have stopped referring to it as a disability benefit and the media has frequently included the sick and disabled people in the group as people found fit to work. The benefit was also one of those capped at 1% and it will not increase in line with inflation. Dividing sick and disabled people up with a points scoring system into two groups, has always seemed to be flawed and unfair to me. If you're too sick to work, then you're too sick to work. How difficult can that fact be to understand?


I'll start by explaining a little about myself so that you might better understand the situation I am now facing because of this rule. Back in March I had a face-to-face assessment at my home with an Atos doctor. It was a tense and anxious wait for the brown envelope because the assessment is a lottery. No one can predict what their decision will be. When the dreaded letter finally arrived in the middle of May I didn't even realise it was the decision. Nowhere did it refer to a decision, or contain words such as, "we have made a decision" or "you have been placed in the work related activity group", or any reference to the assessment at all. What they did send was a leaflet about appealing a job seekers allowance decision. Confused? Yes! It took two phone calls and a week to find out what it was they were telling me.

In the meantime, I received a letter from my local job centre demanding that I attend a work related interview at a date in the near future or lose my benefits. I say local, but it's not the job centre in my own town, but a bigger one nearby in a busy shopping centre. My problem is that I have agoraphobia. I haven't been able to walk into that place in over a decade. I couldn't go there even if someone trusted went with me. I'm also terrified of telephone calls and speaking with people I don't know. I get worked up into an anxious panic, my mind becomes blank, I can't think, I feel unreal and floaty and words won't come. I also get panicked speaking to my own family and friends on the telephone, but that's another matter. The point is, I suffer from severe anxiety. I can't just have a nice meal out, take a trip or a pleasant walk down the street, go shopping on my own, get a haircut, meet new people, sit and socialise comfortably, attend family celebrations (and funerals) and sit with the family around the table at Christmas. I don't want sympathy, I just want to emphasise that if I can't do all of the ordinary and enjoyable things in life, then how can I be expected to suddenly overcome my agoraphobia and anxiety and jump through hoops for the job centre? All of this was explained in thorough detail in the assessment forms, and what a demoralising depressing experience describing it was too. There were lots and lots of letters and reports included from the multitude of mental health team workers who have tried, and failed to cure me over the last fifteen years as proof that I was genuinely diagnosed and struggling to cope with anxiety on a daily basis.

I really didn't feel able to speak to the job centre adviser when they called, but I had no choice. Not knowing what to expect I was brave and listened to what she had to tell me. She was referring me to the work programme and if I didn't attend I would be sanctioned. She asked if I had a mortgage or paid rent. "No". It has been suggested that the job centre have targets for sanctions and I have been set up.

All of this has happened so quickly that my claim was still within the four week time period to make an appeal for the support group. What troubles me most is that I am now receiving nonsensical and threatening letters from A4E and the job centre to arrange a work experience placement even though I still had time to make my mind up whether to appeal or not. I will tell you that I have now sent in an appeal form. This had to be requested and posted to me, and I will also tell you that it does not contain any advice or reference about how to appeal an employment and allowance decision or even where to post it. Are they making this difficult on purpose? You have to wonder?

I think it's cruel to harass someone who isn't fit to work and who can't get out of the house without a great deal of support to attend a work placement when it's simply impossible. I have barely slept and I'm experiencing a lot of horrible anxiety symptoms. Rather than helping me they are making my condition much worse. I don't want to imagine the horrors of having a massive panic attack in a public place with strangers around. Last time that happened in a work environment, I spent the afternoon in A&E.

You also have to wonder if the government is simply denying that sickness and mental illness exists, unless you're so ill or disabled that you're bed bound or in a hospital. If time limiting ESA to 365 days doesn't get you, because you have a partner who will not only be expected to care for you if you haven't recovered quickly enough, but they'll be 100% responsible for supporting you too and you won't have this marvellous tailored support to get you back to work (a blessing). You will find yourself sick and with no independent income or state support whatsoever. If you don't have a partner, or your household has been means tested and found to be dirt poor, the constant harassment and never ending stress might force you to attempt to live off thin air, kindly relatives or just simply throw in the towel for good.

The work programme claims to support sick and disabled people into work. Politicians like to boast that it helps to find lots of jobs for this difficult group of people who face massive barriers to getting into the work place. It is failing miserably. Out of the 80,720 people on employment and support allowance who were attached to a work placement, 1,290 actually ended up with a 'job outcome'.*

There is no way that I can mentally or physically attend this work programme placement whatever they have planned for me. If I can't function in a supermarket or shop or any place unless my mother is with me at all times, how can I be expected to work there? At the moment I am ignoring the letters because I can't cope with them. I am now waiting for the one that tells me my benefit has been stopped.

*http://ilegal.org.uk/thread/7123/work-programme-working

The Lump Hammer Approach to the Work Capability Assessment

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...

http://epetitions.direct.gov.uk/petitions/43154

GP Speaks Out About the Brutality of the Work Capability Assessment

Today in the Guardian, a doctor has written to express her fears that disadvantaged patients, especially those suffering from severe mental illness are being found fit to work by the Atos assessment. These people include patients who are extremely unwell and in their doctor's opnion, in no fit state to seek employment. They are being placed at high risk of homelessness and suicide as their income is stopped and their rent falls into arrears. The result of government policy is that vulnerable people with mental health conditions that were being managed by their GPs and local community health teams are now finding themselves on the streets. This cannot be right in a fair and caring society. Do we really believe that bullying vulnerable people to the point that their mental health breaks down and psychiatric crisis teams have to be called in, is a justifiable consequence of welfare reform? 
 

In the words of the GP,
 

"I have watched with mounting horror as my patient, an extremely vulnerable woman, has been put at risk of homelessness and deteriorating illness as a result of government policy. I am very aware of the importance of work, and as a GP will always encourage people to look for a suitable job if I think they can. But I also know my patients, and I am outraged that some are being put through the punishing stress this assessment causes. Many of my patients have gone through the Atos assessment to be told that they are fit for work with all their benefits stopped without notice. The financial impact is extreme. Several of my patients have shown worsening symptoms of depression, and some have become suicidal. Because we were so concerned about a patient's mental health – which worsened as a result of the stress caused by these assessments – we have had to involve a psychiatric crisis team."
 

"I am fearful that more of my patients will be put at risk of homelessness and suicide by this brutal new system."

Read the full article in The Guardian