With thanks to Mackenzies Rant – http://mackenzies-rant.blogspot.com
Since yesterday, I’ve been thinking hard about the ESA Assessment system and about how it might be possible to help present and future claimants through this farcical but mandatory process. Yesterday’s blog was relatively light-hearted, insofar as one CAN be light hearted about this situation, but today I’m going to start getting down to the nitty-gritty.
Let’s start by going step-by-step through ATOS’ own web page concerning “What A Claimant Can Expect”.
Before your assessment you will be sent a questionnaire, composed mainly of tick-box answers with spaces for you to add detail where you feel it is appropriate / necessary. The MOST important thing you need to remember when completing this form is that when the completed questionnaire is received by ATOS the tick-box answers will be scanned into your computerised record – the detail you add may not even be thoroughly read at this stage!
- In answer to every question, deal ONLY with how you would manage on your very worst days. If you give answers capable of being interpreted in such a way that you can accomplish much more on the good days than on the bad days, ATOS will ignore any detail concerning your bad days and focus ONLY on what you can achieve on a good day. Don’t give them this option!
In spite of the fact that they may not even read the detail you enter in the spaces provided, complete these spaces in as much detail as you can (remembering to concentrate on how you would manage on your WORST days) and explain any past adverse consequences, accidents or incidents of harm which have resulted from you doing the thing they ask about.
Repeat these details as often as necessary when answering different questions – hammer home your point at every opportunity just in case someone accidentally reads them in a moment of boredom!
Wherever possible, obtain letters from any and all medical professionals who are involved in your care and/or treatment and which support your claim. They are unlikely to be considered at this stage but you may not have an opportunity to introduce them later in the process, so send them in with your completed questionnaire.
KEEP COPIES OF YOUR COMPLETED QUESTIONNAIRE AND ANY ACCOMPANYING LETTERS. Even if they are not “lost in the system” once they leave your hands, you will certainly need them to refer to during the face-to-face assessment. It is critically important that you have a copy of what you have said and what has been said about you when you go to the interview. Even the most minor discrepancy between what you say at interview and what was written in your questionnaire will be pounced upon and used against you. They actually read the detail at the face-to-face stage, not so much to take it into consideration as to see if they can trip you up!
Once you have completed, copied and returned your questionnaire with the accompanying letters, it becomes a waiting game while the system digests your forms and eventually coughs up either a telephone call or a letter [or both] requiring you to attend a face-to-face assessment interview.
HOW TO SURVIVE
I have been gathering anecdotal evidence from as many people as I can who have undergone this ordeal, as well as taking advice from some experienced ‘mentors’ with expertise in the field. In addition, I have researched ATOS’ own and a number of related websites (which have been and will be linked to the blog) and the following draws on all this, together with a healthy dose of cynicism and some common sense! So, let’s move on to:
Before The Interview
First things first, The ATOS Healthcare website includes a downloadable list of assessment centres, in alphabetical order by town/city, on the “What A Claimant Can Expect” page.
- Research your nearest centre or centres – can you get there?
- When you are there, are the assessment interviews held at ground level and if not, how feasible is it that you can reach the level at which the interviews will be held?
Have all this information to hand so that when your interview date is fixed you can bring up any problems you may have in attending without delay. Remember – always assume the worst case scenario!
- How will you manage the journey to the interview on your worst days? If this could be a problem, make it clear as soon as you receive your appointment.
- If you can manage stairs on a good day but not on a bad one, insist on an interview at ground-floor level! Remember – you don’t have good days!
When you have researched the place[s] where your assessment is likely to be held, go back to the “What A Claimant Can Expect” web page and start doing your homework on the list of things “it will be helpful to think about before your assessment”.
1. “Any relevant information and key dates in your personal medical history”. This is likely to be a real pain for most people. Unless you are one of the lucky few who can keep dates and sequences of events clearly in your head, you need to go to your GP’s surgery and ask to see your medical records, with a view to photocopying any and all relevant pages. You are initially likely to meet with a degree of resistance from the admin staff, and possibly even from your GP. Don’t be deterred – this is your right! Stand your ground and insist that you need this information for a forthcoming ESA Assessment. You will not be allowed to remove your notes from the surgery so they must allow you to copy the parts you need on the premises. To prevent unnecessary delay, ring the surgery in advance and make an appointment to go in and carry out this research. No matter what they say – it is your right to do this!
2. “How does your medical condition affect you in daily life? What are you able to do and how do you do it?” The wording of this is, in itself, designed to catch you out, because it asks you to think about what you CAN do, not what you CAN’T do. Go through the copies you have made of your initial questionnaire and make a bullet list of all the ways in which your physical and/or mental condition affect your daily life on a really bad day, and how you cope with the things you absolutely have to do. Take this bullet list with you to the interview.
3. “Does your condition vary day-to-day or over periods of time? What are good days and bad days like?” If you do have good and bad days – remember that this interview is designed to establish that you ARE fit for work, not the reverse. Use your bullet list again, minimise the difference between bad and good days (without telling lies, obviously!) and ensure that your emphasis is ALWAYS on the bad days. Remember that anything you say about good days will be what they focus on. Minimise their opportunity to do this!
4. “What is the difference between what you can do and can’t do?” Of all the vaguely-worded, ambiguous questions I have ever come across, this has to be one of the worst! The difference would appear to be obvious – either you CAN do a thing, or you CAN’T! But be careful here – the question is vague and ambiguous for a reason. They will be trying to establish a range of things you can do with relative ease, so that they can say that with the right “support” you are fit to be employed doing this type of task! So consider this – how do you cope with the strange and unfamiliar? How do you cope with people you don’t know? How do you cope with the day-to-day environment that healthy, able-bodied people take for granted? How do these things affect the difference between what you can and can’t do? This is the hardest line of questioning to deal with and all I can say is BE WARY! I believe this area to be the “catch-all” under which so many “ATOS Miracles” are performed!
5. “If you have a condition that affects your mental health, please try and tell us how this affects your daily living.” Picture this – it’s a dark morning in February and the rain is battering off the windows. What do you have to do to get yourself out of bed on a day like this? If you received a phone call from the bank on this morning, how would you cope? If you had to go out for any reason how hard would that be? Would you put it off? Would your first instinct be to stay in bed, not get dressed, not make meals or eat them? This is the kind of day you need to describe in detail in answer to this line of questioning. How do you relate to other people on this day? How do you deal with stress, conflict or just the unfamiliar on this day? Whatever else you do, remember to emphasise what your daily life is like on your worst day – if possible, gloss over any good days and turn the subject back to the bad ones!
So – you’ve completed your questionnaire, copied it and sent it off. You’ve done all your advance research and made yourself notes and lists. Now put it all in a file and REMEMBER TO TAKE IT WITH YOU TO:
HOW TO SURVIVE
So – how do you survive the assessment interview itself? I have to confess that here we are straying into unknown territory for me personally, as I am still waiting for this particular instrument of torture to be applied. From here on I shall be relying more heavily on advice from experts in the field, suggestions and comments from people who have been through the mill and last, but by no means least, on common sense based on what we have learned so far!
It’s very important to stress that at no point in these proceedings should you be tempted to tell an outright porky! Not on your initial questionnaire and definitely not at your assessment interview. However, it is equally important that you steer the focus back towards your ‘worst case scenario’ whenever it seems to be focussing on ‘the good days’! Always remember that they want to tell the Benefits Agencies you are capable of work. Irrespective of what they may say on their website under “Frequently Asked Questions, No.19” their remit is to find you capable of work! I’ll return to the “Frequently Asked Questions” document in due course. For now, let’s take a look at the interview itself.
Most of us, when we know we must face a difficult situation involving other people whom we don’t know, dress carefully and as smartly as possible because this is one of the ways in which we give ourselves confidence. They know this and will use it against you – as soon as they see a smart, clean, well-dressed claimant this will be recorded on the computerised record as evidence that you are fit for work. Make no extra effort with your appearance on the day of your interview. Attend dressed as you would be in your own home.
When you first enter the room, beware the “friendly chat designed to put you at your ease”! When they ask “Did you get here alright? Did you have to use the bus?” or a variation thereof, the answer will go down on their computer as “Can travel up to X miles without difficulty”! Don’t go into detail or be drawn into this ‘chat’! Answer monosyllabically and, if appropriate, tell them you needed someone to bring you to the interview. If they ask, as part of this ‘chat’ “How are you today?” DO NOT be tricked into saying “Fine, thanks” as you would probably normally do! This too will go down on the computerised record! If it’s appropriate, say that you are very stressed and anxious, if in doubt, simply do not reply.
Throughout the entire interview, try to be as brief and monosyllabic as possible. If the interviewer falls silent, DO NOT be tempted to fill the silence yourself! Keep quiet and leave the onus on the interviewer to fill the vacuum.
- It is important to remember that the “computerised form” (“What A Claimant Can Expect”) consists largely of ‘tick-boxes’. From these tick-box responses, they allocate each claimant a ‘score’ and each box they tick which shows you able to comply with a requirement is added up and used against you and in favour of you being capable of work.
- The computer form will have small additional spaces for extra detail – much like the questionnaire – so keep your responses brief and to the point – long, rambling detailed replies simply won’t be recorded. I know it’s hard to include everything you want to say and still keep your answers brief and relevant – and so do they! Don’t be afraid to pause and think carefully before you answer. You’re not working to a deadline, even if they are!
- ATOS admit that “some of the questions may not relate directly to your medical condition”. You should assume that the majority of questions they ask and/or any tests they perform on you or ask you to undertake will NOT be in any way related to your medical condition. Once again, this has to do with the fact that ATOS’s remit is to find you capable of work if humanly (or, indeed, miraculously!) possible and as a result they have to complete totally irrelevant tick-boxes in order to build up the ‘score’ against you.
- Blood pressure shouldn’t be a problem – by the time you have ‘prepared’ yourself properly for this interview, your blood pressure is likely to be through the roof as a matter of course! The “informal” test of sight or hearing is likely to be so simple that the vast majority of people will have no difficulty with it, thus improving their chances of ‘scoring’ you fit for work. If your condition is mental rather than physical, you may well feel that being asked to undress and/or carry out physical tests is an unnecessary indignity. It is! Once again this comes down to their ‘one-size-fits-all’ computerised form – everything they record you capable of doing is a ‘score’ in favour of you being found capable of work.
- When it comes to the physical tests such as stretching, standing & bending, naturally these will be extremely simple so that 90% of claimants will have no difficulty with them. More ‘scores’ against you and in favour of you being fit to work! So, don’t exert yourself and definitely don’t push yourself beyond what you would normally do. We automatically do our best to comply when people ask us to do things – it’s part of what makes us human. Try to switch off your natural humanity for the duration of the process – you can be sure that the interviewer will have done so!
- When the interviewer indicates that your assessment is complete be sure to ask them to check that all your supporting documentation (anything you sent in with your questionnaire plus anything you may have handed over to them during the interview) WILL DEFINITELY be considered in conjunction with the ‘tick-boxes’ andWILL DEFINITELY be passed on to the “office dealing with your claim” (“What A Claimant Can Expect”). Make a note in your file of their reply!!
It has been the experience of most of the claimants I have talked to that this assessment interview is nothing more nor less than a cipher, designed solely to prove that any claimant who is not in a persistent vegetative state is capable of work! ATOS’s brief is to complete their little tick-boxes and declare to the office handling your claim that your score indicates you are capable of working. Only time will tell whether they are as diligent as they say they are about passing on your supporting documentation with their reports. The information given on their website concerning their complaint process is brief to the point of non-existence. I suspect that the real work of assessment is not actually carried out until you, the claimant, appeal the decision.
In the next part of this blog, I will go through ATOS’s downloadable list of FAQs and see if this can provide us with any further weapons in the armoury we shall all undoubtedly need to deal with this sham!
Before I go through the FAQs available on ATOS’ website – I MUST give you a link to the best website I have come across yet for help with this (and many other) work and benefit related issues. “Benefits and Work” provide a great deal of very useful free information but I suspect that the greatest benefit can be derived through ‘Subscribing’ for one year at a cost of £19.47. There is a wealth of downloadable information about the ESA Assessment, the Appeal Process and information concerning application and appeal for Disability Living Allowance. I would suggest it is an absolute must for anyone currently going through any of these tortuous – if not torturous – procedures.
FAQs are available as a downloadable .pdf file from the bottom of the “What A Claimant Can Expect” page of the ATOS Healthcare UK website. (“Frequently Asked Questions”)
- ATOS maintain that their role is to ‘help determine benefit entitlement based on the extent to which a claimant’s health condition or disability affects their capability for work’. A look at the ‘Limited Capability For Work – Test / Score Sheet’ (downloadable from Benefits and Work, if you are a paid-up subscriber) shows that it is so designed as to give very low scores to all but the most SEVERELY affected claimants with either physical or mental health issues. Any claimant who appears able to walk, talk, and carry out simple, basic tasks cannot possibly achieve a high enough ‘score’ to qualify for the ‘support group’ and will therefore (a) be classed fit to seek work and (b) if they are currently in receipt of Incapacity Benefit, the claimant’s income can legally be reduced by approximately £30.00 per week.
- ATOS further maintain that all their doctors and nurses must be registered with the General Medical Council, Nursing & Midwifery Council or Health Professions Council and must have a minimum of 3 years’ broad-based experience. They further claim that all their medical staff “must have received post-training approval from the DWP Chief Medical Adviser in the appropriate benefit”. Having looked at LCW test/score sheet, I would say that this was complete overkill. A trained chimpanzee could tick the boxes on this form and be sure of arriving at the desired outcome (from the DWP’s point of view)!
- ATOS claim that they do not use specialists in particular conditions because “the DWP considers ATOS Healthcare Professionals to be specialists in disability analysis”. I suspect that the real reason is simply that specialists would recognise the farcical nature of the “tick-box’ system, would not “stick to the rules” and as a consequence, many more seriously ill / disabled claimants would be found to qualify for “support group” status and the DWP would then be unable to cut their benefits!
- ATOS state that there is no time limit on individual assessments and they are tailored to individual needs. If this were true, how would they be able to ‘schedule’ appointments for claimants? Again, having read the LCW Test / Score Sheet, this claim is decidedly disingenuous – it is impossible to “tailor” a tick-box list!
- Concerning the difference between Limited Capability for Work (LCW) and Limited Capability for Work-Related Activity (LCWRA) – ATOS distinguishes between them relatively honestly (for them). LCW applies to anyone who is capable of carrying out some form of work “with the right help”, whereas LCWRA applies to those whose condition is “so severe (such as terminal illness) that it would be unreasonable to expect them to engage in any work-related activity”. As the test sheet shows – LCW will apply to most people who are not actually either dying or in a coma!
- See  above
- ATOS boldly admit that Non Functional Descriptors will be considered to apply to “a very small minority of conditions which would not qualify for inclusion in the ‘support group’ but may still be considered as having a limited capability for work”. In other words – those with mental health conditions or long-term untreatable illnesses / disabilities etc. MAY still be considered as falling into the ‘support group’. I’d love to hear from anyone who has been granted ‘support-group’ status under the Non Functional Descriptor rules and without first having to go to appeal!
- ATOS’s answers to this question regarding quality control are lengthy, detailed – and meaningless! One has only to read the newspapers, check out the online fora or talk to those who have been through the Assessment process to know that “consistent, high-quality, independent assessments” are not even part of the brief! If their quality control is so meticulous I wonder how they explain the fact that 70% of claimants who appeal are successful in having ATOS’ “consistent, high-quality, independent assessments” overturned! Their statistical waffle on this point would be laughable, were it not so serious for those whom it affects!
- ATOS state that doctors, nurses and physiotherapists on their staff receive
- Generic training
- Training to undertake benefit specific assessments
- Scrutiny and file work training.
Apparently, doctors train for 8 days and nurses / physios for 17 days specifically in respect of their duties while working for ATOS. Why? How long does it take to teach someone to fill out a tick-box computerised form? A day or two at most, I think you’ll agree. So what are they ‘teaching’ them during the rest of their training? Could it be the ‘cod-psychological’ tricks designed to catch claimants out and reduce their ‘scores’ as much as possible? You have to wonder, don’t you?
- Regarding the vexed question of fluctuating conditions, ATOS state that their “Healthcare Professionals are expected to be mindful of the fact that many illnesses produce symptoms that vary in intensity over time”. I’m sure they are! But I don’t believe that they are expected to use that to the benefit of the claimant – quite the reverse, in fact, if outcomes to-date are taken into consideration. Apparently, “if the healthcare professional is of the clinical opinion that the history & clinical evidence provided is consistent with the nature of the diagnosed illness, they are instructed that they should advise the ‘decision maker’ that the customer is incapable of performing the activity”. Once again, this statement is in direct contradiction of the experience of the vast majority of claimants who have been through this process to date! I wouldn’t go so far as to say that this answer is untruthful – but I strongly suggest that it is highly disingenuous!
- ATOS seem carefully to avoid the question of whether or not their ‘healthcare professionals’ are actually qualified to assess mental health. They hide behind the catch-all phrase “whether a customer [sic!] meets the criteria set out by the DWP for each mental health activity”. [I would have thought that the DWP was ATOS ‘customer’ and not the individual claimant, since it is the government who pays for this process.]
- In answer to the question of why additional medical evidence is not requested for all claimants, ATOS make another of their now-familiar double-shuffle responses. They will request further medical evidence from a GP or specialist “where information supplied on their medical questionnaire would suggest that the ‘customer’ may be eligible for the ‘support group’”. They neatly side-step the fact that claimants are allowed to include this ‘additional medical evidence’ with the medical questionnaire, provided, of course, that the claimant is prepared to pay a fee to their GP for the privilege (sometimes as much as £70.00!). This implies, but does not state, that if claimants are invited for a face-to-face assessment, the decision that they do not qualify for ‘support group’ status has already been made!
- ATOS freely admit that claimants cannot see a copy of the report prepared about them until it has filtered back to their local JobCentre Plus office. No indication is given as to how long this might take!
- Once again, the answer to this FAQ appears to be distinctly disingenuous. ATOS state that it is “specifically designed to complement the functional assessment”. Judging from the test/score sheet, the physical assessment involves tasks of such a low level that most people not in a wheelchair would be able to carry them out with ease!
- ATOS state that you can have a home visit if your GP can provide medical evidence that you are unable to travel to an assessment centre. It does not give any clues as to what would be the criteria for this, nor does it state whether mental conditions such as agoraphobia or severe anxiety / panic attacks would be taken into consideration for a home visit.
- 17 & 18 Are relatively straightforward and well detailed.
19. In answer to this question, ATOS state that they are NOT incentivised to get people off benefits. I suspect that this is true and that they receive a ‘flat fee’ for their services. However, I would suggest that their initial remit was such as to make all test criteria of such a low level that only the most severely handicapped claimants would qualify for ‘support group’ status.
20. Of course, it is true that ATOS do not actually make decisions regarding benefits. However, it is part of their remit to provide a report to the ‘decision maker’ (the local JobCentre Plus office) and as we have seen, based on the criteria used in their tests, only a very small number of claimants would qualify for ‘support group’ status and most claimants would therefore receive a cut in benefit.
21. ATOS claim that no time limit is set in which their ‘healthcare professionals’ must complete an assessment. Again, if this is true, I wonder how they go about scheduling assessment appointments?
These are the 21 FAQs covered in ATOS’ own downloadable document. At the bottom of the“What A Claimant Can Expect” page on ATOS’ website, there is also a downloadable document by the DWP entitled “About Your Medical Assessment” which any claimant would be well advised to read before undergoing the assessment interview. In addition, there is a link whereby you can contact ATOS if you have any queries which are not covered in the foregoing list. My next posting will be on the Appeal Process, once I have carried out as much research as I can about this stage of the proceedings. Any and all constructive comments and/or suggestions on the subject of the ESA Assessment process will be warmly welcomed by the writer!
Many thanks to the excellent MacKenzies Rant for this informative article.