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Clampdown on future mental health claimants

12 February 2007
Just four months after details of the 'transformed' test of incapacity for work were published, the mental health test has been revised again to make it a great deal more difficult to pass.

The number of activities has been cut from 15 to just 10 and many descriptors have been rewritten to drastically reduce the possibility of claimants scoring points.

Savage
Details of the 'transformed' Personal Capability Assessment for use with the new Employment and Support Allowance were first published in October 2006. Benefits and Work covered them in detail in an article entitled New incapacity test: physical points slashed, mental points boosted.

At that time the new PCA was in draft format only and a pilot version was about to be tried out by the DWP. We warned readers that

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.

We didn't guess, however, just how savage the changes to the mental health test would be when the final draft was placed before the House of Lords last week.

Activities deleted
The activities relating to panic attacks and to maintaining appearance and hygiene have been completely removed. It will no longer be possible to score points for 'overwhelming fear and anxiety, or panic attacks' or for being 'unable to maintain appearance and hygiene' without help or prompts from other people.

It seems likely that these were two activities which allowed a large number of claimants with conditions such as anxiety and depression to score a significant number of points in the recent pilot.

Activities combined
Other activities have been rolled into one so that the opportunities for scoring points are halved. For example, 'Learning Tasks' and 'Understanding instructions' were two separate activities under the original 'transformed' PCA. In the revised pilot PCA they now form the single activity of 'Learning or comprehension in the completion of tasks'.

Similarly, 'Forming relationships with other people' and 'Ability to communicate appropriately with other people' have been rolled together into the single task of 'Dealing with other people'.

Activities redrafted
Other descriptors have been redrafted to make them harder to pass. For example, the activity 'Forward planning' has been renamed 'Getting about' and the descriptors altered. Thus, 'Cannot get to a specified place or appointment on time, without prompting or support . . . ' has become 'Is unable to get to a specified place with which he is familiar without being accompanied by another person . . .'

The change in the wording means it is now only places claimants know well which will be taken into account and that being hours late arriving will no longer be relevant.. Hardest of all, though, claimants now have to show that they need someone with them, rather than just requiring 'prompting and support'. Turning up for your medical unaccompanied would be certain to lose you this descriptor, even if you were hours late (not to mention unbathed, in disheveled clothing and in the grip of a panic attack).

A similar technique has been used to make the 'Memory and concentration' activity more difficult to score points from. The original 15 point descriptor read:

Very frequently forgets or loses concentration to a degree that cannot be self-managed.

This has now been changed to:

On a daily basis, forgets or loses concentration to such an extent that overall daily life cannot be successfully managed without receiving verbal prompting, given by another person in the presence of the claimant.

Here 'very frequently' has become 'on a daily basis', the forgetfulness or loss of concentration now has to make life 'unmanageable' and the claimant needs to show that 'verbal prompting' given in their presence is the only way that they can successfully manage their life. Clearly this is a much more difficult test.

Bewildering descriptors
Some of the new descriptors are Byzantine in their complexity and make a mockery of government claims that they are simplifying the benefits system. Is the following descriptor, for example, really going to appear in future IB50 incapacity for work self-assessment questionnaires?

Needs to witness a demonstration of how to carry out a moderately complex task, such as the steps involved in operating a washing machine to correctly clean clothes, before he is able to learn or understand how to complete the task successfully, but would be unable to successfully complete the task the following day without receiving a verbal prompt from another person.

Some descriptors are simply bizarrely indefinable, such as:

'Frequently demonstrates a moderately disproportionate reaction to minor events or to criticism but not to such an extent that he cannot manage overall day to day life when such events or criticism occur.'

What exactly, many people will wonder, is a 'moderately disproportionate reaction'?

And how would you set about measuring this one:

'Takes more than one and a half times but no more than twice the length of time it would take a person without any form of mental disablement to successfully complete an everyday task with which he is familiar.'

Silence
The revised test is undoubtedly disastrous news for a coming generation of sick and disabled people and, with the government still refusing to say whether they will use this PCA on existing claimants, it could be disastrous news for current claimants too. However, with dismal predictability, yet again visitors will learn nothing of these matters from the websites of the big four advice sector agencies: LASA's Rightsnet, Citizens Advice, CPAG and Disability Alliance.

Three of these agencies - the exception being Rightsnet - sat on the Overarching Consultative Group which helped the DWP to draw up the 'transformed' PCA.

Disability Alliance also has the additional distinction of being funded by Unum Provident, the American based employment insurance company at the heart of the welfare reform programme, whose profits stand to rise considerably as UK residents find it increasingly impossible to be found unfit for work.

It seems then, that in spite of the disbelief of many critics, with every new announcement the government's ambition of reducing the number of incapacity claimants by one million becomes more realisable. Quite how they will deal with the resulting additional 900,000 sick and disabled Jobseeker's Allowance claimants has yet to be revealed . . . but no doubt they have a cunning plan.

You can download a copy of ‘Welfare Reform Bill – Draft Regulations and supporting material’ from the DWP website