A new scoring system has been created to decide if claimants with mental health issues can get into the support group because of a risk of harm to themselves or someone else. The system has been deliberately designed to make it more difficult for women to qualify than men.
There have also been important changes to the way health professionals estimate how far claimants can walk or ‘mobilise’.
The substantial risk regulations are now one of the most important ways of getting into the support group.
According to the independent reviewer of the WCA, Dr Paul Litchfield, 38% of all new support group entries are on substantial risk grounds . Two thirds of these are decided on the papers alone, without the need for a medical assessment.
The regulations apply where a claimant has not qualified for the support group, but where it is then decided that there would be a substantial risk to the claimant or to someone else unless they are found to be incapable of work-related activity.
HARDER FOR WOMEN
Until now there has been no difference in how men and women are assessed.
However, Benefits and Work can reveal that a new scoring system deliberately makes it harder for women to qualify for the support group than for men.
For example, a man with a diagnosis of depression and a history of deliberate self-harm who is unemployed – generally the case for ESA claimants – will be eligible for the support group, according to the guidance.
But a woman in the same situation will not be eligible for the support group. Instead, she will have to also show that an additional factor – such as being homeless or divorced –applies to her.
The gender difference is likely to be based on the fact that more males than females commit suicide.
Indeed, figures released by the Office for National Statistics just last week showed that suicide rates are now at their highest in over a decade and most of the increase is amongst men. Organisations such as Mind are linking the rise to benefits cuts.
However, many people would question whether a difference in suicide rates is sufficient to justify different treatment for men and women in relation to claiming benefits. This is particularly the case because substantial risk is not just about deliberate self-harm or suicide, but also about issues such as unintentional self-neglect.
SCORE YOURSELF OR YOUR CLIENTS
But, as the guidance is already in use, we’ve created a step-by-step method for scoring yourself or your clients in relation to substantial risk.
Understanding how the system works may make it very much easier to present targeted evidence showing that you meet the substantial risk criteria. Conversely, if the guidance doesn’t cover your circumstances you have more information about how the decision was reached in order to challenge it.
You can find the step-by-step method in the updated ESA mental health guide in the members area of the Benefits and Work website.
MOBILITY CHANCES BOOSTED
There is better news for ESA claimants with mobility issues, however.
The new guidance has dramatically reduced the estimates of how far claimants can ‘mobilise’ based on their everyday activities. For example, claimants who can only move around at home have had their estimated mobility reduced from less than 200 metres to less than 50 metres.
This is the difference between getting into the support group or only scoring 6 points for mobility.
You can read further details in the ESA physical health guide in the members area, which also has details of improvements in assessing continence issues for people who also have mobility problems.
The new guidance is included in the latest edition of the WCA Handbook.