When work and pensions secretary Damian Green announced that employment and support allowance (ESA) claimants with severe conditions which will not improve will not be subject to repeat work capability assessments (WCAs), he was not coming up with a new idea.{jcomments on}

In fact under the personal capability assessment (PCA), the old test for incapacity benefit (IB), there were a range of severe conditions which exempted you from having to be assessed at all. You could even be exempted if you were in receipt of certain benefits.

DLA exemption
The most important exemption from being assessed for IB was that if you received disability living allowance (DLA) care component at the highest rate you were exempt from the PCA.

If you were assessed as 80% disabled for disablement benefit, War Pension or Severe Disablement Allowance purposes you were also exempt.

Severe conditions
There were also a range of exemptions for claimants with severe conditions. These included:

• people who were terminally ill

• people who were registered blind

• people who were suffering from the following severe medical conditions:

– a severe mental illness involving the presence of mental disease, which severely and adversely affects a person’s mood or behaviour, and which severely restricts their social functioning, or their awareness of their immediate environment

– tetraplegia

– paraplegia, or uncontrollable involuntary movements or ataxia which effectively render the sufferer functionally paraplegic

– persistent vegetative state

– severe learning disabilities

– severe and progressive neurological or muscle-wasting diseases

– active and progressive forms of inflammatory polyarthritis

– progressive impairment of cardio-respiratory function which severely and persistently limits effort tolerance

– dementia

– dense paralysis of the upper limb, trunk and lower limb on one side of the body

– multiple effects of impairment of function of the brain and/or nervous system causing severe and irreversible motor sensory and intellectual deficits

– manifestation of severe and progressive immune deficiency states characterised by the occurrence of severe constitutional disease or opportunistic infections or tumour formation.

Clearly for some conditions, such as being registered blind, the exemption was largely straightforward.

For others, especially severe mental illness, claimants often had to go to tribunal to prove their eligibility.

How much will be revived?
The big question now is to what extent will the DWP simply reinstate the old PCA exemptions, even if they are now only for reassessments rather than initial assessments?

At this stage it seems unlikely that being in receipt of DLA or PIP will lead to exemptions, but some of the other criteria may well find themselves being brought back into service.

Who knows, slowly and over the course of more years, we may even find ourselves back in a world where doctors and consultants have the final say in whether their patients are fit for work.


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