The WCA: Sick Joke, or National Disgrace?

The migration from Incapacity Benefit to ESA is now underway, a migration the Con-Dems and the rabid press trumpet as a step towards getting all those indolent fraudsters on disability benefits into work. If only anything of that was true. The truth is a system that has been deliberately designed to fail a significant proportion of clearly disabled people and assessment criteria that have already been identified as unacceptable by the independent assessor. Then that system, with its built-in failures, is handed over to the contractor ATOS Origin to operate, and they set out to deliberately overstress it in order to process as many people as possible, in as little time as possible, and at as low a cost as possible, all in the name of the Great God Profit; no matter the inadequacy of the process delivered, no matter the huge percentage of claims overturned at appeal, no matter a failure rate that would be unacceptable in any other industry. And then there are the medics who conduct their inadequate assessments, happily claiming they don’t need to meet their normal standards of care, because they aren’t acting as doctors or whatever – um, isn’t that the very reason ATOS crossed your palm with 30 pieces of silver?

I'm that rare bird, the ESA claimant who actually passed the WCA without needing to appeal, in theory I have no axe to grind from having an application refused. However the process fell so far short of an acceptable level of competence that I have to stand my ground alongside those unjustly failed by the system.

I became unemployed just after ESA and the WCA were introduced, but initially elected to claim JSA, in large part because of the stories already coming out about the way the WCA system was failing disabled people. With an Employment Tribunal claim to manage I just didn’t have the energy available to fight for ESA if necessary. But ESA wasn’t that easy to avoid and it rapidly became clear (contrary to Professor Harrington’s complacent assurances in his review of the WCA) that JCP were utterly incapable of dealing with someone who was either disabled or highly qualified, and god help you if you were both. In fact the only way they could deal with me was by ignoring both qualifications and disability. That sad tale I’ve already described, but the end result was a complaint to ministerial level, abject apologies from JCP, and a request that I transfer onto ESA.

As an ESA claimant I was first expected to fill in the 28 page ESA50 form. The unavailability of an electronic version of this form from 2008 until the new version rolled out a few days ago speaks to an utter institutional contempt within DWP for disabled people and their needs. The paper form is not simply inaccessible to people with visual impairments, but also to anyone, like me, who is unable to write comfortably or legibly as a result of their disability. Equally the space provided in the form is utterly inadequate for anyone, again like me, who needs to discuss several decades of experience of a complex disability. And while someone could potentially fill it in for me, there are details of how my disability affects me that I’m not even comfortable discussing with my specialists, never mind anyone else.

My first WCA assessment was scheduled for May 6^th, 2010 at the local ATOS Assessment Centre, and what an ill-omened day that turned out to be! The building is located in the centre of town and has no on-site disabled parking, so is utterly unfit for purpose before you even get to the door. There is a public disabled car park some 150m away, but that regularly requires a wait of over 30 minutes to find a space in it and like many disabled people I cannot walk even 50m without experiencing significant pain. The next nearest disabled parking is 350m away. If you can manage to get to the building, then access at the door is via intercom, so how someone deaf and/or without speech is supposed to manage is a mystery. The DDA and the Equality Act both require service providers to make provisions based on the likely needs of their clientele, so a building whose entire clientele is disabled should make a significantly greater degree of access provision than most, yet ATOS continue to operate centres, and even open new ones, that fail to meet even the most basic standards of accessibility.

I had informed ATOS in advance via the ESA50 form that I would require adjustable seating because of the difficulty in sitting that results from my disability, which is in fact the core of my problems regarding working, so pretty much fundamental to the whole assessment process. None had been provided. The tattily-dressed individual who checked my ID led me into a waiting room filled with cheap, non-adjustable seating completely inappropriate to the needs of a client population containing a high proportion of people with musculo-skeletal and pain and fatigue based disorders. Within seconds of trying the seating I had realised that I was completely unable to sit on it in any comfort, only by rolling sideways onto my hip was I able to tolerate it at all. By the time I was called through, something over 10 minutes later (despite apparently being the only client in the building), I was in considerable distress, which only deepened when I reached the examination room and found that the seating there was actually worse. It was at this point that I discovered the tattily-dressed individual was actually the doctor who was supposed to assess me, not the caretaker as I had first assumed. I pointed out that I had told ATOS I needed an adjustable seat and his reaction was ‘Oh, you’ll just have to book another appointment’. He then admitted that this was not the first time this problem had occurred, that they had asked for adjustable seating to be supplied and that they had been told by their regional management to ‘make do with what you have’. In my opinion this is a clear indication of an active contempt by ATOS management for both their client population and for the reasonable adjustment provisions of the Disability Discrimination Act and now the Equality Act.

I returned home having wasted my time and experienced major amounts of pain as a result. This pain then served to trigger a massive flare-up in my condition and I spent the following week on the floor of my bathroom as I was wracked by one muscle-spasm after another, not knowing even what day it was. I eventually managed to get to my GP, who doubled the strength of my opiate painkillers, which brought the flare-up under control, but at the cost of my wandering around in a daze for several months with no energy or volition. The loss of control in this kind of flare-up is extremely distressing both physically and mentally and I was completely unable to deal with mail during this period, simply the thought of a letter from ATOS or DWP being sufficient to send my pain levels sky-rocketing. Ultimately it took me six months to completely catch up with my mail, at which point I discovered a letter from ATOS dated a week after my initial WCA date and calling me for another WCA a few days later, which needless to say I had not attended, being barely conscious at the time.

So, knowing that I had a major problem with their centre environment, having failed to provide a requested reasonable adjustment, and having visibly caused me considerable distress, ATOS didn’t even think it was worth ringing me to ensure that my appointment was rearranged for a convenient time and to assure me that the needed reasonable adjustment would be there this time. Their response was actually worse than this, but it would be several months before I realised quite how bad.

In late-August I received a letter from DWP stating that my ESA payments had been stopped, from the week before my initial appointment, owing to my failure to attend the WCA. I called the office the letter had originated with and the person I spoke to was perhaps the only DWP employee ever to have impressed me with competence and common sense. She immediately accepted my inability to attend a WCA I was not aware of and noted that ATOS had made no mention of their failure to provide a required reasonable adjustment, but had simply stated that I had not completed the initial WCA. When ATOS set out to deliberately portray their own error as a failing by the victim of that error, and a failing with fiscal consequences, then there is no way to interpret their actions as anything less than actively and deliberately dishonest.

Thanks to an unusual outbreak of common sense at DWP, my claim was eventually reinstated and a further WCA was arranged for mid-October, again at the local assessment centre. This time I was met at the door with an adjustable chair. Unfortunately I could not even raise the seat of the chair to an appropriate level and at five feet eight I am not exactly tall, nor did the seat angle adjust, the only hope I have of a usable position if the seat isn’t high enough. Again I was reduced to rolling sideways onto my hip. This time the delay was not 10 minutes, it was something over 45 minutes. By the time I was called through (with the receptionist bringing the useless adjustable seat through after me) I was physically shaking. It was a different doctor to my first appointment, but again he was scruffily dressed in a tatty anorak. It is impossible to conclude that this reflects anything other than a profound lack of respect for their clientele on the part of ATOS medical staff.

My pain-management consultant has told me that is almost impossible to get doctors who are not specialists in pain-management to comprehend just how disabling pain is, and I was therefore concerned about how much of a background the assessor had in chronic-pain based disabilities, unfortunately his manner instantly convinced me that any question would be interpreted negatively and I did not feel able to make my point. As the session started I rapidly became aware that I was in so much pain that I was not answering effectively and was making a case for myself that was not as strong as it should have been. It also became rapidly apparent that the doctor was profoundly irritated by my refusal to give yes or no answers. He may have found it irritating, but any understanding of my condition required that he listen to the details and I would not be swayed on this, though undoubtedly many people who are less able to express themselves will have been browbeaten into less than complete answers by his manner. It was also extremely apparent that he was reading from a computer-based script, his eyes fixed on the screen, and less than pleased with answers that did not fit the format its questions mandated. As a result of this there was an almost complete refusal to make eye contact, destroying any sense that he was truly engaging with me.

More disturbingly, he chose to take umbrage at certain of my points. I do not expect automatic complete agreement, but I do not expect to be told that I am wrong to have tried to search out information on the assessment process, particularly when his subsequent conduct proved the correctness of that information, nor do I expect to be criticised for the way I have described the effects of my disability on my walking, particularly when later events demonstrated that I was being absolutely accurate.

Some 20-odd minutes into the assessment I reached my limits on my pain tolerance, either I had to stand, or vomit. I spent the rest of the assessment balanced on one leg and crutches and it was only at this point, a cynic would say at the point he started to fear being found negligent in my treatment, that the doctor finally broke script and started to treat me as an individual. He asked several times whether I was able to continue, but by that point I just wanted the WCA over with, I certainly wasn’t about to put myself through the process for a third time. He completed the physical part of the assessment, but even then he criticised me for being unable to bend my leg so he could tap my knee with his hammer. Locking my leg extended is something my disability does when my pain levels are extremely high, I have no conscious control of it and I don’t expect anyone, certainly not a doctor acting in a medical capacity, to criticise me for it.

WCA thankfully over, I made it back to my car on one leg, and, even though it is a bare 5 minutes from the assessment centre to my house, my pain levels were so high, never mind the opiate painkillers, never mind the TENS machine, that I had to give serious thought to pulling over on the way home. I spent the rest of the day in bed, the first hour physically shaking.

In late-November I finally received the notification that I had been placed into the Work Related Activities Group, which is where I believe I should be, together with back-payment of all the ESA payments I had been due since May, but the process had taken 10 months and caused me a considerable amount of pain and physical distress, actually worsening my disability. The treatment I received has convinced me that ATOS have a complete and utter contempt for the needs of their clients that adds up to institutional disability discrimination and that their medical assessors are happily compliant in this. Sadly DWP is little better, my experience has been that the system only works when you complain.

I have a skill set that should make me an asset, I am making every effort I can to maximise my potential for employment, but to date the organs of state that are supposed to support me in this actually seem to be working against me. And at the start of the 2012 financial year, no matter that my disability is worsening, no matter the efforts I am making to find work, the 12 month limitation of eligibility for contributions-based ESA will kick in and cut my benefits to nothing.

So that’s my experience of WCA and ATOS, contempt for disabled people that amounts to deliberate abuse. They damned near turned me into one of those statistics for withdrawn or failed claims that Nick Clegg loves to claim are evidence of fraudulent intent, rather than what they really are, evidence of a system that is failing those who need it most. I got through the system because I’m too bloody-minded to give in when people erect barriers in front of me and because I’m too articulate and persistent to easily dismiss; but many people aren’t as bloody-minded, aren’t as articulate, aren’t as persistent and the system will be far more of a nightmare for them than it was for me. The system should assess you fairly whoever you are, at the moment it isn’t even doing that for the people it passes. The phrase ‘a national disgrace’ is often over-used, but it was never more appropriate than when describing ATOS and the WCA.

And lest we forget, this isn’t simply Con-Dem policy, but a policy that began under Labour and which Ed Milliband continues to support.