Feb 102013
 

New ‘Use Common Sense’ training module for ATOS HP and DWP Decision Makers

“Common Sense is the collection of prejudices acquired by age eighteen”

(Albert Einstein)

ATOS HPs are well known for having assimilated all what needs to be learnt about any physical or mental impairments, illnesses and disabilities in a grand total of 22 days training.

They are now required to call upon one of their other greatest strengths, namely ‘common sense’ to decide whether a claimant undertaking a Work Capability Assessment would benefit from a mobility aid or appliance, and therefore is fit to work.

In the words of DWP [1]:

 

It must be recognised that specific skills, knowledge, experience and training are required to fully assess individuals for aids and appliances which may ultimately help their function. Additionally, clinicians who assess and prescribe aids and appliances for an individual will normally have access to significantly more information about the individual’s situation than HCPs offering advice as part of the WCA process.

 

Therefore, in situations where an aid or appliance has not been recommended or prescribed, HCPs are being asked to use their skills and experience as a disability analyst to offer ‘common-sense’ advice to the DM in situations where they feel an aid or appliance could improve a claimant’s function in terms of an individual WCA Activity’.

In other words, HPs can without specific skills, knowledge, experience, training and medical information, and simply using their ‘common sense’ decide if person is fit for work IF they were to use a mobility aid or other appliance

If a person in the street, chosen at random were asked “whether a person with mobility problems would benefit from a wheelchair”, the answer would be “yes”

This answer would have as much value as the HP’s advice and be about as accurate.

Using specialist information to make such a decision requires the wisdom of education and experience, not common sense.

But it gets worse:

The ATOS HP’s ‘common sense’ advice is then presented to the DWP Decision-maker, who, let us not forget, has no medical training whatsoever.

According to the new guidelines, the DM will have to:

Consider all the circumstances in order to determine whether it would be reasonable to assess the claimant as using an aid or appliance that has not been prescribed or that they have not been advised to use.’

Here are some of the factors in the DWP guidance, which include:

  • whether the claimant would be advised to use an aid or appliance if they raised it with the appropriate authority such as a GP or occupational therapist 
  • it is medically reasonable for them to use an aid or appliance

At this point, we are entering the world of La La Land:

The Fit for Work decision, which will have huge implications for a claimant, is purely resting on a series of assumptions:

  • The HP’s assumption based on ‘common sense’ that an aid/appliance would improve mobility, without appropriate medical training, skills, experience and without considering :
  •      Its suitability for the claimants condition,
  •      The medical reasons why it might not be appropriate for that person,
  •      The practicality of use in real life and in a real workplace
  • The DM’s assumption that the claimant could be advised to use an aid or appliance if he asked the question, and that it is medically reasonable for them to use an aid and an appliance, without any medical knowledge to back the decision.

In both cases, the new guidelines require HP’s and DM’s to use what is called ‘common sense assumptions’, which are very far away from the informed decisions expected in these kind of cases

In the reality that most of the human race inhabit, a decision whether to use a sophisticated aid such as a prosthetic limb to give a patient mobility would only be undertaken by trained medical professionals in consultation with the patient over the course of several sessions.

However on the planet inhabited by the masterminds at the DWP, it is possible for an untrained, inexperienced ATOS “Health Practitioner” to make this decision using only “common sense” within a matter of minutes (since ATOS allows a very short time for each HP to make a recommendation) and without any consultation with the benefit claimant as to the suitability of such a device.

Notes to Editors:

What the DWP has done, is to use an appeal judgement [1] that it said it has won (when actually the appeal was upheld for the claimant, and the tribunal recommended an oral hearing).

Here is an extract from the DWP Guidance document [2] which explains the judgement:

Here is the background to this change, which was based on the outcome of a single ESA claim, which passed through the Appeals process. It contains the essence of what Decision Makers – and therefore HCPs – will be required to consider as a result of the change.

The facts of the Upper Tribunal decision were as follows. The case was assessed under the ESA 2008 regulations.

The claimant suffered from problems with his knee. He had not been advised to use a walking stick, and did not do so. Following application of the WCA, the DM determined that the claimant did not score any points, and ESA was terminated.

On appeal, the First Tier Tribunal awarded 9 points for descriptor 3(b) (bending or kneeling). They considered that the claimant’s difficulties with walking, standing and sitting could be helped by the use of a walking stick. As the score was still less than 15 points, the DM’s decision was upheld.

On a further appeal, the Upper Tribunal Judge held that

A – Where a claimant normally uses an aid or appliance, they         must be assessed as if they were using it

B – If an aid or appliance has been prescribed or recommended by a person with appropriate expertise, the claimant must be assessed as using it, unless it would be unreasonable for them to use it

C – if a claimant does not use an aid or appliance, and it has not been prescribed or recommended, the claimant must be assessed as if using it if

a. it is normally used by people in the same circumstances acting reasonably and

b. It would be reasonable for the claimant to use it.

The Judge also held that where paragraph C applies, the DM must explain how an aid or appliance would help the claimant.

The Judge’s application of the test of ‘normal use of an aid or appliance’ applies to the assessment of all of the physical activities in the WCA. It is not restricted to those activities that make specific reference to aids or appliances.

Four of the physical activities within the WCA refer specifically to the use of aids. Activity 8 (navigation) and Activity 9 (continence), refer to aids that are normally used.

Activity 1 (mobilising) and Activity 7 (understanding communication) refer to the reasonableness of the use of an aid.

The DWP has extended the judgement from the use of a simple aid (a stick in the present case), to more sophisticated aids or appliances, such as wheelchairs and prosthetics.

Further reading:

[1]http://www.osscsc.gov.uk/judgmentfiles/j3364/CE%201217%202011-00.doc

[2] http://www.whatdotheyknow.com/request/139330/response/358405/attach/3/Mobility%20Aids%20and%20Appliances%20doc.pdf

[3] Guidance for DWP Decision-makers: http://www.dwp.gov.uk/docs/m-24-12.pdf

 by Annie and Bob.

 

Linda

 Posted by at 21:44

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