Thursday, 18 September 2014

Is ESA Really Harder to Claim than IB?

Last week, the excellent John Pring published an article that seemed to show that the new Employment and Support Allowance (ESA or "sickness benefit") was twice as easy to claim as the benefit it replaced (Incapacity Benefit or IB)

Under IB, just 32% of claims resulted in an award of benefit, yet latest figures show that 73% of clams result in an award of ESA.

Firstly, clearly ESA is not easier to claim than IB. firstly, the criteria are much stricter than the old IB criteria. Also, if it were easier to claim, the overall number of claims would have risen steadily since its introduction. When the benefit was introduced, around 2.5 million people claimed IB. Today, around 2.5 million receive support. So for all the pain and misery of the new Work Capability Assessments (WCAs) nothing at all has changed.

So what is happening? I've read several theories, but I don't think they've explained such an apparently dramatic rise.

We do know that Atos, the French IT company responsible for carrying out the assessments on behalf of the DWP have been struggling with increasing backlogs since the start. They have been forced to increase the number of assessments they do every month. At first, it was just 25,000 per month, at it's highest, Atos were doing around 130,000 per month. As the rate they were expected to assess people increased, backlogs increased with them until today, a whopping 700,000 are stuck in the "assessment phase". Once Atos walked away from the WCA contract (possibly last September, but only confirmed publicly this May) the assessment rate has dropped dramatically increasing backlogs still further.

The only way you can be found fit for work is through a face to face assessment. Only a fully trained doctor can decide a claimant qualifies on paper alone. This means that the evidence on a claimants form and the corresponding evidence from their own Drs makes the decision so clear cut that a decision can be made without the need for a face to face assessment. (WCA) Perhaps someone with cerebral palsy who cannot mobilise, feed or speak independently or someone with terminal cancer  Of around a thousand Atos HCPs (Health Care Professionals) very few are actually fully trained doctors. Most are nurses, physiotherapists or other healthcare professionals.

Thanks to HCPs who have been prepared to whistle-blow to me in private, I've known for over a year that Atos were attempting to clear backlogs by getting the trained Drs to do as many paper-assessments as they could. They were asked to work weekends and overtime and all Drs were pretty much flat out doing as many as they possibly could. A doctor can then decide that the claimant qualifies for either the long term Support Group or that they will be able to work again at some point in the future, hence qualifying for the Work Related Activity Group (WRAG) Remember, however obvious it may seem on paper that a claimant will not qualify, they cannot be found "fit for work" without a face to face assessment (WCA)

So for a long time, most decisions made have been those clear cut enough to qualify for ESA on paper evidence alone. Most of the "fit for work" decisions are stuck almost indefinitely in limbo.

If my theory is right and we ever get another provider willing to take on the poisoned chalice of ESA, (Which is looking increasingly unlikely by the day as time drags on) we will see a dramatic fall in the overall % of successful claims. However long that lasts, that won't be a clear indication of how many people get ESA compared to IB either. For a long time, there will be a disproportionate number of "Fit for Work" decisions as all the clear cut qualifying awards have already been weeded out. I wouldn't be at all surprised to see the current 73% success rate plummet to as low as 15-30%

So the real questions are when will the DWP find a new contractor and what are they doing about clearing the backlogs? Around 30,000 people will be compensated for unacceptable delays of up to a few months to their passport applications, when will the DWP compensate the 700,000 people facing unacceptable delays of up to a year to their very subsistence?


  1. This is what they are doing re new claims...

    The government’s new Health and Work Service in England and Wales will be delivered by Health Management Limited, a MAXIMUS company, it was announced today (25 July 2014).


    Almost 1 million (960,000) employees were on sick leave for a month or more each year on average between September 2010 and October 2013. As part of the government’s long-term economic plan the new service will help employees and employers to manage sickness absence.

    Employees on sick leave will be helped to return to work by providing them with an occupational health assessment when they reach, or are expected to reach, more than 4 weeks’ sickness absence. Employees will normally be referred by their GPs. A resulting return to work plan will be shared with their employer and GP.

    More general health and work advice will be available to GPs, employers and employees via telephone and a website.

    The service will be launched in late 2014 with a phased roll-out coming to a close by the end of May 2015. Discussions will take place with the supplier to confirm the exact approach to, and timings of, the roll-out.

    Minister for Welfare Reform Lord Freud said:

    “The introduction of the Health and Work Service is an important step in supporting employees, GPs and employers to manage sickness absence better.

    “Providing support where it’s needed most will help to reduce the length of time employees take off sick which, in turn, will cut sick pay costs, improve economic output and reduce the chances of people falling out of work and having to claim benefits. All contributing to the government’s long-term economic plan.”

    Dr Alasdair Emslie, Chief Medical Officer for Health Management Ltd, said:

    “We are looking forward to delivering this high quality new service which will provide essential support for those on sickness absence. This is an innovative approach by government and we welcome the opportunity to contribute our expertise to this area.”

    The company, the UK’s largest independent occupational health provider, was awarded the contract following a 5-month tendering exercise.

    In Scotland, the Health and Work Service will be delivered by the Scottish government on behalf of the UK government.

    Nearly a million employees a year reach the 4-week sickness absence point.

    The state spends around £12 billion a year on health-related benefits and £2 billion a year in healthcare and foregone taxes.

    Employers face an annual bill of around £9 billion for sick pay and associated costs.

    Individuals miss out on £4 billion a year through lost earnings.

    Around 300,000 people fall out of work and into the welfare system because of health-related issues.

  2. ESA was introduced in 2008. So this is a New Labour project. The question should be looked at in two parts. How was ESA intended to work and how far has it reached these objectives. This article has summarised the failure in practice. The descriptors were initially criticised as some were seen as stricter. Over the years many of these errors have been removed. The new tests were designed to be more objective. This moves the focus from the fundamental question to point collection. The current state of the benefit leaves many people in a state of limbo where they do not get increased benefits but are protected from the demands of the Job centre. Of course when the policy was introduced the Job centre was able to reduce its demands to the capability of the claimant.

  3. the only thing that is important is in getting to implement it correctly to prevent loss of life that should be the top priority everything else comes secondary

  4. They're happy to give away 11 billion a year in foreign aid yet attack the disabled over a lesser amount?

    1. It's always good to remind ourselves that, whatever else is going on, we don't have to walk miles every day to fetch water which may not even be clean.

  5. The IB figures obtained by DNS cannot be taken at face value and they do not show that IB was far easier to claim than ESA.

    The 73% represents the proportion of new claimants who have passed the WCA; however, it is not possible to work out the equivalent percentage for IB on the basis of the FOI response as it doesn’t give the number of PCAs carried out. “Claims received” is not the same as “PCAs carried out”, and “claims awarded” is not the same as “PCAs passed”. The FOI response doesn’t make it clear what the figures refer to; my guess is that the 32% represents the proportion of new claimants who satisfied the IB contribution conditions.

    The PCA pass rate for new claimants was in fact over 60% , as can be seen from this DWP document (page 15, paras 28-30).

    The document also shows that the WCA was ‘designed’ to fail around 50% of new claimants.

    I agree with you about the current surprisingly high success rate for ESA. I’ve suspected for quite a while now that the main reason why fewer claimants are being found FFW is that in order to reduce the backlog and the number of appeals, many more decisions are being made on paper evidence alone.

    1. "I agree with you about the current surprisingly high success rate for ESA. I’ve suspected for quite a while now that the main reason why fewer claimants are being found FFW is that in order to reduce the backlog and the number of appeals, many more decisions are being made on paper evidence alone."

      I think we can take comfort that, even if the provider changes, without meaningful reform they'll be set up to fail and the wave-throughs will continue. This is the value of an incompetent government.

  6. I remember an article from the FT (which I still have) from 2009, where it says that the acceptance rate for IB was about 65%, and the early figures for ESA cut this in half. I'm pretty sure that the figures in the linked to article are unlikely to be at all comparable with each other.