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Insights into WCA appeals rates

1 July 2011

An exchange of questions and written answers about work capability assessments (WCAs) took place between Simon Hart MP and Minister of State for Employment, Chris Grayling this week.

The table on appeal rates is particularly interesting.

Extracts below are reproduced from Hansard for 27 June and 28 June. © Parliamentary copyright.

On WCAs and GPs

Simon Hart: “To ask the Secretary of State for Work and Pensions how many work capability assessments were made contrary to the recommendation of a general practitioner on behalf of a claimant in the latest period for which figures are available.”

Chris Grayling: “Prior to a work capability assessment general practitioner's provide ‘Fit Notes’ as evidence of incapacity in relation to the work that an individual has currently been doing (for those in work). This evidence does not provide a view on benefit entitlement.

“A decision on employment and support allowance benefit entitlement is made by a DWP decision-maker, based on advice from specifically trained health care professionals from Atos Healthcare, who are able to provide independent and robust advice regarding an individual's functional capability.

“The information requested is not therefore available.”

On WCA decisions overturned

Simon Hart: “To ask the Secretary of State for Work and Pensions how many people who failed a work capability assessment in the last 12 months subsequently had the decision overturned on appeal.”

Chris Grayling: “Between March 2009 and February 2010, 258,900 claims for employment and support allowance (ESA) were found fit for work at the initial work capability assessment (WCA). Of these, 34,700 had their entitlement to ESA reinstated after an appeal was heard by the Tribunals Service.

“The figure above comes from benefit claims data held by the Department for Work and Pensions, functional assessment data from Atos Healthcare and appeals data from the Tribunals Service. Figures are only available for appeals that have been completed and not for those that are currently under way.

“The figure above has been rounded to the nearest 100. Appeals data is only available for claims starting up to February 2010.

“Due to the time it takes for appeals to be submitted to the Tribunals Service and heard, it is likely that there are more appeals that have not yet been heard.

“The Department regularly publishes official statistics on ESA and the WCA. The latest report was published in April 2011 and can be found on the internet at the following link:
http://research.dwp.gov.uk/asd/workingage/esa_wca/index.php?page=esa_wca_arc

On WCAs assessed at 0-6 points and appeals

Simon Hart: “To ask the Secretary of State for Work and Pensions (1) how many work capability assessments received zero points on initial assessment and were passed on appeal in the latest period for which figures are available; (2) how many people received between zero and six points in a work capability assessment and were passed on appeal in the latest period for which figures are available.”

Chris Grayling: “Decisions on entitlement to employment and support allowance (ESA) rest solely with the Department's decision-makers who take into account the medical assessment reports from Atos and any other relevant information.

“At the work capability assessment (WCA), a claimant's physical function and mental, cognitive and intellectual function is assessed. Within these categories there are a series of descriptors, scoring between 0 and 15 points. Claimants scoring 15 points in any category or combination of categories will be assessed as having a limited capability for work and placed in the Work Related Activity Group (WRAG).

“If a claimant appeals against a fit for work decision at initial assessment and the appeal subsequently finds in favour of the appellant, this does not necessarily mean that the original decision was incorrect. In many cases new or additional evidence is provided to the tribunal which was not available to the decision-maker, or the tribunal weighs the evidence differently.

“The following table presents the points scored and appeal outcomes for ESA claims received between October 2008 and February 2010, who were found fit for work at the initial WCA and subsequently appealed the decision. Figures are only available for appeals that have been completed and not those that are currently under way.

Points scored at initial WCA,for claims found fit for work where an appeal has been heard by the Tribunals Service.

Points scored at initial WCA

Claims found fit for work at initial WCA

Appeals finding in favour of claimant

Appeals upholding DWP decision

All appeals heard

0 points 246,700 29,000 56,100 85,000
Between 0 and 6 points 57,000 11,100 12,500 23,600
Over 6 points 25,500 7,600 4,300 11,900
Unknown 6,800 400 1,600 2,000
Total 335,900 48,000 74,400 122,500

“The data presented above come from benefit claims data held by the Department for Work and Pensions, functional assessment data from Atos Healthcare and appeals data from the Tribunals Service. The ‘unknown’ category refers to claims where no assessment data are recorded—this may be because the WCA was performed clerically. All figures have been rounded to the nearest 100. Appeals data are only available for claims starting up to February 2010.

“The above data are consistent with that published in the recent official statistics report: ‘Employment and Support Allowance: Work Capability Assessment By Health Condition and Functional Impairment.’ This report is available on the departmental website at the following link: http://research.dwp.gov.uk/asd/workingage/esa_wca/index.php?page=esa_wca_arc

Action for M.E. was alerted to these Parliamentary questions as a subscriber to independent publisher, Benefits and Work.

 

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