As with the clients who helped with our case studies, after submitting their application form (ESA50) for Employment and Support Allowance (ESA), most people will be asked to attend a medical assessment. This is called a ‘Work Capability Assessment’. The assessments are carried out by the Health Assessment Advisory Service.
The original contract to carry out the assessments was held by the now infamous ATOS. In the face of a huge number of appeals, mounting litigation and a tidal wave of bad publicity, ATOS terminated their five year contract early, opting to pay large financial penalties to do so. Into their shoes stepped Maximus, not a Roman gladiator, but an American company with their own fair share of negative baggage in tow. That was a couple of years ago.
What is the current situation?
Maximus inherited a huge backlog. On one estimate, at the time they took over the contract, 600,000 people were awaiting assessments. Maximus have recruited, but they have also changed the makeup of the assessors.
An assessment is carried out by what are described as a “health professional”. Of a total of about 1,000 “health professionals” employed by ATOS, approximately 40% were doctors, 40% were nurses and 20% were physiotherapists. Whilst increasing overall the number of assessors, Maximus has reduced the proportion of doctors, employing instead occupational therapists who are cheaper.
Where will your assessment take place?
Assessments take place at a number of centres nationally. You can request that your assessment take place at home, but you will have to provide medical evidence confirming that you cannot travel.
What can I expect when I get there?
Speaking to a number of our clients who have attended assessments, some common themes emerge.
Do not expect a fancy clinic, these are functional, government offices. One client reported that the disabled toilet was out of order and was told that it had been for some time.
If travelling by car, check the parking arrangements. Many centres do not have car parks and a couple of people reported centres located in Red Zones, where even disabled parking is not allowed.
Common adjectives we have heard to describe the assessors themselves are “weary”, “impatient”, and “apologetic”. Maximus has started to provide further training to staff, particularly it says in mental health and “fluctuating conditions”, but it is unclear just what, if any, training they receive specifically in chronic pain. We suspect very little. Indeed, one client suffering CRPS was told by her assessor, a nurse, that they would need to return for another assessment with a doctor, as she knew nothing about the condition!
Anecdotally, we understand that Fibromyalgia (FM) sufferers can expect the toughest time. In fact, we have not spoken to a FM sufferer who has been awarded ESA on their first application.
Remember that how you have managed to get to your assessment and how you plan to get home actually forms part of the assessment process. You will routinely be observed arriving and leaving and assessors will make their own assumptions, irrespective of what you tell them, which may be recorded on their report.