On the Frontline of the Battle for Benefits

Chaminda Jayanetti speaks to those affected by the Government's failing system of assessing support for some of the most vulnerable people in our society

Earlier this year, Byline Times reported on how Government assessments delivered by private firms are unfairly denying the Personal Independence Payment (PIP) benefit to disabled people, with a high success rate for people when these decisions are appealed.

Figures published last week show that two-thirds of tribunal appeals by benefit applicants were upheld in 2021/22, with the Department for Work and Pensions' (DWP) assessments amended or overturned. That’s just among appeals that reached a hearing – large numbers of appeals are ‘lapsed’, meaning that the DWP does not contest the appeal, sometimes withdrawing its opposition to it at the last moment.

Tribunal appeals come after the compulsory ‘Mandatory Reconsideration’ (MR) phase, where the DWP looks again at the initial assessment.

In 2021/22, the DWP only decided in favour of the benefit applicant in three out of every 10 MRs. Successful tribunal appeals effectively overturn the DWP’s MR decisions.

To dig deeper into how the Government is failing vulnerable people in need of support, Byline Times spoke to those on the frontline of trying to get PIP benefits about how the battle for benefits has affected their lives.

Victor's Story

Victor Calver was diagnosed in May 2019 with stage four prostate cancer – terminal and metastasized. He continued working, but was hit with a perfect storm early in the Coronavirus pandemic, when he was made redundant from his job and served with an eviction notice by his landlord.

In November 2020, he applied for PIP. “I phoned them up myself," he told Byline Times. "They sent through the form – about 300 million pages.”

Calver has a tumour in his femur and another in his hip, plus two small fractures in his back caused by his cancer treatment making his bones fragile.

“I live with chronic pain,” he said. “Whilst I'm talking to you, my back’s in absolute agony, my legs are in absolute agony. I don’t know if it sounds weird, but I've kind of got used to it. I just kind of accept pain really. And it’s part of my life.

“If you looked at me, if you met me, when I tell people I’ve got stage four cancer, they don't believe it – because generally I’m very, very positive. And that’s how I deal with it. That’s why I don’t get a lot of support, because everyone thinks ‘he’s alright’. 

“Mentally have I coped? Probably not. I don't think many people would be able to cope with the pain I’m in. Sometimes it literally brings tears to your eyes.”

Calver’s PIP application included a letter from his doctor confirming the extent of his illness. But nothing happened for months, until he received a phone call from the benefits assessors.

He told Byline Times: “They’d ask me questions like ‘can you feed yourself?’ Of course I can feed myself. They say ‘what do you eat?’ And I’d say ‘eggs and spinach’ because I used to buy them egg pots from the BP garages. That’s what I’d eat. They said ‘can you walk?’ I said 'yeah, oh yeah'.

"‘Can you go to the supermarket?’ ‘Yeah, of course I can go to the supermarket'. ‘What do you do? Can you walk 50 yards?’ And 'yeah, of course I can walk 50 yards – but I might have to stop 30 times in between'. 

“I said to them ‘yeah, yeah I can go to the shop’. And they suck you in, so you’re ‘yeah I’ll be fine’, you know, ‘I’ll fight this disease’. The moment I put down the phone I’m in tears.”

Despite the doctor's letters and his terminal cancer diagnosis, Calver scored hardly any points in his application for PIP and its Motability element. His application was rejected.

“According to them I was an Olympic athlete,” he said.

By now it was 2021. Calver had to go through the MR phase, whereby the DWP reviews the decision. It didn’t work – there was no change to his assessment score.

“They didn’t even look at it," he told this newspaper. "I don’t think I got a call back or nothing – just a manager, one of these DWP managers, wrote back, says ‘we agree with the assessor’.”

Despite the doctor's letters and his terminal cancer diagnosis... his application was rejected

Calver went to Citizens Advice. The organisation handled his tribunal appeal and secured further supporting letters from his clinicians. The hearing was scheduled for November 2021. Amid the pandemic, he had to take part over the phone. 

But just 10 minutes before the hearing – and a full year after his original PIP application – he got a call from the court telling him that the Government had conceded on all counts. He was given full PIP and full Motability support, backdated to the time of his original claim and awarded indefinitely.

“It’s absurd," Calver said. "Their solicitor or their barrister probably would have looked at the evidence and said ‘you’re going to lose this hands down’. And they conceded, obviously on legal advice – because they took it all the way to the courtroom only for counsel to tell them ‘you’re going to lose this’. Or even the judge might have told them ‘you’re going to lose this’. To concede 10 minutes before the hearing, it seems like the judge or their counsel has told them ‘what have you done?’

“They knew my personal circumstances – we had to give them details about money, earnings, what we’ve got. They knew I had just been made redundant. They knew I was living alone, I was shielding.”

The backdated PIP helped clear some of Calver’s bills and debts that had built during the pandemic and eventually managed to get him rehoused – although not until a lack of suitable accommodation had left him living in a freezing caravan and sleeping in his car over winter.

“How I got this flat now is they considered my PIP money," he said. "They said now I can afford somewhere. Because before, I wouldn’t have been able to afford it anywhere.”

Alison and John's Story

Alison (not her real name) has supported PIP applicants since the benefit was introduced in 2013, having previously worked for a Government department. She told Byline Times that the introduction of the compulsory MR phase simply delayed the process to get to appeal and placed more stress on the people trying to claim benefits.

Even worse, she has come across cases where the person assessing the MR was the same person who carried out the benefit assessment being appealed against.

“I have problems with the Mandatory Reconsideration process, because they're marking their own homework,” she said. “And they say that the person who's made the original decision, the decision-maker, doesn't do the MR. But I know, because I've seen signatures on letters, that the person who made the decision has also done the MR.

She said that the process was "corrupt" because "it doesn’t abide by the rule of law".

"Its decision-making is highly questionable," she added. Also, the decision-makers are people with no medical qualifications.”

One of the people Alison helped was John (not his real name). Having been on the old Disability Living Allowance (DLA) benefit, he was assessed for PIP in 2017, under the DWP’s programme of moving people from the old benefit to the new one.

Aged around 60, he had lost his leg in a motorbike accident at 18 and had been a full-leg amputee for 40 years. He drove an adapted Motability vehicle that let him use all the pedals with one foot.

“He’s a part-time actor,” said Alison, “and his job is being a casualty. He works with emergency services and the Ministry of Defence, and he takes his prosthetic limb off, and they transport him to where he’s got to lie, cover him in fake blood, he has to scream, and the emergency services are assessed.”

She said a private firm employed by the DWP to conduct benefits assessments carried out his PIP assessment and asked him about his job.

“His job requires him to remove his prosthetic leg,” Alison told Byline Times. “And we'd had a hot summer and he’d had to stop wearing this prosthetic leg because he’d got ulcers on his stump, which meant the only way to get about was on a pair of crutches and one leg. And he lost his higher rate PIP mobility component because he was able to do this job – that's how they rationalised it.

“He couldn't get to his job without his mobility car, which is adapted for an amputee, and his job requires him to remove a prosthetic limb, without which he can't really stand up – he’s not particularly stable. But they used this job as a rationalisation for taking his high rate mobility component off him.”

As a result, John lost funding for his adapted car, which his DLA payments had funded. Instead he had to borrow the money to buy it.

John then failed at the MR stage – with the MR apparently done by the same person who did the original assessment.

“I'm pretty sure it was the same person who assessed it, and I've seen others where that's been done as well,” Alison said. “I clocked it on the signature – ‘this is the same person’. They’re actually looking at their own decisions.”

John also lost his appeal at tribunal. At that point, Alison helped him go to a second tier tribunal – a route that can be requested if there has been an error in law. 

For a disability benefit award to be lowered or removed, the DWP has to prove ‘betterment’ – essentially, that the person has to some degree got ‘better’.

“How do you improve from having a full leg amputation?” Alison asked. “You can’t.”

Alison found a very similar case to John’s that had previously gone to appeal – as luck would have it, the same person who presided over the tribunal in that other case presided over the second tier tribunal in John’s case too. 

“She looked at it and said, ‘this needs to go back to the original tribunal hearing and the tribunal has erred in law, and they need to make a fresh decision’," she said. "And that case got him his car back.”

John’s payments were reinstated and backdated. It was 2019 and the case had gone on for two years. He sold the car he had bought, paid off the loan, and got his new Motability vehicle with the restored benefits. 

“If he'd lost, if he couldn't afford to use that car, if he couldn't afford to keep it and have a loan, he wouldn’t have been able to do his job,” Alison said. “It’s pretty outrageous.”

Natalie's Story

Natalie (not her real name) is 32 and has been diagnosed with agoraphobia, depression and anxiety. She has rarely left the house since she was 18 and never leaves without someone with her. 

“Most of the time I go out the house three to four times a year for blood tests and that’s it,” she told Byline Times.

But when she applied for PIP, she scored zero in both assessments – for the ‘daily living’ and mobility components.

“The second assessor used me going to my doctor occasionally for blood tests, and the time I was taken to the dentist because I kept getting abscesses, against me as evidence of somehow being able to get out and do everything unaided and having no mobility issues," she said. "So even getting medical treatment is being used against us.”

Both the initial report from her mobility assessor and the response to her unsuccessful MR request explicitly referred to her seeing her GP every three months.

The DWP’s response opposing her subsequent tribunal appeal spelled it out more clearly, using her visits to the GP – which always require a lift from her family or partner – as evidence that she can independently interact with people despite her mental health conditions, and that she can manage her medication independently.

At no stage prior to the tribunal appeal have the private company conducting the assessments or the DWP contacted her GP regarding her PIP application, despite her asking the tribunal to do so.

The report from her mobility assessor also referred to her manner when speaking: "At your telephone assessment, you were pleasant and polite and engaged well. You were not breathless when speaking and spoke in full sentences. Despite mentioning that you felt anxious, you responded to reassurance from the assessor. There were no signs of overwhelming anxiety or distress." 

Natalie told Byline Times that the assessments ignored or distorted what she said.

“I mentioned my new meds [Mirtazapine, which treats depression and anxiety], they asked me to read the name," she said. "Then they reported I hadn’t started any new meds. I explained my vision is slightly worse than it would be if I hadn’t been stuck in almost half my life (I am very short-sighted). Apparently I have no issues with vision according to them. All they have done is lie.

“I told them I was overweight and how my partner cares for me. So they mention I’m not underweight. And somehow come to the conclusion everything my partner does for me I can do on my own too.

“I can’t comprehend it. I heard it was bad but I didn’t realise it was this bad.”

Natalie knows what she would do with the PIP money if she wins her appeal: “At first I’d like to be able to get taxis to get out to somewhere with people. Get used to the drivers, that’d allow to eventually start going on my own. After that, I’d like to work on using public transport, with someone at first then build up to doing it alone. Things like that. I want to use it to help me get better and get passed this point in my life.”

The Government's Response

A spokesperson for the Department for Work and Pensions told Byline Times that "the majority of applications for Mandatory Reconsideration go directly to another decision-maker based in the department’s Disputes Resolution Service and where that doesn’t happen, we have robust internal quality checks so ensure all the correct processes were followed”.

“For the majority of PIP claims, we get decisions right and all assessments are carried out by healthcare professionals trained to consider the impact of someone’s health condition or disability, but we are exploring what more we can do so the welfare system better meets the needs of disabled people through our Health and Disability Green Paper,” they added.

OUR JOURNALISM RELIES ON YOU

Byline Times is funded by its subscribers. Receive our monthly print edition and help to support fearless, independent journalism.