#Also I fuckin HATE the BPS model no joke

[obaewankenope]

Link to the thread on bluesky buuuuut...

I went Off™ about the Disability Benefits aka PIP because I'm just- yeaaaah.

So, enjoy the 2k word rage that happened.

With the recent ‘consultation’ of the changes to Disability Benefits (PIP) presented by the UK Government, I have many, MANY concerns and a burning desire to bring some receipts and challenges to the entire disability assessment process. Hence this thread with the burning hot tea.

Condolences anyone who reads this, it’s gonna be LONG. References will be at the end too.

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The current disability benefits is Personal Independence Payment (PIP) introduced in April 2013 to replace Disability Living Allowance (DLA) that had had been the established disability benefit since the mid-90s. PIP came into being after the then Conservative government had already overhauled the Incapacity Benefit (IB) and created the Employment Support Allowance (ESA) in October 2008. The ESA benefit assessment used the biopsychosocial (BPS) model of disability for its assessment criteria. The problem with this is that the BPS model is... flawed. Especially with the way it was applied to assess claimants of ESA. As Mo Stewart (2017) states, the BPS model is a “non-medical assessment” utilised by ESA and PIP assessments which “totally disregards medical opinion”. Stewart also points out how ALL the research commissioned by the DWP to justify using the BPS assessment model has “failed ALL academic scrutiny”. That’s right. ALL.

[rest under cut]

A peer-reviewed, independent study in 2016 literally stated that the BPS model has “no coherent theory or evidence behind [it]” and that the DWPs research was “POLICY based research not evidence based research” – aka the DWP research was literally designed to support the policy not assess it.

Back in 2014, a Parliamentary Committee literally admitted that the ESA assessment needed “fundamental redesign” and that it was committed to help “stop the ongoing identified preventable harm” of the assessments.

Fun fact. The BPS model used by the DWP for WCA and other disability assessment was “influenced by the PRIVATE INSURANCE INDUSTRY” especially UnumProvident in 2004 which FUNDED the DWP research to “justify the replacement of IB with the ESA”!!! (Stewart 2017) This had been happening since 1995 ffs when “corporate America were first involved with advising the UK government on welfare claims management” (Aylward & Locascio, 1995). This literally caused a 2001 conference that literally REINFORCED ITS OWN BIAS to publish papers that went on to influence future UK social policy leading to the “politics of fear” that sick and disabled people experience everyday now as a result. The bs concept of ‘malingering’ aka people MAKE THINGS UP TO AVOID WORKING BY PRETENDING TO BE SICK was championed during that conference and has affected ALL susequent social policy from that point on because it’s clearly easier to believe people are LYING about being sick than actually being sick.

ANOTHER fun fact: UnumProvident Insurance was identified by the American Association of Justice as the 2nd worst insurance company in America in 2008.

When the BPS model was recommended in 2005, the DWP commissioned research suggested one million plus people could be taken off IB. That number, incidentally, correlated to the number of claimants with mental health illnesses. So the DWP literally didn’t care about people’s mental health – how little has changed, hmm.

Atos is the company that performs the ‘assessments’ of disability claimants and its their decision that is listened to over that of the Jobcentre Decision Maker (in theory the one SUPPOSED to have the final say) because Jobcentre workers aren’t specially trained in understanding disability or medical problems, they “don’t comprehend the medical evidence” and it’s why so many ESA and PIP claimants get the refusal overturned when “all the medical evidence is (finally) considered at Appeal”. It is literally all up to the person doing the in-person assessment who, incidentally, has an INCENTIVE to process as many as possible claims with a leaked 2018 letter indicated they would receive a bonus the more cases they worked through. The problem there is its easier to process more cases by DENYING them than working through the evidence and assessment questions which is time-consuming.

On top of THAT, there’s been House of Commons documents published that showed the DWP set targets for how many mandatory reconsiderations MUST be rejected. Which is ESPECIALLY worrying when the DWP ‘target’ wasn’t even at risk of being failed with only 4% of PIP mandatory reconsideration appeals upheld between April 2013 and March 2017. Hell, the DWP staff were even noted to fell ‘under pressure’ to “rubber stamp” the original decision of cases ffs!

Stewart: “the BPS model of assessment disregards diagnosis, prognosis and the claimant’s past medical history and was always destined to create significant preventable harm. Between January 2011 and February 2014 over 91,000 deaths are linked to the ESA functional assessment, known as the Work Capability Assessment (WCA)”

91,000 deaths in THREE YEARS.

There’s been a DIRECT link identified by research in 2015 (independent and peer-reviewed) “between the ESA assessment and a SIGNIFICANT increase in suicides, self-reported mental health problems and the prescribing of anti-depressants” (Stewart 2017)

Most damning of all, the DWP has REFUSED to publish updated ESA mortality totals since 2016.

Moving on otherwise I’ll be here all day.

I have personal experience with filling out the PIP and DLA assessment paperwork and attending the in-person assessments by ‘trained professionals’. I have completed the paperwork and attended with others who claimed and have been refused and had to go to appeal. I’ve had to fight for them at appeal. I’ve succeeded but it is a long, exhausting, dehumanising process.

Questions from the PIP assessment include questions about food preparation, managing treatments, washing and bathing, toilet needs, dressing, communication (verbally), reading, understanding, following instructions/directions, engaging with others face-to-face, and budgeting. You’re asked how long you can focus on things, how far you can walk, what you can carry, how long, where you go, if you go alone, how you manage your money, if you can take your medication without someone handing each tablet to you, and so on.

On the surface, the questions are innocent and just looking for better information to ‘help’ you better gain the support you need.

On the surface.

But the questions are used during the in-person assessment and what you say and how you act is directly compared to the answers you put on your paperwork and both are used to determine the ‘score’ you receive for each aspect of your mobility needs.

The MAJOR flaw with the assessment is that the paperwork asks you to answer based on your WORST DAY and the in-person assessment is used to MINIMISE the answers you gave on the paperwork.

Because the basis of the BPS assessment model used by the DWP assumes EVERYONE malingers (pretends/exaggerates) and this means the answers you gave on the paperwork are viewed through that lens and your conduct during the in-person assessment is considered to be the ‘real truth’ of your disability.

It doesn’t account for if the day of the in-person assessment is a GOOD day for you.

You’re examined and interrogated and coerced into performing for the assessor during the in-person assessment regardless of whether you CAN do something because you’re NOT told that you CAN REFUSE at all.

They don’t tell you to only lift your arms to where it doesn’t hurt, or where you safely can without harm. They say “lift your arms as high as you can” and that’s it.

Because they WANT to catch you in a lie. They WANT to look at your answer you gave on the paperwork and see you raise your arms high despite pain and discomfort because they didn’t give you ANY additional parameters beyond “as high as you can” because they can then give you a LOWER score and justify it in the final decision as “claimant stated they struggle to lift their arms above their head x days but were able to complete this task with no issue during assessment, indicating their mobility is not noticeably impaired to qualify for the mobility portion of PIP”

Additionally, the psychological and sociological effects of disability on a person aren’t seriously considered. Especially when someone says they struggle to travel or be in public or talk to others yet are FORCED to do these things to attend an in-person assessment that dismisses the person’s difficulties by justifying the dismissal since “claimant attended in-person assessment and was calm, polite, and responded normally to questions”

The dichotomy between the paperwork assessment and in-person assessment aspects of the PIP assessment CAUSES people unnecessary pain and suffering because the in-person part is DESIGNED to reject the paperwork and medical evidence the claimant provides.

The disability benefit assessment is structured with REJECTION as the primary purpose of it, not SUPPORT. It doesn’t ENABLE disabled people to live better or have support without forcing disabled people to constantly JUSTIFY their need to have support and to even be allowed to live in the first place.

THAT is the flaw of the disability assessment and its use of the BPS assessment model that literally was designed with malingering and denial of support from the get-go.

So this government consultation and ‘improvements’ to disability benefits is even more terrifying because the narrative surrounding disability in society today is incredibly hostile.

Disabled people are presented as a drain on finances.

Disabled people are presented as scammers and lazy and malingering illness to avoid responsibility.

Disabled people are presented as UNDESERVING of support.

The narrative focuses on how many people have claimed disability PIP benefit in the last few years. It DOESN’T look at WHO those people really are.

The people who are claiming PIP lately are the same people who were frontline workers and NHS staff during the global pandemic. They’re the ones who DIDN’T die from COVID. They’re the ones who sacrificed and sacrificed because that was their JOB and now they’re being targeted and presented by a narrative as malingering scammers and liars.

Even those who are disabled and weren’t frontline workers or NHS staff are overwhelmingly people who NEED the paltry financial assistance that PIP provides them. These are people who don’t even get more than £900 a month from PIP. People who may be completely unable to work full-time or even part-time because they may not be able to travel or work in office environments or perform manual labour jobs, so they rely on a small amount of money every month to SURVIVE.

I can assure you, even if someone is claiming UC and has the non-working element, as well as enhanced rate PIP, they NEVER have more than £1600 a month in benefit. They receive less than £20,000 a YEAR if they claim UC and PIP. Most retail positions and even a newly qualified NHS nurse receive more than that annually.

The problem isn’t disabled people needing support and it isn’t even social welfare support being so expensive. The problem is that it is much easier to use a minority with little power and a near-silent voice as a scapegoat to avoid tough reforms to taxes and spending and enforcing corporations paying their taxes instead of avoiding them with loopholes.

It’s so much easier to use disabled people like this when it’s a foregone conclusion that disabled people are going to die much quicker than other minorities AND that will save you expenses at the same time.

References:

Mortality Statistics DWP

The Guardian, DWP mortality figures

Mo Stewart, 2017

2015 suicide figures

May 2016, BPS Model: Blaming the victim all over again. 

Parliamentary Committee 2014

Influence of Private Insurance Industry

Atos and leaked letter