Wednesday, August 22, 2012

Update on Proposed New WCA Descriptors (EBR)

We've been passed the latest version of the Evidence Based Review WCA descriptors for people to comment on and scrutinise. This version has to be finalised by the end of the week so there isn't much time. If you leave comments below I can direct the right people to read them but due to health issues I won't be able to do more than that. There's also a slightly different scoring system proposed, but for consultation purposes all you really need to know is that the N/A, Occasional, Frequent, Most boxes roughly correlate to points as follows, 0, 6, 9, 15

Health prevents me from going through this in the detail it requires but my initial impression is that it has lost much of the simplicity of the earlier draft and it appears to me that this is much closer to what a joint test for ESA and PIP would look like... However, testing an alternative version of a WCA can only be a good thing if the DWP are sensible enough to compare both proposals and cherry pick the best parts..

But please bear in mind - intense pain and lots of oramorph do not make for good cognitive functioning!


Movement - within a work environment or travelling to work
1.     Mobilising

Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid normally used, for long periods indoors and outdoors without stopping, and climbing a flight of 12 steps without discomfort, exhaustion or risk of falling. This must be done reliably, repeatedly, safely and in a timely manner, which takes into account speed, time taken and manner of mobilising.      

a
Has no difficulty mobilising indoors and outdoors

N/A
Occ
Freq
Most
b
Cannot climb or descend a flight of 12 steps  




c
Has some difficulty[1] mobilizing, indoors and outdoors, for long periods[2]




d
Has significant difficulty[3] mobilising, indoors and outdoors, for long periods




e
Has some difficulty mobilising, indoors and outdoors, for short periods[4]




f
Has significant difficulty mobilizing, indoors and outdoors, for short periods




2.     Getting About

Getting to familiar and unfamiliar places reliably, repeatedly, safely and in a timely manner, unaided by another person.

a
Has no difficulty getting to familiar and unfamiliar places.

N/A
Occ
Freq
Most
b
Because of distress or disorientation has some difficulty getting to unfamiliar places




c
Because of distress or disorientation has significant difficulty getting to unfamiliar places




d
Because of distress or disorientation has some difficulty getting to familiar places




e
Because of distress or disorientation has significant difficulty getting to familiar places




3.     Navigating

Navigating around familiar and unfamiliar places unaided by another person reliably, repeatedly, safely and in a timely manner, using a guide dog or other aid if normally used.

a
Able to navigate around familiar and unfamiliar places

N/A
Occ
Freq
Most
b
Has some difficulty navigating around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment




c
Has significant difficulty navigating around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment




d
Has some difficulty navigating around familiar surroundings, without being accompanied by another person, due to sensory impairment




e
Has significant difficulty navigating around familiar surroundings, without being accompanied by another person, due to sensory impairment






Movement – at a work station
4.     Standing and sitting

Reliably, repeatedly, safely and in a timely manner, using any aid that it is reasonable to expect them to use, and without receiving physical assistance from another person:

·         Staying in one position (such as a workstation) for at least an hour, either by standing, sitting or a combination of the two, and
·         Moving between this position and another.   

a
Able to stay in one position for at least an hour, either by standing, sitting or a combination of the two, and able to move between this position and another 
Claimant cannot:

N/A
Occ
Freq
Most
b
Stay in one position (either by standing, sitting, or a combination of the two) unassisted by another person in one place for more than one hour without significant discomfort, loss of balance or exhaustion




c
Stay in one position unassisted by another person in one place for more than 30 minutes (either by standing, sitting, or a combination of the two)  without significant discomfort, loss of balance or exhaustion




d
Move from a seated position to a mobilising position without physical assistance from another person




5.     Reaching, picking up and moving

Reaching up, down or sideways a reasonable distance, and picking up and move a range of differently-sized objects up to 1kg

a
Has no difficulty reaching and picking up objects
Due to difficulties with movement, strength, sensation or co-ordination of the upper body (arms, shoulders, back, neck) and/or lower body (hips, knees, ankles), cannot repeatedly, reliably and safely, without significant discomfort or exhaustion, from standing or sitting:

N/A
Occ
Freq
Most
b
Reach up, down or sideways a reasonable distance and reach and pick up and move a range of differently-sized objects up to 1kg (e.g. so as to reach and pick up something off a high or low shelf)




c

Pick up and move a an object up to 1kg with either hand






d
Pick up and move a bulky object (such as a cardboard box) up to 2kg




e
Reach up, down (i.e. through bending, kneeling or squatting) and sideways a reasonable distance




6.     Manual dexterity/ hand movement

a
Has no difficulty with finger, hand or wrist movements/manual dexterity
Has difficulty in one or both hands in repeatedly, reliably, safely and in a timely manner without significant discomfort or pain:

N/A
Occ
Freq
Most
b
Gripping and turning an object such as a:
·         door handle, tap, lid or cap (so as to open a bottle/jar)
·         dial on a radio or piece of machinery




c
Gripping and holding an object such as a:
·         book weighing 500gms




d
Carrying out fine motor/finger movements such as:
·         doing up a button on a blouse or shirt,
·         tying a knot
·         opening a door with a key
·         picking up and moving a 5 pence coin – so as to insert into a slot in a machine/box
·         turning the pages of a book




e
Creating with the dominant hand a legible message of one sentence




e
Using a keyboard, mouse, cash till, telephone keypad, or similar piece of equipment/machinery






Task – task performance
7.     Executing Tasks

Executing tasks reliably, repeatedly, safely and in a timely manner, unaided by another person.

a
Has no difficulty executing tasks


N/A
Occ
Freq
Most
b
Needs additional time to complete some tasks such that the task would take somewhat longer




c
Needs additional time to complete some tasks such that the task would take significantly longer




d
Needs additional time to complete most tasks such that the task would take somewhat longer




e
Needs additional time to complete most tasks such that the task would take significantly longer




8.     Maintaining Focus

Maintain focus to complete tasks reliably, repeatedly, safely and in a timely manner, unaided by another person.

a
Has no difficulty maintaining focus

N/A
Occ
Freq
Most
b
Due to poor memory or concentration, has difficulty maintaining focus on some tasks[5]




c
Due to poor memory or concentration, has difficulty maintaining focus on most tasks




d
Due to poor memory or concentration, has difficulty maintaining focus on all tasks




9. Learning Tasks

Learning processes necessary to having a job, and undertaking tasks within it

a
Is able to learn processes necessary to having a job

No longer requires support to carry out the task after
2-3 occasions

Between 4 and 9 occasions

10 or more occasions
Cannot learn task
b
Has difficulties learning a complex task[6]




c
Has difficulties learning a moderately complex task




d
Has difficulties learning a simple task





Task - risk
10.  Awareness of Hazards

Being aware of potential hazards.

a
Is fully aware of potential hazards

N/A
Occ
Freq
Most
b
Some reduced awareness of hazards leads to risk(s) of harm to self or others, or of damage to property or possessions




c
Moderately reduced awareness of hazards leads to risk(s) of harm to self or others, or of damage to property or possessions




d
Significantly reduced awareness of hazards leads to risk(s) of harm to self or others, or of damage to property or possessions





11. Consciousness
a
Does not experience episodes of lost or altered consciousness

At least twice in last 6 months
At least once a month in the last 6 months
At least once a week
b
Has an involuntary episode of lost or altered consciousness resulting in significant disrupted awareness or concentration with a recovery time that is normally less than one hour



c
Has an involuntary episode of lost or altered consciousness resulting in significant disrupted awareness or concentration with a recovery time that is normally more than one hour




12. Bladder/ bowel continence
a
Has no difficulty with continence

N/A
Occ
Freq
Most
b
Experiences an unusual and/or frequent need to use the toilet (or manage a collecting device), due to an underlying health condition or the side effects of essential medication




c
Without immediate urgent access[2] to a toilet, suitably modified where appropriate, would experience loss of control




d
Has experienced unpredictable or recurrent loss of control[1]




















Communication
13. Understanding communication

Understanding communication reliably, repeatedly, safely and in a timely manner, by both verbal means (such as hearing or lip reading), non-verbal means (such as intonation or body language) and written means (such as reading 16 point print or Braille), using any aid it is reasonable to expect them to use

a
Has no difficulty understanding communication
Due to sensory, cognitive or social difficulties:
N/A
Occ
Freq
Most
b
Has some difficulty understanding complex information from a stranger




c
Has significant difficulty understanding complex information from a stranger




d
Has some difficulty understanding simple information from a stranger




e
Has significant difficulty understanding simple information from a stranger





14. Making self understood

Making self understood reliably, repeatedly, safely and in a timely manner through speaking, writing, typing, or other means normally used, unaided by another person

a. Has no difficulty making self understood
Due to sensory, cognitive, physical or social difficulties:
N/A
Occ
Freq
Most
b.  Has some difficulty conveying complex information to strangers




c.  Has significant difficulty conveying complex information to strangers




d.  Has some difficulty conveying simple information to strangers




e.  Has significant difficulty conveying simple information to strangers





















Supporting behaviours for work

15. Social Engagement

Engaging socially

a
Has no difficulty engaging socially reliably, repeatedly and safely, unaided by another person.
Because of difficulties interacting with others, anxiety, distress or other emotions:
N/A
Occ
Freq
Most
b
Has some difficulty with social engagement with people unknown to the person




c
Has significant difficulty with social engagement with people unknown to the person




d
Has some difficulty with social engagement with people known to the person




e
Has significant difficulty with social engagement with people known to the person













16. Organising self and planning (was Managing self and schedule)
a
Has no difficulty managing him/herself and his/her schedule reliably, repeatedly and safely, unaided by another person.


N/A
Occ
Freq
Most
b
Has some difficulty managing self and schedule to an acceptable standard for much of the day




c
Has significant difficulty managing self and schedule to an acceptable standard for much of the day




d
Has some difficulty managing self and schedule to an acceptable standard for short periods




e
Has significant difficulty managing self and schedule to an acceptable standard for short periods





17. Coping with Change
a
Has no difficulty coping with minor planned changes to daily routine unaided by another person.


N/A
Occ
Freq
Most
b
Experiences some difficulties with unplanned changes to daily routine.




c
Experiences significant difficulties with unplanned changes to daily routine.




d
Experiences some difficulties with planned changes to daily routine.




e
Experiences significant difficulties with planned changes to daily routine.





18. Appropriateness of Behaviour
a
Display behaviour which work colleagues consider appropriate reliably, repeatedly and safely without support from another person


N/A
Occ
Freq
Most
b
May display moderate verbally aggressive or socially inappropriate behaviour




c
May display severe verbally aggressive or socially inappropriate behaviour




d
May display physically aggressive behaviour














Key
N/A – Not applicable
Occ – Occasionally
Freq – Frequently
Most – Most or all of the time 



[1] Some difficulty - could include has to do so at a slow pace and to stop during the process of walking the distance on one occasion.  May have problems with balance but not at risk of falling.
[2] Long periods - can walk for a period of 10 minutes or distance of 500m, (journey to/from work: having to get out of a house to a bus stop or equivalent)
[3] Significant difficulty - could include the pace would be significantly slow, movement is restricted or painful, the person has to stop on more that one occasion, there is a significant risk / history of falling, or is unable to mobilise independently.
[4]  Short period - can walk for a period of a minute (whatever consensus is for times) or distance of 50m (something that represents moving around in a work place).
[5] Tasks to be defined/ examples given
[6] Note: As an initial indicator of the  level of tasks, provisional definitions of tasks could include toe following (will need further work and consultation with Mencap):
-          Simple task – photocopying a single piece of paper, sweeping up
-          Moderately complex task – taking a simple phone message, finding a particular item of food in a supermarket
-          Complex task – ?? searching a database, working a till, taking minutes


8 comments:

Anonymous said...

With the Mind guest post recently, and now this, it feels very much like you are being used as a reaction tester. Anythhing of any importance seems to be being spread to the masses and reactions asked for through you and Sue.

Is there a link to anywhere this has actualy been published?

Nickd Mylegal said...

Time is limited on making comments on the individual descriptors and there respective application; but from a glance I'm not sure if it is significantly better than what we have now particularly in respect of the mental health descriptors.

As I see it (from a welfare benefit specialists' point of view) the greatest problems with the descriptors are the way they are relayed from the ESA 50 by the claimant to the HCP on the ESA 85 to the decision-maker in the scoring process when considering the regulations contained within schedule (2). A major flaw in the whole process is the way the regulations (in whatever form they take) are 'condensed' in to the ESA 50. I would like to see much clearer explanations as to the application of the descriptors so that the claimant at least has a clue over how they are being considered.

It would be good to see a much clearer distinction between mental health and physical with perhaps a dividing page explaining the difference. There should also be a section at the beginning giving a claimant a clear explanation over examples of 'physical' and 'mental' with guidance on how to consider conditions where the two may merge.

It is the layout of the ESA 50 in itself which is very much the problem. Provision should also be made for advising the claimant to indicate how they felt at the time they felt when answering a particular descriptor (many complete a section at a time over the course of quite a few days). It would also be good to have a section which could be completed by the claimant's doctor/CPN etc in accordance with a revision on the medical evidence requirement contained within regulation 21 of the original ESA 2008 regs.

In essence what I am saying is that no matter how the descriptors are re-worded, the fundamental problem is in many cases the self assessment form used by the claimant to indicate his or her problems. It should more accurately portray what the statutory test is in a language which the claimant is able to relate to. In making it 'user friendly' there is a danger in straying too far from the regulations. It's a difficult balance I know but at the moment claimant's are just looking at the lead 'yes' or 'no' question attached to the descriptor and often indicating 'no' because they can't see how there is a relevance to them. When the regulations are applied it all takes on a different meaning.

One question which for instance I think should be included is one relating to whether the claimant needed to be helped in completing the form, it gives an indication as to their own difficulties in comprehending the meaning.

Social phobia and problems with a lack of assertiveness are inherently linked to the amount of support a claimant needs to find employment as are lack of motivation, need of encouragement, coaxing & persuasion. The form should be much more 'employment focussed' because ultimately it is about recognising the problems claimants will face in that environment. The claimant's limitations have to be considered as if they were in the workplace. Their ability to cope with pressure must be considered with regard to if they were in work?

Hope this helps and please do let me know how you get on with this Sue; great work by the way!

Nick
Mylegal.proboards.com
Mylegalforum on Twitter




Anonymous said...

While the proposed descriptors are a definite improvement on the current ones, they don’t address what to me is the main issue, i.e. how much mental and physical activity a person is able to do on a given day. The descriptors assess functional abilities in isolation and therefore fail to reflect the demands of real jobs. For instance, you are asked about your ability to remain at a work station, but not whether you have enough mental and physical energy to actually do your job.

Anonymous said...

I fail to understand why any disabled people would benefit from a slight degree of understanding on how they are going to be abused - as if it would help?????

These descriptors are still underpinned by an ideology that is reminiscent of nazi warfare!! In no way, even if you can move a cardboard box, does it put anything in a context. Each individual point is purely that - individual, devoid of context, not based on realtime experience, it is a sham.

The real part disabled people have to play is in the total and utter removal of the WCA from anything to do with their lives.

Anonymous said...

I agree with anon 1.36om 0 This is inhumane - ATOS should be binned and our speialists shoudl have a say after all they are - amazingly - our SPECIALISTS

Anonymous said...

If this is true (below link) then 99.9% of disabled people will be thrown to the wolves

http://socialwelfareunion.org/archives/2164

And they read nothing like the ones above :-(

I pray this is just a nightmare and I can wake up and for it to not be so inhumane. tho with cameron at the helm - it dont feel like a dream!

Anonymous said...

WE ARE NOT SAFE

Let the Games begin

When I am ill I look for a place of safety

There is nowhere to hide

WE ARE NOT SAFE

A TRIUMPH FOR IDEOLOGY OVER HUMANITY

Anonymous said...

I look at that list and see bugger all recognition of the effects conditions such as ASD have on physical ability. The movement at a work station descriptor, for example, assumes that physical disability is the only inhibiting factor in staying in one position for one hour.

Our oldest boy has ASD and he is completely unable to stay in one position for five minutes, let alone an hour. He doesn’t suffer significant discomfort, loss of balance or exhaustion because the problem isn’t physical. It’s mental. He can not stay still, fidgets, roams, bounces, rocks and bumps.

And the descriptors don’t allow for complex behaviours. Look at the learning tasks descriptors, it’s A, B, C or D but there’s no allowance for someone who can learn extremely complex tasks while struggling with simple every day ones. Our oldest can disassemble and reassemble a computer in the blink of an eye, but can’t clean his teeth, wash effectively or dress without supervision. So one assessor might rate him A and another D.

Or the continence one. He has no problem with control. What he has a problem with is understanding that it’s anti-social to walk to the back door and piss out of it because he can’t be bothered waiting for someone else to finish in the bathroom.

Many of the descriptors are like that. It’s crap.