PIP investigation: Claimant group tell MPs of ‘systemic malpractice’ by assessors

A group of nine disabled people with the same rare neurological condition have written to MPs to warn of “systemic malpractice” by healthcare professionals who carry out benefit assessments and then write “fraudulent reports” for the government.

The nine who signed the letter are part of a larger group of 20 people who all share chronic forms of the condition trigeminal autonomic cephalalgias (TAC), and have been assessed for personal independence payment (PIP).

The nine say they have been “astounded” by the behaviour they have experienced at the hands of assessors working for both Atos and Capita, the two outsourcing companies paid by the government to carry out PIP assessments.

They say the evidence shows that the assessors breach PIP regulations, case law and Department for Work and Pensions (DWP) guidance.

Among their concerns, they say they have evidence of assessors: making false statements about TAC; reaching conclusions that directly contradict those of neurological specialists; refusing to accept documentary evidence about their conditions; failing to record key evidence told to them during assessments; and altering what they are told by the claimant during the assessment.

They have written to Frank Field, chair of the Commons work and pensions select committee, which this week carried out an “emergency” evidence session on the PIP assessment system.

Mary*, the wife of one of the claimants and herself a former nurse, has now been collecting evidence of the flawed PIP process for more than two years, and has supported all of the group at various stages of their PIP claims, including representing some in their appeals.

Her husband’s neurologist wrote in 2015 that the condition meant that “daily functioning is severely impacted and the person becomes unreliable, unpredictable and unable to work”, and added: “The impact on his life is massive and entirely in keeping with the nature of this condition.”

But her husband was originally granted just one point – when he needed at least eight to qualify for any PIP support at all – when he was assessed by an Atos healthcare professional in 2015.

Among his concerns was that he had been scored zero on the PIP bathing criteria by his assessor who argued that it was “his choice to avoid having a bath due to trying to avoid having an attack”, even though heat – and therefore bathing – is a known trigger for the neurological attacks they all experience.

He told Disability News Service (DNS): “It was immediately apparent that the healthcare professional had not read my claim file.

“She proceeded with her own agenda and used a variety of methods that consistently prevented me from explaining my difficulties.

“The assessment was a travesty, and I find it inconceivable that the DWP continue to support this charade that the public are paying for.”

A mandatory reconsideration – the internal DWP appeal stage – had led to his original PIP decision being re-examined by Atos and then upheld, while a subsequent complaint to Atos led to the company finding the report to be “a thorough and robust representation” of the assessment.

A further complaint, this time to DWP, led to the department asking Atos to look yet again at the assessment report, which this time led to the conclusion that the original assessment had “not accurately considered” his ability to function reliably.

Atos then issued a “change of advice” – stating that its new conclusion was “consistent with the recognised symptoms” of the condition – and DWP revised its decision, issuing him an award for the enhanced rate of both the daily living and mobility components of PIP, the maximum possible award. 

After her husband’s experience, Mary began to help other people with the same condition with their claims, and soon realised that a pattern was developing.

Mary has told Field that she has “significant evidence of the existence of an institutional practice of repeated behaviour patterns by healthcare professionals, resulting in fraudulent reports”.

She told him: “The evidence I hold shows not only serious wrongdoing in individual cases, but also provides a cross-section of claims from around the UK by people who have the same neurological condition which by its specific nature means that these claimants cannot fail to meet the correct and lawful threshold test for enhanced PIP, and yet have been refused any award by a disingenuous process that does not stand up to scrutiny.”

*Not her real name