'Cruel and humiliating': why fit-for-work tests are failing people with disabilities

This month Kathy Mohan told the prime minister she has been forced to live on £100 a month in benefits after being denied help with the extra costs of coping with a learning disability.

“I’m talking about everybody who’s got mental health and learning disabilities,” Mohan said. “I want them not to have their money taken away from them and being crippled. The fat cats keep all the money and us lot get nothing.”

The issue goes deeper than the Conservatives’ controversial switch from the disability living allowance to personal independence payment (PIP). People with mental health and learning disabilities are also being failed by the manner in which they are assessed for welfare: fit-to-work tests.

Since they were introduced, 2,380 people have died within two weeks (pdf) of being found fit for work, and an extra 1,340 have died within two weeks of appealing a fit-for-work decision. In October ministers promised to overhaul the assessments as part of proposals aimed to help disabled people find employment.

But since then nothing has changed. Inaccurate assessments are still rife: between 2013-15, 56% of work capability assessment (WCA) appeals were successful. In November 2016, a UN report judged that the UK’s welfare reforms amounted to “grave and systematic violations of disabled people’s rights”. It said WCAs were particularly ineffective for people with intellectual and psychological disabilities. So why are fit-for-work assessments not fit for purpose?

How do the tests work?

The first component involves 18 multiple-choice questions, but the methodology is flawed. Claimants are scored based on their answers to questions such as: “Can you use a washing machine?” – but these all relate to what someone can do in their own home.

Social worker Andrew Wilks says the assumption that somebody’s abilities at home reflect their capabilities in the workplace is disastrous. He points out that people at home are under no obligation to perform the tasks, and that their confidence may vary daily. “The skill gap between home and work is a major thing that [the Department for Work and Pensions (DWP)] are disregarding, or they’re blind to,” says Wilks.

Rob Holland, of learning disability charity Mencap, echoes Wilks’ concerns that WCAs don’t work for people with learning difficulties. He says that people with learning difficulties often can’t articulate their issues and end up self-reporting to be more capable than they are. “There are enough barriers to knock people with mental health problems out of the system,” he adds.

After completing the questionnaire, claimants will then often have a face-to-face assessment. But according to Helen Armstrong, from disability charity Dial West Cheshire, assessors are often not qualified mental health practitioners.

Without qualifications in mental health, assessors may not know how to accurately assess hidden disabilities. Rosemarie Hayden, from Masbro Centre, a west London community support organisation, accompanied a client with bipolar disorder to his assessment and says the assessor did not ask any questions relating to his mental health. He was found fit for work, had his payments stopped and was forced to use a food bank until the decision was overturned at appeal some months later. One justification for the initial decision was that he was “able to get on and off a chair”. The appeal judge concluded he had not been properly assessed. Unless all assessors are qualified mental health practitioners, it seems likely these problems will continue.

What protection do claimants have?

Another issue with fit-for-work tests is that reports do not always accurately reflect what was said during an assessment. According to Andy King, welfare benefits adviser at the Avon & Bristol Law Centre, tribunals are often willing to accept that reports are not 100% accurate.

One potential safeguard is that government guidelines state all WCAs may be audio-recorded, provided claimants request this in advance.

But Armstrong from Dial says the DWP does not advertise this service, and most people are unaware of it. A spokeswoman from the Health Assessment Advisory Service also admitted most centres do not have the equipment. To give a centre time to source it, she said, an appointment would likely need postponing. According to the DWP, claimants are advised by letter that they can request a recording, but there is no legal right to one.

The main protection for claimants who are inaccurately assessed lies with an appeal, however these are lengthy and complicated, and many people need substantial support to be represented at tribunal. Cuts to support services also mean the number of people lacking the help needed to appeal is likely to grow.

The impact of fit-for-work tests

A study by Oxford and Liverpool universities found there were 590 extra suicides between 2010-13 in areas with high levels of WCA claimants, and suggested a link between the tests and worsening mental health problems. The government said this was “wholly misleading”.

With so many barriers to accurate assessments, it’s clear fit-for-work tests are failing people with disabilities. According to one anonymous claimant, the process is “intrinsically cruel, humiliating and distressing”. Another said: “You are literally on trial for being sick and disabled.” This is a common feeling, especially among those with “hidden disabilities” like mental health conditions or chronic pain. The simple truth is WCAs need to be abolished: the current situation does not work for people with disabilities.

Looking for a job? Browse Guardian Jobs or sign up to Guardian Careers for the latest job vacancies and career advice