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Monday, 24 October 2011

FoI Act Request - The reality of ESA Decision Making

Dear Department for Work and Pensions,

The main principle of a WCA is that it concentrates on a claimant’s ability to work. It regards clinical condition/history as largely irrelevant and the WCA handbook instructs Atos HCPs to use drop-down menus and simplify condition/diagnosis wherever possible for the benefit of DWP Decision Makers (DMs) who are not medically trained. As part of the final assessment process, DMs consider a range of available information including information they might
have researched on the internet.

1. How can a DM make an informed, accurate and robust decision if the condition they are researching has not been precisely recorded? For example, a brain tumour may be recorded as "occasional headaches" and a serious spinal injury might be recorded as simply "back pain".

2. Given they are not medically trained, how can DMs interpret and understand information with which they are presented if it uses highly technical medical terminology?

3. Would they be expected to interpret the following, which relates to a very well known condition:
“The estimated rates of this complication are 0.3-4% after total
knee arthroplasty and 3-13% after proximal tibial osteotomy.
Ischemia, mechanical irritation, traction, crush injury, and
laceration can cause intraoperative injury to the peroneal nerve.”

4. Not all information on the internet has been fully authenticated and therefore cannot be regarded as reliable. To which websites are DMs therefore restricted and where is this "safe" list documented?

5. In many cases medical opinion on a particular condition and its short/long term effects can be divided and revolve around some very complicated features of the complaint. How does a DM resolve such dilemmas?

Yours faithfully,

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