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Work Capability Assessment*, the test undertaken to determine whether a person is eligible for Employment and Support Allowance (ESA)**, fails to recognise the impact of HIV on ability to work, according to a new research report by NAT (National AIDS Trust).
The report Unseen disability, Unmet needs – A review of the impact of Work Capability Assessment on people living with HIV details concerns with both the design of the WCA and how it is implemented in practice. For example, the WCA does not fully reflect the impact that fluctuating symptoms, fatigue, side-effects of HIV treatment and depression can have on capacity for work. In addition, claimants going through the medical examination do not always have the opportunity to discuss the important issues around how their HIV affects their physical and mental health in ways that that limit their capability for work.
NAT‘s research finds continuing ignorance about HIV amongst medical assessors and decision makers drastically reduces the likelihood of a fair and accurate assessment on a claimant’s ability to work and need for disability-related benefits.
Deborah Jack, Chief Executive of NAT, says:
‘HIV is a disability, and like many other disabilities, people living with HIV can have vastly varying experiences relating to their condition. Whilst some find they can still work, many others find the impact of HIV or their treatment means employment is not an option at the moment and they need to claim disability related benefits.
‘As it currently stands, the WCA is based on an outdated model of disability which only recognises a narrow medically defined set of physical and mental impairments. Also, it does not appropriately acknowledge the fluctuating nature of the condition and the impact that low self esteem due to HIV related stigma can have on a person’s ability to work.
‘NAT has submitted our ongoing concerns to the Independent Review of WCA, lead by Professor Malcolm Harrington, and hopes these will fully considered before any new rules are finalised and come into effect.’
Key findings from the report include:
The WCA does not take into consideration key HIV clinical markers, such as CD4 count***, in making the medical assessment
During the assessment, WCA decision makers often give greater weight to the opinions of those contracted to make the medical assessment than to HIV clinicians and other specialists who have provided medical evidence
A wide range of problems with administration and communication of the WCA process materially disadvantage claimants, and the stress and pressure of the process impacts negatively on their health