Friday, March 7, 2014

Work Capability Tests Based on Flawed Researcch


MEDICAL AND WORK CAPABILITY ASSESSMENTS – BASED ON THE CONTROVERSIAL BIO PSYCHO-SOCIAL MODEL

reprinted from http://nzsocialjusticeblog2013.wordpress.com/

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MEDICAL AND WORK CAPABILITY ASSESSMENTS – BASED ON THE CONTROVERSIAL BIO PSYCHO-SOCIAL MODEL, AIMED AT DISENTITELING AFFECTED FROM WELFARE BENEFITS AND ACCIDENT COMPENSATION: THE AYLWARD – UNUM LINK
‘An article summarising comprehensive, revealing research results’
Introduction:
Media revelations during 2012 exposed a kind of “exit strategy” that ACC has apparently been using to off-load complex and costly claim cases by using in at least some cases highly questionable practices and medical assessors.
(see YouTube links: http://www.youtube.com/watch?v=DNkN3DW1W6s andhttp://www.youtube.com/watch?v=55LzKcivWuM from Sept. 2012).
Following this, recent developments in the social security system in New Zealand now also give rise to immense concern, as work capability assessments will be applied to virtually all disabled and seriously ill, suffering degrees of incapacity.
On 15 July 2013 fundamental changes to the New Zealand social security system were introduced. Most in the public only learned that 7 former benefit categories would be merged into 3 new categories, that beneficiaries caring for children now have to fulfil certain social obligations, that jobseekers may face sanctions if they do not pass a required drug test, and that benefit recipients facing a warrant for arrest, could lose their benefit, if they would not comply with new rules.
A certainly much more significant set of changes also came into force, which have hardly been taken note by the media and the public. This includes the new, extremely stringent approach by Work and Income (WINZ) to require sick, disabled and incapacitated beneficiaries, to comply with greater work expectations. All former sickness beneficiaries were transferred onto the new Jobseeker Support category, and they will face new, different re-assessments for their capacity to work or train.
Work capability will no longer solely – or primarily – be determined by information on medical certificates issued by medical practitioners or other authorised health professionals. There will be new additional measures, including expected, “self assessments” (on pre-designed forms), additional interviews with Work and Income staff tasked with finding ways to refer sick, injured or disabled back into some form of work on the open market. Further medical examinations by WINZ-trained and paid “designated doctors” can also be required, to assess what work a client can do.
Few will comprehend the magnitude and significance of the new approach, which, when compared with similar, earlier changes introduced in the United Kingdom, can only be described as the biggest attack on the social security system of New Zealand since at least 1991. The new changes under the ‘Social Security (Benefit Categories and Work Focus) Act 2013’, are nothing but a relentless drive to force many sick, disabled and incapacitated to look at least for part time work. The claims by the government and Ministry, that the intention is to “help” people, who are “locked in” benefit dependence, are nothing but cunning, misleading statements to disguise the true intentions and agenda. The goal of that agenda is above all: Reducing the number of persons on welfare benefits, and by doing so – COST CUTTING!
Already with the introduction of the ‘Future Focus’ policies in 2010 did Work and Income introduce a new approach following one used by the ‘Department of Work and Pensions’ (DWP) in the United Kingdom (UK), to rather look at what clients “can do” than what they “cannot do”. From 15 July 2013 a new ‘Work Capacity Medical Certificate’ is being used, which puts the emphasis on assessing what obstacles a client faces, to return to work, before the actual health conditions are being looked at.
Virtually ALL beneficiaries, including those on the new Supported Living Payment, onto which mostly former Invalid’s Benefit recipients have been transferred, will have to attend interviews and assessments for determining capacity to at least attend work preparation obligations, when being asked to do so.
On page 40 (of 48) on the new application form for the ‘Supported Living Payment’ – under “obligations” and “privacy” it says:
“2. Work preparation obligations if you have a health condition,
disability or injury
I understand that while I get this benefit I’ll have an obligation, when asked, to:licants
• attend and participate in interviews to determine if I have the capacity to have work preparation obligations
I understand that if I’m assessed as having the capacity, I’ll have the following work preparation obligations to:
• attend and take part in work preparation interviews, where Work and Income ask me to
• attend and take part in work related activities or programmes such as a work assessment, a programme or seminar to increase particular skills or enhance motivation where Work and Income ask me to
• attend and take part in any other activity that Work and Income require me to (including rehabilitation but not medical treatment, voluntary work or activity in the community).”
It says on page 39 (of 48) on the new application form for the Jobseeker Support benefit – under “obligations” and “privacy”:
“3. Work obligations if you have a health condition, disability or injury that
stops you working full time
I understand that while I get this benefit, if I have a health condition, injury or disability that
means I can only work part-time, I have the following part-time work obligations to:
• be available for and take reasonable steps to get a suitable part-time job
• take any offer of suitable part-time or temporary work, or work that is seasonal or subsidised
• attend and take part in any suitable job interviews Work and Income ask me to
• take and pass any drug test potential employers or training providers require
• attend and take part in interviews with Work and Income as required
• work with Work and Income to plan how I’ll find a suitable job
• take part in any other activities that Work and Income refer me to, such as attend any job
training courses, seminars, work experience or work assessments (including rehabilitation, but not medical treatment) that will improve my work readiness or help me get work
• let Work and Income know how I’m meeting my work obligations as often as Work and Income reasonably requires.
I understand that while I get this benefit, if I have a health condition, injury or disability that
means I am unable to work or can only work less than 15 hours a week, I will not be asked
to meet work obligations until my situation changes and in the meantime I will have the
following work preparation obligations to:
• take reasonable steps to prepare and plan for work
• attend and take part in work preparation interviews, where Work and Income ask me to
• attend and take part in work related activities or programmes such as a work assessment,
a programme or seminar to increase particular skills or enhance motivation where
Work and Income ask me to
• attend and take part in any other activity that Work and Income require me to (including
rehabilitation but not medical treatment, voluntary work or activity in the community).”
It says on page 40 (of 48) on the new application form for the Jobseeker Support benefit – under “obligations” and “privacy”:
“6. Work ability assessment
Where I’ve been asked to I’ll have an obligation to attend and participate in a work ability
assessment.”
Applicants andartners
“7. Working with a Contracted Service Provider
Where I’ve been asked to work with a Contracted Service Provider I’ll have an obligation to
co-operate with them and to:
• attend and participate in any interview with them
• report to them on how I’m meeting my obligations
• complete assessments with them.“
Link for downloading form:
http://www.workandincome.govt.nz/documents/forms/jobseeker-support-application.pdf
Links to a sample Work Capacity medical certificate and additional information – from the website of the ‘Royal NZ College of General Practitioners’:
http://www.rnzcgp.org.nz/assets/WI-Medical-Certificate-Sample.pdf
http://www.rnzcgp.org.nz/assets/Work-Capacity-Medical-Certificate-HDS017W.pdf
http://www.rnzcgp.org.nz/changes-to-the-benefit-system-on-15-july/
Link to law change requiring WINZ clients to work with contracted providers:
http://www.legislation.govt.nz/act/public/2013/0013/latest/DLM4750153.html
With news and other reports about the new approach in establishing work capability for sick, injured and disabled, the name of a Professor Sir Mansel Aylward, as well as names of other members of a core group of medical and health “experts”, many linked to the ‘Unum Provident’ funded ‘Centre for Psychosocial and Disability Research’ at Cardiff University, Wales, UK, have repeatedly been mentioned.
Also have there been frequent references to the so-called “bio psycho-social model” (BPS model), which is strongly associated with, and promoted by Professor Mansel Aylward and their school of thought. He and others have been strongly recommending this model for the diagnosis and treatment of diseases and illnesses that lead to degrees of impairment and incapacity to function – or to do work.
It has been said and written in UK based media that Mansel Aylward was given a “golden parachute” by the ‘Unum Provident’ insurance company, after he finally resigned from his position as ‘Chief Medical Officer’ for the ‘Department of Work and Pensions’ (DWP) in April 2005. ‘Unum’ offered substantial funding for a newly established ‘Research Centre for Psychosocial and Disability Research’ at Cardiff University in 2005 – that would be led by Professor Aylward.
Aylward’s name has repeatedly surfaced here in New Zealand, and it was reported last year, that he met with Social Welfare Minister Paula Bennett, and also with members of a ‘Health and Disability Panel’, set up by the Ministry of Social Development (MSD) to “advise” on “medical” matters, on the way medical assessments, possible rehabilitation and enhanced work referrals, could be further developed as part of the wider social welfare reforms.
Aylward furthermore held speeches at various conferences and meetings with groups of medical professionals here in New Zealand, and he has been accepted by the ‘Counties Manukau District Health Board’, the Ministry of Social Development, certain general practitioner- and other health professional organisations, and Social Welfare Minister Paula Bennett, as an advisor on health and welfare matters.
To understand who Mansel Aylward is, and what supposed “expert” advice he presents, we can look at readily available information on the internet. It will become evident that Professor Aylward, with his version of the “bio psycho-social model”, and with the strong private health- and disability-insurance sector lobbies, and also government backers behind him, has with his efforts achieved that the medical professions have almost been seized upon. The professions have been inundated with reports, speeches, campaigns and policy releases supporting a new, controversial doctrine – or at best theory! It is time to shine light on what is behind the resolute drive to gradually disentitle sick, disabled and incapacitated from support they were traditionally ensured by way of insurance payments or welfare benefits.
In the following 13 parts of this article and analysis I will present a wide range of available, factual, revealing information that is backed up by plenty of resource material, which can be found via the internet and in other accessible sources.
For the rest of the article  see: http://nzsocialjusticeblog2013.wordpress.com/2013/09/02/medical-and-work-capability-assessments-based-on-the-controversial-bio-psycho-social-model/

1 comment:

Anonymous said...

For readers' further info:

So the Work Capability Assessment still used in the UK had its 5th review, but seems to be up for replacement some time in the future after all:

http://www.dsdni.gov.uk/an-independent-review-of-the-wca-year5.pdf

http://quarterly.demos.co.uk/article/issue-3/what-is-incapacity/

http://www.benbaumberg.com/

http://kent.academia.edu/BenBaumberg

And Dr Bratt et al here in New Zealand are with MSD and WINZ still keen on following much of the failed UK experiment promoted by Mansel Aylward.

Always a few years behind of what is going elsewhere it seem, NZ Aotearoa.

Also Google 'nzsocialjusticeblog2013' and find more information on welfare reforms, and how sick and disabled are treated now.