Benefits and Work asked readers to take part in a survey if they had ever asked for, or had, a PIP or ESA face-to-face medical assessment in their home, instead of in an assessment centre.
1,890 people responded to the survey. 1,530 completed the PIP survey and 360 completed the ESA survey.
Below are some of the results.
Please note: figures do not always add up to 100% because percentages have been rounded and, in some case, more than one option could be chosen.
Some headline findings
83% of the people who completed the PIP survey had been allowed a home assessment, whilst the figure for ESA was just 41%.
Set against that was the fact that just 3% of PIP claimants had a decision on the paper evidence alone, without needing a face-to-face assessment, but this leapt to 28% for ESA.
We learnt that 38% of PIP claimants who had a home assessment hadn’t even asked for one, whilst for ESA it was just 7%.
We also found that the chances of being offered an alternative, such as taxi fares, were slim for PIP claimants at just 8%, but much higher with ESA at 21%.
We discovered that the waiting times for an ESA home medical are much longer. 46% of ESA claimants wait more than 8 weeks compared to 16% of PIP claimants.
There was also a dramatic difference in who carries out home assessments. 51% of ESA home assessments were carried out by doctors, for PIP the figure was just 4%.
Health condition
We asked what health condition had led to your claim. There were a markedly higher proportion of mental health claims for ESA.
- PIP 46% physical, ESA 37%
- PIP 9% mental, ESA 20%
- PIP 46% combination of both, ESA 43%
Who carried out the assessment?
We know that for ESA, all assessments are carried out by Maximus.
We asked PIP claimants who carried out your assessment.
For PIP, 49% of our respondents said Atos carried out their assessment, 35% said Capita and 16% didn’t know.
Medical evidence
We asked whether you submitted medical evidence to support your request for a home assessment.
- For PIP 38% said they didn’t ask for a home medical, but got one anyway, ESA 7%
- For Pip 30% asked for a home assessment but did not provide medical evidence to support the request, ESA 23%
- For PIP 22% provided GP evidence, ESA 55%
- For PIP 14% had specialist evidence, ESA 19%
- For PIP 4% had evidence from a nurse, ESA 3%
It wasn’t clear from our survey that one sort of medical evidence was better than another, particularly as many people submitted more than one sort of medical evidence and evidence from support workers, family and carers.
In fact, we couldn’t even conclude that medical evidence on its own would make a difference. Other factors, such as whether there are assessment centres in your area of the country and whether the nearest assessment centres are accessible if you have limited mobility or use wheelchair are also important.
They made me an appointment 25 miles from home but said that I must cancel if I could not use the stairs in case of an emergency. Office on top floor. I said I could not and they gave me a home appointment.
As the assessment centre was on 4th floor and I had difficulty walking , they gave me home visit on the fact if there was a fire I could not get out of building fast enough
One thing that did become clear from the responses relating to both PIP and ESA, was that if medical evidence alone doesn’t work, then support from an MP can make a real difference.
My GP's letter requesting a home assessment was ignored so I contacted my MP who intervened and it was then granted.
Without the intervention of our MP I am quite sure that my daughter, who is on the autism spectrum and has learning difficulties, would have had to attend a medical, despite a supporting letter from her psychologist saying this would be detrimental to her health.
I wrote to my local MP to ask for help and they backed up my GP/specialist requests.
I attended an atos assessment centre, could not do the assessment, went home. They sent me another appointment. Emailed my MP to say I fit the criteria for home assessment. Home assessment appointment arrived - simple.
They initially refused, but MP contacted them.
After writing to my MP!
After getting a note from my Doctor and involving my MP.
Only after being refused twice and then involving my MP
Taxis
We asked whether you were offered an alternative to a home assessment, such as taxi fares to an examination centre.
For PIP 8% were offered an alternative, such as taxi fare, for ESA it was 21%.
Some people seem to have had a taxi provided for them.
I repeatedly asked for home assessment and had sent many medical documents from professionals and were turned down. A taxi were laid on for appointment , there and back, which they paid.
My first appointment was nearly 2 hours’ drive. I rang and asked for home one and referred to evidence. They gave me an assessment half hour away and said would pay and organise taxis as only bed bound people could have home assessments.
Taxi meter cost DWP, or whoever was paying, £130 for 50 mile round trip.
Others were required to provide medical evidence which they could not afford.
To get a paid Taxi, I was told I would have to get a letter from my Doctor and this would have cost time and money (£20).
Some people paid for the taxi themselves, but have had a long wait to get their money back.
I rang them and was told that home assessments were only for people that couldn't get out of their house at all. I asked for permission to claim the taxi fare which they agreed to.
Told to get a taxi and claim it back then waiting several months for them to reimburse it. Had to keep complaining.
Its been over 3 weeks since assessment and not received refund for taxi fares. Although have been turned down for PIP
Some people seem to have simply been misinformed that taxi fares could never be paid.
I was told that help with taxi fares was never given and was not an option
Did you get a home assessment?
We asked whether you actually got a home medical assessment in the end.
- For PIP 83% got a home medical, ESA 41%
- For PIP 13% had to have a face-to-face at an assessment centre, ESA 31%
- For PIP 3% had a decision without a face-to-face, ESA 28%
On the face of it these figures suggest that it is much easier to get a home assessment for PIP than for ESA. But things are not that straightforward.
If you add the 3% of PIP claimants who had a decision on the paper evidence alone, the total is 86% who avoided an assessment centre.
For ESA, 28% had a decision on paper after requesting a home assessment, bringing the total who avoided an assessment centre to 69%.
But another issue that needs taking into account is the fact that a significant proportion of PIP claimants who had a home medical didn’t actually ask for one.
I believe all assessments in North Wales are carried out at the claimants home.
I live in a very rural part of North Wales. Capita have very limited assessment centres here that are accessible for disabled people, hence why most people I know who have applied for PIP or been transferred from DLA to PIP are automatically home assessed.
Where I live Capita only offers home assessments.
To be fair, most people in my area got a home visit so I might have got one even without asking.
I didn't request a home assessment and was surprised to be offered one. However I did submit a lot of paperwork & medical evidence to support my application. As well as a letter from my carer/my sister and a dairy of bad and good days. On the application I did say I could sit for more than 20/30 min in car, I need accessible toilets, no stairs & wheelchair accessible.
So, the reality is that the proportion of claimants who avoid having to attend an assessment centre may not be very different, regardless of whether the claim is for PIP or ESA.
How long was the wait?
We asked you how long you had to wait after being allowed a home assessment before it actually happened.
- For PIP 11% waited less than 2 weeks for a home medical, ESA 7%
- For PIP 41% waited 2-4 weeks, ESA 24%
- For PIP 32% waited 5-8 weeks, ESA 23%
- For PIP 16% waited more than 8 weeks, ESA 46%
There was a huge difference here, with 46% of ESA claimants having to wait more than 8 weeks compared to only 16% of PIP claimants.
For ESA claimants, the fact that their payments may end after a year if they are not put in the support group means that a long wait for an assessment can be a desperate problem.
It hasn't taken place yet. I've been waiting so far for 5 months. Rang the assessment centre last week and they said they're still conducting home assessments for individuals who were granted one in 2014. Thinking may need to agree to attend the assessment centre as my contributory ESA ends shortly (as no assessment so no chance to be placed in support group)
Yes, I was promised one, but because I've asked for it to be tape recorded, I'm still waiting! The ESA 50 was submitted in January 2016, the decision to allow a home visit was made in June 2016, but as of today, 15/02/17, no visit has been booked.
On time?
We asked whether the assessment took place on time.
- For PIP 77% of medicals were on time, ESA 61%
- For PIP 6% waited more than 30 minutes, ESA 9%
Assessors turning up late was not unusual. Sometimes, especially for PIP, they didn’t turn up at all.
But the assessor never came, lied saying that they did and I was automatically turned down.
Assessors twice failed to turn up and no-one contacted me. Appalling.
The first assessor didn’t turn up at all. No explanation.
It turned out that a major issue was not just assessors turning up late or not at all. Instead, assessors turning up early, or without warning, also caused major difficulties.
The assessor turned up about fifty minutes early. Proceeded to start even though I told her I wanted my C.P.N. there. Said we would do the 'housework' first?, but invasive questions asked & I was in tears before my C.P.N. arrived a half hour after I called her to tell her the Capita woman was here early.
He turned up an hour early, told my husband who is my carer to shut up as this had nothing to do with him, asked me to stand on tip toes, I have rheumatoid arthritis so couldn't do it, he actually wrote I refuse to comply! A very distressing horrible experience in my own home!
The assessor came with another person who said they were observing, I felt it was unacceptable for them to turn up 45 minutes early with no prior warning
They were actually 45 minutes early. She said she knew all about my condition which is strange as most doctors don't but she clearly had no idea.
The assessor turned up a day early and I had already arranged for my daughter in law to come and help me shower and so asked her to come back in a hour in which she did I had to find my letter because I thought I had wrote it wrong on the calendar as I sometimes get confused
Length of time?
We asked how long the assessment lasted.
- For PIP 9% lasted less than 30 minutes, ESA 22%
- For PIP 51% lasted between 30 minutes and an hour, ESA 52%
- For PIP 35% lasted between an hour and two hours, ESA 21%
- For PIP 5% lasted over 2 hours, ESA 0%
Whilst for both PIP and ESA, around half of assessments lasted between 30 minutes and an hour, more PIP assessments lasted over an hour and some lasted over 2 hours – which must be extremely gruelling for the claimants involved.
Rate your assessor
We asked you how you rated your assessor for their understanding and communication skills.
- For PIP 54% strongly agreed or agreed the assessor had read their claim pack, ESA 49%.
- For PIP 49% strongly agreed or agreed the assessor understood their conditions, ESA 50%.
- For PIP 70% strongly agreed or agreed the assessor gave them time to answer, ESA 64%.
- For PIP 60% strongly agreed or agreed the assessor listened carefully to what they said, ESA 57%.
- For PIP 91% strongly agreed or agreed the assessor’s spoken English was easy to understand, ESA 78%.
- For PIP 10% strongly agreed or agreed the assessor showed the claimant what they had written about them, ESA 9%.
The biggest difference between claimants perceptions of PIP and ESA assessors was in relation to spoken English, with 13% fewer ESA claimants agreeing or strongly agreeing that the assessor’s spoken English was easy to understand.
It is also clear that the longer PIP assessments left claimants more likely to feel that the assessor had given them time to answer, with 70% agreeing or strongly agreeing for PIP compared to 64% for ESA.
Worryingly, for both PIP and ESA only around half of our respondents agreed or strongly agree that the assessor had read their claim pack. The same proportion considered that the assessor understood their condition.
Some people praised their assessors manner, others were less impressed.
He was a robot.
The assessor sat in a different room to me as he needed a table for his laptop. He complained about the software for home visits throughout and never broke from typing to even look up when I spoke.
Turned up with a laptop. Literally zero eye contact just sat tapping away on her laptop, asked me if I spoke and understood English, asked me if I could read and write to which I said yes to both. Both trick questions as she used this against me in her decision by saying I was able to communicate effectively, pay my bills without help.
Qualifications
We asked you about the medical qualifications of your home assessor. A considerable proportion weren’t given this information, with 29% of PIP claimants and 24% of ESA claimants not knowing.
- For PIP 38% of assessors were generalist nurses, ESA 11%
- For PIP 9% of assessors were paramedics, ESA 0%
- For PIP 7% of assessors were occupational therapists, ESA 0%
- For PIP 4% of assessors were doctors, ESA 51%
- For PIP 4% of assessors were psychiatric nurses, ESA 1%
- For PIP 4% of assessors were physiotherapists, ESA 6%
The very striking difference here was that 51% of ESA assessors were doctors, compared to a tiny 4% of PIP assessors.
PIP assessors on the other hand, were more likely to be generalist nurses at 38% compared to 11% for ESA.
Paramedics and occupational therapists also made up the numbers for PIP assessors – a total of 16% compared to 0% for ESA assessors.
The lack of mental health specialism was clearly betrayed by the fact that just 4% of PIP assessors were psychiatric nurses and an even tinier 1% of ESA assessors.
Looking in other rooms
We asked whether the assessor tried to look in other rooms in your house. This didn’t appear to be a huge issue, with some respondents complaining that they had actually asked the assessor to look at the aids and appliances in other rooms but the assessor had declined to do so.
For PIP 86% said the assessor did not try to look into other rooms in their home, ESA 73%
For PIP 10% said they did look in other rooms, ESA 16%
For PIP 3% said they don’t know, ESA 10%
Conclusions
It’s clear from what we have been told that people are being routinely discouraged from pushing for a home assessment, especially in relation to PIP.
I asked for a home assessment and they told me that they do not do home assessments anymore
I was just refused one was told they didn’t do home visits only for housebound and bed bound.
I rang them to ask about home assessment but was told they were only for terminally ill people.
So, as for most things to do with benefits, if you need a home assessment then you may well have to fight hard for it.
There are some criteria for a PIP home visit on pages 47-48 of the PIP Assessment Guide, which is available online and from the PIP section of the members area of the site, under PIP DWP resources.
Medical evidence and evidence from family, support workers and carers is worth including with your request.
And, though they won’t thank us for saying so, if you are turned down then contacting your MP and asking for their support seems to be especially effective.
