The DWP have acknowledged that a statement about AS which appeared in the ESA handbook is incorrect.

This issue was originally brought to our attention by a chap in Northumberland with AS claiming Employment Support Allowance (ESA). ESA replaces Incapacity benefit.

He sent us a copy of the ESA Handbook which forms part of the training and development materials for healthcare professionals carrying out medical assessments for ESA. He highlighted section 3.4, Examination of the Musculoskeletal System, with specific reference to the information within the heading of Inappropriate Signs. The document specifically stated that an inappropriate sign (indicating that the claimant was exaggerating their condition) would be:

Spinal movements which are reduced equally in all directions. Degenerative disease of the lumbar and lower thoracic vertebrae/intervertebral discs limits forward flexion and extension but rarely affects lateral flexion or rotation. Inflammatory disease (e.g.ankylosing spondylitis) on the other hand, limits lateral flexion and rotation but not forward flexion or extension. Equal limitation in all planes of movement suggests purposeful exaggeration of disability.

NASS did not agree with this statement about AS and we strongly believed that having this statement in the ESA Handbook would clearly have huge implications for people with severe AS trying to claim ESA.

We asked 3 consultant rheumatologists and a specialist rheumatology physiotherapist about this statement and all agreed that it was flawed and that people with more severe ankylosing spondylitis could well have spinal movements reduced equally in all directions.

Armed with this information we wrote a letter to the Right Homourable Chris Grayling MP, the Minister for Employment and copied in Professor Dame Carol Black DBE, National Director for Health and Work.

As a result of this intervention Chris Grayling wrote to NASS stating that:

I have asked my officials and Atos Healthcare to investigate the issue you raised. They have acknowledged that the statement in the ESA Handbook is incorrect and will ensure that it is corrected as soon as possible.

We know Professor Dame Carol Black took up this issue on behalf of NASS and we would like to thank her for her efforts.

April 2011