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Home | Your community | Blogs | Kevin Nuttall | Can you see my arms now?

Posted in Kevin's blog on 19 February 2010 | 3 Comments

The Work Capability Assessment for people claiming Employment and Support Allowance is supposed to be a thorough test to establish levels of capability for work. It involves a long questionnaire and a medical examination performed by a 'healthcare professional'. This person often has only a basic knowledge of visual impairment. So how professional are the tests that are carried out to establish degrees of sight loss?

In order to be considered as having limited capability for work, and therefore to remain entitled to Employment and Support Allowance, you need to score at least 15 points on the assessment. Based on sight loss alone, unless you cannot see at all, you must be unable to read 16 point print at a distance of greater than 20 cm. or have 50% or greater reduction of visual fields to achieve this score. The problem arises when it comes to proving it. If proof is not available I would expect nothing less than a thorough eye examination to be carried out. Clients report that what really happens is this;

Margaret was given a piece of paper with numbers on it. She was asked to read out the numbers and struggled. The conclusion of the health care professional was that she could read 16 point print.

Andy was asked to read a Snellen chart. He managed the top letter, but when it came to the second line he could not see it. No test of visual fields was done. The healthcare professional concluded that he had a 'mild sight problem', despite him being registered blind with extensive loss of visual fields.

Martin's Snellen chart was on a piece of A4 paper!

Martin was tested for loss of visual fields. The healthcare professional stood in front of him and moved her arms saying, in a loud voice of course, 'Can you see my arms now?'

It's hard not to laugh at these examples until you realise that all three clients lost the benefit that was helping them through a very difficult phase in their lives. If these examiners can masquerade as healthcare professionals then I can call myself an eye care expert and offer a solution.

How difficult is it to assess whether a person can read 16 point print at a distance greater than 20 cm? I accept that many people do not know the size of 16 point print or distance of 20 cm. so I have invented an amazingly successful test that I intend to patent. It consists of a card with a piece of paper stuck on it. On the paper is printed some text in Arial 16 point print. I hand this to the client and ask if they can hold it at the point at which they can read it clearly. Good eh?

When it comes to visual fields however I am stumped. Eye clinics and optometrists spend small fortunes on magic boxes that you stick your head in and try to press a button when you see dots flashing. From this a computer maps the areas of visual field loss. I have it on good authority from an ophthalmic consultant that, even with this degree of sophistication, percentage loss of visual field cannot be accurately determined. Perhaps the healthcare professionals are right? After all, it is much cheaper to stand in front of somebody and wave your arms.

Fortunately Andy was able to prove to the tribunal that his loss of visual field was significantly greater than 50%. Margaret provided evidence from her ophthalmic consultant that she could not read 16 point print. Both had their benefit re-instated. Meanwhile Martin's case is being appealed.

About Kevin

Kevin works as a welfare rights officer at Action for Blind People in Lancashire.

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