These are the doctor’s letters that warned of the perilous health of six-stone Stephen Smith – and which were ignored by the Department of Work and Pensions as they continued to deny him vital benefits before his death.
Stephen died last week at the age of 64 having only recently overturned the government’s decision to take him off benefits following a lengthy and draining battle.
In January he had to get a pass out of hospital, weighing just six stone, to battle and defeat the DWP to get his support restored.
And after his story – and shocking images of his condition – were published, the department admitted its mistake and awarded Stephen more than £4,000 in backpay that he had been wrongly denied for so long.
Sadly, he never had the chance to use it – and that money is now being used to pay for his funeral.
Now, the ECHO can reveal the doctor’s letters that were issued to the DWP on Stephen’s behalf, warning about his failing health and how this could be affected if he was found ‘fit to find work.’
Two letters, from two different doctors, sent in October 2017 and January 2018, were ignored by the department as it continued to block Stephen’s benefits and force him to continue exhausting battle, which he eventually won earlier this year.
‘He could not walk 20 metres without pain or exhaustion’
After Stephen’s ESA benefits were stopped following a work capability assessment in Spring 2017, he appealed the decision and included a full examination report from Dr Terence Crowley of Rodney Street, Liverpool.
In his report, Dr Crowley lists the various serious health issues Stephen had, including chronic obstructive pulmonary disease (COPD), cervical spondylosis, osteoarthritis and the fact he had been fitted with a urinary catheter because of ongoing urinary issues, which he was heading for surgery on.
In the Doctor’s opinion summary, he stated:
“Mr Smith has multiple well-established and formally diagnosed medical problems, primarily chronic onstructive pulmonary disease, cervical spondylosis, osteoarthritis of the knee and benign prostatic hypertrophy with a history of chronic urinary retention.
“He is prescribed medication in respect of each of these and his urinary problems necessitate the use of a catheter and future surgery.
“These medical conditions adversely impact upon his mobility and upon the activities used to assess eligibility for ESA and PIP. The nature of these chronic problems is such that they will worsen over time and mean that his mobility and functionality is impaired on a daily basis.
“Mr Smith will be in pain on standing and at the commencement of walking. Whilst on the balance of probability, he would be able to walk 20 metres, in my opinion, he could not mobilise a distance of twenty metres repeatedly without needing to stop due to pain and breathlessness.
“It is my opinion that not only could Mr Smith not walk 20 metres without pain or exhaustion, he coult not do it repeatedly or within a reasonable time period.
“In terms of cooking, his very limited respiratory tolerance, and his difficulties with lifting means that in practical term anything other than straightforward microwave cooking is likely to be beyond his physical capabilities.
“The need to monitor and change his catheter requires medical input and it would therefore be reasonable to describe Mr Smith as requiring assistance with toilet needs.
“The identified restrictions affecting Mr Smith’s mobility and daily living activities have been present for more than three months and, given the nature of his medical complaints, are likely to remain beyond the next nine months.”
Despite this stark assessment of Stephen’s health and warnings about how it could deteriorate from a qualified doctor, the DWP continued to find him fit to find work and block him from receiving his full benefits.
Three months later, of January 23, 2018, another doctor’s assessment was issued to the DWP as Stephen and his friends desperately tried to get the decision overturned.
The second note, from his GP, Doctor P Sivabalan of the Edge Hill Health Centre was unequivocal in its disagreement with the decision of the DWP.
The letter stated:
“I am this patient’s General Medical Practitioner and the custodian of the primary medical records they have accumulated during their lifetime in the UK.
“Following a recent Work Capability Assessment this patient, in contradiction of my own knowledge of the patient over time, clinical assesment and medical certification, was found fit for work related activity.
“Because of my patient’s health condition there would be a substantial risk to my patient’s health if he were found not to have limited capability for work related activity.
“I am of this opinion because Mr Stephen Smith has severe COPD, multiple joint osteoarthritis affecting many joints, prostate issues and difficulty passing urine (patient is still on a catheter).
“In my opinion he has significant difficulty with mobility and daily activities.”
“I disagree with the outcome of your assessment and support my patient in his appeal against your decision.”
Despite the unequivocal opinions of two qualified doctors, including the GP who knew Stephen’s conditions better than anyone, the DWP continued to deny him the benefits he needed.
His battle would continue for another grueling 12 months in which his health – as predicted by the doctors – deteriorated badly, leading him to develop pneumonia and see his weight drop to just six stone.
It was at this point in January this year that he faced the shocking challenge of leaving hospital in an emaciated state to take on the DWP at a tribunal.
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Remarkably, he had the strength to make it to that hearing and overturn the bizarre decision that the dogged DWP had stuck by in the face of overwhelming evidence.
After the decision was made, the department was forced to reinstate Stephen’s full ESA benefits – and when his images and story hit the headlines they agreed to backpay around £4,000 that he had been wrongly denied.
But as we have said, the money came to late – and he died before having a chance to use it to improve his situation.
Amber Rudd’s silence
Since Stephen’s death, the ECHO has repeatedly asked Amber Rudd, the Secretary of State for the DWP to respond or even acknowledge what happened to him.
We have been told that as it is an ‘operational issue’ it would only be appropriate for a generic response from an unknown spokesperson to be issued.
They said: “Our thoughts are with the family and friends of Mr Smith at this difficult time.
“A review has been conducted into Mr Smith’s ESA claim and how this was handled, and we will continue to learn lessons to strengthen the assessment process.
Top news stories
“We are committed to ensuring that everyone with a health condition receives the support they are entitled to, and while assessments work well for the majority of claimants we are changing and improving how we support people with disabilities.”
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