With many thanks to Benefits And Work.

A reader raised a good point in the comments of our recent post about the ESA backpayment blunder.

That point is:

So when people do get this money it will effectively take them off benefits until they reach the savings limit does this also mean they’ll automatically be placed on Universal Credit because it’s a change of circumstances they will be reassessed for ESA etc and will then have no choice but be reassessed every year have I got that right?

Under Universal Credit, a broader span of claimants are required to look for work than under Jobseeker’s Allowance. This has the effect of increasing the number of unemployed claimants
http://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-8262

Our editor doesn’t yet know the answer to the question. However, the Government needs to clarify, at the earliest opportunity, whether the ESA backpayments will count towards the savings limit. Same Difference hopes that, since the money will be a backpayment from the DWP itself, caused by their own error, it will not count.

With the DWP, though, anything is possible.

Now we have to ask- could that be the whole point of these backpayments? We certainly hope not.

Tens of thousands of severely disabled and ill claimants are set to receive backdated payments of up to £20,000 after being wrongly underpaid for years by social security officials, the government spending watchdog has revealed.

An estimated 70,000 claimants were underpaid about £340m between 2011 and 2014 after being transferred from older benefits on to employment and support allowance (ESA) during a government overhaul of incapacity benefits, the National Audit Office (NAO) said.

The error occurred when officials at the Department for Work and Pensions (DWP) failed to follow their own legal guidelines governing the transfer process, meaning that in many cases they failed to properly check claimants’ full entitlements.

Meg Hillier, the chair of the Commons public accounts committee, said: “The government’s shoddy administration of ESA has resulted in vulnerable people being deprived of thousands of pounds they were legally entitled to. The NAO’s report shows the DWP was unacceptably slow to act on early signs something was wrong.”

The DWP “failed to get a grip” on the problem for several years despite being alerted to it by staff as early as 2013, the NAO said. Even when it recognised its error as systemic in 2014 it ignored the issue of repayments for a further 18 months.

Although in May 2016 the DWP’s fraud and error team identified an ongoing and significant issue with underpayments, officials prevaricated for a further year before accepting the department had a legal duty to identify and repay affected claimants.

An estimated 45,000 claimants are owed about £2,500, a further 20,000 stand to receive £11,500, with a small number owed as much as £20,000. The size of the repayments varies depending on an individual’s entitlements and the length of their claim.

The DWP has promised to make repayments by April 2019. They will be backdated to 21 October 2014, the date of a court ruling confirming the error. An estimated £150m of underpayments relating to the period before the court ruling cannot legally be paid, the DWP says.

It is the second time in recent months that the DWP has agreed to repay disability benefits. In January it began moves to backdate payments to 164,000 personal independence payment recipients after the high court found that a rule change blocking enhanced payments for people with mental health conditions was discriminatory.

The administrative cost of correcting the latest error is estimated at £14m. The DWP plans to hire 250 more staff as it sifts through an estimated 300,000 ESA assessments to identify affected claimants. Fixing the problem will add about £700m to the ESA bill by April 2023 as ongoing claims are uprated.

Frank Field, chair of the work and pensions committee, said: “This is a damning report. The department is quick to act in cases of overpayment, quick to sanction claimants for any breach of its rules – but when the shoe is on the other foot, has shown it will take years to recognise and get to grips with its own mistakes.”

A DWP spokesperson said: “We’re well under way with our plan to identify and repay people affected by this issue, and payments have already started. We’re committed to ensuring people get what they are entitled to receive as quickly as possible. Everyone who could be affected will be contacted directly by the department.”

There are two forms of ESA: income-related ESA and contribution-based ESA. The DWP error related to claimants who were placed on the latter form of the benefit only, when they may also have been entitled to the former. As a result they may have missed out on premium payments.

ESA is a form of unemployment benefit paid to people with limited capability to work because of disability or illness. About 2.4 million Britons receive ESA, and in 2016-17 the total expenditure was £15bn.

Amyas Morse, the head of the National Audit Office, said: “The facts of this case are that tens of thousands of people, most of whom have severely limiting disabilities and illnesses, have been underpaid by thousands of pounds each, while the department for several years failed to get a proper grip on the problem.”

Ken Butler, a welfare benefits adviser at Disability Rights UK, said: “The National Audit Office report makes for sorry reading. It shows a shambolic catalogue of mistakes which have had a massive impact on tens of thousands of disabled people who qualified for benefits they were denied.”

Genevieve Edwards, the director of external affairs at the MS Society, said the failure was inexcusable. “Around a quarter of all people with MS access ESA as they can no longer work due to ill health. Many have told us the support they receive isn’t enough to pay for the basics and so any underpayment would obviously have a huge impact on their lives.”

TRIGGER WARNING. But please share widely. This can’t be allowed.

Life began at 40 for severely learning-disabled Colleen say her sisters, when she moved into her own home.

She is living happily in her Coventry house, 11 years after leaving unsuitable residential care, thanks to a carefully-crafted network of 24-hour care and a range of state benefits.

But due to the impending removal of the housing part of her support, known as Support for Mortgage Interest (SMI), that security has been mired in uncertainty and anxiety.

Colleen is one of 124,000 households in England who receive this particular benefit.

It helps them repay the interest on their mortgages and nearly half the recipients are pensioners.

However, within weeks the benefit will be axed and a loan offered instead.

Those who have not signed up to the new government scheme face losing their mortgage support.

Though small, the current funding arrangement makes enough difference to enable Colleen to live on her own, and not in a care home.

With no capacity to make her own decisions, her sisters, Felicity Banbury and Fiona Garrigan, look after her interests.

They fought hard for 13 years to find her somewhere comfortable, safe and suitable to live.

Felicity says the impending changes put that security at risk.

“The biggest worry was that we have been given six weeks to make what are really serious financial decisions affecting Colleen’s future,” she said.

“If we don’t make the right decision, she [Colleen] could get into arrears and even lose her house.”

A lack of timely communication about the new rules, by the Department for Work and Pensions (DWP), has stoked up fears of arrears, and ultimately evictions, for some vulnerable and elderly people who receive SMI.

Beatrice Barleon, the policy manager at the learning disability charity Mencap, said: “Many rely on this benefit to pay for their accommodation, and poor communication around these changes has led to people fearing that they will lose their homes as a result.”

By late January fewer than 7,000 of the 124,000 affected households had signed up for the new loan scheme.

And the latest statistics from the government reveal that 5,500 people have still not been contacted about the options ahead.

With just four weeks to go until the current benefit is withdrawn, neither Colleen nor her sisters have received the full information they need from the DWP (via private firm Serco) to be able to make a judgement on the options ahead.

In fact they were contacted for the first time about the forthcoming changes only three weeks ago.

Shadow housing minister Melanie Onn said: “It is shocking that with just weeks to go people are still yet to be contacted about the end of support for mortgage interest.”

Since the BBC contacted the DWP with these concerns, new rules have been attached to the new regulations

This should give the most vulnerable SMI recipients – those with someone appointed to act for them – extra time to make their decision.

A DWP spokesperson said: “Over time, someone’s house is likely to increase in value, so it’s reasonable that anyone who has received financial help towards their mortgage should be asked to pay that back if there is available equity when the property is sold.

“We have been contacting people to explain the change and signpost them to independent advice giving them plenty of time to make a decision.

“But we understand that there are vulnerable people including those with severe learning disabilities or dementia, many of whom have someone acting on their behalf, who need extra support and time,” said the DWP spokesperson.

The DWP also said anyone who had not yet been contacted about the changes would now remain on SMI until they had been reached and guided through the options.

Mrs Barleon from Mencap said this was not the end of her concerns.

“The worry is now that innovative schemes such as homeownership for disabled people, will no longer be available in the future,” she said.

Before moving into her own home, Colleen spent 26 years in residential care, which her sisters say did not meet her needs.

“When she was part of statutory services, she lived with others and we saw a deterioration in her condition,” said Felicity.

Felicity welcomed the late decision to give the most vulnerable SMI recipients more time to consider their options.

But she said she was still very concerned about those without the sort of support she offers to Colleen, and possibly without a voice to argue their case.

With many thanks to Benefits And Work.

With many thanks to Benefits And Work.

Spotted here.

I now have enough evidence to show that a DWP employee knowingly lied to my MP with the intent to deceive. The DWP is ignoring my formal complaint request. My MP really wants to believe the DWP so is ignoring my correspondence. Does anyone know what the law is for a public sector working knowingly deceiving an elected official?

People in the comments thread of that Facebook post are asking for the MP to be named and shamed. However, that is not what concerns Same Difference. The questions we feel we must ask are: How many more DWP employees are doing this? Will anyone ever do anything to stop it happening, if there are more?

These questions may be stupid ones, and we fear we can guess the answers to both.

However, that’s the whole problem, isn’t it, readers?

It seems we can’t go out in public…

Next month, a terminally ill man is set to take on the government – and with it, the disastrous universal credit (UC) policy. Known only as TP, a 52-year-old ex-City worker – who has non-Hodgkin lymphoma and the lymph node condition Castleman disease – is launching a landmark challenge at the high court after becoming financially worse off under the new benefit system.

This couldn’t come sooner. In October, I warned of the hidden cut within UC for disabled people: thanks to the abolition of both the severe disability premium (SDP) and enhanced disability premium (EDP). As a result, according to the disability charity Scope, the move to UC will see claimants lose as much as £395 a month. The outcome of the legal challenge could have widespread ramifications for 230,000 disabled people who it is estimated will be hit by the removal of disability premiums under UC.

The government says that disabled people will be protected by “top-up payments” as they transfer to UC but no such payments are planned until July 2019. The Department for Work and Pensions claims UC means support is focused on those “who need it most”, but a government removing SDP and EDP – benefits designed to help severely disabled people living without a carer – is pulling a safety net from citizens with the greatest needs. This includes disabled single parents who, without their benefits to pay for help to cook or wash, are likely to be forced to rely on their children as young carers. TP’s case shows this inhumanity in a nutshell. He discovered he was dying in 2016 and moved to London to receive treatment, but as it was an area where UC had already been rolled out in the capital, his benefits were cut by £178 a month.

It’s the political equivalent of kicking someone when they’re down. Disabled people are already hardest hit by austerity, especially when cash-strapped councils are increasingly charging them for their social care (a charge that can hit those receiving SDP even harder as they don’t have a family carer). Research from disability charity Scope this month finds disabled people have to pay on average an extra £570 a month for the costs of disability for anything from taxis to specialist food, with one in five paying more than £1,000 extra per month.

Since its rollout, UC has become synonymous with hardship, often heaped on the most disadvantaged families: from an increase in food bank use and rent arrears, to now one million children set to miss out on free school meals because of UC’s new earnings threshold. But the threat to disabled and chronically ill people has up until now gone largely under the radar. Yet severely disabled people will collectively lose £2bn in disability premium payments (a fraction of what the government is spending on UC’s delayed rollout). Or to put it another way, a mother with multiple sclerosis won’t be able to afford to put the heating on or pay for a carer to help her wash.

Launching a multibillion pound benefit system only to remove vital income from some of the poorest people in the country is a particularly warped use of public money – and a move that exemplifies just how low the Conservatives are willing to sink in their rush to gut Britain’s safety net. The campaign group, Disabled People against Cuts, is launching a national protest in responseon 1 March. As UC is hailed as the biggest reform to the welfare state since Beveridge, there’s a very real risk that its greatest achievement will be making more disabled people hungry and housebound. Led by one terminally ill man, the time has come to fight it.

With many thanks to Benefits And Work.

With many thanks to Benefits And Work.

With many thanks to Benefits And Work.

Disabled people receiving state benefits have been hit with a million sanctions in less than a decade, according to alarming new evidence that they are being discriminated against by the welfare system.

A comprehensive analysis of the treatment of unemployed disabled claimants has revealed that they are up to 53% more likely to be docked money than claimant who are not disabled. This raises serious concerns about how they and their conditions are treated.

The findings, from a four-year study by academic Ben Baumberg Geiger in collaboration with the Demos thinktank, will cause worry that a government drive to help a million more disabled people into work over the next 10 years could lead to more unfair treatment.

Sanctions – the cutting or withholding of benefits – are applied as a punishment when claimants infringe the conditions of their payments by, say, as missing appointments or failing to apply for enough jobs.

While the sanctions regime has been championed by the government as a means of encouraging people to take a job or boosting their chances of finding one, most experts consulted as part of the Demos project concluded that conditionality has little or no effect on improving employment for disabled people. There was also widespread anecdotal evidence that the threat of sanctions can lead to anxiety and broader ill health.

The study found that disabled claimants receiving jobseekers’ allowance – given to people who are out of work – were 26-53% more likely to be sanctioned than claimants who were not. Those hit by sanctions reported that the disparity arose because jobcentre staff failed to take sufficient account of their disabilities.

However, a spokesman for the Department for Work and Pensions said it did not recognise these figures: “If someone has a health condition, we work with them to reduce what they need to do, and people are always supported to meet the requirements of a tailored claimant commitment, which they agree with their work coach. This sets out what is expected of them in return for the support they will receive. Sanctions are only used when someone has failed to meet these requirements without good reason – this is in a minority of cases and people are given every opportunity to explain why they have failed to do so before a decision is made.”

The new study found that more than 900,000 JSA claimants who report a disability have been sanctioned since May 2010. People who claim a different benefit, employment and support allowance, and have been placed in a work-related activity group – which requires them to attend jobcentre interviews and complete work-related activities –can also be sanctioned. The research found that more than 110,000 ESA sanctions have been applied since May 2010.

The findings have caused alarm among charities, many of which have dealt with cases in which disabled people complained of poor treatment and a lack of understanding.

Mark Atkinson, chief executive at disability charity Scope, said: “Punitive sanctions can be extremely harmful to disabled people, who already face the financial penalty of higher living costs. There is no clear evidence that cutting disabled people’s benefits supports them to get into and stay in work.

“Sanctions are likely to cause unnecessary stress, pushing the very people that the government aims to support into work further away from the jobs market.”

Polling for the Demos project found that while the public often supported the imposition of sanctions for disabled people, they did not back the way in which they were applied in practice.

A majority thought that disabled people’s benefits should be cut if they do not take a job they can do, but they were less supportive of sanctioning for minor noncompliance, such as sometimes turning up late for meetings. Even those who supported sanctions preferred much weaker punishments than those the government uses.

The research recommends a reduction in the use of so-called “benefit conditionality” for disabled people and a strengthening of the safeguards to ensure disabled people are not unfairly punished.

Polly Mackenzie, director of Demos, said it was now clear that the benefits system isn’t working for disabled people: “Conditionality is important in any benefits system, but when disabled people are so much more likely to be sanctioned, something is going wrong. Jobcentre advisers and capability assessors too often have a culture of disbelief about disability, especially mental illness, that leads them to sanction claimants who genuinely could not do the job they are being bullied into applying for.

“We need to think again about how we assess work capability. Employers also need to be better at adapting to disabled people’s needs so that more jobs can be done by people with fluctuating conditions.”

This follows a damning report by the National Audit Office in 2016, which found that there was no evidence that sanctions were working. It also found a failure to measure whether money was being saved, and that the application of sanctions varied from one jobcentre to another.

Nina Grant has Ehlers-Danlos syndrome, a genetic collagen defect that causes chronic pain, fatigue and frequent joint injuries. She was sanctioned in 2016 after she informed the Department for Work and Pensions that she was carrying out what the department specifically describes as “permitted work” while on disability benefits. “I only found out about the sanction when I checked my bank balance and realised the payment hadn’t gone in as usual.”

After she complained, her benefits were reinstated. “They didn’t apologise. They didn’t offer any explanation. If I hadn’t called them, it could have gone on for months. It made me feel like I was being punished for trying to contribute while disabled, and scared that they were going to use that as an excuse not to pay me.”

The Londoner is reliant on a wheelchair outside her home, and finds it extremely painful even to use a pen most days. “I understand that people exploit the system, but this government treats disabled people with utter contempt.”

Ten years ago Josie Evans was working as a nurse when she suddenly went into anaphylactic shock. After 41 further life-threatening attacks, she has been diagnosed with idiopathic anaphylaxis, which means she is extremely allergic to more than 100 antigens and triggers.

She relies on disability benefit to pay her rent and buy food but was sanctioned in 2016 after failing to send in a form on time: “The document was 20 pages long and I was in too much pain to write, because my hands were swollen from a recent allergic reaction I’d had.”

She explained this and was told she could take her time. Ten days later, a letter arrived from her landlord saying her housing benefit had not been paid. She discovered all her disability benefits had been stopped because the form had been late. “I was scared. I knew I’d need to buy food in the next 48 hours, and I can’t use a food bank because of all my allergies.”

It took weeks for her benefit to be reinstated, and she had to borrow money from her family. “It was so stressful it brought on an allergic attack. The people who work at the DWP simply do not understand the reality of what it’s like to be disabled. There is no room for compassion.”

And a blind man was told his white stick isn’t an aid:

A press release:

In a report published today, Wednesday 14 February 2018, the Commons Work and Pensions Committee says public contract failures have led to a loss of trust that risks undermining the operation of major disability benefits.

Rt Hon Frank Field MP, Chair of the Committee, said:

“For the majority of claimants the assessments work adequately, but a pervasive lack of trust is undermining its entire operation. In turn, this is translating into untenable human costs to claimants and financial costs to the public purse. Government cannot, must not, fail to recognise the unprecedented response the Committee had to this inquiry, remarkable for the consistency and clarity of themes that emerged through thousands of individual accounts. No one should have any doubt the process needs urgent change.

“Recording the face-to-face assessment would go so far toward increasing transparency and restoring trust it beggars belief that this is not already a routine element of the process. The resistance from the Department to instituting this is equally bewildering. The cost of providing a record of the assessment is surely nothing compared to the benefits of restoring trust. Those benefits should include far fewer decisions going to appeal – and being overturned there – at considerable legal expense to taxpayers.

“The current contracts have not made the system fairer, have not made it more transparent and have not made it more efficient. They are up for review, and market interest appears limp. The existing contractors have consistently failed to meet basic performance standards but other companies are hardly scrambling over each other to take over. The Government should be prepared to take assessments in house.”

Efficient, consistent and objective?

The decision to contract out PIP and ESA assessments in the first instance was taken to introduce efficient, consistent and objective tests for benefit eligibility. The Committee says it is hard to see how any of these aims have been met. None of the providers has ever hit the quality performance targets set for them, and many claimants experience a great deal of anxiety and other deleterious health impacts over a process that is regarded as “opaque and unfriendly” throughout. Successive evidence-based reviews done for DWP show a pervasive culture of mistrust around PIP and ESA processes, with concern about the face-to-face assessment by a health professional at its core.

The Committee recommends DWP:

– Immediately institute recording of face to face assessment and provide a record and a copy of the assessors report to claimants

–  Take measures to improve understanding amongst health and social care professionals, and claimants, of what constitutes good evidence for PIP and ESA claims, and to ensure this evidence is used effectively by contractors;

– Set out how it will measure, monitor and report on the supply of evidence into PIP and ESA assessments

-Improve accessibility of the process at every stage: from the format and style of the application form, to information about home visits, to information about accessing  reconsideration and appeal

 -Improve its use of contract “levers” to improve contractor performance   – and quality control via feedback through the claim process, including feedback from the appeal stage

No dog, can’t walk, or – How did you catch Down syndrome?

On Friday last week the Committee released a report compiling some of the thousands of individual claimants’ experiences of the PIP and ESA claims process – from application form to final appeal. The response to the inquiry was unprecedented – in sheer volume, by an order of magnitude – and composed of accounts that were shocking and moving, credible and consistent. A recurrent, core theme   – that claimants do not believe assessors can be trusted to record what took place during the assessment accurately – has implications far beyond the minority of claimants who directly experience poor decision making.

For the record 

The case for improving trust through implementing default audio recording of assessments has been strongly made: the Committee says DWP should implement this measure for both benefits now. In the longer term, the Department should look to provide video recording for all assessments.

DWP attests that the most common reason for decisions being overturned at Appeal is that new evidence has come to light. Organisations that support claimants say this is sometimes true, but the “overwhelming reason” for revised decisions is the full consideration of pre-existing evidence.  DWP’s own data shows that this “new evidence” is most often oral evidence provided by the claimant. In many cases this evidence could have been gathered at the initial assessment. The Department’s “lack of determination” in addressing this shows real weaknesses in its feedback to, and quality control over, contractors, which must be urgently addressed.

Overall costs to taxpayer

On Monday the Press Association published a Freedom of Information response giving a breakdown of some of the wider, systemic costs of wrong decisions. The Committee has previously published a table of the cost of benefits tribunal appeals to the Ministry of Justice – MoJ itself attributes the starkly increased costs to PIP appeals and their complexity – but was surprised to learn of the existence of the figures provided to PA, which it had previously requested. The Chair has written to  Secretary of State Esther McVey asking for an explanation of the discrepancy.

The definition of an “acceptable” report leaves ample room for reports riddled with errors and omissions. Despite this low bar all three contractors have failed to meet their key targets in any single period.  The PIP contracts set targets for contractors to deliver fewer than 3% “Unacceptable” reports. Neither PIP contractor has met the 3% target to date in any rolling three month period. In Capita’s case, as many as 56% of reports were found to be unacceptable in the rolling period February to April 2015.

The Department’s use of financial penalties to try to bring reports up to standard has not had a consistent effect. Large sums of money have been paid to contractors despite quality targets having been universally missed. The taxpayer has spent hundreds of millions of pounds more checking and defending DWP decisions based on the contractors’ reports – not least in externalised costs in the Tribunal appeal system.

The Committee says DWP must consider whether the market is capable of delivering assessments at the required level, and of rebuilding claimant trust. If it cannot—as floundering market interest may suggest—the Department may conclude assessments are better delivered in house

The Department for Work and Pensions (DWP) has spent more than £100m in just over two years on administering reviews and appeals against disability benefits, figures show.

Tens of millions of pounds a year are also spent by the Ministry of Justice on the appeals, about two-thirds of which were won by claimants in the past 12 months.

The costs were described as “staggering” and a former Conservative minister said “something is seriously wrong with the system”.

The DWP said a small proportion of decisions were overturned and most employment and support allowance and personal independence payment claimants were happy with their assessments.

But the department is facing questions from the work and pensions select committee over the figures, following claims that it was not given similar information for MPs’ inquiry into PIP and ESA.

Figures obtained through a freedom of information request show the DWP has spent £108.1m on direct staffing costs for ESA and PIP appeals since October 2015.

The amount covers mandatory reconsiderations, an internal DWP review and appeals to tribunals run by HM Courts and the Tribunals Service.

Neil Heslop, the chief executive of the disability charity Leonard Cheshire, said: “To spend this amount on admin fighting to uphold flawed decisions that shouldn’t have been made in the first place is staggering.

“Thousands of disabled individuals have had to fight to receive support to which they are legally entitled.”

Since October 2015, 87,500 PIP claimants had their decision changed at mandatory reconsideration, while 91,587 others won their appeals at tribunal.

In the first half of 2017-18, 66% of 42,741 PIP appeals went in the claimant’s favour.

The figures for ESA since October 2015 show 47,000 people had decisions revised at mandatory reconsideration and 82,219 appeals went in the claimant’s favour.

So far in 2017-18, 68% of 35,452 ESA appeals have gone in favour of the claimant.

Ros Altmann, a Conservative peer and former DWP minister, said the money could be spent on benefits for those who need them, rather than the costs of fighting claims.

“Disability benefits need an overhaul and, of course, we must not let people make bogus claims, but the extent of the appeals we are seeing clearly indicates that something is seriously wrong with the system,” she said.

Figures released to the select committee inquiry show further costs to taxpayers.

The Ministry of Justice spent £103.1m on social security and child support tribunals in 2016-17, up from £92.6m the year before.

In a letter to the committee, the then justice minister Dominic Raab said the average cost of an appeal had more than doubled to £579 in 2014-15 because PIP cases “now comprise a much larger proportion of the caseload” and require more members on the tribunal.

The MPs are due to publish the results of their inquiry on Wednesday.

Frank Field, the committee chairman, has written to Esther McVey, the work and pensions secretary, to ask why MPs were not given the information.

The DWP gave the committee the average cost of a mandatory reconsideration and appeal for PIP and ESA, but Field said it was unable to work out the full cost because information on whether PIP appeals were from new claimants or those being reassessed, which have different costs, was not available.

“That this data was provided in response to an FoI request, but not for our report, is doubly regrettable, since the key theme of our report is the need to introduce much greater trust and transparency into the PIP and ESA systems,” Field wrote.

A DWP spokeswoman said it was working to improve the process, including recruiting about 190 officers who will attend PIP and ESA appeals to provide feedback on decisions.

“We’ve already commissioned five independent reviews of the work capability assessment, implementing more than 100 of their recommendations, and two independent reviews of PIP assessments,” she said.

“Meanwhile, we continue to spend more than £50bn a year on supporting people with disabilities and health conditions.”

With many thanks to Benefits And Work.

With many thanks to Benefits And Work.

With many thanks to Benefits And Work.

With many thanks to Benefits And Work.