Forgive the long quote from the ESA Medical Services Handbook...
"Scope
This activity relates to lower limb and back function. It is intended to reflect ability to reach a low level such as a low shelf, or the floor, using supports such as furniture if needed, but without dependence on another person for support to straighten up again.
“As if to pick up an object” does not include the ability to manipulate the object or the ability to lift weights (these activities are covered in other areas relating to upper limb function).
This functional category includes a number of different activities of the spine and lower limbs involving the ability to manoeuvre the body from a standing position. Descriptor B(a) implies a very severe condition, with both lumbar spine and hip movements severely reduced, or restricted by pain.
This activity is very different from the one involved in descriptors B(b) and B(c). These descriptors consider the activity of bending and/or kneeling as if to pick something off the floor or a low shelf which involves a combination of flexing the lumbar spine, flexing the hip joints, and bending the knees to a squatting position.
Details of activities of daily living
Relevant activities include: ı Dressing and undressing especially footwear ı Getting in and out of the bath ı Bending to reach the oven, front loading washing machine, low cupboards or shelves ı Hanging laundry to dry ı Carrying out household cleaning chores. Bending to tend to babies and toddlers may also be relevant as may leisure and recreational activities involving bending e.g. gardening, tending to pets.
Observed behaviour
Record general mobility. Functional knee and hip movement are important for this task and may be observed while the claimant is seated at interview. While it is not appropriate to directly observe the claimant undressing/dressing note the time taken and any help requested with certain items of clothing particularly shoes. Note the claimant's ability to climb on and off the couch. It may be possible to observe the claimant pick up an item such as a handbag or shopping bag from the floor of the examination room.
Clinical examination
Restriction of spinal movement to the degree indicated by B(a) suggests a severe spinal problem. Clinical examination should be consistent with this. There may be evidence of muscle wasting. For B(b) or B(c) to apply, you would expect in most cases to identify significant problems in knees and hips. In some cases, where a neurological condition may be apparent, a registered medical practitioner may need to perform an assessment of functions of balance including testing for cerebellar or proprioceptive functions. Assessment of power in the lower limbs will be essential"
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It seems to me that on the one hand the Manual visualises bending from a standing position when it says...
"This functional category includes a number of different activities of the spine and lower limbs involving the ability to manoeuvre the body from a standing position."
Under the heading of "Details of activities of daily living" it refers to getting in and out of the bath, bending for the oven, and hanging out laundry... hardly things you can do sitting in a chair.
On the other hand it goes on to say (under the 'observed behavior' section)...
"Record general mobility. Functional knee and hip movement are important for this task and may be observed while the claimant is seated at interview"
A mixed message here. On the one hand the Atos person is told to look at general mobility, but then permits observations when seated in the context of knee and hip movement. Of course, the restriction of such observation (in terms of knee and hip, even if correct - which it is not, if some weight is being taken by the chair) is probably lost on the Atos person, who relies on chair based observation generally.
I reckon there is scope to involve Atos person's divergence from their own Manual as a partial platform for any appeal, on top of pure legal arguments concerning the mismatch of the Atos persons recommendations, in the face of the actual tests in the descriptors.
There is nothing like a drop of divergence from their own guidance, to wobble a decision makers general arguments
Best of luck,
Steve
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