JG v Secretary of State for Work and Pensions

Factual and Procedural Background

This appeal arises from a decision of the First-tier Tribunal (FTT) Social Entitlement Chamber sitting at Glasgow on 21 March 2012. The FTT dismissed the appeal of the Appellant against the Respondent’s decision dated 26 October 2011, which found that on conversion from incapacity benefit to Employment and Support Allowance (ESA), the Appellant was not entitled to ESA due to a lack of limited capability for work.

The Appellant, aged 30 at the relevant time, had a history of incapacity benefit receipt since 2003 and completed an ESA50 form in June 2011 disclosing depression, panic attacks/anxiety, and alcohol problems. The Appellant’s GP reported longstanding alcohol dependence syndrome and anxiety with depression. A health care professional assessed the Appellant but concluded that the inactivity observed was by choice rather than illness, and found no significant disability likely in mental function.

The FTT hearing lasted 25 minutes, with the Appellant attending accompanied by a relative. The Respondent did not attend. The FTT found that the Appellant lived a life of inactivity by choice and that no functional deficits arose from a specific disease or mental disablement. The FTT dismissed the appeal.

The Appellant sought permission to appeal to the Upper Tribunal, which was granted. The Upper Tribunal panel identified errors in the FTT’s approach, particularly concerning the application of legal principles to the evidence of alcohol dependence and mental health conditions, and the adequacy of reasons given. The Upper Tribunal set aside the FTT decision and remitted the appeal for rehearing by a differently constituted FTT with directions for further evidence and an oral hearing.

Legal Issues Presented

1. Whether the First-tier Tribunal erred in law by failing to properly apply the statutory test for limited capability for work under the Welfare Reform Act 2007 and the Employment and Support Allowance Regulations 2008 (ESA Regs).
2. Whether alcohol dependence constitutes a "specific disease or bodily or mental disablement" for the purposes of ESA entitlement.
3. Whether the First-tier Tribunal erred in reasoning that the Appellant’s inactivity and alcohol consumption were matters of choice rather than consequences of a mental or physical condition.
4. Whether points under Part 1 (Physical Disabilities) and Part 2 (Mental Disabilities) of Schedule 2 to the ESA Regs can be awarded irrespective of whether the incapability arises from a physical or mental condition.
5. Whether the First-tier Tribunal failed to provide adequate reasons and procedural fairness in its assessment of the Appellant’s case.

Arguments of the Parties

Appellant's Arguments

• The Appellant suffers from a mental illness caused by alcohol dependency, anxiety, and depression, which brings him within regulation 19(5) of the ESA Regs.
• If the First-tier Tribunal did not accept the existence of a mental illness, it erred in law by not putting this issue to the Appellant and failing to provide cogent reasoning for rejecting the medical evidence.
• The First-tier Tribunal failed to adequately explain why none of the specific activities and descriptors relevant to the Appellant’s condition were satisfied.

Respondent's Arguments

• The First-tier Tribunal did not err in law and provided adequate reasoning.
• The Tribunal was entitled to find that although the Appellant may have had a mental disablement, the functional deficits did not arise from it but rather from the Appellant’s choice and control over his drinking.

Table of Precedents Cited

Court's Reasoning and Analysis

The Upper Tribunal began by examining the statutory framework governing ESA entitlement under the Welfare Reform Act 2007 and the ESA Regulations 2008. The core statutory test requires a claimant to have limited capability for work caused by a specific disease or bodily or mental disablement.

The Tribunal emphasized the necessity of a causative link between the claimant's incapability to perform prescribed activities and the underlying condition. It rejected any notion that incapability arising purely from choice or lifestyle, absent a disabling condition, could satisfy the test.

The Court considered the medical evidence, including expert testimony on alcohol dependence as a recognised mental illness under accepted diagnostic manuals (DSM IV and ICD10). It accepted that alcohol dependence qualifies as a specific mental illness or disablement within the statutory language and that the ESA Regulations encompass incapability arising from either physical or mental conditions.

The Tribunal analyzed prior case law, notably R(DLA)6/06, and found it applicable to ESA cases, contrary to some obiter comments suggesting otherwise. It held that the First-tier Tribunal erred in law by failing to properly address whether the Appellant's alcohol dependence and mental health conditions caused functional limitations.

The Upper Tribunal found the FTT’s reasoning inadequate, particularly its conclusion that the Appellant’s inactivity and alcohol use were matters of choice without sufficiently explaining how this conclusion was reached in light of the medical evidence. The Tribunal noted procedural unfairness because the FTT did not put the choice finding to the Appellant or give him a fair opportunity to respond.

Consequently, the Upper Tribunal set aside the FTT decision and remitted the case for rehearing with directions to consider the Appellant’s condition as it stood on 26 October 2011, allow further evidence, and hold an oral hearing before a differently constituted Tribunal.

Holding and Implications

The Upper Tribunal ALLOWS the appeal.

The decision of the First-tier Tribunal is set aside due to an error of law and inadequate reasoning regarding the causation and assessment of the Appellant’s limited capability for work.

The appeal is referred back to a differently constituted First-tier Tribunal for rehearing in accordance with the directions provided, including an oral hearing and opportunity for further evidence concerning the Appellant’s condition as of 26 October 2011.

No new legal precedent is established; the decision directly affects the parties by requiring reconsideration of the Appellant’s entitlement to ESA under the correct legal approach.