Coroner raises possible link between benefits and suicides

Kim BurnsKim Burns, who had multiple sclerosis, left a note criticising the DWP

A coroner has raised the issue of a link between suicides and perceived problems with benefits.

Staffordshire coroner Andrew Haigh said it was possible the number of such cases were increasing.

He recently held an inquest where Kim Burns, of Codsall, near Wolverhampton, left a note criticising the Department for Work and Pensions (DWP).

However, the DWP said that death was not linked to loss of benefits and Ms Burns had been receiving her payments.

 

Christine Hammonds
Image captionChristine Hammonds said Kim Burns had feared losing £1,000 per year and her car

A spokesman said Ms Burns, 51, was still receiving the higher rate of mobility allowance and personal independence payments were not a factor at the time of her death.

Ms Burns, a former worker with the British Council and at various universities, had worked full time until she developed an aggressive form of multiple sclerosis, her friend Christine Hammonds said.

She killed herself on 17 January. Her inquest in April recorded a verdict of suicide.

Ms Hammonds said Ms Burns had suffered with depression, but thought she would lose £1,000 a year in benefits from April and feared losing her car.

“She was an independent, very proud woman and I don’t think that she wanted to get to the state like so many people, she felt, who somehow find themselves on the edge of society,” she said.

Valerie Grant, 73, of Great Bridgeford, died in April. Her son had been told he was to lose his disability allowance on 3 May.

Her inquest has yet to be heard, but following her post-mortem test, Mr Haigh said: “Every now and again I do have to deal with sad cases of people who have killed themselves because of perceived problems with state benefits.

“These do not occur very frequently and I cannot really say if there is an increase in trend, but it certainly is a possibility.”

He added he thought it was a “worthwhile issue to explore”.

The DWP said it was inappropriate to comment on Mrs Grant’s case as she was not in receipt of the benefit.

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ANOTHER DWP ATROCITY: mum’s anger over benefits blunders from DWP

West Kilbride mum's anger over benefits blunders from DWP

SOURCE

A West Kilbride mum was stunned to be told by benefits staff that people who come out of prison were ‘more vulnerable than her son’, who has a severe form of cerebral palsy.
Angela Brown of Gateside Street has received child tax credits for her son who has now turned 18, and so had to apply for ESA – employment and support allowance – as he became an adult.
Connor requires round the clock care from his mother, and since turning 18, has become his legal guardian. However, the Department of Work and Pensions lost the original application last August, and the matter wasn’t resolved until February.
Due to the lack of payments coming in, Angela, who is a single mum, had to cancel her phone, and had to put energy bill payment on hold, and was finding it very hard to make ends meet, saying it was a ‘horrendous’ period.

And upon pursing the matter, Angela said: “The lady told me that there are other people out there more vulnerable than my son, such as people coming out of prison.
It completely broke me that day – it was really a kick in the teeth.” Connor is immobile, and is fed with a tube into his stomach, and has non-verbal communication, He turns 19 at the end of the month. Angela said: “It took until April for the matter to be resolved, but can anyone explain to me why my son, who has cerebral palsy, sitting in a living room, is considered less vulnerable that someone coming out of prison.”

Angela took the matter up with MP Patricia Gibson’s secretary and found out that the DWP had lost the application form. She also spoke to West Kilbride councillor Todd Ferguson who sought assistance from MSP Jamie Greene on the matter.
Angela said: “Connor went to the James McFarlane School in Ardrossan, and I wouldn’t want others to go through the same thing I went through. It is stressful enough with any disabled person but to leave you hanging on for eight months and it was their fault.”
“I have been put through the grinder, I eve had to repeated sick lines from Connor’s GP – which even he found ridiculous.

It kind of pushed us to the limit with a lot of bills unpaid, so I had to cut the phone off, electricity was another nightmare as Connor requires a lot of medical equipment. But to be told by the benefits agency that Connor was not as vulnerable as people leaving prison is what angered me most. It was totally unacceptable.”
“They admitted to losing the form and still made us claim again, and these forms are a nightmare, and given Connor was going to a new day centre, as well as sorting out the money issue, it was a very stressful period.”
A DWP spokesman said: “We have apologised to Ms Brown for the delay, and her son’s
higher rate of ESA entitlement has been backdated in full.”

ANOTHER DWP ATROCITY: Cardiac patient declared ‘fit to work’ by benefits assessors suffers third heart attack THREE HOURS into new job

MIRROR

Michael Bispham, 44, was told he was well enough to work again, despite 11 letters from consultants and other medics saying he wasn’t

1

Micheal Bispham was refused ESA after scoring zero points (Photo: cascadenews.co.uk) 

A cardiac patient who was declared fit for work by benefits assessors suffered a third heart attack just three hours into a new job.

Michael Bispham, 44, was told he was well enough to work again, despite 11 letters from consultants and other medics saying he wasn’t.

He was refused ESA (employment support allowance) after scoring zero points.

Michael had already suffered two heart attacks, and he collapsed with a third on the day he started work as a delivery driver in Barrow, Cumbria.

His plight has echoes of the Ken Loach film ‘I Daniel Blake’, in which a heart patient battles the benefits system.

Michael, of Dalton, Cumbria, was fitted with a cardiac shock device before he started work on February 13.

To add insult to injury, news that his employment and support allowance assessment was being reversed on appeal arrived as he lay in a ward at Furness General Hospital, awaiting transfer to the region’s cardiac centre at Blackpool Victoria Hospital.

Now, his wife Emily has spoken of the double trauma of helping Michael in his recovery while fighting the “horrendous and unfair” benefits system she claims is designed to make honest people feel “worthless”.

The 44-year-old had already suffered two heart attacks (Photo: cascadenews.co.uk)

Emily, 38, said: “My husband scored zero points when he was assessed for employment support allowance.

“He’d already had two heart attacks. That should have been it.

“We knew he was too poorly, we submitted 11 letters about his condition from consultants and the hospital, but they declared him fit to work.

“It nearly killed him. I’m so angry about it.

“Just when we needed help and support, we had to navigate the system with pages of forms.

“They stopped any money because he was no longer able to job seek and we were told to start from the beginning and apply again for the ESA he’d been turned down for in the first place.

“We had nothing for three weeks at what was the worst time of our lives. It was so difficult.”

Stills from the new Ken Loch Palmes D'Or winning film I, Daniel Blake
Michael’s plight has echoes of the Ken Loach film I Daniel Blake (Photo: Daily Record)

Mrs Bispham, a former greeter at a Barrow supermarket, was forced to stop work herself last year after being diagnosed with Crohn’s disease.

She hopes to return to work as soon as she is well again.

She said: “We were just normal people with jobs. We’ve got a mortgage. This could happen to anyone. But the way you are treated by the government is appalling.

“Basically, it’s a case of guilty until proven innocent at these assessments. You are there to prove you’re not making it up.

A DWP spokesperson said: “The decision on whether someone is well enough to work is taken following a thorough assessment, including all available evidence from the claimant’s GP or medical specialist.

“Anyone who disagrees with the outcome of their assessment can appeal.”

‘I was a citizen, now I’m nothing’: disabled readers on life under austerity

In a series of interviews over several months, the Guardian has followed three disabled readers – Stephen, Alex, and Elli – as they experience the reality of life since austerity.

Stephen’s story: Managing to work in pain, but for how long?

“I want the minister in charge to come here and tell me how I’m meant to live. I’ve worked since I was 15. I pay my taxes. Why do I then have my benefit taken away?” Stephen, 52, asks from his front room in Maidstone with his wife, Elaine, next to him.

 A car accident in his 30s left Stephen with osteoarthritis of the spine, memory problems and a degenerative disc in his back. There’s rarely an hour of the day his legs or his feet aren’t racked with pain, and he moves uneasily around the house, holding on to the wall with one hand to pull one leg along. Elaine’s ill herself – she has fibromyalgia, a degenerative spinal disorder, and knee problems – but it’s since the austerity cuts came in that, in Stephen’s words: “Our life’s just got worse.”

Elaine had to give up work as a hotel caterer in 2014 but doesn’t get any income support. The government put a time limit on how long disabled people can have some out-of-work sickness benefits, so after six months of receiving employment and support allowance, Elaine’s benefit was stopped – despite the fact her disability hadn’t got better. Packets of medications and pain relief sit in a small basket on the sofa table. Stephen used to get free prescriptions, but when NHS cuts kicked in three years ago, this went too.

The couple’s only income is Stephen’s job as a warehouse manager at Morrisons. Because the pain in his legs means he can’t use the bus, he relies on a Motability car – a government scheme that lets disabled people swap mobility benefits for the lease of a car, wheelchair, or scooter – to get there. But after being tested for the new personal independence payments (PIP), he was rejected for the mobility part of the benefit this spring and – like more than 50,000 other disabled people since 2013 – he’s been told he must return his vehicle.

The couple have had a temporary reprieve – the Motability charity has extended the lease for a few months – but Stephen will need to return the car in September. Elaine’s already had her own benefit cut in the transfer to PIP – that’s £300 a month gone – but Stephen’s rejection could mean his entire wage could go too. “If I lose the car, I can’t get to work. £30,000 a year,” he says. “Who’s going to pay that?”

The Department of Work and Pensions (DWP) states that “more people are on the Motability scheme now than before PIP was introduced, and under PIP 26% of people get the highest level of support compared to 15% under DLA”, and that anyone can appeal if they wish. Two days ago, Stephen contacted me: the DWP turned down his first appeal to keep his car. “I work despite the pain,” he says. “[And now] they’ve kicked me aside.”

Alex’s story: Treated worse than a farm animal

“It’s not just the cuts. It’s how disabled people are being treated within that,” says Alex, from Islington, north London. “You’re treated worse than an animal going to the slaughterhouse.”

The 44-year-old has multiple severe conditions – a spinal and head injury, degenerative hands and feet, chronic fatigue, double incontinence, and mental health problems – and is unable to walk. For the past four years, Alex has been living in a cramped top-floor flat.

Because the flat is too small for a hoist to let a carer help Alex move safely, Alex is forced to crawl to get from one room to the next: slowly pulling along the carpet, legs dragged on one side. To be able to leave the flat, Alex balances on crutches to get down two flights of stairs. It’s a visible strain: Alex’s feet twist with each step and breaths are short. Outside, at the bottom of another seven concrete steps sits Alex’s wheelchair, chained up on the street. With no lift, Alex can’t get it into the flat.

I first spoke to Alex in January, and it’s clear over the months that the flat is making Alex’s health deteriorate. At one point when we speak, Alex has been bed-bound with a hemiplegic migraine for 11 days – essentially, hit with stroke symptoms that lead the body to go in and out of consciousness. By the end of April, Alex is completely bed-bound. “I can’t crawl or go down the stairs at all now,” Alex emails – but every couple of weeks they risk falling down the stairs with a personal assistant to go to therapy appointments “because my mental health has deteriorated” too. (Alex has asked to be referred to as “they”.)

Alex has fought for months for safe housing from the housing association – even to get on the council’s higher medical band – but there are limited accessible properties in the area, and the only options the council offered were out of borough and too far from Alex’s doctors. In March, Alex was given some hope, after accepting a ground-floor wheelchair-accessible flat in Islington, but it needs extensive adjustments, and three months later, Alex is still stuck in the current flat.

Islington council’s corporate director of housing and adult social services says specialist adaptations and equipment are being installed in the new property and this work is being carried out as fast as possible. They add: “Like London, Islington has a severe housing shortage, and finding suitable, ground-floor, wheelchair-accessible accommodation, in the location requested, has been challenging.”

Talk with Alex and what’s striking is not only the direness of the living conditions, but the fact it’s come at a time when, as Alex puts it, every area of life has also been “infected by cuts” against disabled people. Social care cuts mean Alex is alone in the flat for the equivalent of four-and-a-half-days each week. To afford the wheelchair that sits outside, Alex had to sell possessions from the pavement – “My TV, my landline phone, plates, mugs, my second-hand laptop, clothes, everything” – as the NHS waiting list was three years. (Islington council says a powered wheelchair, which would be suitable for the new property, will be provided as soon as the move is complete.) The fridge is filled with large bottles of milk; since the government cut the medications and equipment available on prescriptions, Alex buys incontinence pants instead of food.

“Only dementia patients get pull-ups now, and then only two a day,” says Alex, who can’t afford the £80 a month required to buy them every day. “So I’m left in soiled pull-ups causing sores and infections.”

Elli’s story: I’ve gone from being a citizen, to nothing

Living with disabilities under austerity: ‘They’ve peeled me back like an onion’

“If I can’t get out of bed, I have to shout to get the pizza man to deliver to my bedroom,” says Elli, 39, in her bungalow outside Norwich.

Elli has hypermobility Ehlers-Danlos syndrome (EDS), anxiety, and chronic fatigue and pain, and leans on crutches as she makes her way from one room to the next. Her social care package used to help her with day-to-day tasks – dressing, preparing meals, household chores – and enabled her to found and direct a local arts organisation. But in late 2016, Elli had her care cut from 44 hours a week to 22. “They halved it overnight,” she says. “It took three 30-minute meetings with a social worker.”

Elli laughs at times as we talk – making jokes about not being able to get up once she’s sat down – but it’s clear that what’s happening is taking its toll. She now has no care hours at all to support her for anything her council defines as “social” – including going swimming as physiotherapy – nor anything “medical”, such as someone going to the hospital with her. Elli’s condition means she falls regularly, but with long gaps without a personal assistant, she’s now regularly left to lay on the floor for five hours with dislocated joints because she has no one to help her up. “I’ve stopped going out now really because if I fall, I won’t be able to get up myself,” she says.

In confronting Theresa May, Kathy has spoken up for all Britain’s disabled people

In March, Elli emails to tell me she’s had more support cut. Her Access to Work funding – which pays for a part-time support assistant – has been cut by 100%: £13,000 a year to nothing. “That’s not really a cut at all, is it?” she says.

A DWP spokesperson tells me “real terms funding of the Access to Work scheme has increased”, but with hers stopped, when her health is at its worse, Elli’s bed is now not only her dinner table but her office too: a laptop on the quilt and a pile of paperwork.

In recent years, she’s become familiar with fighting for disability support – she tells me she dislocated her wrist filling in the long application forms for PIP – but as she stares at the window from her bed, she sums up the reality for an increasing number of disabled people: “They’ve taken me from a citizen to nothing, hidden behind a door.”

Conservative MP dismisses disabled woman who tells him ‘tens of thousands of people are dying’

INDEPENDENT

Dominic Raab tells disability activist putting more funding into health and social care is ‘just a childish wish list’ unless there is a strong economy

A Tory MP has dismissed a disabled woman on live television after she told him tens of thousands of disabled and sick people were dying every year due to cuts in health and social care.

Conservative MP Dominic Raab responded to an emotional address from Fiona, a disability activist from Aberdeen, in which she said she had known disabled people who and committed suicide, by saying it was “just a childish wish list” if there was not a “strong economy creating the revenue”.

During the open debate on the Victoria Derbyshire show, Fiona said disabled people were “fleeing” from England to Scotland where she said the devolved parliament was doing more to protect them.

“You’re all talking about numbers and money, and there is an ocean of suffering under that. Oxford University just released research showing that in 2015 in England and Wales alone there were 30,000 excess deaths caused by cuts to health and social care,” she said.

“Tens of thousands of disabled and sick people are dying every year. We are dying. There have been hundreds of suicides. I spent hours after the last general election trying to talk people out of killing themselves, and I didn’t always succeed.

“People are dying here and nobody cares. I have friends who have been helping resettle disabled people in Scotland because at the very least we have a Scottish parliament which is trying its best with limited funds to protect people against the worst of these cuts. People have been fleeing England for their lives.”

Fiona cited a study by Napier University that found the work capability assessment causes deterioration in people’s mental health and can lead to thoughts of suicide, adding: “It kills people. It is an act of violence and we are dying.

“This election is life or death for us. Anybody who votes for the Conservative Party, who are going to further these cuts, they are complicit in those deaths.”

In response to Fiona’s comments, Mr Raab said: “There are plenty of heart-rending stories here, and no one could be anything other than moved by it. We have put in 11,000 more doctors into the NHS, 12,000 more nurses. We have got a renewed focus on mental health and also making sure we’re trying to take the pressure off big hospitals in the manifesto.

“But the real truth is the money’s got to come from somewhere, and I can think of lots of things that I would like to avoid making difficult decisions on and lots of areas like the health service or schools that I want to put even more money in, but unless you’ve got a strong economy creating the revenue, it’s just a childish wish list.

“We’re trying to do our best to get the balance right between responsible public finances and investing in some of those crucial areas you discussed.”

Fiona responded by saying: “So you choose to sacrifice tens of thousands of disabled people, for the sake of that? This is the sixth richest country in the world. It is a choice that people make.

“In Scotland, we have a limited block grant, and they still manage to create a health service which functions, they still manage to create a care service which functions. And you are choosing to sacrifice us.”

It comes after Theresa May refused to rule out making further cuts to disability benefits in the next Parliament if the Conservatives are returned to government.

Asked by The Independent at a campaign event in Mansfield earlier this month whether she would rule out any further cuts to support, the Prime Minister responded: “If you look at what we’ve been doing on disability benefits, what we have done is look at focusing disability benefit payments on those who are most in need.

“In fact, we are spending more on disability benefit payments than has been done by any government in the past.”

A £30-a-week cut to some new claimants of the Employment and Support Allowance came into effect in April despite opposition from more than 30 disability charities.

The Department for Work and Pensions (DWP) says the lower rate of cash support will encourage disabled people to find work, but charities say the cuts make life harder for disabled people who face extra costs and mean some people will be unable to afford basic necessities.

The Government was also forced to U-turn on a £4.4bn cut to the personal independence payment (PIP) in March last year after signs of a rebellion amongst its own backbenchers and the resignation of Work and Pensions Secretary Iain Duncan Smith, who said he could not back the policy.

Benefit sanctions ‘out of control’ claims Dr David Webster, of Glasgow University

THE HERALD

Benefit sanctions ‘out of control’ claims Dr David Webster, of Glasgow University

Benefit sanctions ‘out of control’ claims Dr David Webster, of Glasgow University

 

BENEFIT sanctions have heaped more acute pressure on welfare claimants than any policy since the abolition of the workhouse, an academic will claim next week.

Statistics from the first six years of the new system, which sees payments to benefit claimants stopped for increasingly lengthy periods if they are judged to have broken the rules, show that sanctions are out of control, Dr David Webster, of GlasgowUniversity will say.

The period analysed by Urban Studies researcher Dr Webster covers the previous Conservative– Liberal coalition government, but recent statistics continue to cause concern, he says.

His research suggests the number of penalties imposed on benefits claimants in 2013 exceeded fines imposed by courts.

An event at Glasgow University tomorrow will hear that this practice amounts to a “secret penal system”, which lacks the checks and balances of the mainstream criminal justice system.

It will also consider the powers of the Scottish Parliament to mitigate the impact of sanctions on benefit claimants in Scotland.

Dr Webster said by 2013, the Department of Work and Pensions applied more than a million sanctions against those receiving job seekers’ allowance, 32,128 against claimings of employment and support allowance as well as around 44,000 to lone parents receiving income support. In the same year, sheriffs and magistrates in Scotland and the rest of the UK imposed a total of only 849,000 fines, he said.

He claimed this was a particular issue because sanctioned benefit claimants are treated much worse than those fined in the courts.

“The scale of penalties is more severe and most sanctions are applied to poor people and involve total loss of benefit income,” he said.

Although hardship payments are available, families and individuals must wait two weeks to make a claim. By which time they can be reduced to destitution. Dr Webster added: “The hardship payment system itself is designed to clean people out of resources: all savings or other sources of assistance must be used up before help is given.”

Unlike the public courts, sanction decisions are opaque, Dr Webster said. “Decisions on guilt are made in secret by officials who have no independent responsibility to act lawfully… “The claimant is not present when the decision of guilt is made and is not legally represented,” he said.

Dr Webster said sanctions have the potential to have a devastating impact on some of the UK’s poorest people often for trivial or disputed rule breaches.

He said: “The transgressions which are punished by this system are almost exclusively very minor matters, such as missing a single interview with a job centre or Work Programme contractor, or not making quite as many token job applications as the Job Centre adviser demands.”

A spokeswoman for the DWP did not respond to Dr Webster’s concerns about the transparency of the sanctions system, but said the majority of job seekers supported sanctions. “Sanctions are only used in a very small percentage of cases. In the last year less than 1 per cent of ESA recipients and 2 per cent of JSA recipients were sanctioned each month,” she added.

Work and Health Programme: Who can be referred, for how long and when?

FRANK ZOLA

Work and Health Programme (WHP) referral criteria.

Work & Health Programme: @DWP says “If they fail to take part in community benefit work placement” @keepvolvol > https://twitter.com/refuted/status/868847128600133632 

“From November 2017 the WHP will be DWP’s new contracted employment provision that will help persons who have a disability, the long-term unemployed (LTU) and specified disadvantaged groups to find sustained work.”

“referrals to begin between November 2017 and February 2018”

“Once a Participant starts on WHP, you have 456 calendar days to work with that Participant, to help them into sustained employment.” or up to “639 days” for people in paid employment.

“To be eligible for Work and Health Programme (WHP) all Participants must be of working age, and resident in England or Wales and be in one of the eligible categories. As stated in Chapter 1, all referrals will be made through Jobcentre Plus….

The majority of eligible participants are likely to be claiming…

Universal Credit (UC); or
Jobseekers Allowance (JSA); or
Employment and Support Allowance (ESA)*; or
Income Support (IS)

*Check link for differences between ESA Work Related Activity Group (WRAG) and ESA Support Group)

“Participant Groups
2.11    The participant groups will be targeted referrals by Jobcentre Plus comprising:

persons who have a disability attending WHP on a voluntary basis;

early access disadvantaged groups attending WHP on a voluntary basis; and

LTU (Long Term Unemployed) attending WHP on a mandatory basis.”

The WHP provider guidance has additional referral criteria for ‘Participants with Disabilities’, ‘Early Access Disadvantaged Groups’, ‘Long Term Unemployed Participants, ‘Signposting Organisations (SO)’ for people who are not customers of Jobcentre Plus and ‘Workers in Paid Employment’:

‘Participants with Disabilities’

Participants with a disability can be referred by DWP to the Contractor on a voluntary basis, at the most appropriate time when the criteria below are met, the participant:

  •     has a disability or disabilities as defined by the Equality Act 2010;
  •     can be helped, in the opinion of DWP, by participating in the WHP;
  •    if relevant, has already been helped by Jobcentre Plus with their core jobsearch activity;
  •  needs more support than can be provided within the standard Jobcentre Plus offer (or through other available services and provision); and
  •    has committed to the goal of finding employment within one year.Please note – for participants with a disability, capacity to participate for any minimum number of hours per week/month will not form part of the decision to refer as there are no minimum hours of support/participation in the WHP.

‘Long Term Unemployed Participants’

“Mandation/Benefit Sanctions
2.36    Participation in the WHP for the LTU group is mandatory. Suppliers will have the delegated authority to require participants from this group to undertake activity which would help them find and retain work. If LTU participants mandated to the WHP fail to undertake mandatory activity, the supplier will refer to the DWP Labour Market and Decision Making Team who will decide if a benefit sanction is appropriate.”

  • JSA participants at 24 months including linking periods as set out paragraph 15;
    UC participants who start in the Intensive Work Search Regime (IWSR) and are in the IWSR when they reach 24 months discounting change of circumstances within the 24 month period; and
    Participants migrated to Universal Credit Full Service (UCFS) from legacy benefits will be considered when their time on legacy benefits including linking rules (as a.) and their time in the IWSR (as b.) totals 24 months.
  •     Participants who have completed WHP in England or Wales will be excluded. The Work Coach will also consider whether a participant should be Exempt from WHP or whether participation should be deferred. Details of Exemption and Deferral criteria will be provided.
  •     Whether eligible participants access the WHP will be determined by a process of random allocation. If a participant is randomly allocated, they will be referred by the Work Coach to the supplier on a mandatory basis.

Early Entrant Groups

  • an ex-offender (someone who has completed a custodial sentence or a community sentence), or offender (someone who is serving a community sentence)
  •     a carer;
  •     an ex-carer;
  •     a homeless person;
  •     a former member of Her Majesty’s (HM) Armed Forces;
  •     a member of the HM Armed Forces reserves;
  •     a partner of current or former Armed Forces personnel;
  •     a person for whom a drug/alcohol dependency (including a history of) presents a significant barrier to employment;
  •     a care leaver; and
  •     refugee.

‘Signposting Organisations (SO)’

In order to make the WHP accessible to all disabled groups, including those who are not regular customers of Jobcentre Plus, DWP approved Signposting Organisations (SOs) will be able to signpost individuals that they think will benefit from WHP to Jobcentre Plus.”

‘Workers in Paid Employment’

“In Work Support whilst on the programme can be for any period of time, but once a Participant reaches the 456 day end point on programme, In Work Support can only be extended for a further 182 days. This may extend the period for which you support a Participant in total up to a maximum of 639 days.”

Source:
Chapter 1 – Introduction and Overview
Chapter 2 – Participant identification
Call-Off Specification for the Work and Health Programme
https://mrfrankzola.wordpress.com/2017/05/28/work-and-health-programme-all-provider-guidance-specifications-and-launch-info/