What you need to know about Atos assessments.

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Courageous Scottish nurse Joyce Drummond, who made a heartfelt apology to Atos assessment victims, has submitted evidence to the Scottish Parliament Select Committee on Welfare Reform.Joyce forwarded some of her notes to me, containing this information about Atos assessments. I have edited where needed, organised the notes and added some information to the text. I’ve included the contents from Joyce’s notes in full. Both Joyce and I share this information in the hope that people going through Atos assessments will find the information helpful and informative.

“I knew nothing about Atos when I joined, and left as soon as I realised that there was no way to fight from the inside. I carried out Incapacity Benefit assessments, these were the forerunner to Employment Support Allowance  (ESA) assessments. I stated at my interview for the job that I believed in social inclusion and social justice.

I went for 4 weeks training in England. The training did not prepare me for what I was expected to do in real life.

The forms that are completed prior to assessment, I have recently found out, are  opened by Royal Mail Staff. They are then sent for “scrutiny” where nurses decide whether or not a face to face assessment is required. I was not involved in this and do not know what criteria are used.  

 It is made clear throughout training and working that we are not nurses- we are disability analysts.  Also, we do not carry out ‘medical assessments’ – we carry out ‘functional assessments’. We did not even need a diagnosis to carry out assessments. I had reservations around consent, as we were expected to assess patients – sorry, we didn’t have patients, we had ‘claimants’ - who appeared to be under the influence of alcohol or other substances. 

We were also consistently told that we did not make benefit decisions. The final decision was made by a DWP decision maker with no medical qualification. If our assessment was overturned at appeal we never knew about it. There was no accountability for assessments overruled.”

Assessment starts on the day of your appointment with the Health Care Professional (HCP) reading the form you completed when you applied for benefit. Remember that every single question you are asked is designed to justify ending your claim for ESA and passing you as “fit for work”. That is what Atos are contracted to do by the Government.This is not a genuine assessment, but rather, an opportunity for the DWP to take away the financial support that you are entitled to.

Things that are noted at this stage are:

  • Did you complete the form yourself
  • Is the handwriting legible
  • Are the contents coherent

These observations are already used in assessing your hand function, your cognitive state and concentration.

Further observations made:

  • Do the things you have written add up
  • Does your medication support your diagnosis
  • What tests you have had to confirm diagnosis. For example a diagnosis of sciatica is not accepted unless diagnosed by MRI scan
  • Do you have supporting medical evidence from your GP or consultants. If you do, it shows that you are able to organise getting this information

“This is also a hidden cost to the NHS. I believe that if ATOS request information there is a charge levied by GP’s. However claimants are expected to source medical evidence themselves. It uses valuable NHS time for medical staff to write supporting statements. 

There were no hidden cameras, at least in Glasgow, to watch people arriving for assessment or sitting in waiting room. This may not be true in other areas.”

When the HCP has read your form they input some data into the computer system. The assessment properly begins when they call your name in the waiting room.

At this point the HCP assesses:

  • Did you hear your name being called
  • Did you rise from your chair unaided, did the chair have support arms or not
  • Were you accompanied – assessing your ability to go out alone
  • Were you reading a paper while waiting – assessing your concentration
  • Did you walk to the assessment room unaided, did you use any aids correctly. Did you navigate any obstacles safely – assessing sight

The HCP will shake your hand on introduction – assessing your handshake, noting if are you trembling, sweating – signs of anxiety. The HCP carefully scrutinises everything you do and say. The HCP will often ask on way to waiting room:

  • How long you’ve been waiting – assessing ability to sit, physically, and appraising your mental state
  • How did you get here today – assessing ability to drive or use public transport

Formal assessment begins by listing medical conditions/complaints. For each complaint you will be asked:

  • How long have you had it, have you seen a specialist
  • Have you had any tests, what treatments have you had
  • What’s your current treatment. Have you had any other specialist input e.g. physiotherapy, CPN

The HCP will use lack of specialist input/ hospital admissions to justify assessing your condition as less severe. Medications will be listed and it will be noted if they prescribed or bought. Dates will be checked on boxes to assess compliance with dosage and treatment regime. Any allergies or side-effects should be noted.

  • A brief note is made of how you feel each condition affects your life
  • A brief social history will be taken – who you live with, if have you stairs in your house or steps outside your house
  • Employment history taken – asking when you last worked, what you work entailed, reason for leaving employment

Your typical day – this is the part of the assessment where how you function on a day to day basis is used to justify the HCP decisions. Anything you say here is what is most likely to be used to justify you failing your assessment and being passed as “fit for work”. Along side this, the HCP records their observations.

Starting with your sleep pattern, questions are asked around your ability to function. This will include:

  • Lower limb problems – ability to mobilise to shops, around the house, drive, use public transport, dress, shower
  • Upper limb – ability to wash, dress, cook, shop, complete ESA form
  • Vision – did you manage to navigate safely to assessment room
  • Hearing – did you hear your name being called in waiting room
  • Speech – could the HCP understand you at assessment
  • Continence – do you describe incontinence NOT CONTROLLED by pads, medication. Do you mention its effects on your life when describing your typical day
  • Consciousness – Do you suffer seizures – with loss of continence, possible injury, witnessed, or uncontrolled diabetes
  • HCP observations include – how far did you walk to examination room, did you remove your coat independently, did you handle medications without difficulty, did you bend to pick up your handbag

Formal examination consists of simple movements to assess limited function. Things the HCP also looks at:

  • Are you well presented, hair done, wearing make-up, eyebrows waxed
  • Do you have any pets – this can be linked with ability to bend to feed and walk
  • Do you look after someone else – as a parent or carer- if you do, this will be taken as evidence of functioning
  • Any training, voluntary work, socialising – this will be used as evidence of functioning

This is not a comprehensive list, but it gives you an idea of how seemingly innocent questions are used to justify HCP decisions to pass you as “fit for work.”

Mental Health:

  • Learning tasks – Can you use a phone, computer, washing machine
  • Hazards – Can you safely make tea, if claiming accident, there must have been some emergency services involvement, e.g. fire service. Near miss accidents do not count

Personal Actions:

  • Can you wash, dress, gather evidence for assessment
  • Do you manage bills

Further observations made by the HCP – appearance and presentation:

  • Coping with assessment interview – any abnormal thoughts, hallucinations, confusion
  • Coping with change – ability to attend assessment, attend GP or hospital appointments, shopping and socialising

More HCP observations:

  • Appearance, eye contact, rapport, any signs/symptoms that are abnormal mood/thoughts/perceptions. Any suicidal thoughts
  • Coping with social engagement/appropriateness of behaviour – any inappropriate behaviour must have involved police to be considered significant
  • Ability to attend assessment, engage with assessor, behave appropriately

Again, this is not an exhaustive list, merely some examples.

Further information: 

At present to qualify for ESA you need to score 15 points, unless the Exceptional Circumstances Regulations apply to you. The 15 points can be a combination of scores from physical and mental health descriptors.

To qualify for the Support Group you must score 15 points in one section.
As long as you are claiming income-based ESA then your award can be renewed at each assessment, if you gain 15 points.

You may also qualify without meeting the 15 points criterion, even if you don’t score any points, because of Exceptional Circumstances (Regulation 29 and Regulation 35, (or 25 and 31 for Universal Credit – see link at the foot of article) if there would be a substantial risk to your mental or physical health if you were found not to have limited capability for work. Regulation 29 is about exceptional circumstances for being assessed as having limited capability for work (WRAG) , and Regulation 35 is about  being assessed as having limited capability for work-related activity (Support Group).

Special cases – exemptions from assessment include those people having:  terminal illness, intravenous chemotherapy treatment and danger to self or others if found fit to work.

Contribution-based ESA lasts for 1 year only, unless you are in the support group. After 1 year in the work-related activity group, you may only get income-based ESA if your household income is below a certain threshold. It makes no difference how long you have previously paid National Insurance.

“For clarity, as far as I know in the real world, doctors carry out medical assessments, nurses carry out nursing assessments and physios carry out physiotherapy assessments. In the world of Atos, each of these separate professions are employed as disability analysts, carrying out functional assessments.

Nurses are employable for these posts if they have been qualified for at least 3 years, are registered to practice with the NMC, and have basic computer skills.
My interview consisted of-

  • Face to face interview with medical director and nurse team leader.
  • A written paper assessing a scenario, in my case someone with back pain
  • A 10 minute basic computer test

In order to be approved as disability analyst I had to complete 4 weeks Atos disability training, reach a certain standard of assessment reports – as decided by audit of all cases seen (don’t know what criteria was) and finally approval to carry out Work Capability Assessments  (WCA) from the Secretary for Work and Pensions.In my opinion the money given to Atos and spent on tribunals should be given to NHS GPs. They are best placed to make assessments regarding patients work capability. They have access to all medical reports, past history, specialist input and know their patients. My concern would be what criteria the DWP would impose on GPs risking the doctor/patient relationship. GPs already assess patients for “fit notes”, which have to be submitted to DWP during assessment phase of ESA.

While I worked at Atos, sessional medical staff were being paid £40 per assessment, as far as I am aware. 
I have no idea of wages of permanent medical staff. Nurses were on a salary, which based on 10 assessments a day (Atos target) equalled around £10 per assessment. These are approximate figures but may give a clue as to why Atos are employing nurses rather than doctors.”

Appendix

Most Atos HCPs are not doctors, they are usually nurses or occupational therapists. There are some conditions that will mean you need to be assessed by a qualified specialist nurse, or a doctor and you can ask for this.

List of conditions judged suitable for assessment by neuro trained nurses/any health care profession:

Prolapsed intervertebral disc
Lumbar nerve root compression
Sciatica
Slipped disc
Lumbar spondylosis
Lumbar spondylolisthesis
Lumbar spondylolysis
Cauda equina syndrome
Spinal stenosis
Peripheral neuropathy
Neuropathy
Drop foot
Meralgia paraesthetica
Cervical spondylosis
Cervical nerve root compression
Cervicalgia
Nerve entrapment syndrome
Carpal tunnel syndrome
Trapped nerve
Paraesthesia
Tingling
Numbness
Brachial plexus injury
Polyneuropathy
Dizziness
Vertigo
Essential Tremor
VWF
Alzheimers

List of conditions judged by the DWP and Atos Healthcare as suitable only for assessment by doctors:

Stroke
Head injury with neuro sequelae
Brain haemorrhage/Sub Arachnoid Haemorrhage
Brain tumour
Acoustic Neuroma
Multiple Sclerosis
Motor Neurone Disease
Parkinson’s disease
TIAs
Bulbar Palsy
Myasthenia Gravis
Muscular Dystrophy
Guillain-Barre Syndrome
Amyotrophic lateral sclerosis
Syringomyelia
Neurofibromatosis
Spina bifida
Polio
Fits (secondary to brain tumour)
Learning difficulties (with physical problems)
Nystagmus Myelitis
Bells Palsy
Trigeminal Neuralgia
Paraplegia
Quadriplegia
Huntington’s Chorea
Huntington’s Disease

Further information:

Special exemptions from the 15 points criteria: The New Regulation 25
Useful updated information about Regulations 25 & 31: Exceptional Circumstances and Universal Credit.
Exceptional Circumstances:
 Employment and Support Regulation 31
Employment and Support Allowance: 2013 Regulations in full
The Amendments to ESA Regulations: as laid before Parliament 
Clause 99 and important changes to the appeal process: Clause 99, Catch 22 – The ESA Mandatory Second Revision and Appeals
Questions you may be asked at assessment: dwpexamination forum 
How to deal with Benefits medical examinations: A Useful Guide to Benefit Claimants when up against ATOS Doctors
More support and helpful advice here: How to deal with Benefits medical examinations

Previous related articles: 

Joyce’s campaign:  The Daily Record 
Joyce Drummond and Sue Jones:  After Atos

Further reading:

Targets in Atos contract

7 out of 8 targeted to lose ESA
Amnesty condemns erosion of human rights of disabled in UK
Whistleblower says Atos Work Capability Assessments are unfair

377683_445086432227557_1770724824_n (1)Many thanks to Robert Livingstone for his excellent artwork. Many thanks to Joyce for the information she has provided, and for her courage and integrity, which is so strongly evident in her outstanding campaign work.

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180 thoughts on “What you need to know about Atos assessments.

  1. I am totally fed up of trying to prove i am unfit for work, these decision makers are the lowest of the low, and i do not know how they can sleep at night, talk about getting blood out of a stone, compared to being awarded ESA, i think it would be easier. I could rant on endlessly about my own account of events, but i will share just two that have annoyed me, the first being when i went to medically assessed, but i was unaware that it was a test to see if i was capable for work, the nurse was talking to me casually, like it was chit-chat, i had recently moved to the area, and asked me if the school where my children attend was close by, and if they had settled in alright, i told her it was about 10 mins away…..
    OMG!!! what an idiot i am sometimes, i see good in people and its my downfall, the crafty cow had been assessing me so slyly, in her report she wrote that it takes me 10 minutes to walk my children to school, making note of the distance and using it against me, i answered her question, but when i said 10 mins i was speaking generally, i didnt mean me, it takes me a lot longer than 10 minutes, and she wrote how i walk my kids every day. I have to get my kids to school, there is only me who can take them, i often am in tears with every step i have to take, i have no choice, she didnt make me aware at all i was being assessed, like she doesnt see me bust out in tears, crying out loud as i shut my front door. All of my assessment she tricked me and used it against me.
    My doctor when i went to get a sicknote to send in for my ESA claim was more concerned about her own hassles she may get from DWP then my hassles having to go out to work, and that right pissed me off too. I am still fighting for my rights, Good luck to yu all.

    • Hi Sally
      Yes completely with you, I went for mine with my 84 year old dad, I was assessed walking 7 meters slowly and painfully walking to the room, and then because once I sat down I didn’t stand up again I lost points and when I did stand up she noted my dad had to help and I was in pain, I didn’t stand up during the meeting because standing to sit again causes more agony so I bared the pain. They actually stated on my decision that I could walk 7 meters slowly but I could walk 200 meters fine???and then I could use a manual wheelchair never been in a wheelchair in my life and have frozen shoulders so couldn’t work one, like you I cry sometimes the pain is so bad they noted that there are days I can’t get out of bed, and they agree I couldn’t stay at a work station for longer then 50 mins and yet I only got 6 points the system is pathetic who would employ me when I am not reliable to turn up I would love a job but realise I couldn’t do one.
      Another thing is I have a professor report saying how bad my bad is and that it’s degenerative so not going to get better and they wont look at it because it’s over 8 years old.
      so frustrating I am fighting like you good luck.

      • keep it up dont let the buggers grind you down , IDS Camtwat included Good luck if you need help let me know , i came out the other end .. Rollercoaster!!!! Emotions

      • Hi
        Thanks for your support, I have started the mandatory reconsideration, but it isn’t clear what happens next if I lose that I go to appeal, is this medicals etc, or just in front of a board, some are saying occy health will come my house, i’ll have x-rays and medicals etc, not bothered will still fight on but not knowing and hearing different stories does get to you.
        Well done for getting there.

      • Once your mandatory review is done, you can claim basic rate ESA again up until the hearing too

        The appeal is a panel, made up of a judge and a doctor. They are usually fair, in my own experience, and will look at the evidence you send them, and read it, listen to you, they may ask a few questions to clarify things. Then they will make a decision about your entitlement.

        I would recommend you read this, too, for info and support regarding your appeal. There are a couple of regulations that you may find useful to use, amongst other sound and up to date advice – http://kittysjones.wordpress.com/2013/04/21/1560/

    • Well im sickened by these posts including this one. I’ll never ever vote Conservative again now, their sub human animals as far as im concerned for doing this, animals. Even the hated Thatcher wouldn’t have tried to have inflicted this on the British. I sincerely hope all of you get your just desserts, keep at it and don’t give into this sick Atos creature thing, disgusting. Hopefully when we get decent government back the whole thing will be scrapped. Goodluck to you all.

      • Thank you James, and I am glad that you can see how others are suffering, many have died.. Yet rather than investigate those 11,000 deaths we know of, that have happened when people have had their ESA claim ended, the Government have chosen instead to label us as “extremist activists”. And they have also refused to release further statistics on the deaths. So 11, 000 was the figure in early 2012.

        I am very fearful of what is being hidden from us, as well as what we can actually see happening.

  2. Cameron knows the numbers there just hidden in a vault and he threw away the key bit like the kengate tapes charlie the queen are best pals with cameron and all know jimmie saville was a pedo ,, its al a cover up , someone needs to find the kengate tapes to uncover the truth unless we do this will still happen 20 years on

  3. Hi. I’m writing this for my Sister. She’s due to have an assessment on 23rd Jan. we’ve had it (reluctantly by ATOS) postponed so it can be recorded and so I can get her medical evidence together as the letter about the assessment only arrived on 23rd December.

    She filled in the ESA50 in June last year and was really poorly then. She’s no right hand, only just survived MRSA by a whisker and has been left with chronic neuralgia and is on loads of drugs incl morphine and had a pain pacemaker on her spinal cord but got staph A and had to have it removed urgently.

    When she filled in the forms this was the state of play. She was due for further surgery to have another pacemaker implanted in September but because of her risk of infection and she also has chronic adhesions the surgeon decided it was too dangerous to proceed. Now she is on more morphine and new drugs that have caused aphasia and absences and she is asleep 16 hours a day. Despite a GP fax, ATOS have refused a home examination although they have agreed to pay her taxi fare but have refused to let us complete a new ESA50 to reflect her new circumstances and condition.

    She’s so upset and depressed about all this. Prior to the small bowel obstruction that caused the MRSA, my Sister was earning £30k a year and had always worked (4years ago) with modifications to her workstation to accommodate her disability.

    Can anyone offer any further help or advice as her GP, consultants and the CAB are mystified why someone so ill is being treated this way.

    Thankyou so much and good luck to everyone.

    • Unfortunately typical Atos. I would email Atos again and request home visit, citing Gp agreement. I would copy this to your MSP
      / MP requesting their intervention. I usually also copy in Ian Duncan Smith. I would also ask Atos why scrutiny have requested a face to face assessment despite medical opinion.
      At the assessment your sister can tell it how it is now. She should also take letters of
      support from her medical team. Good luck, and get in touch if I can help any further. X

      • Thankyou Joyce. I have emailed ATOS already and they have told me that they see no reason why, if my Sister can get to hospital appointments, she cannot make it to theirs.
        She is terrified about the assessment due to the aphasia which is made worse by stress and I fear she is unlikely to communicate her long, drawn out story and catalogue of symptoms well at all at, currently, she can’t even pronounce half of them any more, stares vacantly, cries often and gets frustrated and angry as all she feels people do is talk about her health and poke and prod her these days. Will I be able to answer for her if she gives insufficient answers?
        Joyce, what you did in lifting the lid on ATOS/Government’s real agenda took genuine courage, strength of character and real integrity and I applaud your actions. As Irish statesman and Philosopher Edmund Burke once said; The Only thing necessary for the triumph of Evil is that good men do nothing. You are the modern day (and female) embodiment of why this quote is still relevant today.
        Thanks for your advice and for speaking out against ATOS in the first place. Best wishes. littletyketess@yahoo.co.uk

      • Hi Joyce. I would love to get in touch with you for further help. Please could you advise me how I go about sound this? I do not have a FB account, just in case it had anything to do with Facebook. I do have twitter, and various secure forms of email.
        They have now postponed the face to face until 28 Jan as I exercised my right to have the interview recorded.
        Best wishes and thanks.

      • I had an atos assessment today but had it stopped half way through due to having incontinence they said they would send another appointment but did not know when. This was after telling the person that at the beginning that i had wet myself and it took another 20 minutes to stop the assessment. What happens now I do not want to go through this again I have never been so degraded or humiliated as I have today. I need some surgery and have other things wrong. Really would prefer to be signed off now. What happens now?

  4. It’s nice to know there are decent people around who are brave enough to stand up for what is right. I know it’s no an easy thing to do.

    It’s been breaking me trying to stand up for me and it is true that everything you do to try to help your case, justifies them saying you are able.

    It is there in black and white why I failed my appeal, at the top of the list is, I filled in the ESA50. The other reasons are all twisted.

    Has anyone else been amazed to read their appeal tribunal’s record of proceedings? You have to write and ask for it. Mine is a summarised approximation of what the clerk thought was being said during the appeal. The almost illegible hand writing tells me she was struggling to keep up. The comments said to be mine, are so succint I neither recogise myself nor can I imagine that I said some of the comments in that they are blatantly wrong. I know how I speak and what is written is not me talking. Condensing what I said has had the effect of reversing the meaning. This may not have been intended but why do they allow this practice? Surely I can’t be the only person who has noticed how in shortening sentances, or paraphrasing, the intended meaning is lost?

    I expected the Clerk to record the proceedings or failing that to use shorthand and a typed record to be produced. I expected that the Clerk would have to use our words. I expected a complete record and I expected that it would be signed as a true and complete record of the tribunal. Win or lose, I expected the Record to be true. I expected that the Record would help me understand the deision. I suppose it sort of does. When they were deliberating my case and they asked the Clerk to read back my answers, they heard what they wanted to hear and failed my appeal.

  5. I too applied for appeal which went to tribunal whereby i was openly mocked and humiliated, which continued even when I was in floods of tears. My problems are complex and involve both physical and mental health problems. I was told from the beginning they would only take into account either the physical or mental health. I was told categorically I had no mental health problems, i did not want to argue this with somebody so insensitive and that did not Know me or my medical background. So I sat there wondering why I was covered in scars on both wrists if I didn’t have any mental health problems and why I was being treated like a fraud or some kind of criminal.

    My physical problems are backed up by X rays blood results and MRI scans, not me simply saying I have XYZ wrong with me. Why are ill people being treated in this manner when at there most vulnerable, the whole system is seriously flawed and you should not have to prove on top of your problems you are genuinely ill. If they they believe it to be a fraudulent claim it should be up to them to prove it.

  6. I appreciate, cause I found just what I was looking for. You have ended my 4 day long hunt! God Bless you man. Have a great day. Bye bddccgeedgae

    • to continue, i was born with congenital and also have adult scoliosis along with the associated problems, have also arthritis and hyperthyroidism plus other age related problems , i have been on severe disablement allowance
      and dla, but i think the appointment i have is for the SDA claim from what i have read. i am worried sick what is going to happen as i have heard others go through some terrible times due to this

  7. thanks, i will ask for it to be recorded, i did think because i have asked they will be less likely to allow my claim

  8. Hi! This is kind of off topic but I need some guidance
    from an etablished blog. Is it very hard to set up your own blog?

    I’m not very techincal but I can figure things
    out pretty quick. I’m thinking about settinng up my own but I’m not sure where
    to start. Do you have any points orr suggestions?
    Thanks

  9. David Cameron has said that the voters are his boss & then using his own logic lets all do a sir Alan Sugar.”Your’e fired Mr Cameron. Iain Duncan Smith is a mad man & he should have his own wages stopped & see how the other half live. He is a slimey weasel that couldn’t lie straight in his own bed. I have reform for the Tories. Sack 90% of their MP’s as they are not worth the pay.Think of the money we could save & not a disabled person hurt by it.

  10. Hi all, thanks for the article.
    I too have had a never ending stream of trouble with ATOS/DWP and co, I have a PIP assessment due next month, just sent off a letter for requirement for a home visit
    I have been to tribunal twice, and won
    I have recorded all my assessments, so was able to prove lies by HCP for ATOS- tribunal didn’t care really of course, but as I proved the lies, well that helped I reckon…
    Thing is– don’t give up!!!
    God Bless
    Nick
    p.s. posted this article link on facebook if that’s OK?!
    cheers

    • I’m happy to see it shared, thanks Nick. Agree that having the assessments recorded helps a lot. My first one was unrecorded, the assessor lied, and I also had to go to tribunal. Second was recorded, and I was placed straight into the support group without any ado.

      Good luck with the PIP assessment x

  11. Hi I’ve been on esa for 10 months at £70 odd per week I have just received my mediacal for dec 29 im so anxious,and am stressing about it im worried how I will get there I suffer from depression and panick attacks it’s been bought on by my son who tried killing himself and my daughter has cancer I have really bad mood swings that can get quite bad I shout and scream and even have thoughts of hurting other people my mum will not travel with me to the medical im 50 yrs old pls help im so worried about failing also im in debt upto my eyeballs can’t afford to go bankrupt as it cost £700

  12. I should explain about my thoughts I was out with my mum sitting in her car while she walked the dog and another dog went to attack hers my mum was crying I started screaming at the person and they just told me to shut up I then had a thought to run them over my mum had to calm me down sorry I just didn’t want anyone to think I was a bad person I just get in a bad temper due to depression and meds I’ve also put on so much weight I can’t walk on my feet as I have plantar police and feet

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