The link between poverty and disability is stark: half of those living in poverty either have a disability or live with someone who does (Tinson et al, 2016). Disabled people often face additional costs incurred by purchasing specialist equipment or with additional costs for transport needs. Disabled people are also less likely to be in employment, with an employment rate of 52 per cent for this group versus 75 per cent for the rest of the UK population (House of Commons Library, 2019).
Changes to social security over the past decade have – in the vast majority of cases – reduced the financial security of disabled people, leaving many in poverty and isolation. New research by Tom Porter at the University of East Anglia, Charlotte Pearson and Nick Watson at the University of Glasgow, examines the lived experience of these changes for disabled people in the UK. The research team conducted 50 in-depth interviews with disabled people in receipt of Personal Independence Payment (PIP), Employment Support Allowance (ESA) or Universal Credit (UC). As well as highlighting the worsening of their financial security, findings point to an emerging hostile environment in the social security system, which has had a profound impact on individual health and well-being.
We summarise here some of the key findings.
The impact of new assessment procedures
A key part of the changes to the UK benefits system (pre-dating the new system in Scotland from 2018), was the introduction of rigorous new assessment procedures for those transferring from Incapacity Benefit to ESA or Disability Allowance to PIP, or for those claiming these benefits for the first time or making an application for UC. Under the new system, someone with a stable impairment or health condition will be routinely reassessed for their support. Our research found these processes to be highly stressful, with respondents feeling that they were not trusted and were constantly challenged. Respondents all talked about the fear associated with assessment and the associated risks of losing their benefits. Applying for benefits fundamentally challenged respondent’s identity, damaging both their confidence and how they felt about themselves. As Riya, a 45 year old woman with a visual impairment, told us, “you have to appear to be completely dependent on someone…If you are disabled and you say you can cook and you can manage reasonably well on your own, then they would invariably say, ‘well you don’t need PIP’.”
The research also discovered the importance of providing strong supporting evidence on the success of a claim. We found that far from being straightforward and transparent, the collection and provision of evidence in support of benefit claims is complex, often expensive, and fraught with challenges. In reality, the demands that the system places on the claimants means that many have to spend significant time and energy, as well as financial resources, to substantiate their claims for support.
Disabled people may come into contact with healthcare professionals during this process but this is not always the case. For some of those we spoke to, particularly those for whose condition was stable and did not require medical treatment, the task of providing supporting information from health professionals was very complicated. This was reiterated by Felix, a 30 year old man we spoke to with cerebral palsy and dyslexia.
He said, “the assumption is that disability equals ill health and constantly being in touch with medical professionals, naively assuming there is a constant paper trail”.
Other participants reported paying for private medical assessments as evidence of their impairment. There is therefore evidence to suggest that there is an inverse care law occurring with the difficulties faced when making these applications. Those most in need of help and support are often those who are the most disadvantaged and often the least able to make their case or to challenge decisions.
As well as concerns over the ability of respondents to ‘prove’ their case, perhaps the most frequently occurring theme around assessments centred on the accuracy and veracity of the assessor’s report. Many felt that their reports contained factual errors, with some even including reference to clinical tests that had not been carried out. Others stated that their assessor had inaccurately recorded their answers to questions or even manipulated their answers in order to disqualify them from help. One woman, Maggie, described her report as “appalling”, adding that, “She’s [the assessor] written a load of physical examination results that I cannot possibly have achieved. I physically cannot have achieved the results. She’s just copied and pasted from somebody else’s report”.
Mandatory reconsiderations and tribunals
Having received a decision from the Department for Work and Pensions (DWP), claimants must decide whether they want to challenge the benefits awarded. The Welfare Reform Act (2012) introduced a process called mandatory reconsideration – an internal review of benefit decisions. This process is required before a challenge can be made at an independent tribunal. However for many of the participants in this study, the decision to lodge a mandatory reconsideration was not easy, as the process also risks losing any awards already made by the DWP.
Those who had experienced tribunals said they were stressful and demanded great energy and resilience. Yet those who had endured to see their claims reviewed by a tribunal panel often reported the tribunal itself to be fair, transparent and accessible when compared to the benefits system more generally. Unlike the high numbers of mandatory reconsiderations which result in no change of award, in 2018 71 per cent of PIP and ESA tribunals found in favour of the claimant against the DWP (DWP, 2018), a proportion mirrored in our sample.
‘Survival of the ‘fittest”
Far from affording secure and comfortable lives, participants in this study revealed a picture of life on benefits as insecure and providing for only basic standards of living. Amongst the small proportion of respondents who said they felt financially secure, it was only through employment or private sources of income that a good standard of living was achieved. The majority of participants said that life on benefits was a constant struggle, marked by continuing worries over present and future finances. This was emphasised by John who received UC and the enhanced rate of daily living PIP and described life in impoverished terms, “I wake up in the morning and I’ve got no gas, no electric, no food and it just upsets me that I’ve got no food to cook. It’s not a life you’d want to wake up and think, have I got to live the next 40 years of my life like this?”.
In summary, the picture that emerged from this study was that of a ‘survival of the fittest’ welfare regime, whereby disabled people without knowledge, financial and social resources were less able to weather the protracted and difficult process from application to award. Applying for benefits is a highly complex process, amidst a hostile environment whereby successful applications require significant expertise, knowledge and resilience on the part of those claiming.
Tinson, A., Aldridge, H., Born, T. and Hughes, C. (2016) Disability and poverty: Why disabled people must be at the centre of poverty reduction, York: Joseph Rowntree Foundation. Published on the New Policy Institute website
House of Commons Library (2019) People with disabilities in employment (accessed 1/10/19).
Published as part of Policy Scotland’s contribution to Challenge Poverty Week 2019