Page 37 - Reforming Benefits Decision-Making

However, the best source of information about a claimant’s condition and how
it impacts their ability to carry out activities, in many cases, is the claimant
themselves. They are the ones living with their condition and who deal with
the difficulties it poses on a daily basis. Medical evidence can only ever
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provide indirect evidence as to the impact of someone’s impairment on their
daily life. This is borne out by the fact that the most common reason that PIP
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decisions are overturned on appeal is oral evidence from the claimant. The
new proposed process for Adult Disability Payment in Scotland also reflects
this – the Scottish government propose that only one piece of formal evidence
will be required to determine, on the balance of probabilities, that the
individual’s condition is consistent with the needs detailed on their
application.
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2.29 However, claimants feel that their own account of their condition is often not
believed or taken seriously by assessors. This may be a particular issue when
claimants have non-standard presentations of health conditions, which do not
fit with the medical ‘norm’. It is also a particular issue for individuals with
fluctuating and mental health conditions. Assessors use informal observations
as part of their evidence base for their assessment, for example, how people
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walked into the room and how long they were able to sit for, their mood or
demeanour during the assessment and their attire and grooming. However,
such observations belie the realities of many physical and mental health
conditions which are episodic. It also underscores a lack of understanding
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83 As noted in paragraph 2.21 above, for some claimants with mental health issues this may not always
be the case, as their condition may limit their ability to accurately explain how it affects them and their
ability to carry out activities.
84 Figures are for year 2019/20. This was the most common reason for a decision being overturned (34
per cent of cases), closely followed by the Tribunal reaching a different conclusion on substantially the
same facts (32 per cent) (DWP, ‘Response to Freedom of Information Request FOI2021/38176’ (8
June 2021)).
85 Rather than requiring formal supporting information to evidence each and every difficulty that the
claimant reports experiencing (Scottish Government, Consultation on Adult Disability Payment
(December 2020) para 16).
86 DWP, PIP Assessment guide part 1: the assessment process (17 May 2021) para 1.6.31; Centre for
Health and Disability Assessments, Revised WCA Handbook (October 2020) sections 2.7.2 and 3.1.11
87 B. Geiger, A Better WCA is Possible (see n. 58 above), p.12.

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