Disability living allowance and PIP are the main disability benefits provided by the DWP. Image: Alamy
Disabled people are “set up to fail” by a “soul-destroying” disability benefits system which is target-driven and designed “to catch people out”, according to former disability assessors who have spoken exclusively to The Big Issue.
The trained healthcare professionals claimed there is pressure to “ramp up numbers” with little empathy for vulnerable claimants, leading to people refused support or facing a distressing appeals process. One claimant said it drove him to “severe psychological distress to the point of being suicidal”.
“It is run as a business,” one former assessor told The Big Issue. “It is not run to help people. As long as it’s run like that, nothing will change. It will remain target-driven. It will remain profit-based. It is not putting the best interest of the people using the system at its heart.”
A person with a disability or mental health condition can apply for the personal independence payment (PIP) benefit to help with their living costs, if they pass assessments carried out by private contractors on behalf of the Department for Work and Pensions (DWP).
Previous reporting from The Big Issue found the DWP rejects almost 90% of initial challenges over benefit decisions, but official statistics show 68% of claimants win their case when appealing the decision at tribunal, during which officials have more time to consider an individual’s case.
This process causes avoidable damage for claimants like Aidan, who spent months appealing a PIP decision which lost him critical financial support and his car.
“I’ve been living in quite squalid conditions because I haven’t had the mental capacity to keep the place tidy, clean and sanitary,” Aidan, who has multiple conditions including autism and an amputated leg, told The Big Issue. “The whole process was causing severe psychological stress and trauma to the point of being suicidal.”
Hundreds – “probably thousands” – of disabled people have died avoidable deaths because of failures of the disability benefits system, according to an investigation by the Disability News Service.
The Big Issue spoke to several former assessors who worked at companies contracted by the DWP to carry out assessments for people claiming PIP. Their names have been changed to protect their identities.
“I just think it’s about numbers,” said Lia, who trained as a nurse but took a job as a disability assessor with Atos in 2022. “How many can you get through? What loopholes can we use? Some of the assessments come out fairly, but I don’t believe they all do.”
She said she was expected to increase the number of assessments she completed each day, which often involved reading through page after page of evidence and interviewing the claimant before submitting a judgement which could be rejected by an auditor.
Lia said she struggled to complete more than two assessments a day and was driven to “panic attacks during assessments”. She said this was not an environment which led to fair and accurate results, and she was unable to use her skills as a nurse to make clinical judgments.
Another assessor, Sam, admitted sometimes there were people he felt so much sympathy for he would skew the assessment. “You’ve got people who genuinely were severely disabled, mentally and physically, but yet they still have to go through the rigmarole of this process,” he said.
“I would do what I could to fudge the assessment for people that I genuinely felt really sorry for. The underlying undercurrent was that these people just needed help. And we are not helping these people by doing this. I think soul destroying is the best way to describe it.”
The Big Issue understands assessors have little control over final decisions, with assessments audited by people who have not met the claimants. “Every question you ask fits a box,” Lia added. “I could be talking to someone I know without a doubt deserves this as a right, but I can’t make them fit the box.”
Lia believes the “pressure comes from the DWP”. The government department advises in its PIP assessment guide that a “targeted audit is carried out at the discretion of providers or at the request of DWP – for example, where rework volumes are significantly high indicating problems with quality, or where successful appeals indicate that the evidence was insufficient”.
A spokesperson for the Independent Assessment Services, which is delivered by Atos, said: “We provide PIP consultations in line with DWP guidance and do not make the decision on claims. We always aim to provide sufficient time for claimants and our health professionals while balancing the demands on the service.
“This typically means up to three assessments being completed per day but this can change where more time is required. While it is not possible to comment on individual cases, we are proud of our supportive culture and have robust HR processes meaning any allegations of this kind are fully and fairly investigated.”
Ken Butler, welfare rights and policy officer at Disability Rights UK, said: “A major problem with PIP starts at the very first stage – the medical assessment. Assessment reports are carried out by non-specialists and often contain errors and misleading statements with many disabled people not trusting assessors to act fairly and independently.”
An employee of the Ministry of Justice, who hears PIP tribunals, told The Big Issue he often reads reports which “seem to bear no resemblance to the assessment that the claimant took part in”.
He explained: “Assessors often face time pressures, with another assessment scheduled to begin an hour later, and another an hour after that. This time pressure can be reflected in the quality of the assessments, and this is rarely in favour of the claimant.”
Alice, who was a PIP assessor for NHS Lanarkshire under Atos for eight years until 2021, told The Big Issue: “It was very high pressure. You don’t know who you’re going to get in, and then you have to look up their application form and additional information.
“You have to do four or five a day. And then you would come in the next day and an audit would come back that a word or two were spelt wrong or they wanted further information.”
Alice said there were changes over the eight years she worked as an assessor – but not for the better. “There was more pressure towards report writing and audits. It was more about paperwork than a healthcare assessment towards the end.”
This was also experienced by Sam, who was a disability assessor for Maximus in 2018. He said: “There was massive pressure to ramp up your numbers. Six a day would be your minimum. It’s not manageable, particularly with people that have got difficulty in expressing themselves. It all comes down to waiting lists.”
Charities fear this pressure leads to mistakes in assessments and an impersonal approach. Louise Rubin, head of policy and campaigns at disability equality charity Scope, said: “For far too long, disabled people have been faced with degrading and inaccurate benefits assessments.
“We regularly hear from disabled people who have found the process so difficult that it has made their health worse, and pushed them further away from work.
“The DWP needs to make sure that assessments reflect the reality of disabled people’s lives. It has spoken for years now about introducing a more compassionate, person-centred process – but that has simply not materialised.”
The DWP recently outlined plans to end work and capability assessments, which are used to determine the level of health benefits in an individual’s universal credit payment. But this means using PIP assessments, putting further pressure on the system.
Sam said he felt he was “trained to catch people out” at Maximus when he was assessing people for the disability living allowance, a legacy benefit which is being replaced by PIP and universal credit. Sometimes people would say they wanted to work, he said, but he knew that would damage their chances of getting the benefit.
“It would hurt my heart because I would think: ‘You’ve just tripped yourself up by saying that.’ I know there’s no follow up support for those people. This is just completely backwards to me. We’re punishing these people instead of helping them. It just seemed like we’re setting people up to fail.”
A spokesperson for Maximus’s centre for health and disability assessments added its “priority is to deliver a sensitive, respectful and expert service” and it is “committed to helping them access the financial support they are entitled to as quickly as possible”.
They said they work closely with customers and their representative groups to “continuously improve the service”, and “since 2015 have significantly reduced waiting times, improved assessment quality and achieved record customer satisfaction of more than 97%”.
The government has ring-fenced £2.8 billion to give to companies to complete disability assessments over the next five years. Maximus was recently selected as the largest provider of the new functional assessment services contract on behalf of the DWP, and another contractor, Capita, has also had its contract renewed.
Sam claimed there were financial incentives to increase numbers and a current assessor at Capita said they are paid extra to complete more assessments around Christmas – claims which the DWP disputes.
“Disability assessors do not receive incentives or bonuses for carrying out their work,” a DWP spokesperson said. “They are qualified health professionals who play no part in deciding whether someone should receive benefits.”
The DWP claimed to have a 92% satisfaction rate and that it “helps support millions of disabled people every year to claim the help they are entitled to”.
A Capita spokesperson added: “We are proud to deliver empathetic and claimant-centric PIP assessments, and over the last 12 months, 95% of applicants have told us they are satisfied or very satisfied with our service. We continuously strive to improve our service to ensure it is professional, efficient and kind.”
But not everyone feels they have been treated kindly by the system. Chelsea, who has chronic fatigue syndrome and fibromyalgia, was refused PIP in 2021. “It was a difficult process,” she told The Big Issue . “It always is. I just remember crying pretty much the whole way through.
“You always know that the assessor is incredibly unlikely to know any of the specifics about your condition or if they do, it’s a very generalised understanding. They don’t take into account how it affects you as an individual and your own circumstances.”
Chelsea is currently waiting for her tribunal, and the financial and emotional impact of the process has taken its toll. “It is incredibly dehumanising,” she said. “It leads you to question yourself. It’s easy to read these reports or talk to the assessors and question how legitimate your needs are.”
Butler, of Disability Rights UK, added: “More weight should be given to medical evidence and people’s own accounts of the impact of their disability or health condition, as well as assessments being undertaken by specialists.”
The DWP has confirmed it will begin to test matching a person’s primary health condition to a specialist assessor this year, a move welcomed by campaigners.
But they added there is much more work to be done. Butler said: “The DWP should also automatically issue claimants with a copy of their PIP assessment report which would increase scrutiny and so help to raise standards. Assessors would know that all claimants will be able to see any inaccuracies or misleading statements, which should encourage greater care and accuracy.”
Ayla Ozmen, director of policy and campaigns at anti-poverty charity Z2K, said: “These findings chime with what our clients frequently describe. They regularly tell us that their assessment was impersonal and demeaning, and that the report the assessor produced didn’t reflect the reality of their health condition or disability.
“DWP needs to urgently fix the broken system, so seriously ill and disabled people can be confident it will get decisions right first time.”
The former assessors said they felt failed by the companies they worked for and by the DWP, a feeling shared by the disability benefits claimants.
Aidan, who is now in a better place following a positive outcome to his appeal, said: “The DWP should have a duty of care. They legally shouldn’t be allowed to act in a way that causes any sort of harm, whether that is physical or psychological.
“It is an act of neglect because they haven’t done things properly. In my instance, it has caused psychological trauma. I’m not the only person who has gone through that. I am on a mission to shout it from the rooftops so more people know about these stories. Hopefully there will be public outcry.”
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