Government decisions to wrongly deny disability benefits to tens of thousands each year is likely to be putting a significant strain on GP services, according to new research.

A study by Pro Bono Economics has explored the potential burden placed on the NHS and other services by as many as 150,000 disability benefits claims that were misjudged by the Department for Work and Pensions (DWP) in the year leading up to the pandemic.

The new research found that that if just one in 10 of these Personal Independence Payment (PIP) claimants made one visit to their GP because of the appeal process - known to be long and gruelling - it would cost 2,300 GP hours in total.

PIP was introduced in 2013 to gradually replace Disability Living Allowance (DLA) for working age adults.

Previous studies have found that the process of challenging PIP decisions made by the DWP can often have significant impacts on the physical and mental health of claimants. A recent survey by the MS Society of people with MS who claimed for PIP found that 39% of people who received less under the PIP than under the DLA used the GP more, and 9% have increased use of A&E.

Official figures show that more than seven out of 10 people who appealed in court against a decision to deny them PIP were successful in 2019/20.

The new PBE research adds to growing calls for DWP to re-think the assessment process for PIP, as part of wider reforms to the government’s health and disability benefits system through the Health and Disability Green Paper.

Among its key findings, the PBE study, commissioned by the Advice Sector Panel of the Administrative Justice Council, found that:

• If one in 10 PIP claimants who successfully had their decision changed in 2019/20 had to make one additional visit to their GP because of physical, mental and financial stress related to the process, it would cost around 2,300 GP hours, or £600,000 per year.
• If one in 20 had to make one additional visit to A&E as a result then it would cost around £1.1 million.
• If one in every 100 required statutory homelessness support while they awaited an outcome of their challenge, it would cost an additional £4.4 million.
• If one in 200 required social care while they awaited the result of their challenge, it would cost an additional £9.9 million.

Two independent reviews of PIP have been carried out and both found that the vast majority of people who went through the assessment process had a negative experience.

It also found that nearly two-thirds (63%) of professionals and organisations involved in the process did not think that it was clear what further evidence claimants were being asked to provide as part of their PIP application.

On average, it takes more than a year from an initial application for PIP for claimants to reach the end of an appeal process, meaning they face a long wait for funding to pay for vital equipment required to help them with essential daily tasks such as bathing and reading.

Those individuals going through the reconsideration process to restore or increase a previous PIP award will have their original payments stopped or reduced while they await a revised decision.

The uncertainty and disruption caused by the process can have numerous knock-on effects. These include stress, financial hardship, increased risk of homelessness and reliance on food banks, as well as reduced mobility and ability to deal with physical health problems.

These knock-on effects are highly likely to result in an increased burden on NHS, social care and other public service spending.

PBE analysis found that the administrative costs to the DWP of handling the 60,000 appeal claims the authority lost in 2019/20 are estimated to range between £23-29million.

According to DWP figures, there were 781,152 initial decisions made about PIP awards in 2019/20. Of these, 315,483 decisions were challenged by claimants at mandatory reconsideration (MR), which is the first step if claimants want to challenge a decision.

In total, 29% (92,226) of these claims were changed in favour of the claimant by the DWP at the MR stage. There were a further 78,321 cases taken to appeal from the MR stage by claimants, which saw 76% (59,407) of appeal claims granted.

 

Matt Whittaker, CEO of Pro Bono Economics, said:

“The assessment process for PIP is simply not fit for purpose and this research gives an insight into the very serious human and financial costs.

“The number of wrong decisions being made is alarmingly high and the drawn-out appeal process causes huge stress and uncertainty to tens of thousands of people every year.

“This means people with disabilities and health problems find their conditions deteriorating as they wait for a decision on their claim and even have some of their payments withdrawn. As a result, they are likely to draw even more heavily on their GP, the NHS and other social services.

“It is clear the government needs to look again at the way it supports those with disabilities and find a system that works for taxpayers, departmental budgets and individuals alike.”

 

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