The DWP has revealed more details of what now seems to be a shambolic system for assessing claimants for the Severe Disability Group. According to the latest DWP update, membership will be based on a confused, ad hoc collection of criteria. 

Depending on the claimant’s diagnosis, entry may be based on:

  • medically precise definitions that have no connection with the benefits system at all; or
  • on information that only the claimant or carer will know, but a specialist will still have to provide; or
  • the availability of specialist services where the claimant lives; or
  • even on no clear criteria at all.

There is also a lack of clarity on the overlap between the Severe Disability Group and the light-touch review system for PIP.

And some claimants are voicing the suspicion that the creation of separate group of severely disabled claimants could be aimed at reducing future payments for allegedly less severely disabled people.

What is the Severe Disability Group?

The purpose of the Severe Disability Group, according to the DWP, is to improve the assessment process for claimants who have conditions which are severely disabling, lifelong and with no realistic prospect of recovery.

Claimants who fit the criteria will not need to complete a detailed application form or go through a face-to-face assessment for PIP or the WCA.

There’s more details about the scheme here

But, in essence, claimants will need to show that they have a condition that will not improve, that it is managed or was diagnosed by a specialist, that they need help from another person with at least two daily living activities and that they would qualify for the support group or for at least one enhanced PIP component.

There are then different criteria for different conditions, which also need to be met.

Medically precise definitions

It has long been a basic principle of disability benefits that it is not the condition that matters, it is how it affects your everyday activities. 

Yet, for entry to the Severe Disability Group, it is very much the condition that counts.  In some cases, only those who meet specific medical assessment criteria will qualify.  For example (please note, the links are provided by Benefits and Work, not the DWP):

for autism you need to meet DSM 5 level 2 or 3;

for heart failure, New York Heart Association (NYHA) 3 or 4;

for multiple sclerosis you need to score more than 6 on the Expanded Disability Status Scale;

for  Parkinson’s Disease, you must score 21 to 30 on the UPDRS.

Very often, scores like this will not appear anywhere in NHS records, so new evidence will have to be provided by a specialist.

In addition, many claimants who do not meet these scores will still be in receipt of PIP at the enhanced levels for both components and have no possibility of their condition improving.  Yet they will not be eligible for the Severe Disability Group.

Only the claimant will know

For some conditions the criteria are not only less precisely defined, but they are also ones that a specialist will not be able to give first-hand give evidence on.

For epilepsy, you need to have “incapacitating seizures at least once per week despite optimal medical therapy”.  But probably the only person who can give detailed evidence on the frequency of seizures will be the claimant themselves or a carer, if they have one.  A consultant’s evidence will be hearsay at best.

The only criteria given for strokes is that the claimant “requires assistance from another person to mobilise, dress and feed themselves”.  But this is something that would probably be better judged by an occupational therapist than a specialist and, ultimately, only the claimant or their carer will have first-hand, daily knowledge about this.

Availability of services

For some conditions, access to the Severe Disability Group will depend on having services available in your area.

For example, for bipolar disorder or depression, you will need to show that you are “under the care of specialist psychiatric services” and have a “history of recurrent admissions or crisis team treatment”. If the NHS in your area is too overstretched to provide these services in your case, then you will be unlikely to qualify.

For OCD, you will need to show that you have failed to “respond to treatment by intensive specialist treatment services”.  This assumes that such services exist in your area and are available to you.

For ME/CFS, you will have to show that “all treatment options provided by specialist pain and fatigue services have been exhausted”.  Again, such services may not even exist where you live, may have a very long waiting list or may not be accessible to you because of the travel time involved.

No clear criteria at all

For people with multiple conditions – and that would include a huge proportion of claimants – the DWP explains that entry to the Severe Disability Group may be available:

multiple impairments, for example combinations of COPD, coronary artery disease, diabetes and obesity that would not meet the criteria as single conditions but may do so if present in combination.

But there is no explanation of how this would work in practice.  If you don’t meet the criteria for any single condition, what do you have to prove in order to meet the unexplained criteria for multiple impairments? 

And which health professional would be the one required to provide the evidence?

All of this remains unexplained.

Overlap with light-touch reviews

Oner of the questions that has yet to be answered is how the Severe Disability Group will overlap with the light-touch review system for PIP.

In July 2023 the DWP began sending out the PIP AR2 light-touch review form to claimants who have:

  • very stable needs which are unlikely to change over time
  • high level needs which will either stay the same or get worse
  • a planned award review date due on or at State Pension age

The AR2 form is very much shorter, is unlikely to result in a face-to-face assessment and has to be completed only once every ten years.

On the face of it, this seems to be similar to the Severe Disability Group, at least for PIP claimants.  And it has the advantage that it does not require any medical evidence in order to qualify.

But what isn’t clear is whether the Severe Disability Group will replace the light-touch system, run parallel with it or whether a claimant could be subject to both systems.

Lower payments for non-severe claimants?

Government voices have been issuing warnings about the cost of disability and incapacity benefits for some time. They claim that far too many people are being placed in the support group and that the cost of PIP is spiralling out of control.

This has led some claimants to suspect that the Severe Disability Group is the first step towards cutting the cost of these benefits in the future.

The theory is that, if you divide disabled claimants in to severe and non-severe groups, you can argue that claimants who are not severely disabled should not be entitled to as high a rate of support as those who are.

This is exactly what was done with the WCA, when new claimants in the limited capability for work category were deprived of the additional amount that had previously been awarded.  For new claims now, only those with limited capability for work-related activity get an additional amount.

It is very unlikely that any government would try to reduce current PIP claimants’ awards, because of the unquestionably enormous backlash.

But an altered payments system for new PIP claimants in the future is not hard to imagine and would cause much less controversy, though we should stress that the DWP have made no suggestion that this is their intention.

Specific condition criteria

Below, we’ve listed some of the more detailed criteria that the DWP have now published for different conditions.  There’s more on this DWP page.

We’d really like to hear from claimants with experience of any of these conditions as to whether you think the criteria are reasonable and whether you think you would qualify.  Please use the comments section to let us know.

Please note, the links are provided by Benefits and \Work, not the DWP.

Arthritis

Late or poorly controlled inflammatory arthritis

Autism

Autism spectrum disorders - meet the DSM 5 level 2 or level 3 criteria - requiring substantial or very substantial support (annex 2)

Bipolar disorder/depression

Long term severe depression or bipolar disorder failing to significantly respond to treatment, under the care of specialist psychiatric services, indicators of unstable mood and worsening functioning requiring ongoing high levels of care or supervision including history of recurrent admissions or crisis team treatment, decreasing intervals between episodes of relapse or rapid cycling

COPD

Severe chronic respiratory condition (e.g. chronic obstructive pulmonary disease (COPD), fibrotic interstitial lung disease, diffuse pleural thickening) with grade 5 MRC breathlessness (too breathless to leave the house or breathless when dressing or undressing)

Epilepsy

Intractable epilepsy with associated cognitive impairment and incapacitating seizures at least once per week despite optimal medical therapy

Heart failure

Heart failure with reduced ejection fraction on maximal possible tolerated medical therapy and cardiac resynchronisation therapy if indicated, with ongoing limiting symptoms, New York Heart Association (NYHA) 3 or 4 and not a candidate for cardiac transplant

IBD

Treatment resistant inflammatory bowel disease

OCD

Longstanding obsessive-compulsive disorder (OCD), failing to respond to treatment by intensive specialist treatment services, with severe ongoing symptoms resulting in significant difficulties with ADLs

ME/CFS

Syndromes characterised by chronic pain and fatigue where symptoms are longstanding, affect multiple activities of daily living (ADLs) and confirmation that all treatment options provided by specialist pain and fatigue services have been exhausted

MS

Advanced multiple sclerosis scoring more than 6 on the Expanded Disability Status Scale (EDSS)

Multiple physical conditions

Multiple impairments, for example combinations of COPD, coronary artery disease, diabetes and obesity that would not meet the criteria as single conditions but may do so if present in combination

Parkinson’s disease

Advanced Parkinson’s disease with bilateral symptoms of tremor, rigidity and bradykinesia and impairment of balance, a Unified Parkinson’s Disease Rating Scale (UPDRS) score of 21 to 30 and requiring assistance from another person with most activities of daily living

Schizophrenia

Longstanding schizophrenia, failing to significantly respond to all treatment or rehabilitative options, under the care of specialist psychiatric or support services, significant continuing symptoms and poor self-care requiring ongoing high levels of care and or supervision

Stroke

Stroke, for example where the person requires assistance from another person to mobilise, dress and feed themselves

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  • Thank you for your comment. Comments are moderated before being published.
    Tooty Fruity · 29 days ago
    A few more bit of info about this new SDG on the DWP website over the last few days, from what I can gather is that anyone in the Support Group / LCWRA and those with an enhanced award in PIP (for either daily care or mobility) you would pass the SDG. I think this may apply to those who are already on it or those due for benefit reviews, not totally sure if it only applies to new benefit awards going forward I may be totally wrong but some of the Government and DWP Gobble Dee Gook is hard to make out as it can badly contradict itself and make no sense but we all know it's done on purpose, I think some of the MPs and policy makers who implement these changes don't really understand it either! How the hell are they going to review millions of claims in such a short space of time, it took them years to move Incapacity Benefit/SDA claimants to ESA. the trouble is they muck about with so many reforms and it's been constantly changing on what seems like a weekly basis for benefit claimants, so times we don't know which rules to follow as it changes constantly, do I need to look for work this week? Am I exempt from looking for work this week? Do I need to come to the Jobcentre this week? Am I being Sanctioned this week for being disabled? Am I allowed to have a Birthday without being sanctioned?  If I do the Hokey Cokey at my Birthday Party will I be done for fraud?  I wonder how much has money been "wasted" trying to change the welfare state over the last 20 years and failed, I'm sure the first version of Iain Duncan Smiths baby UC failed first time around due to hardware and software errors, it cost billions on a failed computer system, so they had to start again from scratch, that's why the UC transfer has been painfully slow, every claimant was supposed to be on UC by 2017/18 but it never happened, now it's 2029 12 years late, PIP was created to cut the cost of DLA by 20%, there were 3.2 million people on DLA when PIP was introduced to such a big fanfare, PIP now has more claimants than DLA ever had, 300.000 more claimants, to me the intention of PIP has not worked out very well for the Government but a huge epic win for the sick and disabled! 
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    Paul Howard · 1 months ago
    i was asked to put in a review form for my pip back in august 2023 and  i recieved an update last weekend for a 12 month extention on my allowance that i had for the previose 3 years. Is it taking the dwp that long to decide on reviews. 
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    Trish · 1 months ago
    I was on standard for both adult disability rates diagnosed with COPD waited 8 months after reporting change of circumstances to be told nothing changed
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    kbskylady · 1 months ago
    I find there's no compassion in the system, people are treated like numbers.  There's also the unfairness of telephone assessments: l would defy anyone to accurately assess a person with multiple conditions when they are simply going by what the person sounds like, and questions are often not relevant to a condition or how it affects the individual. I have a work capability assessment telephone call due next week, and I am hugely distressed about it, based on my experience of a PIP telephone assessment of 3 years ago when my whole claim was zeroed by the ATOS assessor (later reinstated by DWP, with a higher award).  I can't get a much needed advocate for the forthcoming assessment, partly because the area of the UK that I live in has so few services available, and also nobody will take time out to support one client over a 4 hour window during which the assessor will call. I have multiple issues including Autism Spectrum Condition, Complex PTSD, an eating disorder (for which I've been on the waiting list for treatment for almost 3 years), severe depression which does not respond to medication, and Type 2 Diabetes for which I am unable to cope with prescribed medication due to sensitivities, condition made worse by the eating disorder. I've been on ESA since 2017, and I will qualify for state retirement pension in less than 18 months.  What the DWP hope to achieve by this new telephone assessment when I am so close to retirement age, have only had 2 Job centre interviews with a Work Coach in 4 years (at both of which I was told I need not look for work) and I live in an isolated location in a county where there's very little work available anyway I don't know.  All the prospect of this latest interview has done is make my depression and anxiety worse, ditto the eating disorder. 
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    Brian Hurton · 1 months ago
    Hi,
    I was placed in what is called the " Severe Condition assessment" it's the same thing but it seems  there changing it to the "Severe disabled group" the Severe Condition was set up back in 2017 it is attached to the WCA , I have discovered there's a lot of people out unaware of the Severe Condition assessment.  I have been trying to raise awareness of it . I was placed in the Severe Condition in 2019 after a long fight with the health assessment centre as I discovered the nurse assessing me never completed the Severe Condition assessment, I ended up getting my MSP on to them and I won my case. I am registered blind and my eye condition is never going to improve it's a degenerative condition. 
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    Nikkimartian · 1 months ago
    So my Husband has intractable epilepsy and significant brain damage caused by previous “status epilepticus” seizures which leave him with impaired memory and cognitive functioning. These will not improve, however he would not fit this criterion as his tonic clonic seizure activity is far less than this, however if they count absence seizures then he would. It isn’t clear from this whether they do or not and it certainly appears they wouldn’t from the descriptor used here as absence seizures are far less debilitating. He does however face significant daily problems due to his poor memory and functioning and also due to the side effects of his medication to lessen his seizures. This can be more debilitating than the seizures themselves, however without this medication he would be at a high risk of further seizures, brain damage and death, so it’s not an option to lessen his medication and indeed he is being asked frequently to consider increasing his medication to be more optimal for preventing all seizure activity but when he was on increased medication levels he was so sedated that he slept over 18 hours per day and struggled to engage in anything even when nominally awake… 
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    robbie · 1 months ago
    Re notes abive, under COPD, "too breathless to leave the house or breathless when dressing or undressing" is grade 4 MRC breathlessness, according to the the link given. Some google links do show a grade 5, so nothing is clear.
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    Nikkimartian · 1 months ago
    The epilepsy and many others of these criteria are wrong. Hubby currently has seizures (tonic clonic) less than weekly (possibly more than weekly for absence seizures) however it has caused severe cognitive and memory difficulties but also his seizures come with no warning at all means he cannot cook or shower/bath at all without help, which of itself should qualify him
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    Steve7701 · 2 months ago
    Another announcement and back to being in limbo. Have depression treated by mirtazapine - aggravated now by severe PTSD due to death of partner which was caused by NHS negligence. Told the specialist treatment I need basically doesn’t exist on the NHS, and for the next best the waiting list is huge & private treatment could cost up to £13,000 - with that & given the constant demonization of the disabled in the press I told the last assessor I was unable to care whether I got an award or not - I got a full award, the assessor was kind this time, I had a brilliant advisor. I also have painful neuropathy which is slowly worsening. I have been assessed so many times over the years - each one takes a piece out of u. Being a volunteer at a charity would help my self esteem but I’m too afraid that my benefits would be cut. Always a stick, never a carrot. Will a future government care?
    To finish, I understand the big increase in numbers on sickness benefits - it’s impossible to survive on unemployment benefits, and one can search without the threat of sanctions for a job for which one is more suited. 
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    Tanya Marlow · 2 months ago
    The ME/CFS one with ‘all treatments provided by specialist pain and fatigue services have been exhausted’ is extremely worrying. As recent history of ME has shown, all treatments has included ones that harmed and disabled ME clients. There’s concern that Graded Exercise Therapy would come in via the back door. And who’s to define what a specialist pain or fatigue treatment is? Really, there aren’t any fatigue treatments, just pacing (staying within your limits) for management. It is very much open to abuse and is a loose definition of treatment.  

    It would be fairer and more scientifically accurate to put a time limit on it - I.e. if someone has had ME for more than 5 years in that more severe state then they should be put into that group. Most recover within the first three years if they’re going to recover. 

    It is also important that a patient is allowed to decline treatments that aren’t suitable for them. For example, nicotine patches is a new thing people are trying but it carries other risks. Do ME patients have the right to say no that? Pregabalin used to be offered as a painkiller but is now advised against. Do ME patients have to say yes to a drug or medication they think could be dangerous? This wording MUST be rephrased. 
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      Asbo · 1 months ago
      @Tanya Marlow I don't think they should say about 5 years even. I'm in the moderate group but have had M.E. for thirty years although diagnosis only 5 years ago. It is so individual the course it takes and mine could easily become severe if I didn't manage/pace my activity. PEM just the same, I just manage it better
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    Jack · 2 months ago
    He seems to understand the problem. We need better strategies to stop people getting sick. He is suggesting cocentrating on preventing disability.

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    Graham · 2 months ago
    Hi
    Just on the physical conditions,
    I have Dystonia
    Which is a painful movement condition
    Often associated with those with Parkinsons
    And yet got the higher rate was taken off me
    Despite them adding the pain element in the criteria years later

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    wibblum · 2 months ago
    As a recently-diagnosed Autistic adult in his late 50s, upon (finally) receiving a paper diagnosis, my experience has been that you get your DSM5 'pass certificate' (with no specific measurement level recorded in my case) and then a fond cheerio with no further support (unless, I suppose, I present 'in crisis' at some point). I wonder how my 'specialist' - most likely a random GP at my surgey as far the DWP are concerned - would express that?
    • Thank you for your comment. Comments are moderated before being published.
      Asbo · 1 months ago
      @wibblum wibblum I was diagnosed in my sixties but via Right To Choose. But our understanding of autism is evolving all the time especially among adult women
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    Bertie · 2 months ago
    Based on the criteria I believe I would qualify for one of my conditions, but like many others I have several conditions and the DWP seem to make it harder for people with co morbidities to claim. My daughter has one mental health condition and was awarded PIP without an assessment, I have several mental and physical conditions and am wheelchair bound, and yet had to go through 4 assessments in the last 10 years and had to go to tribunal the last time after an award reduction! My 3 main conditions are never going to improve yet they still put me through the assessments each time and give short awards. I even had one consultant letter stating I'm never going to improve yet DWP still think I will miraculously get better in 2/3 years each time. I don't hold out much hope of being placed in this new group despite being eligible.
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    wightrider · 2 months ago
    I have had M.E. for almost 30 years.  It is as yet incurable and largely untreatable.  How am I supposed to provide "confirmation that all treatment options provided by specialist pain and fatigue services have been exhausted" when there are no treatment options, and no such 'specialists' where I live?  
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    Elaine S. · 2 months ago
    Having looked at the criteria for Schizophrenia as given above, under the proposed new Severe Disability Group, my adult son would tick all the boxes bar one...... which is that through no fault of his own, he no longer is 'under the care of specialist psychiatric or support services'.

    The circumstances of him receiving a letter from the Community Mental Health Team about 18 months ago, with no face to face discussion first,  informing him that he would no longer be under their care,  frankly disgusts me. This not uncommon practice simply smacks of saving money, though in his case, I also am also suspicious that my criticism of a psychiatrist there was the nail in the coffin. 

    Said psychiatrist effectively stitched my son up in a phone call made to him, that was not revealed to be a brief psychiatric assessment of him for a PIP renewal (initiated by the organisation doing my son's PIP renewal assessment). My son had never met him, and the psych clearly didn't read his file very well, and as a result my son had his PIP entirely removed, until I managed to intervene and get it reversed. He had been on the highest level of daily living, and on either DLA or PIP since he had been sectioned in 2009. 

    Having taken away any psychiatric help, and already having no social work support, he now has virtually nothing, as he finds getting to the GP to be very difficult. He does fortunately have a support worker via Direct Payments, but only because of my intervention in the past, (he lives nowhere near me, but I was aware of his need and did my best for him to get him as much help as possible)

    He also suffers from almost life-long Tourette Syndrome, and it was only the intervention of the Dr at the London TS clinic in writing to the CMHT that has resulted in my son being invited back for a reassessment next month. However it seems that such things as mental health support can be taken away again on a whim and it may then drastically affect where they stand with this new DWP group.

     I even argued a similar point (ie his removal from the CMHT even though there was still need, which happens to many people now, and is even presented as a kind of progressive step! ), with a person involved in helping with an official complaint I had made about another matter on my son's behalf, and they had no idea seemingly (or concern) that when a person applies or renews PIP, that the DWP take this kind of thing into account in their decision making. Essentially someone's financial support from the state can simply hinge on whether they have been booted out of the Community Mental Health Team to the care of their GP .... or not. 

    Even the Decision Maker who overturned my son's PIP wrong decision made a comment to me on the phone about him being in the care of the CMHT as one of the reasons why he deserved to be back on the highest level of Daily Living - not understanding that these decisions are no longer made on purely clinical reasons. If my son is taken back by the CMHT then I have no doubt that they will simply shunt him off it at some point to the 'care' of his GP again, even though he clearly needs more ongoing support than he is getting.
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    Alan S · 2 months ago
    Obvious why they are doing this; they want to reduce the bill for disability payments. No other reason, despite what they claim. We can only hope the new Labour gov will adopt a more considerate approach, but I wouldn't bet on it.
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    Moggie · 2 months ago
    As well as having autism and ADHD (very late diagnised) I also have M.E. and FM and many other conditions. What struck me is how similar autism burnout is to M.E. and yet just seen his Graun article on FB showing that Wessley et al are still not giving up the abusive and disability denying biopsychosocial drivel. Here if link works:
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      Asbo · 1 months ago
      @Jack They're learning all the time about M.E. and there's a huge study (I've taken part in it) Decode M.E. but the DWP are unlikely to take notice of the latest proof in the field, especially not with the likes of Wessley at the helm of the biopsychosocial research that has informed a lot of the DWP thinking on M.E. even though the WHO class it as a neurological condition. Incidentally so is autism
    • Thank you for your comment. Comments are moderated before being published.
      Jack · 2 months ago
      @Moggie It is mitochondrial. This is also the nature of aging. There is also a concept called Cell Danger Response, i.e. in response to toxicological assault, the mitochondria start shutting down to protect themselves.  So yes you feel like crap, but this is for the sake of survival. 
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    Roni · 2 months ago
    My daughter falls into ME/CFS category.she has been told by two specialists  that they can’t do any more for her. She spent 10 years in the care of an immunologist, and at least 10 years in the care of an ENT consultant. Both consultants concluded that they can’t do anything further to treat her. Her conditions have deteriorated, and she suffers chronic pain and fatigue. It would be such a relief if she didn't have the added stress of having to complete a PIP form, when she has explained so often that there is no chance of any improvement in her condition.
  • Thank you for your comment. Comments are moderated before being published.
    Mark · 2 months ago
    Regarding Parkinson's, I was placed in the Protected Group for UC after winning a tribunal (with a lot of help from B&W documentation!).

    What the Benefits Agency needs to understand is that there is huge variation between Parkinson's patients, in both the set of symptoms we experience and the sequence in which they develop.

    I certainly would not qualify under this latest set of criteria, despite the devastating impact that the condition has on all aspects of my life. 

    It is horrifying to think that these criteria may be rigidly applied to people who are suffering from a progressive, debilitating and currently incurable condition, causing untold hardship and suffering.
    And all to support the Government's destructive fetish for tax cuts.

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