Benefits and Work can reveal that, in order to avoid publishing controversial guidance given to health assessors, the DWP are arguing that fraudsters might be inspired to fake end-stage chronic kidney disease if they saw the document.
In December, Benefits and Work made Freedom of Information request for “copies of any training or guidance issued to health assessors and/or DWP case managers in relation to the severe conditions criteria (SCC) for the work capability assessment.”
From April the SCC will be used to decide which new universal credit claimants are eligible for the higher rate of the health element, so it is vital to understand how the department is interpreting the legal test set out in the Universal Credit Act 2025.
This is especially so as there is doubt about whether disability minister Stephen Timms explanation to MPs of how the law would work, is accurate.
However, the DWP refused to provide us with the guidance documents on the grounds that they “would, or would be likely to, prejudice the prevention or detection of crime”. This was a grounds for refusal we had never seen in 20 years of making requests.
Eventually, the department sent us a heavily redacted copy of guidance issued to health assessors in 2023. In the accompanying letter they told us that sections had been redacted because:
“Disclosure of this information would be likely to prejudice DWP’s ability to prevent and detect fraudulent claims. It would enable individuals to manipulate or tailor their responses to meet eligibility thresholds, undermining the integrity of the assessment process and the fair allocation of public funds.”
The SCC were originally introduced in 2017, but their purpose then - and until April of this year – was simply to decide whether individuals with severe conditions need to be reassessed, not to decide how much money they get.
Back then, the DWP were happy to provide us with a copy of the guidance, which we still have.
We have compared the 2017 guidance with the 2023 guidance and concluded that the two appear almost identical in content, except where it relates to the technical aspects of entering findings into DWP software. There have also been some changes to formatting and layout.
So, we can now reveal some of the redacted text that the DWP say would allow individuals to make fraudulent claims.
One redacted section discusses the fact that where there is medical evidence that a claimant is not suitable for a transplant, the assessor should accept this. The example is given of someone with end stage chronic kidney disease who also has significant left ventricular dysfunction. Because they would be unlikely to survive transplant surgery, “severe conditions advice could be offered.”
So, what the DWP seems to be arguing, is that claimants reading this might be tempted to fake end-stage kidney disease along with heart disease in order to get benefits.
Another redacted section explains that although an acquired brain injury may have lifelong effects, some recovery of function is possible over time. It is hard to see how this knowledge would be of value to a fraudster.
Even more difficult to understand is the reason for redacting this paragraph:
“The advice must be based on recognised and current interventions - not based on some research initiatives or proposed research. For example stem cell research in Parkinson’s Disease.”
How is it of value to a fraudster to know that assessors cannot take into account experimental treatments?
The redactions also include all 4 case studies included in the guidance.
One of the case studies involves a man with such severe osteoarthritis that he has had two hip transplants and is on 4 times daily morphine for pain. Even then he fails the SCC, so it seems improbable that fraudsters would be persuaded that surgical interventions were worth trying to fake.
Another involves a woman who has antisocial personality disorder, has had repeated custodial sentences for violence and “harms herself through hitting her head off walls or cutting her wrists . . . on a daily basis”. She also fails the SCC, so it seems unlikely that fraudsters would be inspired to fake years of prison time and self-harm in the hope of eventually getting additional benefits.
The reality is that most of the redactions in this document cannot be justified on the grounds of crime prevention, only on the grounds of obsessive secrecy.
In 2023, the Information Commissioner John Edwards published a highly critical report on the DWP’s FoI failings. He said that there was an increase in the amount of information being withheld by DWP where it previously would have been “disclosed or proactively published”.
In 2022, when he was chair of the work and pensions committee, Timms similarly accused the DWP of having a “culture of secrecy”.
And when he became disability minister in 2024, Timms claimed that he would create a new era of transparency at the DWP, as part of an effort to restore trust in the department.
In fact, he has done exactly the opposite.
Members can judge how reasonable the redactions are, by downloading both copies of the DWP Severe Conditions Prognosis Re-referral Guidance from DWP resources section of the members' ESA/UC guides page. We have highlighted in the 2017 version what we think are all the redactions in the 2023 version. There's more on the guidance, including extracts here.
