The DWP have revealed the draft criteria they will be using to select claimants for the Severe Disability Group, which will allow fast-track claims for disability benefits.  Benefits and Work would like to know if readers with severe, lifelong conditions think they would meet the criteria.

What is the Severe Disability Group?

The purpose of the Severe Disability Group is to improve the disability benefits 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 in order to claim personal independence payment (PIP) or to be found to have limited capability for work-related activity (LCWRA) for employment and support allowance (ESA0 or universal credit (UC).

The introduction of a Severe Disability Group was first consulted on in the Health and Disability green paper in 2021.

The resulting Health and Disability white paper published in 2023 revealed that design and testing of the Severe Disability Group had already begun.

The DWP have now announced that they are widening the testing of the Severe Disability Group, with two separate tests taking place, both relating to PIP.  There is more on this below.

How the Severe Disability Group works

Where a claimant is considered likely to meet the criteria for the Severe Disability Group, a short form will be sent to their specialist clinician.  The form is similar to the SR1/DS1500 form used for claimants who are terminally ill.

You can download a copy of the SR1 form from the response to this freedom of information request.

If the specialist confirms that the claimant meets the criteria, they will not be required to attend an assessment and will no longer be required to fill in complex forms, such as the PIP ‘How your disability affects you’ form or the ESA50/UC50.

Testing the criteria

The DWP are currently running two tests of the draft Severe Disability Group criteria

One test involves asking a selected group of clinicians to identify patients they believe are suitable.

The other test involves the DWP contacting claimants they consider to be likely to meet the criteria and asking if they would be willing to take part.  If they are, the DWP will then contact their clinician and ask them to complete a brief form. 

The DWP have said that participation is entirely voluntary, claimants can withdraw at any time and they “will not be financially disadvantaged by taking part.”

Official criteria

In order to meet the Severe Disability Group criteria, the DWP say claimants must :

have an irreversible or progressive condition, confirmed or managed by a secondary care specialist, with no realistic prospect of improvement 

have had no significant response to treatment, or treatment will not improve function, or no further treatment is planned

have a severe impairment of physical or mental function (or likely to develop this within 6 months) such that they need assistance from another person to complete two or more activities of daily living

The Secretary of State is satisfied that, for the individual patient the criteria have been fulfilled for: 
enhanced Personal Independence Payment (PIP) daily living or mobility components
functional limited capacity for work-related activity (LCWRA) or support group

Our interpretation

There is no published official guidance on how to interpret these criteria. So, please be aware that the definitions below are our understanding of the criteria, they are not official definitions.

An irreversible condition is one that may not deteriorate further but will also not improve, such as a learning disability, ADHD, spinal cord injury or cerebral palsy.

A progressive condition is one that is known to deteriorate, such as osteoarthritis, Parkinson’s disease, COPD or Alzheimer’s disease.  

A secondary care specialist is someone who is not in the first line of treatment.  So, a GP or mental health nurse would not be included, but a cardiologist or a psychiatrist would be.  It appears that you don’t need to be currently seeing a specialist, but you need to at least have had your condition confirmed by a specialist.

There is no planned treatment that will improve your condition further.

Your condition needs to affect two or more activities of daily living to the extent that you need assistance from another person.  These activities aren’t defined, but the list of PIP daily living activities would seem to be a likely place to start.

For PIP, you need to be able to meet the threshold for an enhanced award of the PIP daily living or mobility component.  If you don’t already get an award, you can check the criteria using the Benefits and Work PIP test.

For UC or ESA, you need to meet the criteria for being in the LCWRA group or the support group.  If you don’t currently get either of these benefits you can our UC WCA test for LCWRA or use our ESA test for the support group.

Would you qualify?

The DWP say they worked with specialist health professionals to develop the criteria and also consulted with several charities.

But, as always, they don’t seem to have talked to any of the claimants who will be on the receiving end of this system.

So, we’d like to hear your opinions and queries about the criteria in the comments section below. 

And, if you currently get at least one component of PIP at the enhanced rate or you are in the LCWRA group for UC or the support group for ESA, do you think you would meet these criteria and be eligible for the Severe Disability Group?  Or is there something about your condition, your contact with health professionals or something else that you think would threaten your chances?

You can read the full Severe Disability Group test: information for clinicians  Please note: considerably more details about the Severe Disability Group criteria were added to the DWP web page on 27 February.

Comments

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    robbie · 2 months ago
    Agree with much of what has been posted. If there is to be a fast track process for disability benefit claims, ANY form for the GP to complete should be sent to the claimant, either on the claimant's request, or where the dwp has identified a claimant's potential eligibility and invites the claimant to request the relevant evidence from clinicians. Then the claimant can explain their situation to the GP if they wish and discuss which elements of the medical records would evidence eligibility for the Severe Disability Group.

    GPs will not be able to divulge patient information (ie identify potentially eligible patients) to the dwp without the prior consent of the patient unless there is a law passed along the same lines as is proposed in the Data Protection and Digital Information Bill, whereby the dwp could access patient records in the way it proposes accessing claimants' bank accounts. It is inconceivable that GPs would divulge confidential patient information to the dwp without the patient's permission, so the forms should go to the claimant first, not least because, for a variety of reasons, not every patient potentially eligible for the Severe Disability Group is, or will be, a claimant. 

    Some patients might not want to claim benefits, others might meet the criteria for the Severe Disability Group but not for means tested benefits and existing or prospective claimants might simply not want to share that information with their GP. If a patient is a benefit claimant and needs their medical records as evidence for the dwp they do not have to give a reason for requesting those records.
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    Jlee · 2 months ago
    If I already have SDP   , wil i /we get long term award soon..?
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    Sara · 2 months ago
    Yes, Rosie, because the process will go to tribunal as per usual, where the panel will mostly (because they don't always get it right) hear the impact of the condition on the claimant, match up the relevant evidence and decide according to the actual criteria, not just snatch at some vague, uneducated and illogical excuse to turn the claim down. 

    This is why it's so important for claimants to be clear in stating their conditions, the effects of them, and to supply corresponding confirmation from their medical records and/or other proof, so as to pave a clear route to an award, even if the case goes to tribunal. A GP practice will not have capacity to navigate that route either in terms of know how or time/staffing. 

    The dwp is literally trying to offload its own work and responsibilities, in, as you rightly observe, a complete turnaround from it's habit to date of ignoring GPs. It's another layer of stalling opportunity designed to exhaust the claimant. It's also a disgraceful distraction for clinicians which threatens their professional work and their relationship with patients, who do not want to have their medical treatment tainted with an attempt to justify their benefit application.



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    Rosie · 2 months ago
    The DWP currently have the knack of completing ignoring GP and consultants' opinions, preferring to get their own "Health Professionals" (who typically know NOTHING about the relevant illness/condition) to do an assessment. Why should we believe that anything will change? Won't this just be another supposed improvement to the system that has about the same extremely limited effect as the useless Mandatory Reconsideration has? 
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      Carol K · 2 months ago
      @Rosie I think it's their way of trying to appear compassionate in the media after the news about surveilling bank accounts and nothing will change for most of us. We need a universal system that applies equally to every claimant, not just the most severely disabled, but that's socialism and we live in a capitalist hellscape. 
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    Sara · 2 months ago
    Yvonne, my post got cut, this is the full one, I hope:

    Val, if you are still in receipt of PIP after state retirement age, then you are likely to be subject to what is currently the light touch ten year review. It might be that severe disability criteria will come into play, but that certainly isn't clear to me.

    At state retirement ESA would be replaced by Pension Credit (means tested) if you are entitled. If you are still getting PIP then a disability allowance is included in the means test. Attendance allowance might be a consideration if you cease to get PIP. Contact your local advice centre for confirmation.   Contact your local advice centre for confirmation.
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    Sara · 2 months ago
    Yvonne, if you are still in receipt of PIP after state retirement age, then you are likely to be subject to what is currently the light touch ten year review. It might be that severe disability criteria will come into play, but that certainly isn't clear to me.
    If you are still getting PIP then a disability allowance is added to your entitlement. Attendance allowance might be a consideration if you cease to get PIP. Contact your local advice centre for confirmation.
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    Yvonne Drummond · 2 months ago
    I receive PIP & ESA and will be 66 in May 2024. Will I still qualify for Severe disability benefits as highlighted in the fast track Severe Disability Group? Thank you. 
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    reasonstobecheerful · 2 months ago
    Unsurprisingly, some of that was lost. Here's the rest:

    Will partners' health be taken into consideration? What about dependant children, or pets.... What if a farmer has a disabled wife or husband and the dairy herd gets foot and mouth, will the spouse be accused of trying to disguise or exaggerate his or her state of health by cohabiting with the livestock? Does the dwp need to know how many times my auntie looks out the window?
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      Catelynn · 2 months ago
      @reasonstobecheerful You made me laugh thanks 😆
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      The Dog mother · 2 months ago
      @reasonstobecheerful @reasonstobecheerful  True.
      All of the above.!Hope they don't wanna know how many times I've coughed until I've choked in the night in the past 5months with reoccurring virus. Because I didn't count. 🙄 It would be hilarious if not close to the truth as to how they work.
      Talk about needing to know every best of our hearts. 
      I honestly can't see this SDG working to any degree or for it to be fair and upfront. Just the same old same old. 
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    reasonstobecheerful · 2 months ago
    Just out of interest, is the dwp going to publish a list of the top 15 GP practices who are going to be asked to supply data, will they go back many years and will it look suspicious if a patient stops suffering from a condition or is diagnosed with a different one or registers with a new GP? Is there going to be a limit on how many debilitating illnesses a claimant can have? If so would benefits reduce on a sliding scale up to a total where money would be withdrawn?

    ill partners' health be taken into consideration? 
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    keepingitreal · 2 months ago
    Benefits and Work would like to know if readers with severe, lifelong conditions think they would meet the severe disability criteria.

    Of course, sadly, there will be claimants who think they qualify (and who should qualify), but they will not influence action on what they know about their own capacity. The interpretation of criteria, the assessment, and the benefit award will remain a dwp decision. Claimants are not given credibility, no matter what their experience or what evidence they have of it.
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    Jlee · 2 months ago
    What happens if you/Iam   already on it...?
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      T · 2 months ago
      @Jlee The group isn't created yet, in reality alot if not most of us should be able to be in the group but it's just not clear how it would happen , like would we have to apply for the DWP to send the form to our past or precent specialist as it can't be a GP,,, or would it be done during a review of ESA/pip, would the dwp send the form to a specialist named on our form... As always the DWP love to leave us in limbo of not knowing... 
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    Sharon Dianne · 2 months ago
    They won’t give me enhanced, I walk with a plastic boot and sticks or Walker, mobility scooter and even have a wheelchair for swimming pool visits. I have dyslexia, asthma vertigo, diverticulitis, ibs undiagnosed adhd, my spine has been damaged by walking with a stick and now a plastic boot provided by consultant every 3 months. I get the lowest amount of pip and esa in support group . I am allergic to opioids and pain killers Would I qualify , they wouldn’t let me. It’s a rotten system!!!!
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    Frances · 2 months ago
    Claimants might have a number of different conditions which, over the years, have been discussed with, and treated by different clinicians and specialists. It's not clear how much is recorded and shared by different health providers, or how carefully patient confidentiality is or will be maintained. 

    Some claimants might not wish to share all aspects of their medical history, and certainly could well not wish their GP, and, inevitably, any number of admin staff, to know they are claiming disability benefits. For the dwp to test the severe disability criteria by asking a selected group of clinicians to identify patients they believe are suitable sounds intrusive.

    It should be left to the claimant to support their claim with relevant and up to date evidence they choose to submit.


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      Sarah · 2 months ago
      @Frances I moved from my old GP as we moved away and my new surgery has hardly any info on my health conditions but I have paper based info. Since Covid I haven’t been able to see an actual GP it’s all telephone appointments and I’m struggling with no help from anyone. I do not believe anything that this government creates it’s definitely not in our best interest 
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      Frances · 2 months ago
      @Boogie Of course there are claimants who need help with their apllication, but there are advisers, and it should still be claimants who decide who to share their records with. Those who struggle with the claim process are the most vulnerable to the exploitation of their data.

      In small communities everybody does know you, and laws are not always adhered to. 
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      Boogie · 2 months ago
      @Frances What about claimants who don't understand at all how to even request up to date information and have nobody to help them and can just about make a phone call or fill in a basic form? 

      The people that would see your information wouldn't know you personally anyway. If you're worried about your local GP or receptionist 'knowing you're claiming disability' then that should really be the least of your worries. To be honest as well, there are laws in place so they can't mention anything to anyone even if they DID know you personally.
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    rookie · 2 months ago
    Dwp getting excited at the prospect of snooping on medical records as well as bank accounts. As if those records are always available, complete and accurate. After a proper consultation a decent GP will write a note supporting a benefit claim anyway, which can inform the duration of the award and any need for reassessment. 

    There's no need for this extra layer of bureaucracy over burdening GP practices which already struggle to keep and supply comprehensive accounts of a patient's conditions, especially when patients change GP.

    This latest dwp proposal would rely on a huge amount of data trawling and analysis by GPs . It's not workable. Claimants and their advisers understand which evidence will support a claim and can request specific retrieval from records as it is. Dwp should better train its assessors and decision makers to apply severe conditions criteria based on the claim and medical evidence they already receive. Where a claim fails, the claimant can challenge the decision and ask for more GP support, but it's not a GP's job to determine benefit eligibility.
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    Sara · 2 months ago
    Agreed The Dog mother, to all your comments, and, as keepingitreal has pointed out

     "The severe conditions criteria can already be applied to existing claimants with higher/support group awards where there is no prospect of improvement".

    The dwp can't even implement the systems it already has in place. It tinkers endlessly until nobody - claimant, health professional, politician, dwp case manager/decision maker - can work out how to apply which criteria to whom or with what results for those most impacted. I've even had to correct tribunal judges on points of benefit law, even though they are the best at untangling things, but nobody can keep up.

    It's a load of mischief making is what it is, a more and more blatant design to reject the benefit application.
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    val · 2 months ago
    what concerns me about this is when i go to the doctors after three week wait i never see the same doctor at my practice they are all locums so i have to fill them in with my long list of illnesses then my 10 minuet slot is up before i even get to a new symptom point being how can a GP fill in an form about you when they have never met you ???
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      The Dog mother · 2 months ago
      @val Can't even get a gp appointment.  We get 15 call back slots per day with an hours window for all 15 to be catalogued in order of urgency by the reception staff ,as you have to say why you need a call back. 
      To get a doctors face to face appointment is v v rare where I am. I've suffered six months before I could get to see anyone last year,I mean constant non stop pain in my stomach. Pure luck got a ring back and was told to come to the surgery ASAP. 
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    The Dog mother · 2 months ago
    This is going to involve an awful lot of form filling for those speclists who will comply,and a real shame for those who won't, thus leaving patients who would fit the criteria once more with no help.
    The NHS can't cope as things are.
    They already know (dwp) that many conditions won't change for the better, so why not just scrap assessments for those people right away. For example, a friend aged 54 has heart conditions that they think may have been from birth but were not diagnosed until she was in her mid 20s. She has a number of other health concerns also. Can't rem them all ,but there's quite a few. Now realistically is she ever going to get better? Grow a new heart? She gets v tired easily,heart pounds like fury and she gets dizzy spells where she has blacked out. 
    She's been to consultants and given two (I think) different medications she takes five times per day,but still she gets the dizziness at least weekly. I never understood why she is still reassessed. Her MH is bad, no wonder, and she has tried to take her own life a few times. I just can't get my head around why she is seen to possibly be up for working at some stage. I know many if us are in a likewise situation. The process fills me with fury. 
    To me it feels like we are constantly having to fight against shifting goalposts. We are never going to get to score any goals that way. 
    It's beyond unfair. 
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    keepingitreal · 2 months ago
    My post got cut. Trying again. 

    This new measure looks like a ploy for the dwp to bump existing claimants off PIP and LCWRA/Support rather than a fast track route to qualifying.. Unless GPs are savvy with dwp double speak they might not confirm the necessary criteria, especially with assessment of 'how your disability affects you' regarding 'daily living'', so existing claimants could have their awards reduced or stopped.

    It has long been dwp policy not to base awards solely on condition diagnosis, but on detailed assessment of the effect of conditions on the individual. Suddenly they're asking the GP to assess that without experience of how the 'how your disability affects you' criteria work.

    The severe conditions criteria can already be applied to existing claimants with higher/support group awards where there is no prospect of improvement. Referring cases to the GP, who is unlikely to have time to research the intricacies of the disability benefits points system, could be detrimental to claimants. Patients rarely have sufficient continuity of care with a GP these days for a GP to understand what their day to day lives are like.
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    Carol K · 2 months ago
    We are just a form of entertainment for the super rich. 
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    The Dog mother · 2 months ago
    Question... Those who repeatedly get kept in SG over many years, because its obvious to 'someone' they fit the criteria ,and have no changes for the better each time they get a review,why are they not going to be put into this new group? (Should it become a reality) automatically. 


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      The Dog Mother · 2 months ago
      @T @T My thoughts exactly. We aren't in support group for fun and games. 
      I honestly think the dwp talk rings around themselves..  Absolutely illogical.
    • Thank you for your comment. Comments are moderated before being published.
      T · 2 months ago
      @The Dog mother 'have a severe impairment of physical or mental function (or likely to develop this within 6 months) such that they need assistance from another person to complete two or more activities of daily living'.….....   
               From this rule surely most of us should have to get this new award automatically without any need for specialist to fill in unnecessary forms ???     They claim to be the experts after all don't they the assessors and dwp decision makers, they have all the information needed when awarding us our ESA/PIP..