Sarah
Former DWP assessor deeply concerned about the process
With thousands of sickness benefit claims to process every day, how does the DWP manage? The answer is that it uses private companies who hire hundreds of assessors - who spend an hour (or less) on the phone and decide, using set criteria, if a claimant passes. Some 80 per cent of them do. In the film, former assessors share their misgivings about the process.
Staff are set a target: six phone 'work capability assessments' a day. If they do seven, they get paid an extra £80. Hit eight and it's £160; nine and it's £240 etc. This creates a strong financial incentive to maximise the number of tests processed, rather than focus on the right outcome.
Curtailment
It is possible to increase the number of tests completed every day by "curtailing" - that is to say, end the process after 20 minutes rather than an hour. The easiest way to do this is to recommend early on that the patient qualifies for the full sickness benefit (LCWRA) without any requirement to work again. One assessor we spoke to estimates that she 'curtails' about three in every five claims. The following is an excerpt from guidance one company gives to staff.
We spoke to staff who felt this system is too open to abuse, creating an incentive to end the assessment early by making a quick decision to award the benefit. Such decisions tend not to be audited as they tend not to be challenged by an Appeal.
Sickness benefit assessments via telephone (rather than in-person visit) are now routine and it's not always necessary to provide proof of a sick note. In the film, Michael Houston, a former assessor, is asked how well it's possible to discern, over the phone, if someone should qualify for full sickness benefit. "Not very," he replied, "which is one of the things that ethically and morally I didn't really feel comfortable with."
Anyone recommended for sickness benefit is usually scheduled for reassessment in, say, 18 months' time. But these are also conducted over the phone and rarely end in an award being revoked. "To take a claim away from someone would require an in-depth and long conversation and we are incentivised to get through as many as cases as we can in a day," says one assessor. The number of people moving to work as a result of reassessments seems to have collapsed in recent years, as the graph shows.
One assessor, Sarah, says in the film that she came across some patients who seem to know what words to use that trigger the highest assessment.
"If at any point someone said that they were suicidal everyday, it’s straight away in that high [category]. It's down to the integrity of that person. And sadly my opinion is that not everyone that is claiming is quite telling the truth, which is sad but ultimately it's going to happen. It's really frustrating to me because there's actually people that I chat to that are having them thoughts but genuine. And you really feel for those people that are going through that. But then you're getting people that, you know, after reading these forums... Actually, you're lying. And that's just almost like discredits those that are actually really in need. So it's hard."
The 'forums' she was talking about are online forums where people share experiences and offer guidance on how to navigate a sickness benefit claim. These are quite easily found on TikTok and similar platforms: some of these so-called 'sickfluencers' have more than a million views. Much of this is explaining how the process works and tests applied by assessors for both LCWRA and PIP (the separate disability benefit). To the amazement of some assessors, the DWP handbook issued to assessors - with detailed advice on how to handle claimants - is freely available online (pdf).
Mel Stride, the former Work & Pensions Secretary, says that the switch to phone interviews has not led to an increase in approval rate. But longer-term the trend is clear: since 2010, the ratio of applicants approved for sickness benefit has doubled to 80 per cent.
Combine this with a significant increase in those completing what many see as an easier process and we see the onflow surpass 3,000 a day in March 2024, the latest month for which full figures are available.
There are signs that a bias towards approval has crept into the system. When a new minister starts at the DWP they are shown case studies of claimants who either killed themselves or self-harmed after being wrongfully denied benefits: the implication being that refusing claimants carries the big political risk. No one asks questions about those who are approved.
In the assessment companies too, like Maximum and Serco, case workers say that when they are audited the cases they are hauled up over are invariably the claimants who they believe do not meet the criteria. "They are the people who can then lodge an appeal, which costs the company money," says one of the case workers. "If you curtail [ie, approve] then you're almost never asked why you finished that assessment early. The incentive is to get through as many forms as you can."
I spoke to another DWP assessor, a trained GP, who wishes to remain anonymous. She had this to say.
"What strikes me about this job is how few people I speak to who are genuinely too sick to work. Most of the claims are to do with stress or anxiety: I'm speaking to people who, as a GP, I would not say were too sick to work. But my opinion as a GP does not count in this system: it's all about points, about 'risk' and other triggers that they seem familiar with before they call. What gets me most is the number of young people who are staying in the house, who don't want to go out and want sickness benefit. We sign them off - we have to under the guidelines - but you have to wonder what we're doing to them. I can understand the alcoholics in their late-50s but I can't understand the young people in their 20s."