Written evidence from Sense (HAB0123)


Dear Rt Hon Stephen Timms MP,

Thank you once again for inviting Sense to give evidence at the Work and Pensions Committee on 12 January, and for meeting with us on 1 February.

I am writing to give a more detailed response to Chris Stephens’ question on whether it was ever appropriate for decision-makers to override medical evidence. I would also like to raise supplementary points relating to some of the themes raised during the evidence session.

Decision-makers’ use of medical evidence

After consulting with the person responsible for running our employment service in Birmingham, I can confirm that we do come across cases of decision-makers overruling medical evidence from specialists in the applicant’s condition or impairment. Although both the PIP assessment and the Work Capability Assessment are functional rather than medical in nature, medical expertise can play a vital role in providing evidence that someone has a condition or impairment. It is therefore concerning that some decision-makers do not accept the judgements of medical specialists.

Emotional impact of the assessments

Through our services, we often hear that even those who are familiar with the welfare system can find the process of going through benefits assessments extremely stressful. One person we support with MS was unable to leave her bed both the day before and the day after the assessment as a result of the anxiety and distress it caused her.

As well as the impression that they need to ‘prove that they are disabled’, the nature of the questions the assessor ask can also make the process humiliating and degrading for the applicant. For example, one visually impaired person reported being asked how they ‘knew they were clean’ after using the toilet. Clearly, such questions are not compatible with the dignity with which applicants should be treated.

Default recording of assessments

Although the Department for Work and Pensions has previously committed to the default recording of assessments, the people we support tell us that this does not always take place. Instead, people are sometimes told that they need to book recorded assessments in advance. It is vital that the Department do more to ensure that all assessments are recorded by default, better enabling applicants to challenge unfair or inaccurate decisions.

Receiving a paper report after an assessment

Similarly, some people with complex disabilities we support also tell us that paper reports of assessments are not always available, making it more difficult for applicants to understand the basis for the decisions they receive and to challenge them.

Inaccessibility in the benefits system

Despite being designed to support disabled people, some application forms for benefits are not compatible with assistive technology. For example, the text boxes for answers are only identified as blank spaces by some screen readers, meaning that applicants do not know where they need to write their answers. They may also receive forms in formats that do not work well with their screen reader.

As a result, disabled people can end up needing support from family, friends and other third parties. Given that the purpose of disability benefits is to support independence, this is clearly unacceptable.

Even those whose screen readers do work with the forms can find it exhausting to listen to the lengthy application forms for extended periods of time, making it more likely that they will make a mistake. For this reason and others, Sense believes that the application form for PIP and UC should be simplified, in the same way that the Department for Work and Pensions recently simplified the application form for Disability Living Allowance.

The people we support can often end up being sent information such as decision letters in the wrong format. For example, one visually impaired person told us that she often received information from the Department in the post in large print, despite being unable to read it. However, if that same information came in the form of an email, she would be able to use it with her screen reader.


I hope that these points are useful to the Committee as it produces its report on health assessments for benefits.


Yours sincerely,

Evan John,

Policy and Public Affairs Advisor

February 2022