Independent Review of Adult Disability Payment: final report

Processes That Work

The Charter

Adult Disability Payment is delivered by an Executive Agency of the Scottish Government, Social Security Scotland that has been created with the explicit objective of treating disabled people with dignity, fairness and respect, guided by a Charter against which the public can measure its performance.

The original Social Security Charter^[105] was created and approved in 2019 and sets out the service that people should expect from the whole social security system in Scotland. The Charter, developed through extensive consultation with users of the system and other disabled people, articulates commitments aligned to the principles, delivering high-quality services, and involving people in the design, development, and delivery of social security policies and services. It is a document of legal status that both empowers individuals and holds the Scottish Government and Social Security Scotland accountable for their actions. The Charter plays a crucial role in implementing the values enshrined in the Act, ensuring that the social security system in Scotland not only meets legislative requirements but also aligns with the principles of fairness, dignity, social justice and human rights. The Charter also plays a crucial role in guiding this Independent Review.

The revised Charter was unanimously approved by Parliament on 26 June 2024, and the Scottish Government continues to work with Social Security Scotland to implement the revisions – an updated Charter Measurement Framework^[106] was published on 12 November 2024.

In the revised Charter there are several new outcomes related to the question ‘do processes work’?

• clients are supported when they make an application
• clients are kept updated and given information about what will happen and why
• clients receive clear and accurate decisions and receive the right amount, on time
• clients feel able to challenge decisions and are supported to do so.

There is evidence that this commitment is inspiring hope of meaningful culture change in Social Security Scotland among disabled people and disability support organisations.^[107][108]

The Social Security Scotland Client Survey 2023-24^[109] results show that three-quarters (75%) of respondents with experience of applying for Adult Disability Payment (n = 11,808) rated their overall experience with Social Security Scotland as very good or good, while only 8% described their experience as poor/very poor. Also, the majority of respondents with experience of applying for Adult Disability Payment believed that they had been treated with dignity (76%), fairness (70%) and respect (76%). Written comments left by respondents also highlighted the humanising treatment they received from staff, as well as Social Security Scotland processes.

I often heard the word ‘kindness’ and that people felt listened to and valued and in most cases the experiences shared with me were in a sharp contrast to experiences with the DWP.

The less than positive issues raised by disabled people and stakeholders relate not to their overall experience, which as noted above is generally good, but rather to their frustrations with some of the processes adopted by Social Security Scotland namely the application process, providing supporting information, processing times, lack of communication, telephone response times, third party mandates, inconsistent decision-making, lack of understanding of particular disabilities or conditions and the fear of losing an award if considering a re-determination request.

Eligibility checker

Social Security Scotland has an online suitability checker that allows people thinking of applying for Adult Disability Payment to check if they meet the basic requirements. It does not tell someone if they are likely to get Adult Disability Payment because of their disability or health condition.

The Independent Review sought views on whether a more detailed eligibility checker should be introduced to ask questions about a person’s daily living and mobility needs to help them know, before applying if they are likely to be eligible for Adult Disability Payment or not. This was proposed as a potential way of addressing the stress and anxiety associated with the length of the application form, the time it takes to make an application and the waiting time for a decision to be made, particularly by people who go through all this and then find that they are ‘not eligible’ when receiving their determination letter.

These were the key findings:

• respondents generally supported a more detailed eligibility check prior to applying, suggesting it could save people the time and energy of applying if they knew they did not qualify. A few suggested that any digital eligibility checker must capture the full range of qualifying conditions to ensure people were not wrongly advised
• some individuals preferred the current approach as they felt sufficient information already existed to help people understand whether they are likely to be entitled
• criteria that were recommended for inclusion in an eligibility checker included the impact of disabilities or conditions on daily lives, information about daily living and independent living, emotional wellbeing and cognitive state, assistance needed, and financial circumstances
• there were mixed views on whether people considering applying for Adult Disability Payment would need help to complete an eligibility check. Those who thought they would, suggested that assistance be provided by advice or welfare rights workers, family members, or advocacy and support workers.

Some of the advantages of such an approach included:

• it would help people understand if they qualify
• it would help to reduce stress and anxiety
• it would ensure the application is worthwhile
• it would save time and effort if people do not meet the criteria.

Some of the disadvantages were expressed as technical problems which could result in an incorrect result, putting people off applying. It was felt by some people that introducing something like this at this stage could cause confusion and most respondents said they thought the current approach is preferable.

Therefore although 45% of consultation respondents thought it would be helpful to have a more detailed eligibility check before filling in the application form, for the reasons set out above I am not recommending this as an action. It may be something worth keeping under review.

Application

Pain points across four key areas in the application journey include:

• eligibility criteria
• uploading supporting information
• answering functional questions
• technical issues with the on-line form.

The length and complexity of the application form, coupled with difficulties in the online application process, including setting up an account, present significant barriers.

There is evidence that the simplification of benefit application processes would improve take-up of benefits^[110]. The introduction of automatic enrolment for Scotland’s Five Family Payments is an example of a streamlined application process that is likely to positively impact benefit take-up among families. Following the introduction of automated payments for Best Start Grant School Age Payment, the estimated take-up rate of the payment increased by 20 percentage points.[111] [112] [113] Offering a range of application modes may also improve take-up.[114] [115] [116] [117]There is early evidence that the provision of an online application form for Adult Disability Payment is reducing barriers to take-up among some disabled people.[118] However, digital exclusion in particular among some seldom-heard groups, means it is important that there continues to be provision of a range of application methods.

Disability benefit applications are experienced as particularly burdensome by people with terminal illness, mental health problems, fluctuating or less visible conditions, and learning disabilities/difficulties.^[119] [120] [121] [122] [123] However, people who are terminally ill do not need to complete the application form and the process for applying is more streamlined. Therefore, a distinction should be made in understanding the lived experience of people who are terminally ill applying for Adult Disability under SRTI, and people with mental health problems, fluctuating or less visible conditions, and learning difficulties/disabilities who are not applying via the SRTI route. A survey conducted by the National Autism Society found that people with autism frequently experienced severe challenges when applying for benefits.[124]

For people with energy impairment, chronic fatigue and/or neurological dysfunction, the process is extraordinarily stressful and draining. Completing a lengthy form, providing supporting information (including from professionals who often do not understand their conditions), uploading it when current systems are very cumbersome and time-consuming, waiting on the phone and long phone calls add to stress and exhaustion. There is a genuine risk that the demands of applying for a much-needed benefit cause a deterioration in health.^[125]

Research undertaken by Young Lives vs Cancer^[126] shows that just one-in-three young people with cancer and their families (35%) report being satisfied with the application forms in place throughout the disability benefits process. Many find the forms incredibly complicated. One parent/carer in Scotland commented:

“The questions were impossible to understand, and I wasn't sure how to answer them. For example, did I talk about how my child was that week? That day? Things changed so quickly - I had to list all her medication and chemo drugs, but they would change a few weeks later. It was exhausting and upsetting and then at the end they said it would be six to nine months before I heard.” - Individual response to Young Lives vs Cancer^[127]

Recurring themes from my engagement with disabled people and stakeholders highlighted the following positives:

• the larger font on the paper form is appreciated, especially for people with a visual disability
• the inclusion of guidance and pictures on the form was thought to be helpful for clients.

However, I also heard in my engagements some negative experiences:

• access to the internet is not universal, especially with the current cost of living crisis
• people continue to have issues with log-in and passwords
• some people with certain conditions, for example hearing impairment or those using assistive technology, find it difficult to access mygov.scot online systems and complete online forms
• once submitted the application form cannot be edited
• document upload is causing issues and delays
• when uploading supporting information online, there is not enough file space to upload multiple documents
• it was highlighted by the Royal National Institute of Blind People (RNIB) that the colour contrast on the form is poor for people with severe visual impairments
• people with low levels of literacy or people whose first language is not English find the language used in the application form particularly difficult to understand
• it is difficult to get an overview of the entire application form online, making it challenging for applicants to see which sections have been completed, what questions are coming up and the answers they have already provided.

Other reasons given by some consultation respondents for difficulty understanding the application form included:

• questions being vague, contradictory or unclear
• being unable to understand the rules generally
• questions being too similar or repetitive and can be easily misinterpreted, especially terms such as ‘sometimes’ and ‘always’ which can lead to confusion
• the questions seeming to be binary in some cases and people sometimes feel that they cannot answer a straight ‘yes’ or ‘no’ to a question
• the thinking behind questions not being given, so unsure how to answer
• that it is unclear what ‘reliably and repeatedly’ mean in practice
• that illustrative examples were needed.

“The questions are very repetitive, and I sometimes feel that they are this way to try and catch a person out, because you can ask two different questions, but they amount to the same answer. This confuses me.” – Individual response to The Independent Review of Adult Disability Payment Public Consultation^[128]

Clarifying the language used in questions and enabling people to put into their own words, the impact of living with their condition, by adding more free text boxes would allow for a better understanding of their lived experience.

Some of the barriers to application include the impact on a person’s mental health of filling in the application form. Many people told me that it is highly stressful, and they find completing the application form daunting. Adjectives used to convey reactions to the form include overwhelming, intimidating, distressing, and exhausting. Clients presenting with mental health problems, PTSD-related cognitive impairment, and dyslexia, were all specifically cited as having powerful reactions. However, evidence was also present of a more generalised response by applicants of feeling overwhelmed.^[129]

In a meeting with the Young Lives vs Cancer charity, I was told how their service users have repeatedly underlined the complexity of the application form as a key reason for them seeking help when applying for financial assistance. Many families also found it difficult to manage both cancer treatment and the application process at the same time.

The length of the form has been raised repeatedly as an issue. At a few events there were mixed views about whether to shorten the application form by, for example, removing or having pictures in a separate document.

One benefit adviser told me that it can sometimes take two separate three-hour long appointments with a client to complete the form. When I personally shadowed a Local Delivery adviser the appointment lasted almost three hours, and I was told this is typical.

The length of time taken to fill in the form also highlights that some people are unable to fully explain the extent that their fluctuating condition impacts on their ability to complete tasks of daily living without the support of experienced advisers.

The most prevalent related theme following the online consultation and call for evidence was confusion over the fluctuating conditions section of the application form. While many disabled people acknowledged that there have been changes made to improve how applicants experience the process of completing the application form, these changes seem to have limited or no bearing on how much case managers understand the impact of fluctuating conditions. Some felt that the fluctuating conditions section was ineffective at capturing the continued impact of bad days on a client’s life and wellbeing longer term, and a few respondents found it difficult to describe the impacts of their fluctuating conditions within the application form.

Feedback from the MS Society included comments such as:

“There wasn’t space on the form for me to explain how my condition changes day to day.” – Individual, MS Society Scotland response to the Independent Review of Adult Disability Payment Call for Evidence ^[130]

The strengths of the form, such as the value of free text questions and space for elaboration at the end, the straightforward layout and sensible grouping of questions were noted at a few of the consultation events.

“Provide a section to enable a free text/narrative to allow the applicant to describe how their disability affects them from a very personal perspective. We are all individual, how a person's disability affects one differs to another. Therefore; a section where the applicant can present their disability in their own words can be empowering.” – Client Survey – Child Disability Payment and Adult Disability Payment January – March 2023^[131]

Improvements to the application form were suggested including:

• more open questions and space for free text responses throughout
• multiple choice questions for those who struggle with handwriting
• improvements to colour contrasts on the paper version to increase accessibility for those with visual impairments
• reviewing the use of language through a neurodiversity lens to support understanding of the questions
• providing different versions of the form, for instance a condensed version without photos (specifically for support organisations) so that it is easier to navigate
• less high-quality paper and binding to make it easier to fit into an envelope to return along with supporting documents
• make it easier to un-staple and copy the forms, as the booklet format means support organisations spend significant amounts of time scanning individual pages.

The Scottish Government and Social Security Scotland have attempted to address some aspects of the online application form, including:

• resolving some of the difficulties some people have expressed with uploading attachments
• introducing the ability for clients to download a copy of their submitted application
• ensuring clients receive confirmation that their online application has been received
• providing an estimated processing time when an application is submitted
• signposting clients and representatives to existing guidance about the type and level of information to include with their Adult Disability Payment application
• continuing to review the guidance
• continuing to review the application form to ensure the questions are relevant for all clients and to minimise any repetition
• improving awareness about the fact that clients will not have to complete the full application again when their award is due for review.

Recommendation 10 : Taking into account the findings in this report, review the application form, including its length and reconsider the way the questions are framed to maximise the opportunity for a client to articulate how their disability or condition impacts on their daily life and to reduce the anxiety and stress associated with the task of applying.

Processing times

Processing times were a recurring theme with many disabled people describing the stress and anxiety associated with waiting to hear the outcome of their application alongside the fact that this stress and anxiety could exacerbate people’s existing health conditions or disability.

Feedback from the online consultation and call for evidence included:

• 29% had received a decision within three months
• 42% waited between three and six months
• 30% waited more than six months
• 43% were not satisfied at all with wait times^[132].

Recent research from Young Lives vs Cancer cited that for those applying for Child Disability Payment and Adult Disability Payment, the average time from diagnosis to decision was six months^[133] [134] which resulted in their social ‘workers referring several households to food banks, in addition to providing the maximum amount of grants we can’.

“I started needing a wheelchair and was not able to access other supports like a blue badge until my Adult Disability Payment application had been processed. This made every aspect of my life difficult as I could [not] park near places I needed to be, like work, the doctor, social things such as parking near a restaurant, etc.” – Individual response to the Independent Review of Adult Disability Payment Public Consultation^[135]

Social Security Scotland commissioned a programme of work in 2023 to review end-to-end processes for disability benefits, with a view to understanding how transformation and automation could release capacity and reduce the time it takes to make decisions on applications.

Social Security Scotland states it has been working towards reducing processing times for making decisions. The median average processing time from Part 2 of the application being received for non-SRTI applications has decreased from 42 days in January 2025 to 37 days in April 2025.^[136]

While it is evident that a lot of work has been undertaken by Social Security Scotland to reduce the waiting times for a decision, the feedback I have received has highlighted that the time waiting for the decision is an area that could be improved further.

“It has taken 9 months for the assessment to be completed, and decision given.” - Individual, MS Society Scotland, response to the Independent Review of Adult Disability Payment Call for Evidence^[137]

“Waiting to hear about my application will take at least 6 months for a decision. It is impacting my mental health, and I am worried about keeping my mobility car.” - Individual, MS Society Scotland, response to the Independent Review of Adult Disability Payment Call for Evidence^[138]

As well as highlighting the prolonged decision-making process people have told me that there is a lack of information provided to them in terms of how their application is progressing. Many people told me that they had to proactively engage with Social Security Scotland to see what stage their application was at.

“I regularly went on to the online chat to see if there had been any progress. But if I hadn’t instigated this, and I am quite IT literate, I wouldn’t have been given any information about my application.” – Individual, MS Society Scotland, response to the Independent Review of Adult Disability Payment Call for Evidence^[139]

Another person with a similar experience told me that they had ‘chased a lot’ but that the process could be improved if there was an automated system in place that informed people when their application has been received and when it had been allocated to a case manager for a decision. There was a suggestion that extending opening times (telephone and webchat) would assist many applicants as currently the opening hours clash with people's work or caring commitments.

Almost half (47%) of respondents to the Social Security Scotland Client Survey 2023-24^[140] said they received enough updates on the progress of their application for a Social Security Scotland benefit. This proportion was smaller for recipients of Adult Disability Payment (36%). Within written comments, some respondents suggested that more updates were needed between application and decision. Some expressed that this would ease anxiety during the application processing time.[141]

The Social Security Scotland Business Plan 2024-2025^[142] states:

“We know that our clients want to hear updates from us about their applications. Improving how we communicate with people applying for Scottish benefits will improve their experience while making us more efficient. We have introduced new application progress updates by text or email for Child Disability Payment and Adult Disability Payment clients. Next, we will develop and deliver a new online portal making it easier for clients to apply for Adult Disability Payment.”

Recommendation 11 : As indicated in Social Security Scotland's Business Plan 2024- 25, continue to do all possible to improve decision-making times and call wait times.

Recommendation 12 : In addition to providing an estimated processing time when an application is submitted, proactively provide regular updates on likely wait time for processing an application, review or a change of circumstances.

Recommendation 13 : Develop and deliver a 'Track Your Application' online portal making it easier for clients to apply for Adult Disability Payment and to improve communication on the status of a client’s application.

Implicit consent

It was felt by many stakeholders that effective communication between Social Security Scotland and third parties such as advocates, welfare benefits advisers, benefit appointees, and others supporting individuals in applying for Adult Disability Payment is crucial.

Many people highlighted the fact that there were more barriers to obtaining consent to act on behalf of a third party with Social Security Scotland than they had experienced under the DWP system. One Parent Families Scotland and one anonymous organisation emphasised the importance of providing implicit consent to advocacy organisations, in the same way as it is used for PIP.

Some people stressed that the way that Social Security Scotland required consent to be given was a challenge and potentially discriminatory given their communication needs, despite Social Security Scotland having a process called ‘unavailable consent’ which operates in a similar manner to implicit consent. Interview participants in recent SCoSS research^[143] with people with communication needs, highlighted their concerns about waiting for, getting and using a ‘mandate’ (a form authorising third party representatives to have discussions with Social Security Scotland directly). Such delays could result in welfare rights advisers using the complaints process as a way to obtain a mandate, though this could further delay the process.

However, Social Security Scotland has explained that a mandate does not have to be a Social Security Scotland mandate for it to be accepted. Social Security Scotland can accept a letter from the client; authorisation on the application form; verbal authorisation from the client; and an organisation’s own mandate.^[144]

Several welfare rights officers told me that they are frequently contacted by clients because the client has not received a decision. Clients are anxious that something may have gone wrong and are looking for welfare rights workers to intervene to confirm all is in order and to speed up the decision.

The current absence of a dedicated helpline following the granting of consent to a third party, is suggested to have resulted in delays in supporting individuals to provide Social Security Scotland with necessary information, which in turn delays the overall decision-making process. This was raised several times during our engagement sessions, as obviously timely communication is vital for the smooth functioning of the application and decision-making process.

“We experience long delays getting through on the phone and are not always able to do so while in the presence of the service user.” – Glasgow City Council, response to the Independent Review of Adult Disability Payment Call for Evidence^[145]

Since the publication of my interim report Social Security Scotland has begun to pilot an escalation process for third party representative organisations. The pilot was set up initially with Glasgow City Council for vulnerable Adult Disability Payment clients who were experiencing issues with the service. The pilot has now been extended to cover all Social Security Scotland benefits. Eleven organisations are part of the pilot, six local authorities and five third sector organisations.

Recommendation 14 : Improve the service experience for Adult Disability Payment clients and third-party representatives interacting with Social Security Scotland on their behalf by:

(a) developing an understanding of any differences in the implementation of implicit consent (as used by the DWP) and unavailable consent (as used by Social Security Scotland) to ensure third party representatives can receive equivalent standards of service from both

(b) assessing the consistency of the implementation of the current guidance on unavailable consent to ensure it is aligned with the policy intention and updating it where necessary, and

(c) using learning from the ‘interacting with third-party representatives’ pilot to consider the merits of a third-party escalation route; to update policy and guidance about how declarations and third-party mandates are obtained and to ensure that the way in which mandates are obtained reflect the published policy and guidance

Providing supporting information

Whilst supporting information is outside the scope of my review, I believe it is important to reflect what I have heard, as the provision of adequate supporting information is a critical factor in the initial decision-making process.

In the most recent Disability Payments Client Survey^[146] most respondents who applied for Adult Disability Payment provided supporting information with their application (67%), whilst 25% asked Social Security Scotland to gather it on their behalf. The remaining 9% submitted evidence after they were contacted by Social Security Scotland. The most common forms of supporting information provided were: ‘confirmation of diagnosis’ (44%) ‘medical or social work reports’ (33%), and ‘test results’ (17%). Respondents most often got their supporting information from: ‘a GP’ (44%), ‘a hospital (including from doctors, consultants or nurses)’ (16%), and ‘a family member’ (14%).

When shadowing case managers and experiencing first-hand how they reach a decision about an award I saw many examples of the supporting information provided directly by an applicant and the supporting information requested by the case manager usually from a GP or other professional whose contact details had been noted on the application form. The quality and the content of the supporting information varies widely and in one example I saw supporting information from a GP that contained very little information and, in this case, none of it was helpful in assisting the case manager to make a decision.

In my interim report, I recommended that Social Security Scotland consider ways of working with GPs and other medical professionals in order to promote better longer-term health outcomes for clients. Social Security Scotland said in response:

“Social Security Scotland recognises the importance of this action, and that more evidence and research is required to demonstrate the relationship between receipt of award and long-term health outcomes.

Social Security Scotland is developing a communications plan to improve engagement with Health Boards and practice managers and would be supportive of participating in any research aimed at demonstrating the impact of awards on longer-term health outcomes for clients.”

In its response to my interim report, Social Security Scotland said of the guidance for GPs in relation to supporting information:

“The Scottish Government and Social Security Scotland recognise the importance of clear guidance for GPs. Further assessment will be required to determine feasibility of delivery against current commitments; however Social Security Scotland has established regular engagement sessions with Health Boards to provide support and guidance to improve the timeliness and usefulness of the information provided. These sessions are used to gather feedback and inform updates to guidance.”

One young person with cancer applying through the SRTI route expressed concern over how supporting information held up the granting of their award when Social Security Scotland repeatedly tried to contact their GP for details, despite the contact information for other specialists being on the application form.^[147] In addition, I have been told of difficulties in obtaining supporting information from medical practitioners by people who are clinically vulnerable. People in these situations often avoid engaging with professionals due to the perceived clinical risk.

Social Security Scotland has refined its approach to gathering supporting information by recognising a GP is not always the best source of information on how disability impacts clients and, for example, may instead look to contact other professionals involved with the client. Social Security Scotland has also changed its guidance in relation to contacting GPs for supporting information. It was felt that the previous approach of asking specific questions relating to the client’s application was too onerous and time-consuming a task for many GPs. So, a new approach has been introduced where universal, basic information is requested, by asking GPs to ‘confirm the client’s conditions or disability, if they do not have a diagnosis, please confirm their needs or symptoms, and tell us what medication, treatment, if any, they are prescribed.’ It is too early to see if this revised approach is affecting the quality of decision-making but it reinforces the need and the importance of improving the list of who supporting information can come from so it better reflects the types of professionals the individual will have documents from/will be able to easily contact, including that it does not have to be a medical professional (such as GP) but rather a professional involved in the person’s treatment or care. Stressing that supporting information from a wider support network can be a useful tool to help decision makers understand their needs better, is recognised as a positive step forward.

“My outcome was better than others but not great. I had my mental health advisor with me as an advocate during my telephone assessment and I think that was vital. They also helped me fill out the forms. They helped give evidence. My GP was not forthcoming or at all helpful in providing supporting evidence. 'Luckily' I had a letter from a retired GP explaining PMDD and how it impacts me.” – Individual with PMDD

When applicants say on the application form that they need help in accessing supporting information several factors are considered by a case manager in terms of next steps. In a recent case that I observed the case manager tried to contact the client directly using the telephone number provided but was unable to reach them. On the application form the person had articulated problems with anxiety and depression and the case manager was concerned that an approach from the Local Delivery team to offer assistance may not be the best course of action. The case manager had approached the person’s GP and received limited information. A case discussion, with the input of a Health and Social Care Practitioner was requested in order to assist with the decision-making in the absence of adequate supporting information being available.

Since the publication of the evaluation of supporting information^[148] in addition to the steps taken as outlined above the application form has been reviewed to improve structure and layout of the guidance in the downloadable Portable Document Format (PDF) and physical application form i.e. the hints/helpful information provided in the margins of the form. This focuses on giving better examples of supporting information and what it should contain.

Core messages within public facing communications have been reviewed, updated and strengthened including fact sheets, social media posts, articles, leaflets to specific organisations, stakeholder engagement events, and media enquiries to, where possible stress the following key messages:

• the requirement of one piece of supporting information from a professional, where possible, and what this should include (broadly confirming condition/needs, and should stress that it does not have to include a medical diagnosis)
• that Social Security Scotland can gather the information on behalf of the client but that this can lead to longer processing times
• if they do not have supporting information to hand, they should still apply
• improving the list of who supporting information can come from
• signposting individuals to relevant support i.e. Phone lines and Local Delivery if they need further information/help applying.

Since the evaluation of supporting information was published there have been two other major internal initiatives within Social Security Scotland aimed at improving staff knowledge of both supporting information and its relevance to decision making. Both pieces of work were completed following internal user research to understand where case managers and practitioners are most likely to need support and to identify where implementation of the decision-making policy could be improved.

Some key messages were reinforced including:

• the importance of the approach to social security being trust-based and person- centred
• ensuring case managers understand the principle of equal consideration and what this means in practice i.e. That there is not an intrinsic hierarchy of supporting information and that each piece should be considered on its own value rather than on what the source is
• how supporting information should and shouldn’t be used i.e. A broad confirmation rather than confirming every aspect of the application/every condition listed
• the purpose of the different types of supporting information and what they are likely to be useful for
• when supporting information needs to be gathered and encouraging case managers to think critically about who the best person would be to get this information from, rather than defaulting to GPs
• stressing the importance of other decision-making tools, such as case discussion, or using guidance rather than relying on gathering supporting information Empowering case managers to make decisions on the balance of probabilities.

Social Security Scotland also held stakeholder events for key public sector providers of supporting information.

Improvements have also been made to the Decision-Making Guidance^[149] on supporting information. Clearly collecting insight/information on whether the changes to the external guidance on supporting information for disability benefits has had any impact on processing times may be a useful approach for Social Security Scotland moving forward.

Social Security Scotland do not currently hold any insights/information on whether the changes to the external guidance on supporting information for disability benefits introduced last year has had an impact on processing times. Anecdotally I was told that supporting information improvements have helped to improve processing timescales, although this alone is not the only reason. There are other contributing factors including case managers being more experienced; their confidence, capability and output levels have naturally increased as part of their development. The interaction with Health and Social Care Practitioners continues to flourish via increased case discussions at the earliest opportunity to support decision-making and improve timescales and there have been improvements to the service design of Adult Disability Payment including straight through processing which speeds up the application process.^[150] Straight through processing allows the case management system to automatically process certain applications through to a decision without the need for client advisor intervention.

While conducting the Review, I was introduced to a method of measuring functional capacity called the FUNCAP55 Functional Capacity Questionnaire^[151] which could be a useful tool for case managers if submitted as a piece of supporting information. It uses a self-scoring system across a range of daily activities and considers the impact that carrying out an activity has on carrying out further activities. FUNCAP27 is a patient-informed and validated questionnaire that uses 27 questions to measure Functional Capacity.

As I have noted, supporting information is outside of the scope of the review, but Social Security Scotland may benefit from considering the merits of a FunCap55 assessment being recognised as supporting information and if adopted train case managers and practitioners to understand it.

Observation 2 : Collecting insight/information on whether the changes to the external guidance on supporting information for disability benefits has had any impact on processing times may be a useful approach for Social Security Scotland moving forward.

Decision-making

Decision-making at the first stage of the application and award process is probably the most important and critical element in a client’s journey. The initial determination will always include a decision about whether or not the individual satisfies the eligibility rules and also what components of Adult Disability Payment (and at what rates) the individual is entitled to.

The Scottish Social Security Charter^[152] sets out what the individual can expect in relation to decision-making. It commits to taking decisions in a consistent and accurate way and aiming to get determinations right first time.

From 21 March 2022 to 30 April 2025, there were 340,655 Part 1 applications and 278,780 Part 2 applications received.^[153] There were 313,430 applications processed with a decision made by 30 April 2025, of which 47% were authorised, 49% were denied and 4% were withdrawn.

As of 30 April 2025, 171,875 reviews had been completed^[154] of which 5,090 resulted in a decrease in award, 32,645 resulted in an increase in award and 134,140 resulted in no change in award.

In the consultation to support the work of the Independent Review I asked ‘how effective do you think Social Security Scotland’s decision-making process is with regards to understanding a person’s daily living needs?’ and received 72 responses to this question. There were mixed views amongst respondents to this question. While three-fifths (60%) felt the decision-making process is effective in understanding a person’s daily living needs, 35% felt the process is ‘somewhat effective’, with 7% indicating they find it ‘very effective’. Conversely, 17% found it ‘not very effective’ and 24% ‘not at all effective’.^[155]

The analysis of the qualitative responses is available online.^[156] As part of the consultation, I also asked ‘did you need support to understand the decision?’:

I received 43 responses to this question. Reflecting levels of understanding, four-fifths (81%) of those who answered did not need support understanding the decision. However, one-in-ten (12%) did. A small percentage of respondents said, ‘don’t know’ (7%).

I spent time shadowing case managers and Health and Social Care Practitioners in addition to reading all the decision-making guidance and exploring the training available. It is evident that careful and thorough consideration has been given to the framework and context within which case managers make their initial decision. The importance placed on supporting information is evident as is the role played by the case discussion process, when and if a case manager deems it to be useful or necessary. Consultations also play an important role. I understand from engaging with Social Security Scotland that the number of consultations undertaken each year represents a small proportion of applications received (see the Consultations part of my report).

Case managers are trained to take a person-centred approach to decision-making by:

• considering how the individual’s condition affects them
• taking into account all of their circumstances
• listening to the individual
• treating them as an individual
• recognising that the individual understands their own life best
• considering the individual’s support network, caring responsibilities and work responsibilities
• making sound judgments about the impact that an individual’s condition has on them
• approaching decisions from a position of trust
• only seeking one source of supporting information from a professional where possible.

During the time spent with case managers I saw first-hand the consideration given to the principles of person-centred decision-making and the care and attention applied to the responsibility inferred. What particularly stood out for me was approaching decisions from a position of trust.

Case managers must make findings of fact on the balance of probabilities. This means that a factual circumstance must be accepted as true if the information available shows that it is more likely than not that it occurred. The very process of applying the balance of probabilities involves the use of judgement and although case managers need to be able to explain why they have made a certain decision; this results in an additional degree of subjectivity and personal judgement being introduced to the process.

There is a concern that discrepancies and interpretative variations may lead to inconsistent outcomes, which might undermine the fairness of the process. However comprehensive and thorough the quality assurance process is there will always be room for a level of inconsistency in a system that allows for case managers’ discretion coupled with a degree of subjectivity. As one case manager told me:

“Weighing different pieces of supporting information can prove subjective despite case managers always aiming to be objective in their decision making. If it can be demonstrated that sound judgement and rationale has been used to make a decision, it is rare that managerial team leaders will push back against this decision beyond asking the case manager to justify the rationale for making their decision.” – Case manager, Social Security Scotland

Some welfare rights advisers who, since the launch of Adult Disability Payment have amassed an ever-growing client base, stressed a lack of consistency in how Social Security Scotland made decisions but there was little evidence provided, to substantiate this. Welfare rights advisers from Citizens Advice Scotland told me that there is a greater level of unpredictability in the Adult Disability Payment process when compared to PIP. They are finding it difficult to clearly see rationale in some of the determination letters. Attendees at one of the consultation events discussed the issue of entirely different decisions being reached between application, re-determination and appeal stages.

“The reasons for the decision are usually clear, however, they are also inconsistent. We are aware of decisions made with regard to some claimants with similar circumstances which can vary. With the inconsistent decision-making it leads to further additional workload through appeal processes.” – Epilepsy Scotland, response to the Independent Review of Adult Disability Payment Call for Evidence^[157]

As part of the Review, I was taken through Social Security Scotland’s quality assurance process which appears to be very thorough and provides an ongoing learning opportunity for case managers and other staff. Although entitlement decisions are regularly and independently reviewed and analysed to determine where improvements to the decision-making process can be made, I saw or heard of examples where re-determination decisions varied considerably from the original case manager decision. This may be because of additional supporting or other information being made available or due to a different interpretation of the criteria, the second time around.

Social Security Scotland has embarked on two major pieces of work aimed at improving decision-making. Both were completed following internal user research to understand where case managers are most likely to need support and where implementation of the guidance could be improved.

The first was concerned with providing more detailed guidance and a simplified, quicker way of accessing the tools required. The second was the introduction in 2023 of an intense, targeted training session that covered changes in operational processes to help better gathering of supporting information and covered common areas of the decision-making policy where understanding could be improved.

Social Security Scotland has a thorough process for ensuring guidance is updated whenever there is a legislative change. The process demonstrates how multiple layers of Scottish Government sign-off are embedded to mitigate risk when any changes are being made.

“Only the decision-makers seem to be the issue, not the application itself. I don’t know if the decision-makers are production oriented or quality oriented. It needs to be kept in mind that they are making life-changing decisions that affect real people” – Individual, response to the Independent Review of Adult Disability Payment, Public Consultation^[158]

In the context of a system that allows ‘discretion’ it is likely that decision-making will continue, at times, to be inconsistent. The ongoing challenge for Social Security Scotland in this regard, is to continually assess how one can balance the need for fairness and equity with the discretion that is currently applied.

An interesting point was raised with me several times and it relates to an interpretation of the use of over-the-counter pain relief when case managers are making a decision. Determination letters cite the reason for not scoring a higher number of points is because the applicant is not on any prescribed pain relief. It appears that a case manager is determining that the pain cannot be as severe as articulated in the application. This is contrary to the Adult Disability Payment Decision-Making Guidance which explains reasons why a lack of particular medication, treatment or reliance on services is not necessarily an indication of the impact of a condition.^[159] One welfare rights adviser told me that they know of a client who, just to satisfy Social Security Scotland, asked for a prescription for pain relief from their GP even though they had been managing their pain effectively with over-the-counter paracetamol. A similar argument being cited in the decision-making process relates to physiotherapy, where a case manager supposedly made a decision on the severity or otherwise of the person’s condition based on whether or not they were receiving physiotherapy. Similarly with some mental health problems where the absence of any medical intervention has been used as a reason not to give an award with no account taken of the fact that it can be extremely difficult to access NHS mental health support.

When shadowing an Independent Advocacy Service advocate, I saw a determination letter that stated that the decision not to award higher points for mobility was because the client had ‘cancelled a physiotherapy appointment’. The client was visibly distressed telling the advocate that there was good reason for cancelling the appointment and that subsequently they have been back to the physiotherapist for help. Interestingly there was reference in the re-determination letter to the ‘use of pads to manage irritable bowel syndrome (IBS)’. The client was adamant that they do not use pads and had never told Social Security Scotland that they do. They were concerned that their case had been mixed up with someone else’s and this might be why the case manager had reduced the number of points from those awarded in the original determination. The other consideration was that the author of the letter was making assumptions about people with IBS and potentially using ‘cut and paste’ instead of making an individualised decision.

Interestingly, at the same advocacy appointment the client suggested that correspondence from Social Security Scotland be dated on every page. The client was having trouble determining which pages referred to the original determination letter and which belonged with further communication, as all the correspondence was held loosely in a paper folder and had become muddled. At a time of stress this was an additional complication.

Other considerations include:

• the source of the supporting information adding weight to informing a case manager’s decision
• under-reporting, which experienced case managers come to recognise
• applying the reliability criteria to ensure consistency in the decision-making approach
• case managers using practitioners as a sounding board to confirm their thinking ahead of making a decision noting that some case managers would feel less confident going against the advice of a practitioner
• stressing the importance of other decision-making tools, such as case discussion, rather than relying solely on gathering supporting information
• the value to some case managers of drawing on peer support
• the importance of explaining in the determination letter why a decision has been made but in such a way as to not discredit a person’s experience.

Recommendation 15 : For Social Security Scotland to continually assess how one can balance the need for fairness and equity with the discretion that is inherent in the determination process.

Recommendation 16 : For the decision-making training and guidance to be reviewed to ensure that undue weight is not given to how a person manages pain or whether they have access to clinical support or therapy.

Recommendation 17 : For each letter from Social Security Scotland to be stand-alone so there is no need to cross reference with other correspondence and put the date of the correspondence on every page when sending letters to clients.

Reliability criteria

I received a great deal of feedback regarding individuals not being able to adequately describe the impact of their fluctuating conditions on their daily life when answering questions determined by the current activities and descriptors.

“I feel that it can be difficult to articulate how my conditions affect me on a daily basis. I know this is something that others struggle with too, from reading experiences of others on social media, forums etc.” – Individual response, to the Independent Review of Adult Disability Payment Public Consultation^[160]

Clients are not always aware of the existence of the ‘reliability criteria’, i.e., they do not fully understand that factors such as the time taken to complete an activity, the impact of completing an activity and the ability to undertake an activity as often as required are relevant.

While the concept of reliability was noted to be helpful at one consultation event, participants at a few events felt it lacked clarity on the Adult Disability Payment application form. At one event, concern was expressed that if applicants do not understand what is meant by ‘reliably’, they might answer ‘yes’ to one of the activities and move on to the next activity when in fact they may not be able to do the activity reliably and a significant amount of information about their needs and condition could be omitted from their application. This same issue was highlighted by an anonymous organisation in their call for evidence response who had received similar feedback from their stakeholders. This respondent additionally noted that this confusion and lack of information could potentially lead to incorrect awards if the case manager is unable to apply the reliability criteria in all decisions.

"It should clearly state can you reliably and repeatedly perform a task. It should ask can you undertake certain tasks. Simple ‘yes’ or ‘no’ or ‘do you need assistance?’ Ask how long it takes to walk a certain distance, undertake a task such as dressing, make a meal etc. Include things like being incontinent as you can’t get to the toilet in time, not washing because it’s too difficult, eating ready meals. How long does it take to put your shopping away? Can you hang your washing up or hoover? – ‘How long does it take?’ is a very good indication on general ability.” – Individual response, to the Independent Review of Adult Disability Payment Consultation^[161]

"Reliability is a really important criterion for people with energy impairment conditions (ELCI), but it’s problematic because the energy required to perform any of the activities draws upon the same limited supply of energy, and doing one activity means there is less energy for another activity. Reliability refers to someone who is so exhausted after preparing breakfast that they can’t eat it, or they cannot prepare lunch too. Or someone with ELCI might be so exhausted after preparing breakfast that they can’t get dressed or have a shower. The cumulative impact of activities needs to be recognised, and the need to take into account the full spectrum of activities (e.g. preparing food + washing + dressing). The impact should take into account a range of factors including fatigue as well as delayed fatigue (one symptom of post-exertion symptom exacerbation) as, with people with ME/CFS, the onset may be 48-72 hours or more later.” – #ME Action Scotland response to the Independent Review of Adult Disability Payment Consultation^[162]

Consultation responses about the clarity of the reliability criteria were mixed. Some left brief general comments that the reliability criteria could be clearer. Singular comments included the criteria being hard to understand, the need to provide definitions for terms used and questions feeling repetitive in the absence of clear explanations. The need for more clarity was also raised at a few engagement events.

One third (33%) felt the reliability criteria are easy to understand, just under half (45%) felt they were not, and one quarter (23%) were unsure. Those who felt they could be clarified recommended that a ‘reasonable time period’ be better defined and proposed using more examples to improve applicants’ understanding.

Participants at the consultation events shared similar views but also suggested other changes to enhance understanding of the reliability criteria. This included referencing the reliability criteria in or at the start of the Adult Disability Payment application form and explaining reliability on any initial communication.

At another event, the need to increase applicants’ awareness and understanding of the reliability criteria before starting the application process was identified, although it was recognised that too much information could overwhelm the applicant. There were suggestions to:

• reference the reliability criteria on promotional material
• explain reliability in the initial letter to applicants and during any initial phone call with a Social Security Scotland advisor, to help people determine if they should apply
• explain at the start of the application form how the reliability criteria is being used to understand people’s condition and the impact it has
• restate the reliability criteria more often throughout the application form
• have boxes next to each activity to describe what is ‘reasonable’ to expect e.g. To not be in more pain
• change the wording to ‘reasonable’ to reflect that it is not always possible to be ‘reliable’ due to environmental factors such as the weather.

It appears that one way to partly address this problem would be better transparency of and improved applicability of the existing reliability criteria to ensure that the reliability criteria are at the forefront of all decisions.

Using examples to illustrate conditions and their impact was suggested by some. Similar calls were made at engagement events, such as for improved explanations, case studies people can relate to and more examples of how descriptors apply when someone has a mental health problem or is neurodiverse. Comments included that examples should be specific or given for each daily living activity. #MEAction Scotland called for ‘the use of an example of someone with an energy limiting condition’.^[163]

The need to further define ‘reasonable time period’ so it could be more easily understood was recommended by some consultation responses. Reasons given included that this was a subjective concept which could pose challenges for those who found ambiguity difficult.

It has been a perennial problem that there is no clarity about what a ‘normal’ baseline comparator is understood to be.

“What you classify as safe and timely I don’t. Is taking thirty minutes to get to the toilet a safe and timely manner when I end up wetting myself or worse? It takes every ounce of strength I have, to go to the toilet. Yet for an able-bodied person they cannot imagine how wiped out I am after a simple task they can do in 30 seconds.” – Individual response, to the Independent Review of Adult Disability Payment Consultation^[164]

One welfare rights adviser highlighted the fact that the ‘reasonable time period’ to carry out each activity is not clearly defined although the Adult Disability Payment regulations state that ‘to carry out an activity ‘within a reasonable time period’ means no more than twice as long as the maximum period that an individual without a physical or mental condition or conditions which limits that individual’s ability to carry out the activity in question would normally take to complete that activity.^[165]

Despite this definition I was informed of instances where a tribunal judge has asked the client/their welfare rights advisor to find out the national average of the time people take in the shower. One suggestion could be (where applicable) to compare what a person does now with what they did before i.e. to establish what is normal for that individual rather than what might be deemed normal for a non-disabled person.

Another suggestion made was that the exact wording of the reliability criteria (that a person must be able to undertake an activity safely, to an acceptable standard, repeatedly and in a reasonable time) should form part of the activity descriptor itself. Although this would be repetitive, it would highlight the importance of this part of the decision-making process and provide an opportunity for the client to answer the questions on the application form more fully.

In the guidance provided to case managers it is made clear that ‘where an individual’s ability to carry out an activity is being determined, the case manager should apply the descriptor which they are satisfied applies for the individual to be able to undertake the activity reliably’.^[166] However I repeatedly heard that confidence in this part of the process is limited because of a ‘lack of transparency’ or because in some determination letters the reasons for not making an award make no reference to the reliability criteria, leaving people to wonder if they were applied fairly or at all.

PIP guidance includes some wording to say that assessors should consider the impact of an activity on the ability to carry out other activities.^[167] Specific mention of that point is not within the case manager guidance for Adult Disability Payment although it does say: ‘It is important to consider the impact completing the activity has on the individual. This requires consideration to be given to how a person feels both during and after carrying an activity out’.^[168] I think this doesn’t go quite far enough.

A few respondents to the consultation felt changes should be made to enable better account, or for a more consistent account, to be taken of people’s actual lives. This was viewed as necessary as people may interpret the reliability criteria differently, based on their subjective experience.

Recommendation 18 : Ensure rigorous application of the reliability criteria to ensure consistency in the decision-making approach.

Recommendation 19 : The reliability criteria should be explained clearly both in promotional materials, at the start and throughout the application process with more examples, so that clients understand its importance and have a clear understanding of how it is applied in making decisions.

Recommendation 20 : Make clear in decision-making guidance and in training that the inability to complete one activity reliably may be relevant to whether or not a client can complete other activities and should be proactively considered by case managers.

Recommendation 21 : Social Security Scotland should ensure that explicit reference is made to the reliability criteria in all decision correspondence, so that clients and representatives can understand if, and how, the criteria have been applied.

Recommendation 22 : To ensure that the outcomes of caselaw decisions are reflected in decision-making guidance and training.

Case discussions

Case Managers can utilise case discussions as part of the decision-making process in order to draw on advice and support from Health and Social Care Practitioners to understand the client’s disability or impairment further; to assess the value of the supporting information provided or the types and routes for supporting information that could be further explored.

As part of the Review, I observed a case discussion. In this example the case manager was utilising the discussion as a way of confirming their approach to and rationale for making a particular decision. The practitioner’s knowledge of the disability being discussed was used as affirmation of the facts as set out in the application and within the supporting information.

Although it was acknowledged that people determining applications could not be trained in all disabilities and long-term health conditions, there is concern that if the person making the decision does not understand a client’s disability and how it typically impacts a person’s life the client is somehow disadvantaged in their application. In addition, there is sometimes a perceived lack of transparency and consistency between decisions made about mental health problems and decisions relating to people with physical disabilities. People often told me that they believe there is a difference in how their physical versus mental health symptoms are assessed, despite the psychological symptoms having the most detrimental impact on their life.

“…In some cases, PMDD was not mentioned on the final decision letter despite it being a focus of the application” – Interim report. Premenstrual Dysphoric Disorder and the welfare state: recommendations for reform.^[169]

In the most recent Social Security Scotland Client Survey^[170] issues were raised about practitioners’ knowledge of individual health conditions, as well as issues with the format of consultation questions. When suggestions for improvement were made, these included the need for practitioners to have a good understanding of the individual health condition(s) that impact a client so as to better understand a client’s lived experiences.

Respondents to the Social Security Scotland 2023/2024 Client Survey^[171] described discrimination against particular health conditions, especially those that relate to mental health or ‘invisible’ disabilities. Some respondents described how biases in the application process, as well as errors in the decision-making process, led to unfair decisions on benefit applications. Several respondents commented that they were made to feel ‘not disabled enough’, as though their ability to cope with their health condition was misconstrued as them not needing support.

Many disabled people I engaged with felt strongly that Social Security Scotland staff need to be well trained and supported to understand the complexity and inter-connections between various conditions, functional limitations and lived experiences. Inclusive New Normal (INN) stressed that as a minimum, a basic understanding of ‘spoon theory’, chronic fatigue, post exertional malaise, cognitive dysfunction and clinical risk are needed.^[172]

Following a meeting with people impacted by Long Covid, ME and CFS, I enquired about training and awareness raising related to certain conditions. Social Security Scotland does not deliver specific training on every disability, condition or impairment.

Following a public Freedom of Information request by a third party in relation to ME and CFS,^[173] Social Security Scotland confirmed this position by stating:

“We do not deliver specific learning around Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Learning is primarily designed around guiding decision makers to use a range of decision-making tools to aid them such as medical guidance tools, case discussions and consultations. The emphasis for training is always on the impact to daily living and mobility for clients and to use these avenues of support in particular around health conditions and disabilities. Advice can also be provided by a health and social care practitioner with relevant experience and/or specialism based on the case manager’s request. Practitioners do not diagnose conditions or advise on treatment and are all Social Security Scotland staff members.”

There is no formal policy regarding condition-specific awareness or training although it is noted that organisations can deliver information sharing sessions with staff on an ad hoc basis. In the last eighteen months, sixteen such sessions have taken place.

However, Social Security Scotland do introduce awareness raising sessions when it is apparent that there are several new applications relating to a less common impairment and they may not have the knowledge or expertise within the practitioner team to support case managers to make a decision. A recent example concerns an increasing number of Adult Disability Payment applications relating to issues arising from transvaginal mesh implants. It was acknowledged that additional knowledge on this subject matter would be beneficial and as a result a specialist was invited to speak to case managers and practitioners.

Recommendation 23 : To review the training and guidance available in relation to decision- making to ensure there is no bias in the system when considering mental health problems as opposed to physical conditions and to reinforce the point that an individual’s condition is just one of many factors that the case manager needs to take into consideration when deciding upon an award.

Recommendation 24 : For Social Security Scotland to introduce a plan to clarify the approach they take to engage charities and specialist organisations in providing guidance and training to case managers and practitioners on specific disabilities or conditions.

Consultations

Having read the guidance provided to case managers and practitioners and getting the views from Social Security colleagues on the process it is evident that consultations, when they occur, play an important role in the decision-making process.

There is universal praise for the cessation of DWP-style assessments and that consultations do not appear to be used on the same scale. I understand from engaging with Social Security Scotland that the number of consultations undertaken each year only represents a small proportion of applications received (5% reported having had a consultation as part of the Disability Payments Client Survey).^[174] This is reflected both in the responses to my own consultation and call for evidence. Most people I spoke to said that in their experience, most consultations took place by telephone.

A client is asked to attend a consultation when it is the only feasible way for Social Security Scotland to obtain the information needed for making a decision. From the online consultation of those receiving a decision only 10% of respondents^[175] said they had been invited to a consultation as part of applying for Adult Disability Payment.[176] This will usually be because the application itself doesn’t contain all the information required to make a decision or there is insufficient supporting information and/or a case discussion hasn’t been helpful. A consultation only covers the areas of the application that Social Security Scotland need more information about.

A recurring theme from the online consultation was that clients found practitioners helpful and consultations less stressful than expected. Two respondents noted that the people they spoke with, whether that was case managers clarifying application points or healthcare professionals undertaking a consultation, were kind. One individual noted that they appreciated the lack of medical assessments, and another felt the phone call they had was efficient.

“The lady was very polite, explained fully why she was calling and didn't keep me for too long. She only asked one question, and it wasn't intimidating or anxiety inducing.” - Individual response, to the Independent Review of Adult Disability Payment Consultation^[177]

Most comments about the quality of service provided by Social Security Scotland’s practitioners were positive. Some respondents mentioned that they felt vulnerable or upset explaining their circumstances, but for most the practitioner put them at ease. Qualitative responses to the survey said:

“My (consultation) was amazing, very patient and understanding. It was very easy and stress free.” – Client Survey: Disability Payments (October 2024 – March 2025)^[178]

“It is upsetting but I understand why it’s needed and the lady I had was polite and professional.” – Client Survey: Disability Payments (October 2024 – March 2025)^[179]

As part of the Review, I engaged with disabled people’s organisations to acquire more information on their and their client’s experience of the consultation process. One person described their experience as ‘excellent’ and explained that Social Security Scotland took the use of assistive technology into consideration, ensuring that everything was accessible. They recalled that the consultation invitation arrived via email, and they simply had to respond to it to confirm the details. They highlighted that they felt they were given sufficient time to respond and described the experience as ‘barrier-free’, saying that “I struggle to think of any negatives with regards to the consultation process”.

The commitment to ensure that where a consultation is necessary in relation to mental health or learning disability, the person conducting it will have relevant experience, and therefore be more capable of understanding the applicant’s condition has helped to create a process that is more dignified and less stigmatising.

The other common themes raised included:

• disabled people potentially being disadvantaged by not having the opportunity to have a consultation and to speak to someone about their application
• people not understanding what a consultation is
• people thinking they have had consultation when they have had a clarification or update phone call from a client advisor or case manager
• not having enough information about a consultation in advance, including what will be discussed during the consultation
• greater clarity being required to inform clients that consultations should be held in the way best suited for the client.

Social Security Scotland colleagues stressed that the client should receive adequate information in advance of the consultation.

Some disabled people who were not invited to take part in a consultation by Social Security Scotland told me that they would have appreciated the opportunity to speak to the case manager. In some cases, this was because writing down all the relevant information in an application form was difficult and in other cases people thought it would speed up the process if they had an opportunity to talk to someone directly. There was also a strong feeling amongst some people that it was their life, their story and as a result, that their voice should be heard, and they should be more involved when decisions are being taken that will impact on their life.

Another recurring theme from welfare rights advisers is in relation to how much agency the client has in determining the format of their consultation. It is felt that some people are disadvantaged by having a non-face-to-face consultation. For example, people with learning disabilities may find it easier to engage with someone face-to-face. Feedback from the online consultation showed that 88% of consultations took place over the telephone.^[180]

It was highlighted that when a decision goes to consultation, case managers and practitioners will decide the method of communication in the first instance and the letter that is issued to the client will outline how to change the method of communication if required or requested. Social Security Scotland explained that unless something has been stated in the application which indicates a specific preference or a practitioner feels that a specific format would best suit the client, a consultation by telephone is routinely offered. It was suggested that this approach can potentially disadvantage individuals with communication challenges or anxiety and some stakeholders felt that a person’s health condition or disability can’t always be captured fully on the application form.

It appears that more can be done to balance the benefits of in-person interactions with the fears associated with previous DWP practices to get the process right for the individual in a way that gives them the best opportunity to convey vital information.

During a visit to Social Security Scotland, I asked about trauma and how this is considered when colleagues are determining the need or otherwise for a consultation. I was told that a client does not need to say the word ‘trauma’ for this to be considered and that practitioners have the relevant experience needed to carefully explore the impact of trauma on a person’s quality of life. It is unlikely that a consultation would be requested if a client has indicated a high-level of trauma in their application. Social Security Scotland should take into account the emotional and physical toll a consultation may have on a client, for whom the consultation may include the disclosure of upsetting and/or traumatic life experiences.^[181]

Recommendation 25 : For the initial choice of whether or not to have a consultation to be the client’s choice, rather than the case managers.

Recommendation 26 : For the initial choice of format for the consultation to be the client’s choice to ensure the client understands fully the options available and clients do not feel in any way compelled to default to the telephone route.

Re-determinations and appeals

The re-determination step offers recourse for those that do not agree with the outcome of their determination who may otherwise not pursue a challenge if they were forced to go straight to appeal.

Re-determinations also allow Social Security Scotland to correct mistakes at an early stage, as well as strengthening decision-making as advisors engage with clients, gather any further supporting information and coordinate referrals to Health and Social Care Practitioners for clinical views if relevant.

Social Security Scotland publishes regular statistics on the number of re-determinations and appeals received by Social Security Scotland and the number of Tribunal decisions made. They monitor Tribunal outcomes to continuously inform and enhance learning through regular reviews of the appeal process.

There were 52,790 re-determinations received by 30 April 2025.^[182] Of these, 42,855 were requested by new applicants, while 9,935 were by people who had their award transferred from the DWP. By 30 April 2025, 49,355 re-determinations had been completed. Of these 22,655 (46%) were disallowed, 25,025 (51%) were allowed and 1,365 (3%) were invalid.

There were 9,140 appeals received by 30 April 2025.^[183] Of those, 3,510 have had an appeal decision made. Of those 1,835 (52%) were upheld and 1,670 (48%) were not upheld. Of the appeals received by 30 April 2025, 79% were for clients who applied as new applicants, and 21% were for clients who had their award transferred from the DWP.

When considering the feedback from the online consultation and call for evidence it is evident that clients feel several things are working well about the re-determination process. Two individuals noted that they liked having the flexibility to provide additional supporting information in multiple formats and one individual reflected positively about their treatment during the re-determination process. Offering an online form reportedly makes the process more accessible. Other feedback from the online consultation included a request to improve the re-determination timescales.

The most common reasons cited for seeking re-determination included case managers incorrectly interpreting application information and support from outside agencies being available, enabling clients to feel confident in asking for a re-determination.^[184]

Although people can call Social Security Scotland if they would like further support to request a re-determination or appeal, Social Security Scotland also encourage people to seek support from independent advice services to discuss all their options. Re-determinations and appeals advice for Adult Disability Payment is the fastest growing area for independent welfare advisers:

“For the second consecutive quarter, redeterminations and appeals together represent 19% of Adult Disability Payment advice being delivered and are the fastest growing areas of Adult Disability Payment advice”– Citizens Advice Scotland^[185]

More recent data from Citizens Advice Scotland (at the time of publishing) indicates that assistance with re-determinations and appeals has grown to 21% of advice work related to Adult Disability Payment delivered by Bureaux.^[186]

The most common reasons cited within the call for evidence responses that prevent people from seeking re-determination include:

• finding the process confusing and therefore did not seek a re-determination in the right timeframe or unable to seek a re-determination without assistance
• concerns that a re-determination may result in fewer points
• concerned about the impact of the process on mental wellbeing
• people do not understand that seeking re-determination is within their rights
• not having a copy of their original application, or having lost documents
• previous negative experiences with PIP.

The administrative complexity and duration of the re-determination and appeal process can be a significant determinant of whether a person proceeds to challenge a decision.^[187] The necessity of repeating sensitive information and continually confronting limitations, which has been described to me as the trauma of ‘re-telling’ and by one welfare adviser as ‘the pressure of intense scrutiny’, can be a formidable barrier. People considering requesting a re-determination are often weighing up the extent to which they feel able to re-tell their story to progress a re-determination, knowing that they may have to go through the same process a third time if the re-determination is unsuccessful and an appeal is required.

Some clients are hesitant to provide new information during the re-determination stage in case it may be viewed suspiciously by Social Security Scotland which could then risk their award.

If a person disagrees with their re-determination or Social Security Scotland misses their statutory deadline to make a re-determination, they have the right to appeal to the First-tier Tribunal. An appeal form is included with every re-determination outcome letter and is also available online through the Social Security Scotland website or can be requested by phone.

The main reason cited in the online consultation for seeking appeals included having help from third sector welfare advisors and advocates which gave the appellants additional confidence to appeal.

“One key factor for this will be whether they are supported during the appeal process. This is why it is key for Social Security Scotland and the Third Sector to work closely together to ensure that applicants are supported by organisations who have a full understanding of their condition. People living with epilepsy who have been turned down with regards to their ADP application will see their mental health deteriorate and will require emotional support as well as professional support with regards to the appeal process.” – Epilepsy Scotland, response to the Independent Review of Adult Disability Payment Call for Evidence^[188]

Also, if clients felt that the original decision did not represent their lived experience or had not captured their supporting information accurately, they were more likely to appeal.

Reasons cited that might prevent appeals included:

• the possible impact of the appeal process on mental wellbeing – on occasion driven by bad experiences with appeals under PIP
• clients not understanding their right to do so or how to move forward with an appeal
• lengthy timescales.

I heard some evidence from stakeholders that going straight to appeal could put some clients off challenging a determination altogether. Many people reiterated the high levels of stress and worry they had experienced when going through appeal processes in the past with PIP and DLA.

The First-tier Tribunal is independent of Social Security Scotland and can uphold Social Security Scotland’s determination or make its own determination. This may result in a different level of entitlement (including removal of entitlement) for the client.

“We have noted on occasions that at the appeal stage, points that were awarded on the initial claim have been removed in the re-determination process without a full explanation. This is confusing for appellants and undermines their trust in the process.” – Glasgow City Council, response to the Independent Review of Adult Disability Payment Call for Evidence^[189]

Observation 3 : The re-determination process currently involves a new case manager looking entirely afresh at a disputed decision. This can result in the risk of a client losing entitlement or seeing their entitlement to Adult Disability Payment reduced. However, a client may equally see their entitlement increase, because of the discretionary way in which decisions are made. Communicating the risk of losing an award to clients may result in clients choosing not to ask for a re-determination if they fear that their entitlement may be withdrawn. It is worth considering how to ensure clients are appropriately informed in a way that does not discourage them from exercising their rights.

Recommendation 27 : To consider how to mitigate the risk of removing an award, for example, by empowering case managers only to focus on the areas in dispute raised by the client if a new decision is likely to be disadvantageous and adopting the previous rationale for making a decision in those areas not in dispute.

During the Review, the comparison with the DWP process was raised where a person can lodge an appeal directly upon receipt of a decision. Meanwhile if an automatically triggered re-determination resulted in an acceptable award decision, the appeal would not be required to go ahead. The Scottish Government response is that the DWP introduced a mandatory reconsideration process^[190] for clients in 2013. Whilst the Scottish Government cannot speak further to the Department’s past and present policies, they were able to provide factual background on the policy decision of implementing a two-stage process for challenging a decision in Scotland. Some respondents to the Social Security in Scotland Consultation in 2016 felt it was important to have a clear, consistent and impartial internal review process, with clear timescales, and they recognised that an internal review could provide an opportunity to correct mistakes at an early stage. This consultation helped to inform the development and design of the re-determination and appeal processes for Social Security Scotland. Challenging a decision has been designed to be accessible for clients, with clear timelines and accountability if these are not met, making it easier for people to engage with the process.

I met with Scottish Government officials, who provided me with factual information during the passage of the Social Security (Amendment) (Scotland) Bill^[191] about its provisions. I note that the policy memorandum to the Bill explains the changes are intended ‘to empower clients and give them choice and flexibility.’ Provisions via the Social Security (Amendment) (Scotland) Act 2025 allow Social Security Scotland to make a new, more advantageous determination after a client has lodged an appeal. A new determination will only be made with the client’s consent and would end their appeal. This means that should a client wish to challenge re-determination outcome further and opt for an appeal, Social Security Scotland can make another advantageous determination should the client agree, thereby preventing unnecessary appeals.

These new provisions were designed to embed client choice and ensure that clients can engage with the challenge process on their own terms, thereby helping to promote continued accessibility to challenging a Social Security Scotland decision.

Social Security Scotland seems keen to change the perception of the challenge process and reduce anxiety and stigma. However, there are a few further areas of improvement to the process that could be considered.

Recommendation 28 : For Social Security Scotland to improve re-determination timescales.

Recommendation 29 : For information about appeals, and re-determinations to be given more prominence on the front page of the determination letter.

Short-term assistance

Short-term assistance is a temporary payment that is unique to Scotland. A person can access short-term assistance if they were or are in receipt of Adult Disability Payment and a decision has been made to reduce or stop their longstanding award (e.g. via a review or re-determination) and the client has requested a re-determination or an appeal against this decision. The payment tops up a person’s current award to their longstanding award level for the duration of the re-determination and/or appeal process. People will not have to repay any money they were entitled to, regardless of the outcome of their challenge. Short-term assistance was introduced to protect a person’s right to challenge decisions and so they don’t have to try to manage for a period on a reduced income.

Without any doubt it is evident that the introduction of short-term assistance is welcomed by disabled people and is viewed as an improvement on the DWP process. There were some suggestions that the process should be automatic without the need for clients to apply but other than that, the issue of short-term assistance was rarely mentioned.

Keeping in mind that short-term assistance is out of scope of the Independent Review, I am mindful that the Scottish Government will wish to consider on its own terms how to implement the following recommendation (if accepted):

Recommendation 30 : To consider introducing automatic awarding of short-term assistance with an opt-out clause to acknowledge a client’s right to choose.

Changes in circumstances

Some people commented on the length of the change of circumstances form; with many people saying it is too long.

There remains some confusion amongst clients about the purpose of reporting a change of circumstance. Some people I spoke to thought this only applied if something practical happened in your life like moving home or changing your bank account. Others said they would report a change of circumstance if there were changes to how their disability impacted them; if their condition worsened, or if they received any new medical interventions.

Young Lives vs Cancer suggest that further guidance could be provided by Social Security Scotland on what changes of circumstances need to be reported and when in the patient journey, e.g. when is the change in circumstance of a young person finishing cancer treatment considered to apply, because despite treatment ending, the young person is still impacted by their condition for a significant period of time post-treatment.^[192]

As with re-determinations and appeals several people told me that fear of losing existing benefit or ending up with a reduced award can deter people from reporting a change in their circumstances.

Some clients reported that they had been left disadvantaged because their Adult Disability Payment change of circumstances increased payment did not take effect until a later date. (i.e. not from the date they initially reported the change of circumstance).

Two respondents to the consultation liked the online process for submitting a change of circumstances form. Two respondents felt updated supporting information had not been considered in their change of circumstance decision and two were confused about what information they could submit alongside their change of circumstances form. One individual felt that they were asked irrelevant and intrusive questions during a telephone consultation to review their change of circumstance.

Many people suggested improvements including shortening wait times, improving communication by providing updates during processing, and offering clearer guidance on submitting a change of circumstance and what needs to be included on the form.

Specific improvements related to change of circumstances included:

• a suggestion to reiterate the need for clients to contact Social Security Scotland in cases where conditions have changed
• a suggestion from VoiceAbility that older clients be made aware of the ‘mobility clause’ of the change of circumstances form
• a recommendation from Young Lives vs Cancer to create integration between benefits systems to ensure that updates to one benefit would update the system for all
• a recommendation from Alzheimer Scotland to provide more details about what needs to be included in the change of circumstances submission.

Recommendation 31 : Provide more detailed guidance on what qualifies as a change of circumstance; the reasons why reporting a change of circumstance is important and provide examples to illustrate the types of situations when it might be necessary.

Effect of time in hospitals or care homes

People in receipt of Adult Disability Payment must tell Social Security Scotland when they go into hospital or a care home as soon as reasonably practicable. Subject to some exceptions, if a person is in hospital or a care home for more than 28 days (either as one single period, or multiple periods no more than 28 days apart), payment of their daily living component stops.^[193]

For hospital stays, someone who is aged over 18 and receiving in-patient treatment where the costs are met out of public funds, will have their payments of both the daily living and mobility component stop after 28 days.

The Scottish Government says that in most cases, people in alternative accommodation will have the costs of their care met out of public funds, so non-payment of the daily living component ensures that a person does not receive the support for the costs of their care twice. Furthermore, the mobility component of a person’s award is not paid either, as the Scottish Government’s position is that disabled people will not have the same mobility costs to meet while receiving in-patient care.

According to Young Lives vs Cancer the condition that an individual will stop receiving their payment if they spend more than 28 days in hospital (across a series of short stays separated by no more than 28 days) places a significant administrative burden on young cancer patients to record days spent in hospital across a large period. Considering the frequent short-term hospitalisations that a person with cancer experiences (due to their treatment or sporadic infections), as well as the lasting impact that their treatment can have on their finances and mobility, they have requested that cancer patients are exempt from this aspect of eligibility for Adult Disability Payment.

Keeping in mind that consideration of payment when a person is spending time in hospital or a care home, is out of scope of the Independent Review, I am mindful that the Scottish Government will wish to consider on its own terms how to implement the following recommendation (if accepted):

Recommendation 32 : To re-visit the eligibility rules in respect of cessation of Adult Disability Payment if 28 or more days are spent in hospital.

Qualifying periods

To qualify for Adult Disability Payment, a person must have a disability/health condition that has lasted at least three months and is expected to last at least nine months more. This is sometimes referred to as ‘the backwards and forwards test’ or ‘qualifying period’. There is no backwards test or forwards test for individuals qualifying under the SRTI route.

DACBEAG had recommended the removal of the three-month qualifying period in its advice to the Scottish Government on Assessments in December 2018:

“We looked at the past period test for PIP, where the condition had to be of at least three months duration before an award is made. We felt that this qualifying period should be abolished, as it discriminates against people who experience sudden onset debilitating conditions (e.g. stroke) who are unable to claim disability benefit for the first three months of their condition.” – DACBEAG Advice on Assessments^[194]

Research published by Young Lives vs Cancer^[195] shines a light on the experiences of, and challenges faced by, children and young people with cancer and their families as they navigate the disability benefits system to help manage the additional costs of living with cancer. On top of the significant financial costs, a prolonged wait for Adult Disability Payment of an average of six months following a cancer diagnosis is resulting in young people and their families in Scotland being forced into impossible financial positions, having to find and pay out nearly £3,000 in extra costs before their disability benefits are awarded.

Almost one-in-two young people with cancer have to use their savings and three-in-five must borrow money following a diagnosis^[196]. Almost half the patients in Scotland finish active treatment before receiving a decision on their application for Adult Disability Payment.[197]

There is no option to receive backdated payments to cover the wait during the qualifying period, meaning support is not always provided immediately following diagnosis. However, a diagnosis is not required in order to satisfy the qualifying period if a person has been impacted for three months before diagnosis. Being entitled to Adult Disability Payment allows people to access other forms of support such as a Blue Badge for parking and additional Universal Credit premiums, which cannot be accessed until Adult Disability Payment is awarded. A carer will similarly not qualify for Carer Support Payment until the person receives the daily living component of Adult Disability Payment. Due to the immediate nature of the extra costs experienced by young cancer patients and their families, Young Lives vs Cancer believe children and young people with cancer and their families should be entitled to access welfare benefits immediately following diagnosis and not be subject to a qualifying period.

Being treated for cancer is not the only time when these issues arise and therefore utilising supporting information quickly may be worth some further consideration, whilst acknowledging that in terms of fairness and equality, people would need to satisfy explicit criteria. I also acknowledge this would mean a big change that is not only relevant to Adult Disability Payment and may therefore be out of scope of this review.

Automatic entitlement

Automatic entitlement to Adult Disability Payment could potentially be introduced for people who have already been assessed for and awarded other forms of support such as for example, a social care package, Independent Living Fund and Blue Badge for mobility. This would significantly decrease the administrative burden on clients and on Social Security Scotland by simplifying the application process and reducing the amount of supporting information needed to make a decision. It could also help reduce the volume of case discussions and consultations carried out and go some way to reduce the trauma, anxiety and stress associated with having to repeatedly tell one’s story and prove one’s eligibility.

Automatic entitlement could also potentially be used in cases where people with particular conditions are entitled to an award without having to provide any further information beyond confirmation of their diagnosis with an eligible condition.

Work undertaken with the Social Security Experience Panels was supportive of a process of automatic entitlement, with 80% of respondents answering yes to: ‘Should people with certain conditions be automatically entitled to disability benefits (n=241)’. Only 10% of respondents said ‘no’ and a further 10% said: ‘don’t know/not sure.’

The report on the findings noted:

“Participants were asked if they could think of any ways that Social Security Scotland could identify those who may be automatically entitled before they apply.

Responses tended to fall into three groups: enhanced data sharing between the NHS and government, an improved application form and referrals from third parties.”– Report on Social Security Experience Panels: Award Duration and Automatic Entitlement^[198]

Young Lives vs Cancer believe that given the medical supporting information available, young cancer patients should be able to bypass the application process in a similar way to SRTI clients. They understand the medical vs social models of disability, but for cancer they believe they are intertwined. More than seven-in-ten young people with cancer and their families (72%) believe introducing automatic entitlement would be most helpful to them and other children and young people diagnosed with cancer. To help achieve this, many of them felt that supporting information from a medical professional could be better utilised in the process.^[199]

There are obvious challenges with this approach including the emphasis on a medical model of disability however it is worthy of further consideration when coupled with the current approach taken to identifying particular disabilities and conditions when deciding upon indefinite awards.

Keeping in mind that SRTI and supporting information are out of scope of the Independent Review, I am mindful that the Scottish Government will wish to consider on its own terms how to implement the following recommendation (if accepted):

Recommendation 33 : For consideration to be given to granting automatic entitlement to Adult Disability Payment when satisfying certain conditions or being in receipt of other forms of assistance without having to satisfy the qualifying period.

Award periods and reviews

Awards of disability assistance do not have a fixed end date after which clients have to re-apply for disability assistance. As Adult Disability Payment is ongoing, most awards are reviewed periodically to ensure that the individual continues to receive the right amount of assistance.

‘Light touch’ reviews which don’t require a DWP-style assessment were broadly welcomed as is the use of a diagnosis, in some cases, to determine award periods.

Challenges with reviews were raised in a few engagement events. These included examples of instances where Adult Disability Payment review periods had been shorter than PIP review periods and it was unclear why; reviews provoking anxiety in applicants; a perception that there are inconsistencies with Adult Disability Payment decision-making with the nature of decisions changing over time, and confusion over the timescales for review decisions.

As part of the consultation,^[200] I asked ‘Have you ever received an indefinite award for Adult Disability Payment?’ and received 75 responses to this question. The responses show that only 7% of respondents to the consultation said they had received an indefinite award whilst the majority (84%) said they had not. A small number of respondents said they did not know (9%).

I also asked, ‘Was the reason for this decision communicated clearly?’ and received three responses. The majority of respondents felt that Social Security Scotland communicated its decision clearly (67%), whilst the remainder said they did not know (33%).

Disabled people told me that they appreciated the ability to submit review paperwork online and most cited good communication throughout the process. Most also appreciated the lack of face-to-face assessments. Two respondents liked the communication they received leading up to the review. There were also several people who said communication about reviews and review periods could be improved. Decision waiting time is felt to be too long and the review form was cited as being too time-consuming to fill out.

Many disabled people told me that they do not always understand the logic behind the decision to determine the period of time before a review is deemed necessary. This is most pronounced if a person views their condition as progressive or if they are living with a life-long condition. People reported feeling intimidated by the prospect of a review, even when there had been no changes. There have been some very particular issues arising from an apparent lack of consistency in award length with one person left perplexed when their case was transferred, and with them being given their award for two years even though their previous DWP award had been for four years.

The most prevalent theme, mentioned by many, was that longer review periods would positively reduce clients’ stress and anxiety and allow for extended periods of better wellbeing between reviews. The security of planning finances and managing the cost of care was mentioned by some and a small number questioned why they needed to undergo reviews when their conditions were permanent and either unchanging or progressively worsening.

“I have received reward periods of 3 to 5 years. As someone who was born with a condition that impacts my daily life and will never improve, longer review periods give you a sense of relief that you will not continually be subjected to evaluations and reassessments which add to the daily stress and anxiety of living with a condition that daily impacts your life.” – Individual, response to the Independent Review of Adult Disability Payment Consultation^[201]

“The award of Adult Disability Payment on an indefinite basis offers reassurance and certainty about entitlement which leads to better financial security. For example, people with dementia who have an indefinite award of Adult Disability Payment feel more able to source ongoing care and support services since an indefinite award provides them with a secure source of income that enables them to engage services without the risk that this might not be possible in the event that their award ends and is not renewed.” - Alzheimer Scotland, response to the Independent Review of Adult Disability Payment Consultation^[202].

On a visit to Social Security Scotland a case manager talked me through how they make a decision regarding the award period. I was informed that two years is usually the minimum review period with ten years being the maximum. Case managers can also award clients an ‘indefinite award’. This is where a client remains entitled to Adult Disability Payment without the need for a scheduled review in the future and can be awarded to clients who are entitled to the enhanced rate of both components and whose needs are highly unlikely to change. Furthermore, case managers must request a case discussion in all cases before making an indefinite award. This is because decisions on indefinite awards can be highly complex.^[203] The case discussion must focus on whether or not setting a review date is appropriate. This is a mandatory step and practitioners must approve an indefinite award.

An award of less than two years can be selected in some instances, for example, where a person is scheduled to receive surgery that is likely to improve their condition, and the healing time is considered to be less than two years. In cases where a person’s condition is likely to be degenerative a shorter review period may also be determined.

Some conditions or their impact on the individual are likely to change over time, so a review may be appropriate to see whether the individual might be entitled to a different rate of Adult Disability Payment in the future. Small changes in the individual’s condition might make a significant difference to their overall level of entitlement for Adult Disability Payment, depending on the score for each activity awarded by the case manager for the daily living and mobility components. This should not prevent a case manager from setting a longer review period, as the individual can still ask for an unscheduled review by reporting a change of circumstances.

Several things are taken into account including the awareness that some conditions are degenerative and it may be that a shorter review period will benefit the client as it provides an opportunity to update Social Security Scotland on any changes that are affecting their daily life. This would apply in cases where the highest rates for daily living and mobility have not been determined.

The guidance for case managers^[204] has a list of conditions that is used in cases where the individual is entitled to the enhanced rate of both Adult Disability Payment components and where, based on the balance of probability the client’s condition is unlikely to improve. The first list refers to 25 conditions that are likely to mean the individual has a stable level of needs and it is highly unlikely that the individual’s condition will improve. The second much longer list refers to a number of conditions that potentially mean the individual has a stable level of needs, but it is possible that the individual’s condition may improve. If the individual has a condition or multiple conditions that do not appear on the list, the case manager should nevertheless go on to consider whether the individual’s needs are highly unlikely to improve.

It is important to note that there is no specific guidance on review periods for individual conditions. This is because an individual’s condition is just one of many factors that the case manager needs to take into consideration when setting a review period.

Recommendation 34 : As part of Social Security Scotland’s quality assurance process, review a selection of determination letters to assess how effective or otherwise the communication is in relation to the award duration and/or consider using the client survey to gather feedback on decision making and communication in this regard.