Literature Review: Decision-making for Adult Disability Payment

This report has provided a rapid evidence review of the decision-making process for ADP, from initial determinations to redeterminations and appeals. It has also considered the uptake of STA. Drawing on official statistics, client surveys, independent reviews and qualitative research, the report identifies areas of progress evident in a comparison to claimant experiences of PIP. It also highlights evidence gaps and recommends area for future research.

While eligibility criteria for ADP has remained the same as PIP, Social Security Scotland has introduced changes to the application process intended to reduce the burden on clients and build trust. This has been done by providing multiple application routes, increasing reliance on supporting information and ensuring that continued client contact through consultations is limited; all areas that have been highlighted negatively by PIP claimants. Client survey data suggests the Scottish changes are generally experienced positively. However, there are still lingering concerns, particularly about the complexity of applying for ADP. Quantitative data shows that award rates are changing, but there is little qualitative evidence to explain these trends and some researchers feel that it is still too early to start identifying lasting trends for ADP rates.

Again, while implementation of ADP is still at an early stage, evidence to date shows ADP clients request redeterminations at a substantially lower rate than PIP claimants request mandatory reconsiderations. Additionally, ADP redeterminations are far more likely to result in a changed outcome in the client’s favour. There is limited available evidence to suggest why this may be occurring and whether this is an indicator of satisfaction with initial decisions. Further work is needed to understand client motivations for seeking redeterminations.

Data on appeals is more limited than initial decision-making and redeterminations. Official statistics show that more than half of ADP appeals are upheld, favouring the client, which could raise questions about consistency and accuracy earlier in the decision-making process. Far less is known about how why certain people appeal ADP redetermination decisions and the barriers faced, as compared to PIP.

STA was designed to protect clients from financial hardship while challenging decisions, yet uptake remains low relative to the number of potentially eligible cases. Although payments have increased over time, and at a more rapid rate recently, evidence suggests limited awareness and confusion about eligibility as possible reasons. There is a lack of robust evidence on claimant understanding and experience of STA to understand whether it is achieving its intended purpose.

Overall, the review finds that ADP represents a clear departure from PIP in terms of stated values and aspects of process design, and that many clients report more positive experiences at the application stage. However, across all stages of decision-making there are substantial gaps in the evidence base. These gaps limit understanding of why decisions change at different stages of the process, which groups face greater barriers, and how far the system is consistently delivering fairness, dignity and respect in practice.