Literature Review: Decision-making for Adult Disability Payment

This rapid literature review examines evidence on decision-making for Adult Disability Payment (ADP), from initial determinations through redeterminations and appeals, and considers uptake of Short-term Assistance (STA). The Scottish Commission on Social Security (SCoSS) commissioned The Lines Between to compile the review as part of their remit to consider the conformity of the Scottish social security system with the social security charter.

The research was guided by the following questions:

• What data exists to enable a comparison between initial decisions on Personal Independence Payment (PIP) and ADP entitlement?
• Why are Personal Independence Payment (PIP) decisions more likely to receive a reconsideration when compared with ADP redeterminations?
• Why are ADP determinations more likely to be changed at the redetermination stage?
• Why are awareness and use of STA low?
• What evidence exists on the extent to which social security charter expectations are being met in this area?

This report draws on official statistics, independent reviews, client surveys, qualitative research, and third-sector evidence. TLB also assesses how far current practice aligns with the commitments set out in Social Security Scotland’s charter, ‘Our Charter’.

Initial decision-making for ADP

Evidence on initial decision-making indicates that while eligibility criteria remain broadly similar, ADP represents a clear departure from PIP in process design and stated values. ADP was introduced with a rights-based and person-centred approach, relying more heavily on supporting information, offering multiple routes to apply, and replacing disability assessments by default with more tailored consultations¹Social Security Scotland notes consultations provide an opportunity for Social Security Scotland to ask a client questions about specific areas of their application that require more information. They are not a medical examination but rather provide people applying with a chance to speak about how their disability or condition affects their daily life. only when necessary.

Client survey data and qualitative evidence suggest that many applicants experience the ADP decision-making process as clearer, more respectful and easier to navigate than PIP, although there are still some concerns around the application length and complexity. The removal of routine face-to-face assessments is widely viewed as a positive change, especially for people who found PIP assessments stressful or dehumanising. Consultations, when used, are generally rated positively, although concerns persist about decision-makers’ condition-specific knowledge.

Official statistics show that overall ADP award rates are broadly similar to PIP, but patterns within awards are changing. Over time, fewer new ADP applicants receive both components or enhanced rates, with a corresponding increase in standard awards. While several hypotheses are suggested—such as increased applications from people who may not previously have applied—there is little qualitative evidence to explain these trends.

There are some identified gaps in the data around the initial decision-making process for ADP and how it relates to data reported about PIP. In fact, comparisons between ADP and PIP are constrained by differences in how data are categorised and reported. Other gaps in research include limited qualitative research on how initial decisions are experienced by different groups, particularly those who are unsuccessful, and insufficient data to explain emerging statistical patterns.

Redeterminations

ADP clients request redeterminations at around half the rate that PIP claimants request mandatory reconsiderations. However, nearly half of ADP redeterminations result in an outcome favourable to the client, a much higher success rate than under PIP. This contrast raises important questions. It may indicate greater satisfaction with initial decisions, a more substantive review process at redetermination, or shortcomings in initial decision-making accuracy. At present, the evidence base is insufficient to determine which explanation is most plausible. The absence of data on redeterminations by primary disabling condition further limits understanding of equity and consistency.

Available evidence on client experience of redetermination is mixed. Survey data suggests that slightly more people report positive than negative experiences, with some valuing opportunities for clarification and dialogue with decision-makers.

Appeals

Appeals allow clients to challenge ADP decisions with which they disagree. More than half of concluded appeals are upheld in favour of clients, a rate similar to that seen in redeterminations. As with earlier stages, this raises questions about decision-making accuracy and consistency at the initial decision stage.

Evidence on client experience of appeals is limited and mixed. Survey responses show an even split between positive and negative overall experiences. Qualitative examples from advice organisations highlight stressors including late access to evidence, tight timeframes, and the psychological burden of tribunal proceedings. Similar to PIP, appeals are commonly linked to perceptions that earlier decisions did not fully or accurately reflect claimants’ circumstances.

Recent legislative changes could allow Social Security Scotland to make a new determination after an appeal is lodged, with the client’s agreement, potentially reducing the need for tribunal hearings. However, as this has not yet come into force, there is no evidence on how this change would operate in practice.

Short-term Assistance

Short-term Assistance was designed to protect clients from financial hardship while challenging decisions. This benefit award is unique to Social Security Scotland with few comparable provisions in the UK or internationally. Uptake has remained low relative to the number of potentially eligible cases. Although official statistics show a rapid increase in STA payments in recent periods, whether all those eligible are requesting the award is unclear as are the reasons some clients decide to use STA and other decide not to.

Evidence suggests that low awareness and confusion about eligibility are possible barriers. Survey data indicates very limited awareness of STA among respondents, although methodological limitations mean this may understate awareness among those who are actually eligible.

Third-sector evidence raises an additional concern. As STA does not ‘passport’ the recipient to other benefits (as ADP would), it, may leave some clients financially worse off during the challenge period. There is no comprehensive assessment of the wider financial impacts of STA, representing a significant evidence gap. This along with greater qualitative data to understand client thoughts on using STA are the main data gaps around this award.

Charter expectations

TLB reviewed the evidence alongside Social Security Scotland’s charter, ‘Our Charter’. Using this evidence, TLB considers the four pillars of ‘Our Charter’ including ‘A People’s Service’, ‘Processes That Work’, ‘A Learning System’, and ‘A Better Future’. Across the evidence reviewed, ADP shows strong alignment with the principles of ‘Our Charter’, particularly in relation to dignity, respect and person-centred service design. Many clients report positive interactions with staff and improved experiences compared with PIP, especially at the application stage.

There is clear evidence of learning and reflection within Social Security Scotland, including engagement with stakeholder feedback, independent reviews, and qualitative research with clients. However, significant evidence gaps persist—particularly around who faces barriers, why decisions change at later stages, and how experiences differ by condition or lived circumstance—limiting robust assessment of Charter compliance over time.

Conclusions

Overall, the review finds that ADP represents a clear departure from PIP in terms of approach and decision making, and that many clients experience improvements in fairness, communication and respect. Nevertheless, across initial decisions, redeterminations, appeals and STA, there are substantial gaps in both qualitative and quantitative evidence to provide a clear picture of clients’ experiences of ADP decision making and how it compares to feedback on DWP’s PIP.