How the PIP Assessment Criteria Exclude Hidden Disabilities

🔊 Listen to Post

Rephrasing The Discrimantory PIP Assessment

Phrasing and structure of the PIP assessment unfairly disadvantage individuals with invisible and fluctuating disabilities, leaving many without the support they need.

“One of the most overlooked aspects of disability assessments like PIP is the failure to fairly account for fluctuating conditions. Many individuals live with illnesses that vary from day to day — such as Multiple Sclerosis (MS), ME/CFS, fibromyalgia, or certain mental health conditions. These are not linear or predictable, and yet the current system often assumes a static level of ability. This creates a harmful narrative that if someone can perform a task once, they can always do it — which is simply not the case. A more compassionate and realistic approach would recognise how the severity of symptoms can fluctuate, affecting daily living and mobility in deeply inconsistent and exhausting ways.”

The Personal Independence Payment (PIP) is designed to help people with long-term health conditions or disabilities manage the extra costs of daily living and mobility. However, the very questions used in PIP assessments raise serious concerns about fairness, inclusivity, and hidden discrimination. While PIP is supposed to support a broad range of needs, the structure of its eligibility criteria is biased in ways that systematically disadvantage individuals with certain types of disabilities.

The Issue: Discriminating by Design

The statement, “Whether you get one or both parts and how much you get depends on how difficult you find everyday tasks and getting around,” might seem reasonable at first glance. But this sentence—and the detailed list of tasks that follow—frames “difficulty” in a way that prioritises visible, physical impairments and downplays cognitive, neurological, and psychological challenges.

This bias becomes more apparent when examining how daily living and mobility are assessed.

Discriminatory Impact on People with Certain Disabilities

1. Mental Health Conditions (e.g., Depression, Anxiety, OCD, PTSD)

While the DWP briefly acknowledges that people with mental health conditions might qualify for the mobility part, the listed tasks overwhelmingly focus on physical actions. For example:

• “Preparing food”
• “Washing and bathing”
• “Physically moving around”
• “Leaving your home”

These tasks don’t reflect the complex realities of mental health. A person with OCD might not have trouble physically preparing food but may spend hours performing rituals before being able to eat. Someone with PTSD or anxiety might find leaving the house emotionally and psychologically impossible, but that distress isn’t easily measured in steps or time.

This framework suggests that unless a difficulty can be clearly observed or timed, it is considered less valid—a clear example of discrimination against those with “invisible” disabilities.

2. Neurodivergent Conditions (e.g., Autism, ADHD, Dyslexia, Dyspraxia)

People with neurodivergent conditions may face extreme challenges in managing money, reading, understanding social cues, or following a route due to sensory sensitivities, executive dysfunction, or communication barriers. Yet, the criteria are based on binary, oversimplified interpretations of these complex issues.

For instance:

• “Managing your money” might be impossible due to impulsivity or difficulty understanding abstract concepts.
• “Socialising and being around other people” is not just about willingness but about neurological processing.
• “Talking, listening and understanding” underestimates difficulties with processing speed, overstimulation, or language reception.

By reducing these tasks to basic functions, the system discriminates against neurodivergent individuals whose experiences fall outside the narrowly defined parameters.

3. Chronic Illness and Fatigue-Based Conditions (e.g., ME/CFS, Fibromyalgia, MS)

Conditions that fluctuate—like ME/CFS, fibromyalgia, and MS—pose another challenge. Many people with these conditions can perform tasks sometimes, but not always, or only at the cost of severe after-effects (known as post-exertional malaise).

However, the PIP framework focuses on whether a person can perform a task, rather than how performing that task affects them later—despite supposedly assessing frequency and safety. This misrepresents the nature of these conditions and can lead to denial of benefits due to a lack of visible or consistent evidence.

🌍 Updated PIP Assessment Criteria: Fair for All Disabilities

🔹 Daily Living Part – You might be eligible if you need support or experience difficulty with:

1. Preparing, cooking, or accessing food
   • This includes physical assistance, supervision due to risk (e.g., memory lapses, sensory overwhelm, or fatigue), or support due to psychological barriers (e.g., anxiety, OCD rituals, trauma).
2. Eating and drinking
   • Covers not just physical ability, but also cognitive prompts, emotional support, or help managing sensory sensitivities and disordered eating.
3. Managing medication or treatments
   • Includes memory issues, executive dysfunction, mental health conditions that impair focus, or needing help understanding or organising treatments.
4. Washing, bathing, or personal hygiene
   • Not limited to physical assistance — includes sensory aversions, fatigue, or psychological barriers that prevent regular personal care.
5. Using the toilet or continence management
   • Accounts for physical impairments, cognitive or neurological conditions, and mental health conditions such as trauma-related incontinence or phobia.
6. Dressing, undressing, or managing appearance
   • Includes motor difficulties, pain, sensory sensitivities, fatigue, or conditions that affect organisation or motivation.
7. Reading and understanding written information
   • Covers visual impairments, dyslexia, cognitive difficulties, or information processing challenges (e.g., ADHD, brain fog, anxiety).
8. Managing finances, budgeting, or understanding money
   • Recognises support needs due to learning difficulties, autism, mental health issues (such as bipolar disorder), or neurological impairments.
9. Social interaction, communication, and managing relationships
   • Includes support needed due to social anxiety, autism, trauma, schizophrenia, or difficulty interpreting cues or maintaining focus in conversations.
10. Verbal communication and understanding speech

• Includes difficulties due to hearing loss, speech impairments, language processing disorders, or sensory overload.

🔹 Mobility Part – You might be eligible if you experience difficulty with:

1. Planning, initiating, or following a route
   • Includes memory problems, disorientation, anxiety, panic attacks, autism, or executive dysfunction — not just visual or cognitive navigation.
2. Physically moving between locations
   • Considers stamina, pain, balance, muscle weakness, fatigue, and how symptoms worsen after exertion (e.g., MS, ME/CFS, fibromyalgia).
3. Leaving your home and accessing your community
   • Acknowledges not just physical barriers, but also psychological, neurological, or sensory challenges (e.g., agoraphobia, PTSD, OCD, autism).

⚖️ Additional Clarification on Assessment Principles

The revised criteria ensure assessors consider:

• Fluctuations — If you are unable to perform a task safely, repeatedly, reliably, or within a reasonable time on more than 50% of days.
• Hidden disabilities — Including the impact of invisible conditions such as mental health disorders, sensory overload, or executive dysfunction.
• Support needs — Whether physical, emotional, supervisory, cognitive, or sensory in nature.
• Consequences — How attempting a task affects you later (e.g., fatigue, trauma response, symptom relapse).

Framing the System for Failure

Though the DWP claims to assess whether a person can do a task “safely,” “reliably,” and “repeatedly,” these guidelines are often interpreted in ways that disadvantage people with fluctuating or non-visible symptoms. Assessors may overlook:

• The mental exhaustion following a simple task
• The use of coping mechanisms that mask difficulty (e.g., masking in autism)
• The mental health deterioration caused by repeated attempts at “normal” functioning

The bar for “difficulty” is not inclusive—it’s designed around traditional, physical disability models that do not reflect the lived experiences of many disabled individuals today.

🔍 PIP Assessment Criteria – Original vs. Inclusive (Fairer) Version

Category	Original DWP PIP Criteria	Revised Inclusive Criteria	Issue with Original / Benefit of Revised
Preparing food	Preparing food	Preparing, cooking, or accessing food (including sensory, psychological, and cognitive barriers)	Original assumes only physical difficulty. Revised includes issues like OCD, trauma, executive dysfunction, sensory aversions, or memory issues.
Eating and drinking	Eating and drinking	Eating and drinking, including emotional support, prompts, or sensory issues	Revised recognises needs linked to eating disorders, autism, or anxiety which the original ignores.
Managing medications	Managing your medicines or treatments	Managing medication or treatments (includes supervision, cognitive reminders, understanding, or emotional barriers)	Original excludes people with ADHD, depression, or cognitive decline who may forget or misunderstand medical routines.
Washing and bathing	Washing and bathing	Washing, bathing, or personal hygiene (includes sensory and psychological factors)	People with mental health or sensory conditions often struggle here without physical disability – now included.
Using the toilet	Using the toilet	Using the toilet or continence management (includes trauma, neurological or mental health-based continence issues)	More inclusive of those with PTSD, anxiety, or neurological bladder issues.
Dressing and undressing	Dressing and undressing	Dressing, undressing, or managing appearance (includes cognitive, sensory, or motivational impairments)	People with autism, ME/CFS, depression, or sensory sensitivities are more accurately reflected in revised version.
Reading	Reading	Reading and understanding written information (includes visual impairments, dyslexia, or information processing conditions)	Better accounts for neurodivergence, sensory impairments, and brain fog.
Managing money	Managing your money	Managing finances, budgeting, or understanding money (includes cognitive, emotional or neurological difficulties)	Revised includes bipolar, autism, learning disabilities – overlooked in original.
Socialising	Socialising and being around other people	Social interaction, communication, and managing relationships (includes anxiety, autism, trauma, psychosis)	Social disabilities are complex; revised phrasing avoids simplistic “yes/no” bias of original.
Talking and understanding	Talking, listening and understanding	Verbal communication and understanding speech (includes auditory processing, language disorders, and mental overload)	More inclusive of auditory processing issues, neurodivergence, and hearing loss.
Route planning	Working out a route and following it	Planning, initiating, or following a route (includes executive dysfunction, disorientation, mental health or sensory challenges)	Recognises difficulties in autism, PTSD, ADHD, and agoraphobia – not just visual or cognitive impairments.
Physical movement	Physically moving around	Physically moving between locations (includes fatigue, joint pain, balance, and symptom worsening after activity)	Revised version accounts for fluctuating conditions like MS, ME/CFS, and fibromyalgia.
Leaving home	Leaving your home	Leaving your home and accessing your community (includes psychological, neurological, sensory or trauma-related barriers)	Original implies physical movement only. Revised version reflects agoraphobia, OCD, panic disorder, sensory overload,

⚖️ Summary:

• Original wording is biased toward visible, physical impairments.
• Revised criteria account for hidden disabilities, fluctuating conditions, cognitive and sensory impairments, and mental health issues.
• Fairness improves dramatically when we ask how a task affects someone overall—not just whether they can perform it physically once.

A Call for Reform

This narrow and outdated understanding of disability embedded within PIP questions contributes to systemic exclusion. It unfairly penalises people with non-physical, cognitive, fluctuating, or mental health conditions, pushing them out of eligibility or reducing the level of support they receive.

To create a truly fair and equitable benefit system, the DWP must:

• Broaden the criteria to reflect invisible disabilities and fluctuating conditions.
• Provide clearer guidelines for mental health and neurodivergence.
• Ensure assessors are properly trained in complex, non-physical disabilities.
• Allow claimants to explain why a task is difficult—not just whether they can physically do it.

Until such reforms are made, the current PIP system will continue to discriminate—silently but systematically—against the very people it claims to support.

#STANDUP4HUMANRIGHTS