Tomorrow, (18th March 2025) the UK government is set to announce proposed changes to disability-related benefits. While the details are not yet confirmed, the discussions leading up to this announcement suggest a significant shift in how disabled people’s needs are assessed and supported. As both an occupational therapist and a disabled person, I want to examine these changes through the lens of occupational justice, autonomy, and the very real risks that disabled people face when support systems are altered.
Understanding the Benefits Landscape
To appreciate the potential impact of these changes, it’s important to understand the different benefits that disabled people may claim. These benefits can broadly be divided into those related to employment and those related to daily living and care needs.
Employment-Related Benefits
- Employment and Support Allowance (ESA): Financial support for people unable to work due to disability or health conditions. Some recipients are in the ‘Work-Related Activity Group’ (expected to move towards employment) and others in the ‘Support Group’ (not expected to work).
- Universal Credit (UC): Replaces multiple legacy benefits and includes a ‘Limited Capability for Work’ (LCW) or ‘Limited Capability for Work-Related Activity’ (LCWRA) element for disabled people unable to work.
- Access to Work: Provides financial support for adjustments in the workplace, including equipment, support workers, and travel assistance.
Daily Living and Care-Related Benefits
- Personal Independence Payment (PIP): A non-means-tested benefit covering extra costs associated with disability, split into daily living and mobility components.
- Disability Living Allowance (DLA): The legacy benefit for those who claimed before PIP was introduced, still available for some children and older adults.
- Carer’s Allowance: For people providing unpaid care for someone receiving PIP or DLA at a certain level.
- Severe Disability Premium (SDP): An additional amount for some people on older benefits who need support with daily living and don’t have a carer providing support.
What Could Change – and Why It Matters
Government rhetoric around benefits reform often focuses on ‘getting more people into work.’ This is framed as an economic necessity, but it often ignores the real-life barriers that disabled people face. Some of the speculated changes include:
- Stricter assessments for PIP and ESA/UC LCWRA – potentially making it harder to qualify.
- Tying benefits more directly to employment expectations – a shift that may not account for fluctuating conditions or the broader occupational impact of disability.
- Reduction or removal of certain elements for those deemed ‘able to work in some capacity’ – failing to consider that ‘some capacity’ does not equate to sustainable or meaningful employment.
From an occupational therapy standpoint, these changes could be catastrophic. The government often frames work as the ultimate goal, but occupational therapists understand that meaningful occupation is not just about paid employment. The ability to engage in self-care, leisure, social participation, and advocacy is just as important. Without adequate financial support, many disabled people will be forced into survival mode, with little energy left for anything beyond meeting basic needs.
Reforming the System – But in the Right Way
Prime Minister Keir Starmer has stated that the welfare system is “economically and morally unsustainable” and that reform is necessary to ensure that more people, including disabled individuals, can enter employment. His government argues that the current system holds both individuals and the country back, and that significant change is required to address this.
I do not disagree that the system needs reform. However, the issue is not that disabled people need to change or ‘work harder’ to fit into a system that does not support them. Rather, the system itself—and the society that shapes it—must be transformed to recognise disabled people’s talents, contributions, and the realities of living with disability.
A truly inclusive system would ensure that appropriate, individualised support is provided to enable disabled people to thrive. This means fully funding Access to Work, ensuring benefits assessments are fair and reflective of lived experience, and addressing systemic barriers that make meaningful employment difficult or impossible for many. This kind of transformation may cost more to implement initially, but in the long term, it would create a society where disabled people can contribute in ways that work for them, rather than being forced into a one-size-fits-all approach that fails to acknowledge occupational diversity.
Risks for Disabled People
- Increased Poverty and Occupational Injustice
Many disabled people already live in poverty, relying on benefits to cover the extra costs of disability. Reducing support could lead to increased food and fuel poverty, further marginalising an already at-risk population. - Threat to Health and Wellbeing
If disabled people are forced into unsuitable work environments or left without enough financial support to manage their conditions, there will be an inevitable deterioration in health. This will create additional strain on NHS services and social care. - Impact on Independence and Choice
PIP and Access to Work enable autonomy. Without these, disabled people may be forced to rely more on unpaid care or may lose the ability to work entirely due to lack of workplace support. - Increased Barriers to Meaningful Occupation
The assumption that all work is ‘good work’ ignores the complexity of disability and employment. Without reasonable adjustments and proper support, some disabled people will be left without the means to engage in any meaningful activity, not just employment.
What Occupational Therapists Need to Know
- Advocacy is Essential
OTs must be prepared to advocate for clients navigating an increasingly difficult system. Understanding the practicalities of benefits and how they support occupational engagement is key to supporting service users effectively. - Assessments May Become More Complex
If benefits assessments become more stringent, OTs may find that clients experience heightened distress, increased anxiety about proving their needs, and more difficulty accessing necessary financial support. - Understanding the Link Between Financial Security and Occupational Performance
Without stable financial support, disabled people will struggle to access occupations that promote wellbeing. OTs must be ready to highlight the wider impact of benefits cuts on health, not just on work participation.
Moving Forward: Fighting for Occupational Justice
As OTs, we promote independence, choice, and participation. As a disabled person, I know that when the government talks about ‘helping more disabled people into work,’ they often mean removing support rather than truly addressing barriers to employment.
This is a moment for the profession to step up. We must reject the notion that paid employment is the only valuable occupation and instead advocate for a system that recognises the full spectrum of occupational participation. Disabled people deserve the right to thrive, not just survive.
Tomorrow’s announcement could change the landscape of disability support in the UK, likely not for the better. It’s crucial that we listen, understand, and act. Disabled people’s lives and futures depend on it.
References
- Department for Work and Pensions (2024). Understanding disability benefits: A guide to PIP, ESA, and Universal Credit. UK Government. https://www.gov.uk/browse/benefits/disability
- Royal College of Occupational Therapists (2023). The role of occupational therapy in supporting disabled people into work and beyond. https://www.rcot.co.uk/file/6275/download?token=7jZJna1N
- Scope UK (2023). Disability benefits and financial support. https://www.scope.org.uk/advice-and-support/disability-benefits/
- The Times (2025). Keir Starmer defends welfare reforms. https://www.thetimes.co.uk/article/keir-starmer-defends-welfare-reforms
- Citizens Advice (2024). Changes to benefits: What you need to know. https://www.citizensadvice.org.uk/benefits/
- Shakespeare, T. (2018). Disability: The Basics. Routledge. https://www.routledge.com/Disability-The-Basics/Shakespeare/p/book/9781138652777
If you’re an occupational therapist, disabled person, or ally, now is the time to speak up. Challenge misconceptions, advocate for those affected, and recognise that real occupational justice means fighting for financial security alongside access to meaningful occupations.
#DisabilityBenefits #OccupationalTherapy #LivedExperience #OccupationalJustice