In common with most decisions of the Supreme Court, the judgment in R. (on the application of Carmichael) v Secretary of State for Work and Pensions  UKSC 58 tells two stories: a short version and a long version. This article outlines both. The short story is the immediate impact of the decision: the application of the high-bar ‘manifestly without reasonable foundation test’, a distinction drawn on ‘transparent medical need’, and the lack of regard given to international obligations under the UNCRPD and the UNCRC. The long story is how this decision fits into the ‘cut-and-devolve’ approach to welfare reform in the UK, where local authorities are left to mitigate the effects of centrally determined benefit reductions without adequate support. After outlining the basis of the decision and its likely effects, this article argues that the decision does little to square this key structural circle at the heart of the UK government's welfare reform agenda.