Part 2 of the report - Getting it right and putting it right in DLA
included a number of interesting findings:
In 2002-03, the Department received some 430,000 new claims and
244,000 renewals for DLA. The total number of people receiving the benefit has
gradually increased and now stands at some 2.4 million.
Some 89,000 appeals - around a twelfth of decisions - reached a
tribunal hearing in 2002-03. More than half of these appeals were decided in
favour of the customer, with the rate on a rising curve. The number of appeals
heard each year has increased under the new appeals system since there is now no
compulsory review stage as there was under the pre-October 1999 scheme. The
average time for clearing appeals is 6 months.
In 2001-02, some 45 per cent of decisions on DLA and Attendance
Allowance contained decision-making errors, although not all of these involved
paying the wrong amount. The main reasons for errors were decision-makers
failing to ask all the necessary questions, and problems with interpretation and
application of the law. There were also errors in appeals submissions.
More than 30,000 DLA decisions each year are corrected by appeals.
The most common single factor leading to tribunals overturning
decisions was the presentation of new evidence not available to the original
decision-maker. This was often new medical evidence or sometimes evidence
provided by the customer orally. The President of Appeal Tribunals considers
that this suggests there is insufficient investigation of the circumstances
surrounding a decision before the matter comes before the tribunal. In a sample
of 516 overturned appeals the tribunal was given additional evidence in 72 per
cent of cases.
The DLA form is considered too long, confusing and repetitive by
claimants. It is often filled in inadequately, if the claimant has no help.
Welfare rights advisers also commented that some disabilities were
not well reflected in the claim form, so customers were not able to provide all
the relevant evidence.
Welfare rights advisers believe that decision letters are often
confusing and unhelpful because decision makers use standardised
"reasons" selected from a list, which do not explain how a particular
decision was made, or against which parts the claimant may appeal. There is a
current pilot being undertaken in which decision-makers include "reasoned
decision" information to see if this affects the numbers of appeals
received.
Decision-makers can feel under pressure to select the cheapest and
quickest medical evidence. They consider EMP reports to be the most reliable but
in 2001 12 per cent of EMP reports were unacceptable and a further 26 per cent
were below standard. SEMA is trying to improve this situation. In addition the
GP's factual report has been redesigned and is in use in some areas.
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Getting it right, putting it right - key
findings
