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In this report the Work and Pensions Committee reiterates its call for the establishment of a Welfare Commission to create a fairer and simpler benefits system that claimants can understand and the Department of Work and Pensions (DWP) can administer more accurately. The report concludes that the vast majority of decisions DWP makes are accepted by claimants and lead to the right benefits being paid on time to those who are eligible. But the level of official error in the benefits system has increased substantially since 2000-01. The level of overpayments due to official error has risen from £0.4 billion (0.4 per cent of benefits paid) to £0.8 billion (0.6 per cent of benefits paid) in 2008-09. Although the Department has made great strides in reducing fraud, this increase in error should be a cause for concern. The report also highlights a worrying lack of response to scrutiny of the decision making and appeals (DMA) system by DWP. A former President of the Appeal Tribunals, Judge Robert Martin, felt his reports were effectively ignored, and there is evidence that the Decision Making Standards Committee lacks influence. There should be a much more constructive response to scrutiny. Another area that seems not to be working as effectively or as quickly as it should is the reconsideration process - the review of decisions - and the Department should examine this urgently.
Response to HC 313 (ISBN 9780215543875)
Following on from a previous NAO report (HCP 1142, session 2002-03; ISBN 0102923523), the Committee's report examines the progress made by the Department for Work and Pensions (DWP) to improve the quality of decision-making in social security benefits since the introduction of reformed procedures in 1998. Conclusions reached include that: the complexity of the benefits system remains a major problem for staff and customers alike, and is a key factor affecting the performance of the DWP; enhanced staff training and wider on-the-job experience is needed to further develop decision-making; there is a need for greater transparency in monitoring and reporting performance; there are some striking regional differences in decision-making practices; and that too few decisions are right first time, especially in the case of Disability Living Allowance, where over half of appeals cases are given in the applicant's favour.
This report examines how the Social Security Agency (Northern Ireland) applies the complex rules which affect eligibility for Disability Living Allowance (DLA). Despite progress since 1998 in reducing the volume of DLA claims held by the Agency and improved accuracy, there is still scope for further improvement. The speed of decisions has been adversely affected by several factors. There should be improvements in the training of frontline staff, and further improvements in information technology solutions. Fewer cases should be referred to the Agency's Medical Support Services. The identification of errors in decision-making by the Agency has improved, for example, through the use of the Periodic Enquiry process. There has been a significant increase in the number of appeals by claimants, since the decision-making procedures were changed in October 1999. Decision-makers should make more use of personal communication with claimants to collect initial or follow-up evidence, and this is especially important as DLA applicants are unlikely to have a detailed grasp of the disability eligibility rules. If the Agency aimed for a 10 per cent reduction in DLA / Attendance Allowance appeals the saving would be in excess of £190,000 per year.
The Social Security Administration (SSA) provides Social Security Disability Insurance (SSDI) benefits to disabled persons of less than full retirement age and to their dependents. SSA also provides Supplemental Security Income (SSI) payments to disabled persons who are under age 65. For both programs, disability is defined as a "medically determinable physical or mental impairment" that prevents an individual from engaging in any substantial gainful activity and is expected to last at least 12 months or result in death. Assuming that an applicant meets the nonmedical requirements for eligibility (e.g., quarters of covered employment for SSDI; income and asset limits for SSI), the file is sent to the Disability Determination Services (DDS) agency operated by the state in which he or she lives for a determination of medical eligibility. SSA reimburses the states for the full costs of the DDSs. The DDSs apply a sequential decision process specified by SSA to make an initial decision whether a claim should be allowed or denied. If the claim is denied, the decision can be appealed through several levels of administrative and judicial review. On average, the DDSs allow 37 percent of the claims they adjudicate through the five-step process. A third of those denied decide to appeal, and three-quarters of the appeals result in allowances. Nearly 30 percent of the allowances made each year are made during the appeals process after an initial denial. In 2003, the Commissioner of Social Security announced her intent to develop a "new approach" to disability determination. In late 2004, SSA asked the Institute of Medicine (IOM) to help in two areas related to its initiatives to improve the disability decision process: 1) Improvements in the criteria for determining the severity of impairments, and 2) Improvements in the use of medical expertise in the disability decision process. This interim report provides preliminary recommendations addressing the three tasks that relate to medical expertise issues, with a special focus on the appropriate qualifications of medical and psychological experts involved in disability decision making. After further information gathering and analyses of the effectiveness of the disability decision process in identifying those who qualify for benefits and those who do not, the committee may refine its recommendations concerning medical and psychological expertise in the final report. The final report will address a number of issues with potential implications for the qualifications of the medical experts involved in the disability decision process.
Approximately half of the total UK population are in receipt of one or more welfare benefits, giving rise to the largest single area of government expenditure. The law and structures of social security are highly complex, made more so by constant adjustments as government pursues its often conflicting economic, political and social policy objectives. This complexity is highly problematic. It contributes to errors in decision-making and to increased administrative costs and is seen as disempowering for citizens, thereby weakening enjoyment of a key social right. Current and previous administrations have committed to simplifying the benefits system. It is a specific objective of the Welfare Reform Act 2012, which provides for the introduction of Universal Credit in place of diverse benefits. However, it is unclear whether the reformed system will be either less complex legally or more accessible for citizens. This book seeks to explain how and why complexity in the modern welfare system has grown; to identify the different ways in which legal and associated administrative arrangements are classifiable as 'complex'; to discuss the effects of complexity on the system's administration and its wider implications for rights and the citizen-state relationship; and to consider the role that law can play in the simplification of schemes of welfare. While primarily focused on the UK welfare system it also provides analysis of relevant policies and experience in various other states.
This major study of the workings of the British social security adjudication system, the first since the tribunal structure reforms of 1984 and the benefit changes of 1988, examines the decision making processes in Department of Social Security local offices and at the social security appeal tribunals. A unique nationwide study based on hundreds of interviews with claimants, social security staff, and tribunal members, as well as on observation of hundreds of appeal hearings, Judging Social Security highlights the divergence between the way the system ought to work and its operation in practice. In the process, it debates whether the system's current emphasis on procedural fairness actually serves to mask the reality of the restrictive and rigid rules governing entitlements.
The Ministry has improved its financial management since the Committee's last report in January 2011 (HC 574, ISBN 9780215556042). Many of the Ministry's processes have improved, including modelling and forecasting, but the Ministry has not achieved significant improvements in the delivery of key financial outcomes and therefore has much still to do. The most serious issue is the Ministry's inability to report its financial affairs on a timely and accurate basis. The Ministry's own resource accounts for 2010-11 were delivered late and there were significant problems with the accounts produced by two of its major arm's length bodies, the Legal Services Commission and HM Courts Service's Trust Statement. The Ministry faces significant accounting challenges for the 2011-12 financial year, due to the required earlier publication of the accounts. The Ministry needs to break the cycle of continuing failure to produce accurate and timely accounts. It also faces considerable challenges in meeting its tough spending review commitments, but without a full understanding of its costs, the Ministry risks unnecessarily cutting frontline services, which are critical to the poorest in the community, rather than ensuring savings are achieved through genuine efficiencies. Maximising the income it obtains will help the Ministry and fine collection is improving, but it is being outpaced by the growth in fines outstanding. Excellent financial management is critical to the Ministry's future success as it seeks to achieve significant efficiency gains while coping with workload pressures, such as increases in the prison population, that are largely outside its control.