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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.
Integrates research, theory, and practice in supported decision-making and describes implications for supports provision in the disability field.
The Department for Work and Pensions make millions of benefit decisions every year. In around 230,000 cases a year (around one per cent of decisions), customers disputes end in an independent tribunal and some 40 per cent of these cases are changed in favour of the customer. Following reforms introduced in 1999 to decision-making procedures and appeal arrangements, this NAO report examines the overall impact of the changes, performance on payment accuracy and case clearance times, focusing on the effectiveness of arrangements in two major benefits: Jobseeker's Allowance and Disability Living Allowance. Findings includes that the number of appeals against decisions has fallen overall by around 15 per cent and waiting times for appeal hearings have been cut. Examples of good local practice in decision-making and a number of improvement initiatives are noted. However, whilst more than 90 per cent of payments checked were correct, there were errors in around a fifth of all decisions, and, on average, it takes 26 weeks to finalise an appeal. A number of recommendations to improve the situation and save on administration costs are made including: increasing the proportion of decisions which are pre-checked, focusing on where errors are most often found; and setting minimum standards for the process of looking again at decisions without the need for appeal (reconsiderations) including a maximum waiting time and a stipulation that decisions are re-examined by a different decision-maker.
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.
"Focusing on helping answer families' questions concerning the future needs of their family member with a disability, this practical, easy-to-use guide presents a plan that respects choices...of the adolescent or adult with disabilities...of the parents...of other family members. Disability and the Family: A Guide to Decisions for Adulthood introduces guidelines for making plans that are legally and financially effective, that consider real-life choices and preferences, and that take into account the social, leisure, residential, and vocational options that can help ensure a desired quality of life for persons with disabilities and their families. Here-in one source book-are guidelines and strategies for simplifying the future planning process" -- Back cover.
Painâ€"it is the most common complaint presented to physicians. Yet pain is subjectiveâ€"it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.
This publication informs advocates & others in interested agencies & organizations about supplemental security income (SSI) eligibility requirements & processes. It will assist you in helping people apply for, establish eligibility for, & continue to receive SSI benefits for as long as they remain eligible. This publication can also be used as a training manual & as a reference tool. Discusses those who are blind or disabled, living arrangements, overpayments, the appeals process, application process, eligibility requirements, SSI resources, documents you will need when you apply, work incentives, & much more.