Memorandum submitted by Department for Work and Pensions (DM 29)

 

 

CONTENTS

 

Summary

 

1. Introduction

 

2. Decision making

3. Training for decision makers

 

4. Appeals

 

5. Operation of decision making in individual benefits

 

6. Initiatives to improve decision making

 

7. DWP Decision Making Standards Committee

 

8. European Court of Justice ruling on exportability cases

 

9. Administrative Justice and Tribunals Council

 

10. Presenting Officers

 

11. Upper Tribunal

 

12. Liaison between the Department and Tribunals Service

 

13. Conclusion

 

SUMMARY

 

The Department for Work and Pensions makes millions of decisions on social security benefits each year. Decisions are made by a large number of staff in Jobcentre Plus and the Pension, Disability and Carers Service. Decisions on Housing Benefit and Council Tax Benefit are made by Local Authorities.

 

The majority of decisions are accepted by customers

 

Around 250,000 appeals are received every year by the First-tier Tribunal. In about half of those appeals, the decisions are upheld. There are clear variations between the different types of benefit. Those benefits which involve the exercise of discretion and consideration of medical evidence in particular generate a large number of successful appeals, often based on new evidence.

 

Effective decision making supports other departmental initiatives, for example, the reduction in official error overpayments

 

Payment accuracy rates across the major benefits all more than 90 per cent

October 2007 - September 2008 2 per cent of benefit overpaid due to fraud and error - continues to be the lowest proportion recorded

 

October 2007 - September 2008 4.5 per cent overpaid due to fraud and error on Housing Benefit (HB)/Council Tax Benefit (CTB) - 10 per cent reduction since 2002-2003

 

October 2007- September 2008 HB/CTB official error at an all time low, 0.9 per cent of expenditure

 

Claims clearance rates across the major benefits all within target

 

There are a number of initiatives within Jobcentre Plus and Pension, Disability and Carers Service (PDCS) to improve service to the customer and decision making and reduce official error. These include claims by phone and online; professional development programmes for decision makers; Lean process improvements

 

Improved decision making on certain Disability Living Allowance claims has led to savings of 20 million in PDCS

 

In August the Department launched its Customer Charter. Developed in collaboration with more than 2000 staff, customers and intermediaries, it clearly spells out what customers can expect from its decision makers: that they are knowledgeable; they will make the right decision at the first time of asking; they will do this quickly; and where customers need to contact the Department about their decisions this will be easy for them.

 

The Department believes that the decision making process for benefits is robust and practical and that it provides an effective basis to deliver services to all its customers. But it is constantly working to make it even better.

 

 

 


1. INTRODUCTION

 

1.1 This memorandum is provided by the Department for Work and Pensions as a contribution to the Work and Pensions Select Committee's inquiry - "Decision making and appeals in the benefits system".

1.2 The Department makes millions of decisions on social security benefits each year. Decisions are made by a large number of staff in Jobcentre Plus and PDCS. These decision makers act on behalf of the Secretary of State for Work and Pensions. Decisions on Housing Benefit and Council Tax Benefit are made by Local Authorities. The Department makes around 2.5 million payments each day.

 

1.3 The current decision making system was introduced by the Social Security Act 1998. The aim was to introduce a clearer, simpler, more effective process that would be easier for the Department's customers to understand and allow for decisions to be made and disputes handled more quickly. The Department strives to achieve the best decision for all its customers. The current system for making decisions and handling appeals in benefit and child support matters is accessible, thorough and comprehensive. Customers can make an initial claim and the Department is committed to increasing customers' ability to claim by telephone and on-line. They can seek an explanation of the decision made on their claim or application, and can ask for it to be reconsidered - this often provides a quick and simple way to resolve disputes. They then have access to two independent tribunals. If a legal point remains unresolved, the customer can seek access to the higher courts.

1.4 The benefits system itself is complex. There are different entitlement conditions for different benefits. There are also the huge variety of circumstances faced by the Department's customers which require consideration by decision makers.

 

1.5 Of the millions of decisions made each year, around 250,000 decisions - less than 10% are appealed. That implies that customers are satisfied with the majority of decisions given to them. The number of these appeals where the Secretary of State's or Local Authority's decision is upheld varies between benefits. In the medically and disability based benefits such as Disability Living Allowance (DLA), Attendance Allowance (AA) and Incapacity Benefit (IB) around 60 per cent of decisions are upheld. For the non-medical benefits such as Jobseeker's Allowance (JSA) and Income Support (IS) the rate is higher. The Annex contains statistical information on appeals. Of the 250,000 cases appealed each year, about 3,000 go on to the next stage of the process before the Upper Tribunal, from where a smaller number will proceed to the higher appellate courts.

 

1.6 The Department continually seeks to improve current standards of service to customers in both decision making and associated areas. Initiatives such as making claiming easier on-line and by telephone, will not only benefit customers but will also speed up the decision making process. In certain areas of decision making the Department is investing in programmes for its decision makers such as the Professionalism in Decision Making and Appeals (PiDMA) course run in conjunction with the University of Chester. The Department is also applying Lean[1] techniques to streamline its processes.

 

1.7 In August the Department launched its Customer Charter. Developed in collaboration with more than 2000 staff, customers and intermediaries, it sets out what customers can expect from decision makers:

that they are knowledgeable;

they will make the right decision at the first time of asking;

they will do this quickly;

and where customers need to contact the Department about their decisions this will be easy for them.

 

1.8 The Department believes that the decision making process for benefits is robust and practical and that it provides an effective basis to deliver services to all its customers. But it is constantly working to make it even better.

 

 

2. Decision making

 

2.1 The essential elements of the decision making and appeal processes are common to all benefits. A customer submits a claim and the evidence to support it. A decision maker assesses the claim and issues a decision on it. If the customer is not satisfied with the decision, they can ask for an explanation or can ask for the decision to be reconsidered.

 

2.2 A decision maker will consider the request and any new evidence submitted by the customer. The decision maker will then decide whether the original decision was correct or should be changed.

 

2.3 If the customer is still not satisfied, in the majority of cases they can appeal to the First-tier Tribunal, which is independent of the Department. These tribunals are administered by the Ministry of Justice's Tribunals Service. The customer can ask for an oral hearing of the appeal or for it to be decided by the tribunal on the papers only.

 

2.4 The tribunal will consider the appeal and the evidence submitted by the customer and the Secretary of State or Local Authority. The tribunal will then issue its decision.

 

2.5 Both the customer and the Secretary of State/Local Authority have the right of appeal, on a point of law only, to the Upper Tribunal (formerly known as the Social Security and Child Support Commissioners). Further avenues of appeal lie with the higher appellate courts.

 

2.6 Both Jobcentre Plus and PDCS have sufficient numbers of decision makers for the levels of claims and applications they normally receive. There are a large number decision makers in JCP, including approximately 1500 specialist decision makers, around 8,000 in PDCS and 298 in Debt Management[2]. In addition there are the thousands based in the 380 Local Authorities making decisions on HB and CTB. The Department and Local Authorities will continue to keep staffing levels under review during the current economic downturn.

 

The reconsideration process

 

2.7 If a customer is not satisfied with a decision, they can ask for an explanation and for the decision to be reconsidered. A decision maker will re-examine the original decision, in the light of the customer's representations or additional evidence, and will decide if the decision should be changed; legally this is known as a revision (prior to the introduction of the current decision making system by the Social Security Act 1998, this was legally known as a review). If the decision is changed, the customer has the right of appeal against the new decision.

 

2.8 The ability to revise decisions is key to the decision making system. Of course, the aim is to get the decision right first time. However, if a decision is challenged on revision it will be referred to another decision maker. It is beneficial both to the Department and the customer if the decision can be corrected at this stage instead of waiting for a tribunal hearing.

 

2.9 The onus is on the customer to explain why he thinks the decision is incorrect. A decision will only be revised if a decision maker agrees an error has been made.

 

2.10 If a decision is not revised but is then overturned on appeal, it does not necessarily mean that the revision outcome was wrong or that the revision process was ineffective. Whilst every effort is made to ensure that the customer provides all relevant information at the revision stage often new evidence will be presented at the tribunal hearing - this is particularly so with the medical/disability benefits (In his report for 2007 - 2008 the President of Appeal Tribunals found that in a sample of DLA cases overturned by the tribunal, 73 per cent were because the tribunal was given additional evidence not available to the decision maker, with 78 per cent of this being provided orally).It is also possible for the tribunal to examine the same evidence as the decision maker and interpret it differently - again this is more likely with the medical/disability benefits.

 

Is the decision making and appeals process clear to customers?

 

2.11 When a customer contacts the Department or a Local Authority, they are told what they need to do to claim benefit or, as necessary, dispute or appeal a decision.

 

2.12 Customers are told about their dispute and appeal rights in the decision notification on their benefit claim and application. They are also told that they can ask for leaflet GL24, If you think our decision is wrong which provides a detailed explanation of the decision making and appeals process.

 

2.13 The customer can also check the law and benefit guidance on the Directgov website.

 

 

3. Training for decision makers

 

3.1 The Department invests a considerable amount of effort in providing training and support to decision makers.

 

Jobcentre Plus

 

3.2 All decision makers receive training in the relevant benefit . Recent developments to improve efficiency include criteria to differentiate between non-complex and complex decisions, so that the former can be dealt with quickly and without reference to a specialist decision maker.

 

3.3 Jobcentre Plus is currently reviewing all of its decision making training with a view to improving the quality of decisions made. From April 2010, all new decision makers will undergo Foundation Decision Making Training with more complex subject areas delivered as needs arise.

 

3.4 Jobcentre Plus has established accuracy teams to monitor error levels in cases where wrong decisions affect the amount of benefit to be paid. Guidance and templates are provided to decision makers to improve the standard of consideration of evidence, legislation and the presentation of decisions. These matters are subject to external checks by the Department's Risk Assurance Division and the National Audit Office.

 

3.5 Annexes B & C further explain the role of decision makers in relation to the labour market and benefit sanction regime within Jobcentre Plus.

 

 

PDCS

 

3.6 The initial training for new decision makers is already robust, but after nine months in post they will all be taken through the Technical Evaluation Package (TEP) process for further development. The DWP Standards Committee will be looking at the effectiveness of training for all PDCS administered benefits in their work programme for 2009-2010.

 

3.7 PDCS has developed a series of TEPs for State Pension (SP) and Pension Credit (PC) that target the more complex areas of decision making. These are being delivered in Pension Centres with a completion date of March 2010.

 

3.8 All DLA/AA decision makers receive full technical training that includes contributions from health care professionals. Decision makers then move to mainstream operations where, under the guidance of more experienced colleagues, they begin to gain operational experience. Annex D provides further details of the training given to DLA/AA decision makers.

 

3.9 The decisions made on certain claims, for example DLA, are complex and require the exercise of discretion. In the light of this, PDCS has developed a learning and development programme called PiDMA (Professionalism in Decision Making and Appeals) - over 200 staff have completed or joined the programme. It is targeted at Executive Officer decision makers and Higher Executive Officer managers for DLA and AA. The programme includes an accreditation scheme linked to the University of Chester. PDCS consider that PIDMA provides high quality training for decision makers who are involved in complex decisions which require the exercise of discretion.

 

3.10 The Department wants to be sure that all its decision makers can receive appropriate accreditation. Work is in hand with the Council for Administration to refine the content of the existing National Occupational Standards to ensure that the requirements of departmental decision makers are covered.

Advice and guidance to decision makers

 

3.11 The Department's Decision Making and Appeals (DMA) Leeds unit provides support to all its decision makers. They also issue guidance to HB/CTB decision makers on certain common subjects. DMA Leeds publishes and maintains guidance for decision makers in the Decision Makers Guide (DMG)[3]. There are a large number of amendments to social security law and practice every year. DMA Leeds ensures that these are communicated to decision makers by memos and consolidated in the DMG. In addition they maintain the social security law volumes (known as the Blue Books) and a complete record of reported Upper Tribunal decisions. The unit also responds to more than 3,300 guidance requests per year from decision makers on specific cases.

3.12 For HB/CTB the DWP Performance and Good Practice Guide and the Performance Development Team provide free consultancy support to Local Authorities in delivering effective decision making.

 

3.13 In DLA and AA expert medical advice about impairments is supplied by Atos Healthcare medical services when requested by the decision maker. This informs decision making.

 

3.14 Customer Case Management medical guidance on-line has replaced the Disability Handbook. This has been written by experts and reviewed by disability organisations. It is a comprehensive resource for the latest information on medical aspects of disability.

 

 

4. Appeals

 

4.1 Customers are informed of their appeal rights in a clear and unambiguous way. The decision notice explains what needs to be done and within what time. It also explains that they can get more information from leaflet GL24 If you think your decision is wrong - this contains an appeal form but it is not essential that it is used.

 

4.2 However, the Department encourages customers to seek explanations for decisions before appealing. Where a customer feels that the decision is wrong, the Department will look at it again, so that any favourable change can be made as soon as possible - see para 2.7 above. Where the Department does not change the decision, the customer has the right of appeal.

 

4.3 The Department provides the customer with a full explanation of how and why it reached the decision (now known as the response) along with copies of all the evidence used to reach the decision. It is sent to the customer and Tribunals Service well in advance of the hearing allowing both the customer and the tribunal time to prepare for the hearing or seek further advice.

 

Timeframe for appeals

 

4.4 The time limits for customers to make an appeal are now prescribed in the Tribunal Procedure (First-tier Tribunal) (Social Entitlement Chamber) Rules 2008[4]. They replicate the time limits which have existed since 1999, that is, normally one month from the date of decision which may be extended by up to 12 months where special circumstances apply.

 

4.5 The Department considers that the one month appeal time limit is reasonable (particularly allowing for the possibility of extension). It encourages people to exercise their rights promptly and ensures their case can be resolved quickly. It also ensures that decisions are revisited while the facts are still fresh.

 

Support for customers during appeal process

 

4.6 The Department publishes leaflet GL24 If you think our decision is wrong. As well as containing the form which can be used to make an appeal, the leaflet explains how the process works and who is responsible for each step. Page 20 of the leaflet provides advice on the type of organisations who may provide free assistance in preparing for a tribunal hearing and page 21 directs customers to websites where more information can be obtained on the law or processes involved.

 

4.7 The Department and Local Authorities ensure that all disputed decisions are fully reconsidered. Customers' rights are fully explained in decision notifications. Every effort is made to ensure that the right decision has been given and that it is adequately explained. When a decision is revised in favour of the customer, the appeal will lapse. Where the decision is checked and found to be correct, the appeal response is prepared and the case referred to the Tribunals Service. The response sets out the relevant law, case law, evidence and argument in support of the decision under appeal and stands alone as the Department's case.

 

4.8 From that point the Tribunals Service is responsible for handling the appeal and providing support for their customers. They will contact the appellant and provide further information about the hearing.

 

4.9 If a Presenting Officer attends the hearing then as part of his role (see section 9 below) he will make points in favour of the customer where appropriate.

 

Alternative Dispute Resolution pilot

 

4.10 The Department participated in a Tribunals Service pilot of Alternative Dispute Resolution, which tested the Early Neutral Evaluation approach. The pilot operated in Tribunals Service and PDCS, and focussed on DLA and AA appeals. It involved a preliminary assessment by a tribunal judge of the facts, evidence and merits of the appeals. Where deemed appropriate, and supported by the evidence available, the judge then sought to secure an early resolution of the case by contacting the relevant party advising them that their appeal has little prospect of success. The pilot ran from September 2007 to January 2009. The pilot has been evaluated and the Tribunals Service is considering the report's recommendations.

 

Review of time limits for an appeal response

 

4.11 The Department and HM Revenue and Customs are currently working with Tribunals Service officials and the Tribunals Procedure Committee to review time limits for sending an appeals response to the Tribunals Service. The First-tier Tribunal Rules currently require responses to be sent as soon as reasonably practicable. The review involves working together to establish how best to achieve workable time limits.

5. Operation of decision making in individual benefits

 

5.1 As explained in section 2 there is a common process for decision making across social security benefits, including HB/CTB.

 

5.2 For the individual benefits the method of claiming may vary, for instance, by phone, internet or claim form, but once the claim is made the process of determining the claim is common. A front-line or specialist decision maker will consider the evidence and make a decision. If the decision is challenged again the steps taken to resolve the dispute are common.

5.3 The effectiveness of the operation of the current process in individual benefits can be gauged from the following statistics[5]:

 

Benefit accuracy rates

 

The 2008 - 2009 position on payment accuracy for the major benefits is as follows:

 

Carer's Allowance (CA) - 99.4.per cent (target 98 percent)

Pension Credit (PC) - 92.1 per cent (92 per cent)

State Pension (SP) - 98.2 per cent (98 per cent)

HB/CTB - 98 per cent

 

For DLA and AA the accuracy is measured in terms of the quality of the decision itself: for DLA it is 92.2 per cent (target 94 per cent), for AA it is 94.1 per cent (94 per cent).

 

Claims clearance rates

 

The 2008 - 2009 average clearance rate for the same benefits is as follows:

 

AA - 12.3 days (target 16)

CA - 12.4 days (13.5)

DLA - 29.8 days (38)

PC - 15 days (15)

HB/CTB - 26 days (down from 56 days in 2002 - 2003)

 

A further measure of the effectiveness of decision making can be seen in the fraud and error figures - see section 6 below.

 

6. Initiatives to improve decision making

 

6.1 The decision making and appeals process supports much of the rest of the work done by the department. Effective decision making is important not only to the individual customer but also to help in improving standards of service to all customers and in making the Department more efficient. Details of some of the relevant initiatives are given below:

 

6.2 The Department want to be able to get the right decision for every customer. That means work on decision making itself but there is also a range of other initiatives that contribute to get the right result every time. These include:

 

- The Customer Management System enables working age customers to experience, as far as possible, a single claims process when claiming HB and/or CTB alongside claims for Income Support (IS), Jobseekers Allowance and Incapacity Benefit. Jobcentre Plus obtains the necessary benefit claim information by phone and then passes it to the relevant Local Authority, thus simplifying the procedure and avoiding duplication for the customer.

 

- Employment and Support Allowance, Pension Credit, State Pension, Income Support and Jobseekers Allowance can be claimed by telephone;

 

- Carers Allowance and, from October, State Pension can be claimed on-line;

 

- The role of Jobcentre Plus Personal Advisers in supporting jobseekers in finding work continues to develop;

 

- From September 2009 PDCS is testing a shorter DLA claim pack for benefit renewals;

 

- PDCS has plans to test a new approach to deciding DLA entitlement for children - a difficult area for the Agency

 

- Jobcentre Plus is introducing an online service for claims to JSA. This will allow customers to claim contributory-based Jobseekers Allowance on-line - the main advantage will be to speed up the processing of the claim.

 

- Jobcentre Plus has a strategy and programme of continuous review and improvement of administrative processes using Lean techniques.

 

- Trials have been conducted on how decision making and appeal processes could be improved and simplified. For example, up to

20 per cent of ESA assessment decisions have been re-allocated to a lower grade of decision maker; this has removed the need for referrals to senior staff when customers have satisfied the requirements of the medical examination. This speeds up the decision making process. Jobcentre Plus has centralised the processing of benefit claims and decision making within its Benefit Delivery Centres. The agency anticipates looking again at how this is working to ascertain what further opportunities there may be.

 

- In PDCS specialist teams support all decision makers. It uses other internal and external scrutiny mechanisms to assess decision making effectiveness - National Audit Office, DWP Standards Committee, Accuracy Support team.

 

- From November 2008 it has been possible for pension age customers to make a telephone claim for HB/CTB alongside their claim for PC without the need to complete or sign a claim form.

 

- The pension benefits decision making process has been reviewed recently by the Pensions Transformation Programme. The process has been simplified to enable most decisions to be made by AO grade staff. The evidence gathering process has been revised. More complex decisions will increasingly be done by more experienced staff.

 

- In HB/CTB for working age customers, Jobcentre Plus has developed the Customer Management System with the objective of introducing a more streamlined and integrated approach to benefit administration.

 

Tackling official and customer error

 

6.3 In January 2007 the Department launched its strategy for reducing the level of official and customer error 'Getting welfare right: Tackling error in the benefits system'. This strategy was aimed at reducing the levels of both over- and underpayments caused by official error and customer error. It is now fully implemented and the latest decrease in the Department's overall level of official error shows it is working.

 

6.4 Between October 2007 and September 2008 2 per cent (2.7billion) benefit overpaid was due to fraud and error. This is the lowest proportion since 2000 - 2001. Underpayment was 0.9 per cent of benefit expenditure in the same period.

6.5 Between October 2007 and September 2008 4.5 per cent (770million) HB expenditure is estimated to have been overpaid due to fraud and error.

This is a 10 per cent reduction since measurements were first taken in

2002 - 2003.

 

6.6 In the same period HB official error was at an all time low at 0.9 per cent (150million of expenditure).

6.7 In 2007 - 2008 20,985 cautions and administrative penalties were applied by Local Authorities for HB fraud; there were 6,493 successful prosecutions.

 

6.8 In Jobcentre Plus further measures are in hand to further reduce the level of official error:

 

it has increased checks on staff by over 25 per cent;

there are short- and long-term projects looking at how better use can be made of the Department's IT in tackling official error;

data matching of IT systems both within DWP and with outside systems has proved to be beneficial in identifying anomalies and errors;

fraud and error training is to be made mandatory for all new Jobcentre Plus starters, those changing their role and promotees.

 

6.9 PDCS initiatives include:

 

targeting the most frequent and common errors - issuing additional guidance on these;

holding accuracy workshops;

introducing pre-payment checks on cases which have a high probability of going wrong;

requiring mandatory medical evidence for certain DLA claims - it is estimated that this prevents approx 20million pa of benefit being incorrectly paid out;

enhancing its IT to identify errors caused by the non-compliance with benefit regulations;

undertaking a full review of its accuracy checking process and management arrangements.

 

 

7. DWP Decision Making Standards Committee

 

7.1 The DWP Standards Committee (SC) provides independent advice to the Agency Chief Executives on matters relating to decision making. It consists of a Chair and three members, all independent of the Department. Each member of the SC has a specific role. The SC has no executive authority and its scope is exclusively to Jobcentre Plus and PDCS (including decisions made on their behalf by Debt Management in relation to Jobcentre Plus and PDCS-administered benefits).

 

7.2 The SC agrees a programme of work with Jobcentre Plus and PDCS on the areas where work is needed. The role of the SC is to provide independent advice and make recommendations on areas where decision making standards can be improved. The SC presents its findings to the board of directors of Jobcentre Plus and PDCS annually.

 

7.3 Jobcentre Plus works closely with members of the SC and gives them access to all levels of the business. Their work plan is informed and agreed by the Jobcentre Plus Board and their comments are actively sought and acted upon as part of the agency's efforts to continuously improve standards of decision making. In particular, Jobcentre Plus has worked with the SC to improve access to agency services for vulnerable customers and to extend levels of support for decision makers and their managers.

 

7.4 Two members of the SC work exclusively with PDCS, one covering pensions and the other disability benefits. PDCS ensures that the members are continually supported by effective liaison arrangements to ensure that their recommendations are based on full information.

 

 

8. European Court of Justice ruling on exportability cases

 

8.1 The October 2007 European Court of Justice decision in case C-299/05 reclassified the United Kingdom's disability benefits - DLA (care component), AA and CA - as sickness benefits. Since the judgment over 1400 claimants have exported their benefits to another European Economic Area (EEA) state or Switzerland and 200 [of these] people have had their benefits which they lost on leaving the country reinstated.

 

8.2 The export of sickness benefits within the EEA and Switzerland is regulated by Title III, Chapter I of Council Regulation (EC) No 1408/71. This European Regulation provides rights for workers and people who used to work and in certain circumstances, their family members. Thus people in receipt of long term contributory benefits like State Pension and Incapacity Benefit and those who have been paying National Insurance Contributions recently may be eligible to export disability benefits.

 

8.3 But there are also people who do not come within the scope of the Regulation at all. For example, people who have never worked, perhaps because they have been disabled from birth, will not be able to export their benefit (unless they can claim as a family member of someone who does fit the relevant criteria) because they will not have rights as a worker or a pensioner. In addition people who have worked in their new country of residence will find that the United Kingdom is no longer the competent state for payment of sickness benefits.

 

8.4 Cases are considered by decision makers on the basis of customers' individual circumstances taking account of the interaction between domestic and European law in relation to the disability benefits.

 

 

9. Administrative Justice and Tribunals Council

 

9.1 The Administrative Justice and Tribunals Council (AJTC) was created under powers in the Tribunals, Courts and Enforcement Act 2007 and replaced the Council on Tribunals from November 2007.

 

9.2 It continues to maintain an overview of the work and procedures of the tribunals within the Ministry of Justice and has a new function to keep the administrative justice system under review. It is as yet too early to predict what impact the Council will have on the Department's customers.

 

10. Presenting officers

 

10.1 A presenting officer (PO) is someone (usually an experienced decision maker) from the Department who represents the Secretary of State at First-tier Tribunal hearings of appeals against decisions made on her behalf; a similar arrangement exists for Local Authorities. The role of the PO is to act as 'amicus curiae' (friend of the court). The PO helps the tribunal to reach the correct decision based on all the facts and the application of the law. Although the PO presents the Secretary of State's/Local Authority's case, they should also assist the appellant, where possible.

 

10.2 The Department's policy is that a presenting officer should attend tribunal hearings:

 

where the facts and law are considered to be complex, for example where complex legal arguments have been raised or where contentious case law has been referred to;

where the appeal involves new legislation which needs a 'bedding in period' (this period will be determined by the complexity of the legislation);

at an Upper Tribunal rehearing (where that is to be an oral hearing); and

where directed to do so by the Tribunal Judge.

 

 

11. Upper Tribunal

 

11.1 DMA Leeds provides written responses on more than 1500 DWP customer (and some local authority) appeals to the Upper Tribunal on benefits, child support and compensation recovery cases as well as supporting legal colleagues in taking appeals to the higher courts. With the support of policy and legal colleagues the unit makes applications for permission to appeal (and if permission is granted, submissions on the substance of the case) on behalf of the Secretary of State in more than 500 cases a year before the Upper Tribunal and higher appellate courts. The unit also responds to more than 350 directions from Upper Tribunal Judges.

 

 

12. Liaison between the Department and Tribunals Service

 

12.1 The relationship between the Department and the Tribunals Service is important. Operational links have to work smoothly. Jobcentre Plus has a Joint Steering Committee (JSC) with the Tribunals Service which deals with strategic and operational issues - it has nothing to do with judicial matters.

 

12.2 At present liaison meetings take place on a regular basis (usually every eight weeks) with other communication and discussions taking place between meetings.

 

12.3 Jobcentre Plus is currently working with the Tribunals Service to investigate ways of improving average clearance times for Income Support appeals, particularly those involving overpaid benefit and considering how best to establish improved feedback loops between the two organisations.

 

12.4 PDCS and the Tribunals Service have two JSCs in place. The JSCs enable both agencies to monitor and discuss appeals arrangements and processes with the aim of improving the end to end service to their mutual customers.

 

12.5 There are also liaison arrangements between the Department and the Tribunals Service to exchange information on developments affecting appeals. In addition, the Department is involved in the initiatives described in paragraphs 4.10 and 4.11 above.

 

13. Conclusion

 

13.1 The Department believes that the process for making decisions it has put in place from claim through explanation, reconsideration, first appeal and, finally, appeal to the Upper Tribunal and beyond, offers its customers an accessible service in terms of getting decisions right and the opportunities to bring about that result.

 

13.2 This is illustrated by the fact that whilst the Department makes millions of decisions each year, the majority are accepted. Of course, no system will ever produce 100 per cent accuracy, and there is always room to improve. Overall the figures illustrate an efficient system: overpaid benefit due to fraud and error and expenditure on official errors is low and claims clearance and payment accuracy rates are within targets. The Customer Charter makes it clear that customers can expect decision making of the highest quality and the Department is working continuously to make further improvements.

 

September 2009

 

 

 

ANNEX A

 

APPEAL STATISTICS[6]

 

1/4/2008 - 31/3/2009

 

 

Benefit

Intake

No of cases cleared at hearing

No. Decisions Upheld

% Upheld

No in Favour of Appellant

% in Favour

HB/CTB

5,491

3,408

2,304

67.6%

1,062

31.2%

HB

4,989

2,971

2,080

70.0%

864

29.1%

CTB

1,236

775

583

75.2%

181

23.4%

IS

21,669

12,166

8,185

67%

4,043

33%

JSA

22,842

9,245

6,917

75%

2,299

25%

IB

85,510

62,926

31,222

49.6%

31,964

50.4%

ESA

1,319

27

26

96%

1

4%

DLA

70,204

53,875

30,135

55.9%

23,600

43.8%

AA

3,959

2,782

1,892

68%

857

30.8%

CA

1,190

693

579

83.5%

126

18.2%

SP

755

415

392

94.5%

45

10.8%

PC

1,448

883

634

71.8%

270

30.6%

 

 

ANNEX B

 

Jobseeker's Allowance

 

- The Welfare Reform Bill will introduce a number of changes to the Jobseeker's Allowance regime, subject to Parliamentary approval.

 

- The Bill provides for a sanction for customers who fail to attend their fortnightly jobsearch review or other advisory interview; a new sanction for customers who have been convicted or cautioned for violence against a Jobcentre Plus member of staff; and mandation to an initial discussion with a drug treatment provider and subsequent participation in the programme.

 

Decision making and the new sanctions

 

Failure to attend interview

 

- The changed procedure for failure to attend an interview will build on the existing process for sanction decision making, including considering good cause for the failure in the same way as now. The only difference in the process is instead of the award terminating a sanction is imposed. Decision makers will receive guidance on this and the agency is considering the need for awareness sessions.

 

Violent behaviour

 

- A sanction will be imposed where someone has been convicted or cautioned. Decision makers will have no discretion in this matter - good cause will not be an issue. The customer will need to challenge the conviction or caution to have the sanction lifted. Accordingly there are no training issues for this sanction.

 

Mandation to treatment centres

 

- Existing legislation, in the form of a Jobseeker Direction and the associated good cause will be used to mandate customers onto drug treatment programmes. As this is an existing process the decision makers will not require any new training, instead this proposal will be supported by detailed guidance.

 

- Decision makers will be required to make decisions on whether a customer has failed to undertake a work-related activity and the usual good cause reasons will apply.

 

- Guidance and specific training modules will be issued to decision makers on the application of the sanctions. Guidance on good cause will also be reviewed for both Advisers and decision makers.

 

 

Lone Parent sanctions - child care issues

 

- Decision makers are very clear of their responsibilities in relation to child care issues. Where a parent with childcare responsibilities refuses or fails to carry out a jobseekers direction or refuses to apply for or accept a job because their childcare responsibilities make it unreasonable for them to do so, these will be taken into account for good cause and just cause (the latter, which is similar to good cause, applies when a lone parent has left employment). Decision makers will take account of the availability and suitability of childcare and whether any childcare costs incurred represent an unreasonable sum from the person's earnings.

 

- Normally if a customer fails to attend an interview their award would be terminated but for lone parents this action is not taken. Instead Jobcentre Plus advisors make at least one attempt to contact the lone parent by telephone on the day they fail to attend. The advisor then sends a follow up letter to advise the lone parent of the need to make urgent contact with the office.

 

 

ANNEX C

 

 

LABOUR MARKET SANCTIONS - EMPLOYMENT SUPPORT ALLOWANCE AND INCAPACITY BENEFIT

 

General

 

- Jobcentre staff ie those working on labour market issues in ESA and IB, have a specific role in the decision making process arising from decisions on failing to attend or participate in a work-focussed interview.

 

- For incapacity benefits the jobcentre staff will consider the good cause issue and decide whether the sanction should be imposed. For ESA Jobcentre staff will consider only the good cause issue; the decision whether to impose a sanction is made by a decision maker usually based in a Benefit Delivery Office.

 

- A comprehensive training programme is designed to equip advisers with the full range of knowledge and skills required to support all customers, for example, in health conditions. This contributes to informed decision making in these cases, where attending or participating in the work-focussed interview is a condition of receiving the full amount of benefit.

- The training for employment advisers has been organised around employment related topics. The focus is on encouraging advisers to regard the jobseeker as the expert on their capability and capacity for work and to include them fully in any work related discussions.

 

- Advisers have access to suitable internal and external support which can assist them in arriving at a decision on good cause arising from failure to attend or participate in work-focussed interviews. Specialist services, for example, the Work Psychology Service can provide this service in cases of more extreme or severe health conditions or disability.

 

Managing Mental health conditions

 

- A customer with a mental health condition may act in a way which could lead to their benefit being sanctioned. The customer may fail to attend a work-focussed interview or a medical assessment or they may fail to return a questionnaire.

 

- The department has put a process in place which ensures that before any consideration is given to imposing a sanction, every effort is made to contact the customer. The Secretary of State has made a commitment that in cases where a customer claiming ESA or incapacity benefits has a stated mental health condition, a learning disability or a health condition which affects cognition, for example, a stroke, no sanction will be imposed until the customer has had a face-to-face explanation, with an advocate in support, if appropriate.

 

- It is only when this process has been completed that a determination on good cause and a sanction decision will be made.

 

- Jobcentre staff identify customers with mental health conditions from sources including: direct information on the medical certificate provided by the customer when they claim benefit; the department's medical services may advise staff; and advisers may also identify a problem through interaction with the customer. After these customers are identified, staff need to manage their claims.

- A new training product 'Introduction to Working with Customers who have a mental illness' was introduced in 2008 and provides a basic introduction to mental illness. Specialist Incapacity Benefit advisers (now Pathways Advisers) will have already received this introduction in their additional specialist training.

 

Moving from ESA to Jobseekers Allowance

 

- The department recognises the need to continue to manage those customers with mental health conditions who move off ESA on to Jobseekers Allowance.

 

- The department is putting into place a package of support for ESA customers moving onto Jobseekers Allowance. This includes ensuring that advisers who are knowledgeable about locally available support provide specific health-related advice. This may include Improving Access to Psychological Therapies, an NHS programme, which offers evidence-based psychological therapies to people with mild to moderate depression and anxiety disorders. The mental health co-ordinator will act as a focal point for Jobcentres to build practical links between health and employment services and provide advisers with further information.

 

 

 

ANNEX D

 

Training for DLA/AA decision makers

 

- All DLA/AA decision makers begin their careers with an initial seven week technical training program covering the law, case law and the criteria for entitlement to benefit. This includes five days' input from Health Care Professionals discussing common disabilities and a session by Disability and Professional Programmes Group (DPPG) entitled "Understanding our Customers".

 

- Decision makers consolidate their learning by making decisions on live claims within a supported classroom environment prior to moving to mainstream operations where, under the guidance of more experienced colleagues, they begin to gain further operational experience.

 

- The technical training includes modules on disability awareness, how disability impacts on daily life, what guidance and information is available and how medical facts are interpreted. Mental health conditions, learning disabilities, fluctuating conditions and the impact on parents who have a child with a disability are all covered during this training.

 

- All decision makers have on-line access to comprehensive, up-to-date impairment specific medical guidance, developed and maintained by medical experts in Health, Welfare and Wellbeing Directorate. This is the Customer Case Management [CCM] system.

 

- The guidance provides information on medication, treatment, prognosis, duration and the likely mobility and care needs arising from the specific impairment, depending on the severity of the functional loss

 

- The content and delivery methodologies of modules delivered by Medical Services colleagues are currently being updated to ensure they reflect the contemporary work based learning methodologies of the PDCS Professionalism in Decision Making and Appeals [PiDMA] accreditation programme and CCM guidance.

 

- PDCS is also close to a trial of a new approach to dealing with claims for children, which includes a new design of claim pack developed with input from customers, supported by new and expanded guidance in the CCM system.

 

- The work of decision makers is sampled and checked both locally within operational units and by national teams. Emerging information about difficult areas or weaknesses is used to inform any remedial training and developmental activity. Decision makers' development and competency is kept under review during the ongoing Departmental staff appraisal system.

 

 

 

 

 

 

 

 

 

 

 

 

 



[1] LEAN is the application of a set of behaviours and techniques to improve the department's benefit administration. By using Lean ways of working and a set of techniques to make the most of staff knowledge and experience, Lean reduces 'waste', engages staff and improves efficiency.

 

[2] Debt Management is part of the Department for Work and Pensions, responsible for decision making on the calculation and recoverability of overpayments of benefit.

[3] This is available on the Department's website.

[4] SI 2008/2685

[5] PDCS Annual Report

Housing Benefit Operational Database Timeseries data

[6] Provide by the Tribunals Service - Generic Appeals Processing System (GAPS)