Annex D: Note of Committee visit to Leeds,
2 November 2009 |
Attending: Terry Rooney MP, Oliver Heald MP, Greg
Meeting with officials, Quarry House, Leeds
Jobcentre Plus (JCP)
- In the last 18 months, work
has been undertaken to expedite new claims which are not considered
to be complex to non-specialist decision makers (DMs) to ensure
that specialists are able to concentrate on more difficult decisions.
Complex decisions are currently cleared in between 3 and 5 days.
- Most decision notification letters are automatically
generated. JCP accepted that this can make decision letters difficult
to understand and it is currently looking at ways to improve
- There are around 1600 (1100 Full Time Equivalents)
specialist DMs, who concentrate on complex decisions.
- Once claimants have received their decision,
they can either ring the Benefit Delivery Centre call centre and
ask for an explanation or, if the decision is complex, they can
ask a specialist decision maker for a "call back".
- JCP acknowledged that there are concerns with
the Work Capability Assessment (WCA), for example, claims that
the assessment does not adequately capture pain. However, the
Committee was told that this was a very difficult area to overcome.
Decision makers can request further evidence beyond the WCA but
often claimants do not have more information than that which was
originally provided. If the customer can put forward alternative
medical evidence, it is up to the DM to take this into account,
and, if necessary, refer a claimant back for further medical assessment.
It was acknowledged that it was not common for someone to be referred
back for further medical assessment in this way.
- JCP is looking at ways to identify causes of
official error and how to remove them. There is now a taskforce
in JCP focusing on this, supported by "error reduction champions"
on each JCP site.
- Quality assurance work is undertaken to review
the work of DMs; efforts are also made to focus on areas where
there are a high proportion of revisions or decisions overturned.
- The reconsideration process aims to make decision
making swifter. If a claimant asks for a reconsideration, the
decision will be looked at again by a different DM. Despite the
fact that all decisions which go to appeal will be reconsidered
anyway, JCP argue that there is value in retaining reconsideration
as a separated tier in the decision making and appeals process.
- There are no official target times for processing
a reconsideration. However, reconsideration requests are logged
Pensions, Disability and Carers Service
- A perception still existed
amongst claimants that the tribunal was an arm of the DWP; it
was important to make clear that this was not the case. The tribunal
was an opportunity for facts and evidence to be tested in an oral
hearing; claimants could bring representation if they wished.
- The DWP does not present every case. The DWP
presenting officer is an "amicus curiae", not there
to "win" the case for the Department, but to assist
the tribunal by outlining the claim, the evidence and reasons
for the decision. The presenting officer can not make a decision.
- After the hearing, the presenting officer reviews
the decision; provides feedback to the DM; where necessary calls
for a written statement of reasons; and deals with any queries
from the appellant.
- There is a medically qualified member of the
tribunal for DLA/AA, ESA and IB cases.
- The strengths of tribunals were identified as
their clear independence and the opportunity for face to face
discussion, submission of new evidence and challenges to evidence
- The weaknesses identified were expense; stress
for appellants; and the lack of incentive for new evidence to
be provided by appellants before the hearing (which might aid
the reconsideration process).
- The high levels of turnovers at appeal for DLA
cases were not a reflection of poor decision making but were due
to the discretion of the tribunal on meeting the appellant and
making a face to face assessment of the evidence. DLA and ESA
cases all required an exercise of judgment; the opportunity to
question a claimant in person may lead to a different judgment.
- Tribunal benefit appeals were
categorised as follows:
|Appeal Type 1
||Appeal Type 3
||Appeal Type 4
||Appeal Type 5
|Income Support||Disability Living Allowance (DLA)
||Industrial Injuries Disablement Benefit
||Attendance Allowance||Employment Support Allowance
|| ||Road Traffic and Excess Allowances
|| ||Compensation Recovery
|| ||Severe Disablement Allowance
|Statutory Sick Pay
|Statutory Maternity Pay
|Council Tax Benefit
- The tribunal composition for
each type of appeal was as follows:
- Appeal Type 11 lawyer,
1 financial member (in some Child Support cases).
- Appeal Type 31 Judge, 1 doctor, 1 disability
- Appeal Type 41 Judge, 1 medical member.
- Appeal Type 51 Judge, 1 Senior medical
- Procedural changes, including
removing the requirement that the TAS1 form sent to appellants
be returned within 14 days, meant that fewer appeals were now
being "struck out" on procedural grounds.
- There had been a very significant rise in the
intake in 2009-10 to date; the increase was particularly large
for Type 4 appeals (Incapacity Benefit and ESA). The Tribunals
Service expects the number of appeals for 2009-10 to be in excess
of 300,000. This was placing a strain on resources.
Intake of Cases
||2009-10 (to September)
|1 and 2||76595
|5, 6 and 7||7434
- Three-quarters of cases are
seen within 14 weeks but there was evidence of real pressure of
volume in the system having an impact on waiting times.
- Advice for appellants is available
through the government website, Welfare Groups, Citizen Advice
Bureaux etc. and appellants are provided with a leaflet on "How
to Appeal". The Tribunals Service held 50 local user forums
in 2009. 69% of customers had responded positively when asked
about the process.
- The Tribunals Service was engaging with DWP in
a strategic review of processes, using LEAN techniques to remove
waste and delays, to focus on improving the "end to end"
service to appellants. It was also running strategic workshops
with DWP (November 2009 to March 2010) to agree service improvements.
- The Decision Making and Appeals
unit in Leeds comprised 77 staff (68 fte) working in 7 teams,
dealing with guidance, appeals and support for decision makers.
- Teams specialise in particular benefits or subjects
(such as overpayments); the authors team is responsible for writing
and updating the Decision Makers Guide (which is also available
to claimants and their advisers on the internet).
- The Appeals work involves writing submissions
to the Upper Tribunal on claimant and Secretary of State appeals
on benefits, child support and compensation recovery; supporting
DWP lawyers on appeals to the higher courts; and deciding whether
to take appeals to the Upper Tribunal and higher courts on behalf
of the Secretary of State in consultation with policy and legal
- In addition to work on the DMG, the unit is responsible
for maintaining the Code of Appeals Procedures and the Suspension
and Termination Guidance; maintaining parts of the Housing Benefit
Guidance Manual which is used by Local Authorities; and maintaining
DWP intranet/internet sites where these documents are published.
- The Guidance work comprises responding to specific
case guidance queries sent by Decision Makers; maintaining and
moderating a DWP intranet Discussion Group for Decision Makers;
delivering seminars to Decision Makers to discuss specific issues.
The team also comments on policy papers on proposed changes to
the benefits system; drafts instructions to lawyers to write new
legislation; drafts legislation; and produces training material
and procedural guidance.
- During 2008-09, DMA Leeds recorded the following
Written requests for guidance
Number of priority requests received: 1,821
Number of priority requests cleared: 1,827
Average number of working days to clear
from date of receipt: 5
Number of non-priority requests received: 1,558
Number of non-priority requests cleared: 1,554
Average number of working days to clear
from date of receipt: 8
Appeals to the Upper Tribunal
Number of appeals made by the claimant: 1529
Number of appeals made by the Secretary of State:
Decision Makers submitted 570 potential cases to
DMA Leeds for consideration to appeal to the Upper Tribunal but
many are thought unsuitable to pursue.
Supplementary information was also provided by the
DWP and the Tribunals service in response to questions raised
during the meetings. This is published in the Appendix at Ev 157.
Note of meetings with claimants and advisers,
Chapeltown Citizens Advice Bureau, Leeds
- The WCA process was described
as arbitrary, superficial and blunt and particularly unsuited
for claimants with learning difficulties and mental illnesses.
One adviser told us of clients who had found the process of examination
by the Examining Medical Practitioner (EMP) traumatic, feeling
that they were accused of being liars. At least one claimant had
found the process so upsetting that she had decided to withdraw
- It was reported that the WCA was often carried
out with claimants with poor or no English with no interpretation.
- One claimant who had been receiving incapacity
benefit as a result of depression felt that the evidence she gave
to the EMP in her WCA had been "embellished". She had
been driven to the interview by her son, and this was recorded
as "able to travel to interview independently". The
assessment had ignored the extent to which she had "good
days" and "bad days"; it was a Catch 22 situation
that she was only able to attend an assessment when she was having
a "good" day. This individual had "failed"
the WCA in July and was claiming JSA for the duration of her appeal,
but had now been told that her appeal would not be before January.
Her levels of debt were mounting. She had not known that her case
had automatically gone for reconsideration (triggered by her appeal)
until she was informed that her request had been turned down at
reconsideration for lack of new evidence (which she had not been
asked to supply).
- It was felt that decision makers needed more
training in how to deal with cases of individuals with learning
difficulties and mental health problems. The appeals process was
stressful and potentially damaging for those with mental health
problems or learning difficulties.
- It was reported that additional information was
frequently lost by DWP; it was suggested that receipts for information
should be provided.
- Cases were reported of front-line advisers giving
incorrect information that pushed claimants into the appeals process
- Lone parents from EU states
being advised to claim income support but then failing the right
to reside test (they would have been better advised to stay on
- The difference between claiming
for income-based and contribution-based ESA was not being explained
to claimants on the phone: customers did not understand what they
were claiming, and one adviser had worked with a refugee who was
appealing against being turned down for contribution-based ESA
(when he should have applied for the income-based benefit). Some
advisers found it easier to submit claim forms clerically (which
were time consuming and clogged up DWP's system) so that they
could help claimants submit claims accurately.
- No list of desriptors for ESA
is provided for claimants, so they are "working blind"
when they submit an appeal. It was felt by one adviser that if
decision makers' letters were clearer about the grounds on which
someone had been turned down for ESA, it would be easier for claimants
to accept and would prevent unnecessary appeals. Many claimants
assumed that proof that they had a particular condition was sufficient;
they did not realise that the condition in itself might not be
enough to qualify for the benefit. The adviser was currently advising
one in three claimants that she saw on this matter to withdraw
- Advisers believed that very few decisions were
overturned at reconsideration stage, even when substantial independent
medical evidence was provided contradicting the WCA. It was suggested
that c.25% of cases used to be overturned at reconsideration,
but very few were now. Reconsideration was regarded as a missed
opportunity for proper dispute resolution. It was suggested that
the reconsideration process should be put on a two-tier basis,
- Reconsideration waited for
additional independent medical evidence (and took it properly
into account); or
- The case was fast-tracked to appeal if no additional
medical evidence was to be submitted.
Case study A
- One claimant had been in receipt
of Carers Allowance and DLA, paid at higher rate mobility and
care, on behalf of her terminally ill daughter. Every three years,
the daughter's right to reside had to be renewed. 12 months ago,
the right to reside was again reviewed but payments of Carers
Allowance and DLA were stopped for a period of eight months. During
this period, with no income, the family accrued very substantial
debt and rent arrears. Once the right to reside was again renewed,
the DLA was reassessed (on the basis of no additional information)
at lower rate care and mobility. This meant that the claimant
lost her Carer's Allowance. She was told to claim Jobseekers'
Allowance even though her daughter still had an incurable terminal
disease. She reported that a number of items of independent medical
evidence, including her own GP's report, had been ignored by the
Examining Medical Practitioner (EMP).
- The claimant has appealed the decision to downgrade
her DLA claim. She has been told that, unless her daughter is
not expected to live beyond six months, she can not be classified
as having a "terminal illness" (notwithstanding statements
of medical professionals treating her). An individual who lived
for longer than 6 months would be subject to reassessment.
- This individual had submitted her appeal form
and had received a TAS1 form specifying that a reply was required
within 14 days otherwise the appeal would lapse (the Committee
had been informed in the morning by DWP officials that this was
no longer the procedure). She had previously asked for the decision
to be reconsidered but did not feel that there was any value to
this process. She had never been asked to provide further information
and the decision was upheld.
- As a JSA claimant, she is expected to look for
work, which is difficult as her daughter requires full-time care.
She has sought support from CAB to help her with her appeal and
feels that this support has been invaluable (for example, her
adviser explained that her GP's letters must include certain "buzz
words" if it is to be valuable in supporting her appeal).
The claimant is very concerned about her worsening financial
situation and explained that this had been exacerbated by the
expense of phone calls to DWP - her bill for calls to DWP cost
£40 last month alone.
Case study B
- Another claimant made a claim
for ESA in October 2008, after he left work due to a mental health
condition. His WCA lasted approximately 20 minutes and the majority
of the questions focused on his physical capabilities; the WCA
awarded him zero points and he was therefore not deemed eligible
- The claimant asked for the decision to be reconsidered.
A decision maker undertook a reconsideration but did not ask for
any further evidence. The claimant's Welfare Rights Adviser commented
that the reconsideration process simply "rubber stamped"
the original decision. He argued that, even where people do provide
extra information, very rarely are decisions changed at the reconsideration
stage, despite the fact that many of these decisions are then
overturned at appeal. It was common practice for DWP to provide
a three-line letter to notify claimants that decisions have been
upheld after reconsideration. He suggested that DWP should adopt
a similar approach to local authorities, which provide far more
information and are much more amenable to discussing the outcome
of a reconsideration over the telephone.
- The claimant decided to appeal against the decision
and opted for an oral hearing, which lasted approximately 30 minutes.
He explained that the tribunal judge asked appropriate questions
that specifically focused on his mental health condition and its
impact on his ability to work. His sister attended with him and
was also able to give evidence. The tribunal judge overturned
the original decision and the claimant was awarded ESA on the
support rate, 12 months after his first application.
- The claimant felt that his appeal could have
been avoided had appropriate questions, relevant to his condition,
been asked during the WCA. The process of reconsideration and
appeal had placed a great amount of stress on him and had led
him to accrue significant debt.