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Decision-making and Disability Living Allowance

Author: Northern Ireland Audit Office

Publisher: The Stationery Office

Published: 2005-06-16

Total Pages: 56

ISBN-13: 9780102931181

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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.

Book Synopsis Decision-making and Disability Living Allowance by : Northern Ireland Audit Office

Download or read book Decision-making and Disability Living Allowance written by Northern Ireland Audit Office and published by The Stationery Office. This book was released on 2005-06-16 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Improving the Social Security Disability Decision Process

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2007-06-14

Total Pages: 290

ISBN-13: 0309103819

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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.

Book Synopsis Improving the Social Security Disability Decision Process by : Institute of Medicine

Download or read book Improving the Social Security Disability Decision Process written by Institute of Medicine and published by National Academies Press. This book was released on 2007-06-14 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Supported Decision-Making

Author: Karrie A. Shogren

Publisher: Cambridge University Press

Published: 2018-11-22

Total Pages: 323

ISBN-13: 1108475647

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Integrates research, theory, and practice in supported decision-making and describes implications for supports provision in the disability field.

Book Synopsis Supported Decision-Making by : Karrie A. Shogren

Download or read book Supported Decision-Making written by Karrie A. Shogren and published by Cambridge University Press. This book was released on 2018-11-22 with total page 323 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrates research, theory, and practice in supported decision-making and describes implications for supports provision in the disability field.

Getting it right, putting it right

Author: Great Britain. National Audit Office

Publisher:

Published: 2003

Total Pages: 58

ISBN-13: 9780102923520

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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.

Book Synopsis Getting it right, putting it right by : Great Britain. National Audit Office

Download or read book Getting it right, putting it right written by Great Britain. National Audit Office and published by . This book was released on 2003 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Decision making and appeals in the benefits system

Author: Great Britain: Parliament: House of Commons: Work and Pensions Committee

Publisher: The Stationery Office

Published: 2010-02-09

Total Pages: 262

ISBN-13: 9780215543875

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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.

Book Synopsis Decision making and appeals in the benefits system by : Great Britain: Parliament: House of Commons: Work and Pensions Committee

Download or read book Decision making and appeals in the benefits system written by Great Britain: Parliament: House of Commons: Work and Pensions Committee and published by The Stationery Office. This book was released on 2010-02-09 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Pain and Disability

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1987-01-01

Total Pages: 318

ISBN-13: 0309037379

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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.

Book Synopsis Pain and Disability by : Institute of Medicine

Download or read book Pain and Disability written by Institute of Medicine and published by National Academies Press. This book was released on 1987-01-01 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Cardiovascular Disability

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2010-12-04

Total Pages: 304

ISBN-13: 030915698X

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The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Book Synopsis Cardiovascular Disability by : Institute of Medicine

Download or read book Cardiovascular Disability written by Institute of Medicine and published by National Academies Press. This book was released on 2010-12-04 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

The Dynamics of Disability

Author: National Research Council

Publisher: National Academies Press

Published: 2002-08-16

Total Pages: 368

ISBN-13: 0309169372

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The Society Security disability program faces urgent challenges: more people receiving benefits than ever before, the prospect of even more claimants as baby boomers age, changing attitudes culminating in the Americans With Disabilities Act. Disability is now understood as a dynamic process, and Social Security must comprehend that process to plan adequately for the times ahead. The Dynamics of Disability provides expert analysis and recommendations in key areas: Understanding the current social, economic, and physical environmental factors in determining eligibility for disability benefits. Developing and implementing a monitoring system to measure and track trends in work disability. Improving the process for making decisions on disability claims. Building Social Security's capacity for conducting needed research. This book provides a wealth of detail on the workings of the Social Security disability program, recent and emerging disability trends, issues and previous experience in researching disability, and more. It will be of primary interest to federal policy makers, the Congress, and researchersâ€"and it will be useful to state disability officials, medical and rehabilitation professionals, and the disability community.

Book Synopsis The Dynamics of Disability by : National Research Council

Download or read book The Dynamics of Disability written by National Research Council and published by National Academies Press. This book was released on 2002-08-16 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Society Security disability program faces urgent challenges: more people receiving benefits than ever before, the prospect of even more claimants as baby boomers age, changing attitudes culminating in the Americans With Disabilities Act. Disability is now understood as a dynamic process, and Social Security must comprehend that process to plan adequately for the times ahead. The Dynamics of Disability provides expert analysis and recommendations in key areas: Understanding the current social, economic, and physical environmental factors in determining eligibility for disability benefits. Developing and implementing a monitoring system to measure and track trends in work disability. Improving the process for making decisions on disability claims. Building Social Security's capacity for conducting needed research. This book provides a wealth of detail on the workings of the Social Security disability program, recent and emerging disability trends, issues and previous experience in researching disability, and more. It will be of primary interest to federal policy makers, the Congress, and researchersâ€"and it will be useful to state disability officials, medical and rehabilitation professionals, and the disability community.

Mental Disorders and Disabilities Among Low-Income Children

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2015-10-28

Total Pages: 397

ISBN-13: 0309376882

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Children living in poverty are more likely to have mental health problems, and their conditions are more likely to be severe. Of the approximately 1.3 million children who were recipients of Supplemental Security Income (SSI) disability benefits in 2013, about 50% were disabled primarily due to a mental disorder. An increase in the number of children who are recipients of SSI benefits due to mental disorders has been observed through several decades of the program beginning in 1985 and continuing through 2010. Nevertheless, less than 1% of children in the United States are recipients of SSI disability benefits for a mental disorder. At the request of the Social Security Administration, Mental Disorders and Disability Among Low-Income Children compares national trends in the number of children with mental disorders with the trends in the number of children receiving benefits from the SSI program, and describes the possible factors that may contribute to any differences between the two groups. This report provides an overview of the current status of the diagnosis and treatment of mental disorders, and the levels of impairment in the U.S. population under age 18. The report focuses on 6 mental disorders, chosen due to their prevalence and the severity of disability attributed to those disorders within the SSI disability program: attention-deficit/hyperactivity disorder, oppositional defiant disorder/conduct disorder, autism spectrum disorder, intellectual disability, learning disabilities, and mood disorders. While this report is not a comprehensive discussion of these disorders, Mental Disorders and Disability Among Low-Income Children provides the best currently available information regarding demographics, diagnosis, treatment, and expectations for the disorder time course - both the natural course and under treatment.

Book Synopsis Mental Disorders and Disabilities Among Low-Income Children by : National Academies of Sciences, Engineering, and Medicine

Download or read book Mental Disorders and Disabilities Among Low-Income Children written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-10-28 with total page 397 pages. Available in PDF, EPUB and Kindle. Book excerpt: Children living in poverty are more likely to have mental health problems, and their conditions are more likely to be severe. Of the approximately 1.3 million children who were recipients of Supplemental Security Income (SSI) disability benefits in 2013, about 50% were disabled primarily due to a mental disorder. An increase in the number of children who are recipients of SSI benefits due to mental disorders has been observed through several decades of the program beginning in 1985 and continuing through 2010. Nevertheless, less than 1% of children in the United States are recipients of SSI disability benefits for a mental disorder. At the request of the Social Security Administration, Mental Disorders and Disability Among Low-Income Children compares national trends in the number of children with mental disorders with the trends in the number of children receiving benefits from the SSI program, and describes the possible factors that may contribute to any differences between the two groups. This report provides an overview of the current status of the diagnosis and treatment of mental disorders, and the levels of impairment in the U.S. population under age 18. The report focuses on 6 mental disorders, chosen due to their prevalence and the severity of disability attributed to those disorders within the SSI disability program: attention-deficit/hyperactivity disorder, oppositional defiant disorder/conduct disorder, autism spectrum disorder, intellectual disability, learning disabilities, and mood disorders. While this report is not a comprehensive discussion of these disorders, Mental Disorders and Disability Among Low-Income Children provides the best currently available information regarding demographics, diagnosis, treatment, and expectations for the disorder time course - both the natural course and under treatment.