ANNEX B
FURTHER INFORMATION ON DLA AND ASSOCIATED ISSUES
THE DISABILITY
LIVING ALLOWANCE
ADVISORY BOARD
(DLAAB)
1. The DLAAB was established in September 1991 principally
to advise the Secretary of State on matters relating to Disability
Living Allowance (DLA) and Attendance Allowance (AA). Seven of
the members are people with disabilities and one is a carer. Members
of the DLAAB have specialist knowledge of nursing, social work,
occupational therapy, physiotherapy and medical practice.
MOTABILITY
2. A significant proportion of disabled people cannot obtain
the credit to acquire a car. As a response to this problem, the
Motability Scheme was established in 1977. Customers in the Scheme
who receive the higher rate mobility component of Disability Living
Allowance (previously Mobility Allowance) could use all or part
of their allowance to hire or purchase a vehicle. The Scheme is
administered by Motability, an independent charity, and its service
providers - principally Motability Finance Limited (MFL). MFL
is corporately and financially independent of Motability and administers
the Scheme on Motability's behalf by arranging provision of the
vehicles under a lease or hire purchase agreement. It receives
customers' benefit directly from the Benefits Agency to finance
the lease or hire purchase agreement, normally for up to a period
of three years.
3. Between 1983 and 1995 the Motability Scheme grew by an
average of 24 per cent. For the financial year 1996-97, growth
was 17 per cent. During the coming year, the one millionth car
is due to be handed over since the scheme's inception. There are
currently some 320,000 cars and wheelchairs in the fleet - around
6 per cent of the car market. The scheme represents good value
for money - some models are available with no initial deposit
required, and some at less than the weekly rate of benefit. The
customer payment covers not only the vehicle but also insurance,
roadside assistance and maintenance costs.
LOCAL AUTHORITY
CHARGING
4. Local authorities can charge for domiciliary services
they provide for disabled people, if they consider it reasonable
to do so. But charges should not leave the disabled person with
insufficient resources to live on.
5. In assessing the level of charges, local authorities can
treat the disability benefits AA and DLA (except for the DLA mobility
component) as assessable income, but there is no national charging
regime. It is for each local authority to work out how it assesses
charges.
6. Any questions about local authority charging policy are
for the Department of Health. And we consult with the Department
of Health about changes we make to the disability benefits which
might impact on local authority charging policies.
7. It is not known how many disabled people have social security
benefits taken into account as income when assessed for charges
for domiciliary services.
INDEPENDENT LIVING
FUNDS (ILFS)
8. There are two Independent Living Funds (ILFs) - the Independent
Living (Extension) Fund and the Independent Living (1993) Fund.
The Funds operate at arm's length from the Department and are
financed by cash limited grant-in-aid. They are managed by a Board
of Trustees appointed by the Secretary of State. The Trustees
have discretion about whom they help within the framework of the
Trust Deeds. Although eligibility criteria for each fund differ
at a detailed level, both funds are designed to support UK residents
who are severely physically or mentally disabled people to the
extent that they need help with care in order to live independently
in their own home. They must also live alone or with people who
are incapable of providing the level of care needed.
9. The Extension Fund is closed to new clients. It only makes
payment to clients of the former Independent Living Fund which
was wound up on 31 March 1993. The number of clients of the Fund
is falling through death and admission to hospital or other residential
care (now below 11,000 cases within a cash limited provision for
1997-98 of £82 million).
10. The Independent Living (1993) Fund is open to new clients.
From April 1993, under the community care arrangements, the Fund
works in partnership with local social services departments (social
work departments in Scotland and health and social services boards
in Northern Ireland) and supplements their prime role in community
care by making cash payments to enable younger more severely disabled
people (aged 16-65) to live independently in the community. The
cash payments are contingent on social services departments making
a minimum contribution of £200 net per week by way of cash
and/or social care services to an agreed care package. The 1993
Fund may then make a further cash contribution up to £300
per week. The number of clients now being helped is over 4,000
within a cash limited provision for 1997/98 of £38 million.
1993 Fund client disabilities include 23 per cent with severe
learning difficulties, 17 per cent with multiple sclerosis, 14
per cent with cerebral palsy, 9 per cent with spinal injury, 7
per cent with brain damage with the remainder having other generalised
or other localised physical disabilities and/or psychological
disorders.
THE DISABILITY
BENEFIT DIRECTORATE
AND DISABILITY
BENEFIT CENTRES
(DBCS)
11. The Disability Benefits Directorate is the largest of
the Central Benefits Directorates of the Benefits Agency. There
are staff located in a network of 11 Disability Benefit Centres
(DBCs) throughout the country based in Glasgow, Edinburgh, Newcastle-upon
-Tyne, Leeds, Manchester, Bootle, Birmingham, Wales, Bristol,
Wembley and Sutton. The DBCs process all the initial claim, review,
renewal and appeal action within the first three months of the
claim. Medical Appeal Tribunal services are provided throughout
the DBC network.
12. Staff based at the Disability Benefits Unit (DBU) at
Blackpool provide the follow up services for those customers whose
review requests fall outside the three month early review period.
They also deal with renewal and appeal cases.
DLA MONITORING REGIME
13. Following recommendations made in a report on the variability
of decision making within DLA and AA, a national monitoring scheme
was introduced in September 1994 and became fully operational
on 3 January 1995. The idea was to ensure consistency in approach
and of standards across the Disability Benefits Directorate (DBD).
The scheme consisted of the local checking teams (based in Disability
Benefit Centres [DBCs] and the Disability Benefit Unit [DBU])
and a national team, which became National Adjudication Support,
Checking and Advice Team (NASCAT).
14. Currently, NASCAT monitors adjudication officer decisions
made in the DBCs and the DBU. As part of the national monitoring
scheme a total of 1152 DLA decisions and the same number of AA
cases are monitored during each six monthly period by NASCAT and
a similar number by the local checking teams (i.e., 96 DLA decisions
for each unit). The number of decisions monitored is based on
figures supplied by Analytical Services Branch in order to produce
a statistically valid sample accurate to plus or minus 5 per cent.
NASCAT produces a six monthly report showing the findings of the
national scheme. The purpose of this report is to inform managers
about the quality of adjudication decisions made by the Directorate
and for each local site. The report also identifies trends and
makes recommendations on how to improve the quality of decision
making.
15. As part of their role to ensure a consistent approach,
NASCAT also monitors a selection of cases examined as part of
the national scheme by the local checking teams.
16. In addition to NASCAT each of the DBCs and the DBU has
their own checking and advice teams, varying in size. Although
each is required to monitor a number of decisions as part of the
national scheme they are also able to do additional monitoring
as requested by their own local management.
17. Central Adjudication Services (CAS) monitored a total
of 323 DLA decisions during the period 1 April to 31 December
1997. The accuracy rate found was 79 per cent. Payment was incorrect
in 3 per cent of the DLA decisions monitored by CAS in this period.
The CAS findings are published in their annual report.
18. Medical Evidence usage in relation to DLA Claims from April
1997 to January 1998
|
| Volume | Per cent of claims intake
|
|
| Examining Medical Practitioners Report (EMP)
| 162,972 | 43.61 |
| GP Factual Report | 185,551
| 49.65 |
| Consultant Report DLA | 22 |
0.006 |
| Hospital Report DLA | 9 |
0.002 |
|
| Total | 348,554 | 93.26
|
|
Source: data extract from FAMIS payment data January year
to date representing total payments brought to account.
NOTE
19. The data is derived from the number of reports paid for.
The figures do not link specifically with actual cases. Some claims
will have more than one type of evidence requested (ie a GP factual
report followed by an EMP). Therefore the total percentage figure
is an over-estimate.
DLA CLAIMS, REVIEWS
AND APPEALS
20. Figures for April 1997 to January 1998
| DLA Claims received | —
| 373,727 |
| | |
| DLA Reviews received within 3 months of the original decision
| — | 169,113 |
| | |
| Total DLA Reviews received | —
| 325,738 |
| | |
| DLA Appeals received | —
| 39,458 |
NOTES
21. The DLA computer system does not provide data that directly
links each DLA New Claim which then goes on to a Review and subsequent
Appeal. The data available relates solely to the number of Reviews
and Appeals received during the period in question which, in turn,
could emanate from New Claims received during an earlier period.
22. The Reviews total is mainly compiled from Reviews received
either within or outside three months of notification of the initial
claim decision.
23. Reviews received within three months result, in the main,
directly from New Claims whereas Reviews received outside three
months includes reviews notifying a change in circumstances from
a claim made at any time in the past.
24. Year to date performance (as at 31 January 1998)
| Target | Target
| Achievement | Achievement |
| Primary | Secondary
| Primary | Secondary |
| | |
| |
| DLA reviews | 60% in 55 days
| 80% in 75 days | 63.28% |
84.96% |
| | |
| |
| DLA appeals | 60% in 30 days
| 90% in 60 days | 65.61% |
93.33% |
HELPLINE
25. The helpline is the Disability Benefit Directorate's
(DBD's) national telephone claims advice and enquiry service.
The number is included on all DBD correspondence. The service
is located in Blackpool where 400 operators deal with in excess
of four million calls annually from customers and their carers.
Calls are charged at local rate.
26. The number of calls answered from April 1996 to March
1997 was 4,319,553. The number of calls answered from April 1997
to February 1998 was 4,158,545.
THE DLAAB DISCUSSION
PAPER ON
THE FUTURE
OF DLA AND
AA
27. In the latter part of 1997 the DLAAB was asked by Baroness
Hollis to present her with its ideas concerning the possible ways
that DLA/AA and its administration might be improved, in order
to ensure that it is targeted to those most in need. The Board's
recommendations are contained in its discussion paper published
on 12 March.
FIRST FINDINGS
FROM THE
1996/97 DISABILITY FOLLOW-UP
TO THE
FAMILY RESOURCES
SURVEY
28. Some early findings from the disability follow-up to
the 1996/97 Family Resources Survey (FRS) about the prevalence
of disability and take-up of disability benefits have now been
published. Questions in the FRS on limiting longstanding illness,
restrictions on capacity for work, and receipt of disability and
incapacity benefits were used to identify a sample who were re-interviewed
in greater detail about type and severity of disability and the
extra needs and use of services associated with it. Information
from the FRS and the follow-up survey was merged to provide a
comprehensive source of data about the incomes and resources of
disabled adults in private households. Analysis of this dataset
is just beginning, and the findings presented are necessarily
provisional; the purpose of releasing them at this stage is to
encourage discussion with a view to refining and improving the
methods. The first findings were published on 12 March.
DLA AND AA AWARDS
STUDY
29. The study was based on a survey of 1200 DLA/AA cases
where benefit was awarded between April 1994 and April 1997. Casepaper
analysis was carried by the DLA Advisory Board (DLAAB) and the
Benefits Agency's National Adjudication, Support, Checking and
Advice Team. The aims of the study were to find out how effective
the current gateways are and to understand more about the characteristics
of those receiving the benefits. The main findings were that there
are problems with the decision making process, including evidence
gathering, and there is some blurring between gateways. The report
was published on 12 March.
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