February 4, 2011 • 2:43 pm

‘Half of [Disability Living Allowance] claimants are not asked to prove eligibility’, ran the headline in The Daily Mail yesterday.

The article elaborated on the claim, observing that: ‘half have not been asked for evidence to support their claim, having been given the benefit based on their original application form’. In addition, the current Disability Living Allowance (DLA) awards process was characterised as a ‘great disability benefit free-for-all’.

Although we are still awaiting confirmation of the sources that the paper used, we have looked at the claims in more depth and our findings provide some important context that is missing from the Mail’s article, particularly the headline.

The observations chime with criticisms that the Government has levelled at the current DLA awards process, particularly with regard to the lack of a systematic review process. In a consultation paper on proposed reforms to the Disability Living Allowance launched in December, the Government outlined proposals to replace the DLA with the Personal Independence Payment (PIP). This new scheme has been presented as a “more dynamic benefit [that] will take account of changes in individual circumstances and the impact of disabilities.”

If we look at the statement that ‘half have not been asked for evidence to support their claim, having been given the benefit based on their original application form’, there appears to be a contradiction in the terms. It could be argued that the application form is itself a form of evidence, providing an assessment of the claimant’s needs and capability.

The Government’s consultation document notes that to apply for the benefit ‘individuals complete a lengthy DLA claim form which requests detailed information about the impact that their impairment or health condition has on their ability to manage their care themselves and/or get around’. It further notes that the form is considered alongside other evidence which may include reports from a General Practitioner and that ‘additional medical evidence is gathered in around half of all cases.

The Mail appears to have conflated the proportion of cases that don’t require the collection of ‘additional medical evidence’ with cases that require no evidence and no checks of eligibility. This does not follow when we look at the initial application process. It can hardly be claimed that half of claimants are not asked to prove eligibility since all claimants fill out an application form, although it is not clear what proportion of applications include evidence from a doctor at the initial stage.

The implication from the headline is that, in the absence of a systematic review process for DLA claims, there is scope for fraud in those cases where claimants ‘are not asked to prove eligibility’. Previous research from the Department for Work and Pension (DWP) indicates that the percentage of cases that were overpaid due to fraud was 0.4%, pertaining to roughly 10,000 cases in 2005. It is also worth noting that additional medical evidence is not necessarily sought to prove eligibility for the award but rather to ascertain the actual level of award that the applicant should receive (higher, medium, or lower rate).

The article in the Mail also stated that ‘more than two million people on DLA have been given indefinite awards, which means they have no further contact with officials about whether they still need the benefit’. The figure is confirmed by the DWP who have estimated that the number of indefinite awards amounts to 2,239,500 or 70.9 per cent of all awards. Although indefinite DLA awards – which are not subject to routine reviews – account for roughly 71 per cent of DLA awards, it is worth noting that two thirds of all new claimants for Disability Living Allowance are given awards for a fixed period, whilst the remaining third are awarded indefinitely. Since the awards that are given for a fixed period inevitably come to an end, the proportion of the stock of DLA claims that are indefinite is higher. This cumulative effect accounts for the overall proportion.

Under the current system DLA awards can be made for a fixed period or indefinitely. Those applicants that are awarded a DLA for a fixed period will have to make a renewal claim – following the same procedures as a new claim – before the period runs out. Meanwhile, indefinite awards are not subjected to routine reviews. This need not mean that there will be no checks – in fact the guidelines for applicants warn that under the ‘Right Payment Programme’: “indefinite awards can sometimes be reviewed and you may need to have another medical investigation as part of the review.” Whether or not this happens in practice is uncertain, as another DWP report from 2009 observes that “assessments of ongoing claims – in essence, ‘spot checks’ on continuing eligibility – appear to occur infrequently if at all.”

The lack of a systematic review process for the allowance means that a proportion of claimants may not be required to submit additional evidence following their claim. It could be argued that this leads to over- or underpayment of benefits in instances where circumstances change, errors are made in the application or fraudulent claims are put forward. However it does not follow that claimants are not asked to prove their eligibility for the benefit during their initial application. Indeed it could be argued that there is a rationale for this lack of systematic review since applicants are likely to have been awarded indefinite awards because of the nature of their condition.

With misinformation rife in the reporting of welfare reform, clarity appears to be at a premium. We hope that the Mail will be able to provide us with the source they have used to inform their article, as it is difficult to gauge its accuracy without it.

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