§ Mr. DismoreTo ask the Secretary of State for Social Security what was the total number of claims in each of the last three years for(a) disability living allowance, (b) attendance allowance and (c) incapacity benefit; in each category, how many and what proportion of the total (i) were successful on the original application and (ii) resulted in an appeal; of those that were successful how many and what proportion of the total (1) were successful on appeal and (2) resulted in an appeal to the commissioners; and of those applications that resulted in an appeal to the Commissioners, how many and what proportion of the total were successful. [106671]
§ Mr. BayleyThe information is not available in the format requested. Such information as is available is in the tables.
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Disability living allowance decisions on initial claims, reviews, and appeals 1997 1998 19991 Decisions on initial claims All decisions 486,566 391,583 373,645 Successful decisions 220,228 178,802 176,371 Proportion successful 45% 46% 47% Reviews2, 3 All decisions 374,494 319,501 278,365 Successful decisions4 140,245 108,842 91,994 Proportion successful 37% 34% 33% Appeals All decisions 35,696 47,025 49,857 Successful decisions5 19,335 22,350 24,051 Proportion successful 54% 48% 48%
Attendance allowance decisions on initial claims, reviews, and appeals 1997 1998 1999 1 Decisions on initial claims All decisions 425,903 394,354 381,378 Successful decisions 301,908 291,353 280,967 Proportion successful 71% 74% 74% Reviews2,3 All decisions 121,474 102,520 94,289 Successful decisions4 70,241 57,999 50,345 Proportion successful 58% 57% 53% Appeals All decisions 5,215 6,538 6,066
The numbers of claims for Incapacity Benefit (IB), awards and decisions relating to application of the incapacity tests 1995–96 1996–97 1997–98 1998–99 Claims received by BA 1,054,340 1,062,817 1,012,981 930,002 Disallowed at outset due to failing the contribution conditions 382,443 439,645 435,095 398,605 IB awards commencing in the period1 535,100 495,560 455,380 409,980 Examinations performed2 434,617 716,084 615,324 n/a Awards subsequently disallowed Disallowed following OOT test 1,288 2,170 2,664 2,750 Disallowed following AWT 66,367 112,046 104,339 88,904 Disallowed—non-return of questionnaire 7,710 9,134 10,887 10,578 Disallowed—did not attend examination 2,416 6,652 7,069 8,687 1 The sum of the IB awards and those disallowed at outset does not equal the number of IB claims, as this figure includes claims that are subsequently withdrawn and accident declarations (which are made in case a claim to benefit becomes necessary at a later date as a result of an industrial accident). It is not therefore possible to give proportional figures. 2 Examinations performed includes Severe Disablement Allowance cases and cases where only National Insurance Credits are awarded. Source:
Claims received—100 per cent. clerical count work.
IB spells commencing—1 per cent. sample of claimants.
Disallowance figures—100 per cent. count of the computer system.
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IB appeals and decisions (calendar years) 1996 1997 1998 A A B B Number of IB AWT appeals lodged 55,813 30,512 37,405 68,541 Number of IB AWT appeals heard and decided 37,740 46,411 5,551 61,931 Found in favour of appellant 18,026 20,301 2,175 25,107 Proportion found in favour of appellant 47% 44% 39% 40% Original decision upheld 1— 1— 3,342 36,597 Proportion where original decision upheld 1— 1— 60% 59% Number of IB appeals lodged (not AWT)2 6,490 3,097 5,118 11,259 Number of IB appeals heard and decided (not AWT)2 3,120 4,133 661 6,801 Found in favour of appellant (not AWT)2 1,035 1,182 121 1,732
Attendance allowance decisions on initial claims, reviews, and appeals 1997 1998 1999 1 Successful decisions5 3,003 3,382 2,899 Proportion successful 58% 52% 48% 1 The figures for 1999 include reconsiderations and supercessions under the new system of decision making and appeals. 2 Includes some cases where the initial decision was in a previous year. 3 Figures relate both to awards made following review of unsuccessful initial or renewal claims, and to cases where the value of the award has increased as a result of the review. 4 Figures relate both to awards made following an appeal against unsuccessful reviews, and to cases where the value of the award has increased as a result of the appeal. 5 Successive decisions may be made in different years, so the figures for each stage of decision making are likely to relate to different caseloads. Source:
Analytical Services Division100 per cent. data.
Entitlement to Incapacity Benefit is based on a person's incapacity provided they satisfy the National Insurance contribution conditions. An award of benefit is made from the outset if the contribution conditions are satisfied and there is acceptable medical evidence to support the claim. Subsequently, incapacity is assessed under the relevant medical test (either the Own Occupation Test (OOT) during the first 28 weeks of incapacity where the claimant has a recent work record or the All Work Test (AWT) after 28 weeks or from the start of the claim where the claimant has not recently worked). If the test is not satisfied, benefit is disallowed from that point.
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IB appeals and decisions (calendar years) 1996 1997 1998 A A B B Proportion found in favour of appellant 33% 29% 18% 25% Original decision upheld (not AWT)2 1— 1— 438 5,039 Proportion where original decision upheld 1— 1— 66% 74% 1 Information not available 2 Includes OOT cases Note:
1. The appeals lodged in a particular period may not necessarily go on to tribunal in the same time period.
2. The figures provided are counts of each event in each time period.
Source:
A—100 per cent. extract from ITS computerised records.
B—100 per cent. download from the Generic Appeals Processing System (GAPS) which replaced the earlier computer system in 1997.
§ Mr. DismoreTo ask the Secretary of State for Social Security if he will state, for each of the last three years, and the present year to date, how many(a) applications for and (b) reviews of (i) disability living allowance, (ii) attendance allowance and (iii) incapacity benefit were (1) decided on paper and (2) decided after a medical examination; and how many in each category resulted in (x) continuation of benefit, (y) an increase in benefit and (z) withdrawal of benefit. [106685]
Disability living allowance applications Decision and evidence used 1997 1998 1999 Decisions based on claim form 83,886 59,733 46,637 Decisions based on claim form in conjunction with an external medical practitioner's report 171,719 131,593 146,078 Awards based on claim form 30,130 23,843 20,592 Awards based on claim form in conjunction with an external medical practitioner's report 77,005 52,578 61,079
Attendance allowance applications Decision and evidence used 1997 1998 1999 Decisions based on claim form 178,830 160,700 138,823 Decisions based on claim form in conjunction with an external medical practitioner's report 60,419 45,675 57,627 Awards based on claim form 131,242 127,114 114,222 Awards based on claim form in conjunction with an external medical practitioner's report 26,946 18,133 23,191 Source:
Analytical Services Division: 100 per cent. data
Incapacity Benefit is awarded on the basis of medical evidence at the outset of a claim, provided the contribution conditions are satisfied, and continues to be paid subject to satisfaction of incapacity tests.
There are two tests of incapacity, the Own Occupation Test (OOT), which applies for the first 28 weeks for people who had a regular occupation, and the All Work Test (AWT) which applies to all cases where incapacity lasts more than 28 weeks. The AWT may be reapplied periodically to ensure that the entitlement conditions continue to be met. Where, following the application of
IB cases allowed and disallowed following application of medical control 1995–96 1996–97 1997–98 1998–99 Benefit continued following referral to Medical Services1 561,502 840,679 773,741 740,067 Disallowed following OOT test 1,288 2,170 2,664 2,750 Disallowed following AWT 66,367 112,046 104,339 88,904 Disallowed—non-return of questionnaire 7,710 9,134 10,887 10,578 Disallowed—did not attend examination 2,416 6,652 7,069 8,687 1 Includes cases where no medical examination was carried out and where benefit was allowed following medical examination. Note:
From April 2000 the All Work Test will be replaced by the Personal Capability Assessment
Source
100 per cent. count of the computer system
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§ Mr. BayleyDisability Living Allowance (DLA) is a non-contributory benefit available to severely disabled people aged under 65 on the basis of their care and mobility needs; Attendance Allowance (AA) is available to those over 65 with care needs.
Information on the use of medical examinations in determining entitlement is available only for applications for benefit, and is in the tables.
the relevant test, a person is found capable of work, the incapacity decision is reviewed and benefit will be disallowed. An unfavourable determination on incapacity is not made without the claimant being given the opportunity for a medical examination, except where they fail without good cause to respond to requests for information in relation to the All Work Test.
Unfavourable determinations may be challenged on appeal and, since September 1999, may be reconsidered and revised where the claimant requests this within a specified time limit (one month). The available information is in the table.