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Computers to decide disability living allowance claims?

1 February 2005

Benefits and Work can exclusively reveal that the DWP is developing a computerised “guidance” system for Disability Living Allowance (DLA) decision makers to ensure that they reach what the department consider to be “better decision outcomes” and lose fewer appeals. In addition, work is being undertaken with American computer giant IBM to develop an “Appeals Wizard”.

Disability Handbook unreliable
Using the Freedom of Information Act we have obtained minutes of recent meetings of the Modern Service Working Group. The group meets three times a year and until now details of its proceedings have been kept secret not just by the DWP but also by a range of participating voluntary sector groups, including Disability Alliance and Citizens Advice.

Minutes of meetings between January 2003 and October 2004 detail new work being undertaken entitled ‘Awards Management’. Much of the information provided by the DWP in the minutes is in the form of power point presentations and so, perhaps conveniently, lacks detail. However, John Lacey, the head of Awards Management, admitted that the current tool for training decision makers about impairments, the Disability Handbook, needs updating and expanding in order to reduce inconsistencies in: award level; award duration; evidence gathering and requests for medical evidence.

Computerised decisions
It appears that what will replace the unreliable Disability Handbook is an Awards Management system which is intended to “provide structured, IT based guidance to decision makers at the point of need”. The computerised Award Management system will contain specially written information on specific impairments, which the decision maker will be able to read on screen. More importantly, though, the computerised Award Management system will prompt the decision maker to ask impairment specific questions and will then offer “structured, IT based guidance” to the decision maker as they deal with a case. The guidance will address: “Component and award; Award duration; Post award intervention; Whether to invite a renewal

The DWP expect computer led decision making to result in a “Reduced level of appeals” and “Fewer changes following an appeal”.

How it will work in practice.
This is how we suspect the new system will work. We must stress though, that this is simply speculation on our part based on how computer guided personal capability assessments for incapacity for work are carried out.

A claimant with, for example, depression will fill out one of the new short DLA claim forms currently being piloted and likely to be introduced nationally within months. The new claim form requires claimants to list their diagnoses, how long they’ve had any condition, which part of the body it affects (if it’s something like arthritis or rheumatism), which health professional they see and when they last saw them. They also have to list all their medication, which illness it’s for, dosage rate and frequency, how long they’ve been taking each medication and whether it’s a repeat prescription.

The decision maker will open a file on computer for the claimant. They will then click on depression as the diagnosis. If the decision maker wishes they can bring up a screen which will tell them more about mild, moderate and severe depression – but this will be entirely optional. The computer will ask the decision maker a number of multiple choice questions covering such things as what medication the claimant takes, what dosage and how often; whether they are seeing a Community Psychiatric Nurse or Consultant; whether there is a history of self-harm and so on.

If the required information is already in the claim pack the decision maker will enter it. If not, the decision maker will contact the claimant, their GP or someone else to obtain the information. Once all the boxes have been ticked the computer will tell the decision maker: which components, if any, to award; how long to award them for and whether to invite a renewal six months before the award runs out. The decision maker will not be obliged to accept the computer’s decision but will be obliged to type an explanation if they choose to disagree with the computer. Where a decision maker does disagree with the computer the decision may be checked over by the decision maker’s line manager before being issued.

Once all the boxes have been ticked and the decision has been made the decision maker will click their mouse on a final button. This will create a very detailed decision notice explaining what facts were taken into account, what law was used and what the decision is. The claimant’s name will be inserted regularly throughout the document, rather like a Readers Digest prize draw notice, giving the impression that many hours of careful research and thought have gone into reaching a decision about this specific claimant.

The Dark Lord of the Adelphi
The MSWG minutes also reveal that the DWP is working with American computer giant IBM to develop both “electronic links to evidence providers” and, should any claimants have the temerity to challenge a computer generated DLA decision, an ‘Appeals Wizard’. We assume that this is a Wizard in the Microsoft, create a big document with a few simple mouse clicks, sense of the word. However, just to be on the safe side, Benefits and Work has made a Freedom of Information application to the DWP for copies of any documents “referring to Slytherin, Mordor or Customer Service Orcs”.

Deep depression.
There are three depressing aspects to this story.

The first is that by embedding information that was previously openly available in the Disability Handbook inside computer software, the DWP may make it very hard to discover how inaccurate and out of date their medical information is. This is because computer software does not have to be provided to people making requests under the Freedom of Information Act.

The second is that the use of computers to make decisions which are then rubber stamped by humans will probably work very successfully from the DWP’s point of view. And we know that in pilot areas the short claim forms have already succeeded in reducing the number of appeals by one third.

The third is that Maria Eagle told MPs that the function of the MSWG was to “ensure that the changes meet the needs of and are in the best interests of disabled people and are not just administrative expedients. Those organisations can tell us whether we are on the right track.”

There is a real possibility that entitlement to DLA will in future be largely based on what medication you have been prescribed and when you last saw a specialist, rather than how you are actually affected by your condition. This is extremely unlikely to be in the best interests of disabled people, but is highly likely to be administratively expedient in that it will slash the cost of DLA decision making. Yet the previously secret minutes of these meetings reveal that a group of DWP top brass armed with power point presentations appear to be running rings around voluntary sector groups. Aside from a question about how the computer software would deal with multiple disabilities there seems to have been not a squeak of private, let alone public, protest at these plans.

Crack of Doom
If their best interest continue to be represented by a small, secretive group of DWP staff and voluntary sector organisations, some of whom receive very considerable sums of money from central government, then things can only carry on getting harder for disabled claimants.