Experience panels: complaints, re-determination and appeals

The process of challenging a decision

Accessing information about how to challenge a decision

Survey respondents were asked about where they would look for information about how they could challenge a decision that was made about their benefits by the DWP. Almost two thirds (65 per cent) of respondents said that they would look for this information on the DWP website. Almost three in five (58 per cent) said that they would use an advice service like Citizens Advice Scotland. Table 1 outlines these responses in full.

Table 1 (n=158)

Where would you look for information about how to challenge a decision?	%
The Department for Work and Pensions website	65%
Using an advice service like Citizens Advice Scotland by phone, email or in person	58%
Through my local Welfare Rights Office by phone, email, or in person	47%
Phoning the Department for Work and Pensions	46%
Citizens Advice Scotland website	46%
Through an internet search engine	35%
Another way	27%
From friends or family	18%
Visiting a job centre	15%
From my local carers centre	11%

Among those who said that they would look for this information in another way (27 per cent of respondents), many listed a local or national charity or support service that they would contact. Others mentioned online forums or local authority or housing services. A small number mentioned that they would go through advocacy services, that they would contact their elected representatives, or that they would seek advice from a lawyer.

Clarity in the process and timescales for challenging a decision

A number of participants spoke about the need for greater clarity around the process of challenging a decision. In particular information about your rights, what evidence you can submit and how it can be used, and the timescales involved for each stage.

"Giving people more information about what to expect/information on what their rights are may be helpful. Where is the line of responsibility? Why are we using the tribunal service?" (Focus group participant)

Some also highlighted that many appeals could be avoided if there were better communication on these topics for the original application stage. A number of focus group participants felt that this lack of awareness of the process was on the side of staff as well as clients.

"An absolute nightmare thorough lack of understanding… People who answer the phones first time round are not aware." (Focus group participant)

Survey respondents commented that the deadline for submitting requests to challenge a decision is currently too short.

"The time limit for appealing must be at least 3 months. This is extremely important for those who live in remote rural areas, cannot use mobile devices because there is no signal. Past experience has shown that giving appeals tribunals the power to accept late appeals is useless because they don't like giving more time. Time limit for appealing must be at least 3 months." (Survey respondent)

Many also felt that there should also be a time limit on how long Social Security Scotland has to respond to a request to challenge a decision, and that this should be clearly communicated.

"People should be given a period of time to know how any challenges they make will take i.e. 6 Weeks!" (Survey respondent)

"It needs to happen much quicker. It took 15 months to get a reversal on my child's decision. Also where an individual makes a decision to withdraw or lower a benefit which is later re-instated there has to be sanctions for the person..." (Survey respondent)

Receiving updates

Respondents were asked about how they would want to receive updates if they were to challenge a decision about their benefits from Social Security Scotland. More than a third of respondents said that they would prefer to receive updates by email (37 per cent) and by post (35 per cent).

Table 2 (n=179)

If you wanted to challenge a decision about your benefits, what would be the main way that you want to receive updates?
Email	37%
By post	35%
Telephone	15%
SMS/text message	2%
In person	8%
Typetalk	1%
another way	1%

This was also reflected among focus group participants who said that it was important for updates to be possible in a range of formats. The preferred way of receiving updates was often related to their wider needs, for example because of a disability or long term condition, or because of where they live.

Some felt that it was important to have a written record of this type of correspondence so would prefer letter or email correspondence.

"Regular feedback, as it can be stressful wondering if it is being dealt with and not hearing anything . An email or quick call . It just reassures people that they have not been forgotten." (Survey respondent)

"When a benefit applicant challenges a decision, all communications should be sent to the applicant by post, in order to give them a legal record of the events." (Survey respondent)

Respondents were also asked about when they would want to receive an update if they were to challenge a decision about their benefits. Over a third said that they would like to receive an update every two weeks. However, almost three in ten would like to receive an update every week, and among those who suggested they would want updates another amount than that, some said that updates should be given "ASAP" or "daily if need be". More than a quarter said that they would want to receive an update whenever there was new information (for example the request being received or when there was a decision). Others said that there should be clear deadlines set for both parties, so that the client can contact the agency if they haven't heard within those timescales.

Some participants said that they would prefer updates less frequently – around one in ten (9 per cent) said they would want an update once per month.

Table 3 (n=179)

If you challenged a decision by Social Security Scotland, how regularly would you want to receive updates?
Once per week	28%
Once every 2 weeks	34%
Once every month	9%
Only when there is new information (for example that we have received your request or when there is a decision)	26%
Another amount	2%

"There should be a time limit on how long the social security agency has to respond it should not be able to take months if a person has a set time to challenge it." (Survey respondent)

The mandatory reconsideration process

In particular, timescales were felt to be a problem with the DWP's mandatory reconsideration process.

Many participants felt this step to be simply a delay to going to a tribunal. Reasons for this included feeling that the mandatory reconsideration lacked independent scrutiny and was unlikely to result in a decision being changed.

"Why do you need to replicate the two stage process about challenging a decision? My belief is that the DWP only instituted this because there were too many appeals and they wanted to put an additional barrier in place to discourage and dissuade dissatisfied claimants from challenging a decision." (Survey respondent)

"I would hope that the Scottish Government will do away with mandatory reconsiderations, or at least allow claimants to still receive benefit while awaiting decision. I waited more than six weeks with no money coming in and then was refused again. I immediately applied for a tribunal and within a week DWP changed their minds and I was granted full benefit (no further evidence was provided to them during this time)- clearly shows they were at it and merely trying to save money rather than support someone with medical conditions." (Survey respondent)

Some felt that it was a step which should be abolished in the new Scottish system.

Others felt that there is merit in having this internal review stage, but felt that it is currently not well understood or utilized.

"I see mandatory reconsiderations and for me it's actually been – it's quite a useful step between – it used to be complaint and appeal… the reconsiderations tend to be much more detailed. I think there are certain frustrations about re-determinations about evidence because I think it is a point where the DWP could get additional evidence but there is a whole issue about money and doctors and people being represented. And it's a big issue that people are really floundering when they are told it's going to be looked at again they don't know what they can input to it themselves." (Focus group participant)

"The mandatory reconsiderations concept could be a massive money saver as far as not wasting thousands of pounds on appeals, if it was actually used the way it was intended" (Focus group participant)

A number of focus group participants felt that the mandatory reconsideration process could be improved by better communication and clearer systems around evidence gathering. In particular, participants felt that there was an assumption amongst applicants that the DWP would contact their healthcare providers, and that this doesn't always happen.

"There's a lot of confusion – people generally assume the DWP will contact their GP or consultant as you are asked the names of them on the form and you are asked for contact details. Very rarely in my experience." (Focus group participant)

Focus group participants also felt that there was confusion about what evidence could be taken into account as part of a mandatory reconsideration or appeal. In particular, that this process is looking at whether the decision was right at the time of application, and so subsequent changes to their condition would not be taken into account, and would need to form a new application. They described how this can pose particular challenges due to the length of time that it can take to go through the process of challenging decisions.

"You had the assessment and it might have taken 3 months and now you've got to do the mandatory reconsideration and then appeal. The whole thing can take 6 months and then you need to remember all the issues from 6 months ago." (Focus group participant)

"That's the time problem. You are asking a vulnerable person how things were 6 months ago and some of them won't remember at all. So you are asking them about away back then, and that's the length of time if they have to go to the appeals process and all that could have been solved at the start." (Focus group participant)

Focus group participants felt that it was important for Social Security Scotland to emphasise how its re-determinations process is different from mandatory reconsiderations in order to establish trust in the new system.

"You need to emphasise that it's different from mandatory reconsiderations." (Focus group participant)

Some focus group participants suggested that in the new system, the re-determination and appeals processes could be independently audited to reassure that where decisions have been changed, lessons are being learned from these.

Communicating decisions and keeping clients updated

Respondents also talked about the importance of how decisions are communicated. In particular, it was felt that it was important that decision letters should be written in plain English and that alternative formats should be available.

"That the initial decision notice is in plain English and not filled with gobbly gook, so I can understand what it means." (Survey respondent)

Respondents felt that it was important that the decision included information about why the decision had been reached, particularly if an application had been turned down, and that it should provide clear information about next steps if you would like to appeal, or other next steps that they could take.

"As a claimant if you have input at every step and staff can explain to me why a decision has been reached, then I might still disagree, but having that understanding from where that decision has come from makes it easier. I'd want this at all stages." (Focus group participant)

"The refusal of the benefit could be perfectly legitimate, but it doesn't mean that the person doesn't have needs that need addressed." (Focus group participant)

"I would like a more detailed explanation of why the decision had been made in the first place so that I would be in a better position to challenge it." (Survey respondent)

Some respondents also said that they would like to the know the name of decision maker on their application so that they could know who to speak to when challenging a decision.

"It would help if you knew the name of the person dealing with the challenge, reference numbers are all very well, but if you're not dealing with the same person when giving more information, or when getting updates, then misunderstandings can happen." (Survey respondent)

Others, however expressed concern that this could put individual staff members at risk.

"You could then have situations where decision makers are threatened and could put staff at risk." (Focus group participant)

Respondents also spoke about how important it can be for people to have support when going through the process of challenging a decision – this might be through an advocate, an independent organisation, a carer, or a friend or family members. Respondents felt that it was important that this support be recognised and listened to, and highlighted how important it can be in terms of helping them to understand the process and submit all of the relevant evidence and documentation in a timely way.

"I would like people to be made aware that they could have a representative with them could be a family member or a welfare rights or CAB person but to know that the person can speak on their behalf sometimes people think they can do this themselves but then say entirely wrong thing because intimidated by panel" (Survey respondent)

Financial impact of challenging a decision

A number of respondents spoke about the financial impact of challenging a decision or waiting for it to be overturned. Some felt that if a decision was changed, payment should be backdated, or felt that any existing payments should continue until the re-determination and appeal process was complete.

"Benefits continue while decision is being challenged otherwise fragile ecosystem collapses over each and every error/contested process." (Survey respondent)

"The benefit should not be stopped until the whole determination is finished and the appeal is over. You should get to keep the benefit and car etc. during the determination and appeal." (Focus group participant)

Focus group participants also highlighted that the length of time it takes to go through the mandatory reconsideration and appeals process can put people under both financial and emotional strain.

"I have had 3 attempted suicides in the last 6 months. The process exacerbates it. The stress it puts them under. Most are sitting there with no money trying to fight this. And no one seems to appreciate that. It highlights the need for speeding up this process." (Focus group participant)

Behaviour of staff

Respondents also spoke about the importance of staff being helpful and respectful throughout the process, and having empathy with the situation that clients are in.

"I would certainly have appreciated it if the lady I was speaking to sounded as if she had some had empathy. She was brisk and efficient and had a time limit probably. She could have been a bit nicer, I was in tears by the time I came off." (Focus group participant)

Some also spoke about how intimidating the system can be.

"We have to find a way to take the terror factor out of this entire process, I am about to enter the world of reapplying for PIP, you have no idea the level of fear this is producing in my life. Please make it different when Scotland takes over." (Survey respondent)