UK:Man with epilepsy who couldn’t cook for himself, wash or travel alone denied disability benefits after appearing ‘well dressed’

I commented earlier about my work in the US. Everything that you said is true in my case with one exception. Within each agency, there’s a Quality Assurance dept. Because of the legal ramifications that could result in an improper denial/cessation, QA scrutinizes denials more than allowances. Allowances receive the most scrutiny if there’s a change in onset, or something that would negatively affect the claimant.

For continuing reviews, continuing a person on benefits requires the least amount of scrutiny. If the disability examiner (me) can prove that no medical improvement has been achieved in terms of the beneficiary’s disabling condition(s), then we can write a rationale establishing that, have it signed by an agency doctor, and then the person is continued on benefits until their diary expires (3-7 years).

It’s when the medical evidence begins to suggest that medical improvement has occurred, that we have to more thoroughly investigate the health of the beneficiary. This takes more time and a lot more effort than continuing that person.

Case accuracy from QA, completion speed of claims, are major factors in our performance evaluations, so in short. You can move cases quicker and receive less scrutiny if you put in the effort to allow/continue people.

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