Child Disability Payment decision making guide
Requesting more additional supporting information
In some cases, you may not have enough information to understand the individual’s circumstances and entitlement based on:
- the application or review form
- available additional supporting information
- the balance of probabilities
This might be due to:
- gaps
- inconsistencies
in the information provided in the information you do have available.
Information provided by the individual or their source might not contain enough detail to make a determination if the information:
- is of low value (for example generic information about a condition, rather than about a person’s needs)
- is not up to date i.e. information from a time when their needs were significantly different
- does not provide the level of detail needed to understand an individual’s needs, particularly where the case is complex
You can ask for more information if:
- there’s not enough information to make a determination on the balance of probabilities
- you’ve considered other decision-making tools
You can contact an individual only where necessary to:
- clarify information already provided
- update or confirm details on a form
- ask for another source of information
- get more information to support what the individual told us
This means that you must not request more additional supporting information because you:
- would find it interesting to find out more about the case in question
- would find it helpful, but not strictly necessary, to learn more
- do not feel confident enough to make a determination as you are new to the role
- need more general information on the individual’s condition when this information is also available in medical guidance or upon request through a case discussion with a practitioner
- need to have confirmation from a professional where an individual has good cause for not having this
Individuals can request help to gather supporting information at any time.
When requesting supporting information, you should limit the number of questions asked. You should also keep them general enough for the provider to give information on the individual’s condition and needs.
Who to ask for more additional supporting information
Depending on the details you need to make a determination, you should decide whether you should request this supporting information from:
- a professional
- the individual’s wider support network
Before asking for more information, you should consider whether information about a condition or disability can be gathered by using other decision-making tools, such as
- medical guidance
- a case discussion
You must also consider whether it can be established if the information you need is the confirmation from a professional.
As with all supporting information, anything additional should be:
- given equal consideration
- used to broadly support the information provided in an individual’s application or review form
You must never ask an individual to ‘prove’ or ‘disprove’ anything they have told us about any aspect of their:
- conditions
- disabilities
- needs
If the confirmation from a professional is unavailable
If after all efforts have been made, there’s still no confirmation from a professional, you can still make an award if you can establish the good cause for the missing information.
You should:
- use the balance of probabilities, as always
- consider requesting a case discussion
If you cannot establish good cause and there is no confirmation from a professional, move on to the section on when it is appropriate to deny an application due to lack of supporting information.
If no additional supporting information is available
Other decision-making tools may be necessary to establish the facts of a case in cases where all of the following apply:
- an individual has a confirmation from a professional, including good cause for not having the confirmation from a professional
- the application form does not contain enough detail for you to conclude whether it is more likely than not what their needs are
- there is no additional supporting information from any other source
One of those tools includes requesting more additional supporting information. You should ensure that this is the best tool for gathering the missing details before using this tool.
Other tools may be more appropriate, or produce results quicker, than gathering more additional supporting information.
You should always attempt a follow-up call, if it is appropriate to do so, to gather any information you need before requesting more additional supporting information.
Where you have utilised the available decision-making tools and you have still been unable to gather all the information you need, you should:
- continue to make a determination based on the facts they have been able to establish
- continue to use the balance of probabilities, as always, throughout this decision-making to establish what needs they are more likely than not to have
- recognise that this might lead to a lower award than the individual might have expected, or to no award.
When it is appropriate to deny an application due to lack of supporting information
We’re required to make a determination on every application we receive. In instances where there is either
- no confirmation from a professional and no good cause
- not enough information to determine entitlement after using the relevant decision-making tools,
the determination might be that the individual is not entitled to.
A lack of confirmation from a professional or good cause is not the only basis for denying an application on grounds of supporting information.
Alternatively, an individual’s application can be denied if you are unable to determine the individual’s entitlement based on the information available. To deny an application on this basis, all of the following must be met:
- they have a confirmation from a professional or you have established good cause
- the information provided in their application form does not provide enough detail for you to establish their entitlement
- you have used other decision-making tools to resolve these gaps or inconsistencies but you are still unable to establish entitlement
- you tried to gather more additional supporting information and did not receive the detail you needed
- due to inconsistencies or lack of detail, you were unable to establish their entitlement based on the balance of probabilities
- you have made every effort to support the individual to provide more additional supporting information, including offering to gather is on their behalf