Child Disability Payment decision making guide
Lack of confirmation from a professional
Individuals are asked to provide confirmation from a professional where possible when they apply.
There are many reasons an individual may not be able to provide confirmation from a professional.
Good cause
Good cause is the term for a reasonable explanation as to why a confirmation from a professional is not available or is delayed on an application. Where you do not have a confirmation from a professional, you should consider if there is good cause for this.
Establishing good cause allows you to continue with the decision-making process without a confirmation from a professional and make an award where the individual meets the eligibility criteria for Child Disability Payment.
Where an individual has good cause
The individual might have a reasonable explanation for:
- a delay in providing information
- not providing information
- disengaging from the supporting information gathering process
When determining what is a ‘reasonable’ explanation, we continue to follow the trust-based approach.
Reasonable explanations might relate to:
- lack of access to or contact with professionals
- their health or disabilities
- a hospital stay
- being placed in local authority care or legal detention
- lack of support needed from an advocate or support worker
- dealing with an unexpected life event, like a death in the family
- have difficult lives due to their disabilities or conditions
This list is not exhaustive.
Where an individual has not provided a confirmation from a professional with their application form, you should take the following steps before considering if the individual has good cause:
- support the individual in identifying suitable documents they might have at home
- advise the individual on how to request confirmation from a professional and who to request it from
- gather it on behalf of the individual, where the individual has given us permission to do so
You should only move on to establishing if there is good cause for a lack of confirmation from a professional if either:
- the above steps have not provided a confirmation from a professional for the application
- you identified early in the decision-making process that it is more likely than not that you would be unable to source a confirmation for a professional for this application. For example, the individual has told you that the information does not exist and based on the balance of probabilities you determine that it is more likely than not that none of the steps outlined above will be successful
Good cause due to unsuccessful supporting information requests
Good cause does not just apply to the individual’s personal circumstances. It also applies where the response from a professional to your, or the individual’s, supporting information request does not deliver the outcome you were hoping for.
You can establish good cause, where a professional:
- is unresponsive to a supporting information request
- responds declining to answer your questions
- provides a response that is of low quality
- does not provide information relevant to the individual or the application (e.g. sending a leaflet on a condition, rather than confirming that the individual has the condition or how they are impacted by the condition)
After you have established good cause
If you have established good cause, you should move on to establishing the individual’s level of need and their entitlement. You should use the information you have available to you to do so, such as the information provided by the individual in the application form.
If you are able to use the information available to establish the individual’s level of need and entitlement, you should continue to make a decision.
Lack of supporting information where the individual is unlikely to meet the eligibility criteria
The information an individual provides on their application or review form can suggest they’re unlikely to meet the eligibility criteria, for example, because it is unlikely that:
- their needs would meet the threshold for an award
- their needs meet the forwards test and backwards test
If the individual has asked you to gather supporting information on their behalf, you should take the steps necessary to do so.
If the individual has both:
- not provided supporting information
- not asked Social Security Scotland to gather it on their behalf
you must request a case discussion to understand whether it is more likely than not that supporting information would change the outcome of the application from a likely deny to a likely award. As case managers are not health and social care professionals, they are not able to determine whether supporting information could potentially provide crucial details that might lead to an award.
This is because individuals with certain conditions are likely to under-report their needs. Preventing them from accessing support they are entitled to is part of making fair and balanced decisions.