Requesting a case discussion

Reasons for a case discussion

There are a number of circumstances in which you may decide to make a formal request for a case discussion. Examples include:

• an application, review or change of circumstances that contains conflicting information or relates to the combined impact of two or more health conditions or disabilities
• an application which relates to a particularly complex or rare condition, or a fluctuating condition
• where there is a lack of supporting information, or where there is conflicting supporting information
• where you require guidance interpreting regulations.
• where there are any doubts about how to proceed with a suspension of payments and ending entitlement.

This list is not exhaustive. You should consider discussing the case discussion request with your line manager.

Considerations for a case discussion

You should not request a case discussion by default because an Adult Disability Payment(ADP)  application does not have supporting information. Instead, you should refer to the Supporting Information chapter and operational guidance.When making a request for a case discussion, you should:

• define the specific questions you have
• provide any supporting information that is relevant to the request
• reference the relevant decision making guidance
• note the preferred type of the case discussion, such as an email case discussion and provide reasoning for this decision
• where appropriate, state whether it’s the first request for a case discussion on a specific case or a follow up request.

There is no hierarchy of supporting information. If a conflict arises between pieces of supporting information, you must provide clear reasoning for determinations based on one piece of supporting information over another. If you cannot provide clear reasoning for why you accept the facts of one piece of supporting information over another, you should consider requesting a case discussion.

You should take a person-centred approach when deciding whether a case discussion is required in order to make a reasoned determination.. For more information on a person centred approach, see the 'Principles of Decision-making' chapter  

For guidance on approaching gaps, apparent inconsistencies or conflicting information, reference should be made to the 'Understanding and Interpreting Information' chapter.

For more information on how to approach an application without any supporting information, reference should be made to the 'Supporting Information' chapter.

Case discussion requests should highlight the specific gaps which prevent a determination from being made. This will allow the case discussion to focus on how these gaps may be filled and reduce the need for further case discussions on the same application, re-determination or review. A case discussion may not be necessary if youreceive the necessary information to allow you to make a determination in advance of the case discussion.