Requesting a case discussion

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

• an application that contains conflicting information or relates to the combined impact of two or more disabilities or health conditions
• an application which relates to a particularly complex or rare condition, or a fluctuating condition
• where a case manager requires 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. Case managers should consider discussing the case discussion request with their line manager.

Case managers should not request a case discussion by default because a PADP application does not have supporting information. Instead, case managers should refer to the Supporting Information chapter.

When making a request for a case discussion, a case manager should:

• define the specific questions they have
• provide any supporting information that is relevant to the request
• reference the relevant decision making guidance
• note the preferred type of case discussion, such as an email case discussion, and provide reasoning for this decision
• where appropriate, state whether it is a 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, case managers must provide clear reasoning for determinations based on one piece of supporting information over another. If they cannot provide clear reasoning for why they accept the facts of one piece of supporting information over another, they should consider requesting a case discussion.

A case manager 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 a case manager receives the necessary information to allow them to make a determination in advance of the case discussion