Types of decisions

You use your skills and expertise to make different types of decisions when processing award reviews.

The decisions that you make can be described as either:

• process decisions
• determinations of entitlement

Process decisions

In the context of Scottish Adult DLA, a process decision is a decision about whether the process of challenging determinations by way of re-determinations as set out in the Social Security (Scotland) Act 2018 has been followed properly. It is also relevant where someone has made a request for an award of Scottish Adult DLA, where they previously had an award of Scottish Adult DLA or DLA, but they have not made this request within a year of the previous award ending.

When Social Security Scotland makes a process decision and the individual disagrees with the decision, they can appeal to the First Tier Tribunal.

There are three process decisions which you might make in the Scottish Adult DLA context:

• To reject a request for a re-determination which is not made in the format we require (Social Security (Scotland) Act, s41(3))
• To reject the reason an individual has given for not making a re-determination in the time period required (Social Security (Scotland) Act, s42)

Determinations of entitlement

A determination of entitlement is the decision about a person’s entitlement to disability benefits.

For Scottish Adult DLA recipients, it is the outcome of one of the following (SS (S) Act 2018, s50 (Decisions comprising determination))

• a determination without an application, such as a review
• a re-determination

People have challenge rights if they are unhappy with the determination we make. These rights include:

• Requesting a re-determination
• Appealing to the tribunal.

Making determinations

You must make a determination when carrying out an initial transfer determinations, reviews and re-determinations.

The determination always includes a decision about whether the individual continues to meet the eligibility criteria for Scottish Adult DLA.

If they do, a determination also includes a decision about:

• what rate of Scottish Adult DLA the individual is entitled to
• when their new entitlement begins
• whether there will be a scheduled review in the future, and when this will be

If they do not, a determination also includes a decision about:

• When their entitlement ends
• Whether an overpayment has occurred.

You must make determinations:

• in a timely manner
• based on relevant information and decision-making principle
• without including irrelevant information, such as informal observations, in your decision-making
• without gathering more information than is necessary to make a determination

Related reading

• Applying for Scottish Adult DLA chapter
• Scottish Adult DLA - Eligibility - Rates and criteria chapter
• Choosing an Appropriate review period chapter
• Residence and presence chapter
• Re-determinations chapter
• First-tier Tribunal chapter
• Upper-tier Tribunal chapter
• Gathering Supporting Information chapter [section on not having good cause]

Findings of fact and conclusions of law

The decision-making process for determining entitlement to Scottish Adult DLA involves making a series of smaller decisions. These allow you to make a decision on an individual’s entitlement.

These smaller decisions are either:

• a finding of fact
• a conclusion of law

A finding of fact means deciding that a detail relevant to an individual’s award review, such as how their disability affects them, is accurate. This is done based on the information you have available. You may need to use decision-making tools to help you do this if there is not enough information or where you are identify a relevant inconsistency.

A conclusion of law means applying the eligibility criteria for Scottish Adult DLA to the facts you have established. This is done to determine the appropriate level of entitlement.