General approach when carrying out award reviews

Confirmation from a professional

Confirmation from a professional used to be called the one piece of supporting information from a professional. Its role is to broadly confirm the individual’s conditions, disability, or needs.

Most award reviews will not require new confirmation from a professional. You must only request confirmation from a professional as part of a review if both of the following apply:

• The change relates to a condition for which the individual has not previously provided confirmation from a professional or for which good cause has been established. This can be because the condition is new or because the individual’s confirmation from a professional related to a different condition they have.
• The reported change in their condition is likely to lead to a change in their level of entitlement.

In all other scenarios you must accept the previously provided confirmation from a professional (either provided to DWP or Social Security Scotland), or the fact that good cause has been established for the absence of confirmation from a professional, as sufficient.

See section on specific review scenarios for more details

See the chapter on gathering supporting information for more detail on our policy regarding confirmation from a professional and supporting information.

Because Scottish Adult DLA does not have an application process, we may not hold confirmation from a professional where this was not received from the DWP. It is not always necessary to seek confirmation from a professional in this circumstance.

Confirmation from a professional should only be sought where the reported change in needs varies drastically from what we would expect or includes a wholly new condition.

Needing more detail to establish the new level of need

When carrying out a review and a change is reported, you might need more detail to establish the individual’s new level of entitlement.

You should choose either of the options below:

• Contact the individual or their client representative to ask follow-up questions. Here, you must ensure that this phone call does not become, or feel to the individual, like a consultation. There are no client consultations within Scottish Adult DLA. These only exist for ADP and are carried out by Health and Social Care Practitioners. For more details, see operational guidance on contacting individuals with follow-up questions. You should also consider that individuals in receipt of Scottish Adult DLA may struggle to see that their level of need has increased. If you suspect that this might be the case, you should use appropriate decision-making tools (such as requesting supporting information from the client’s wider support network).
• Choose the decision-making tool that is most appropriate and most likely to provide the information you need.

There are a number of decision-making tools for you to use:

• Guidance, such as the Decision-Making Guidance, Operational Guidance, Medical Guidance
• Case discussion
• Requesting supporting information.

For more detail on choosing the correct decision-making tool consult the Principles of Decision-Making chapter.

Individuals might not be aware of their increased needs or might not feel that (some of) the changes they have experienced are relevant to their review. This can be because the changes might be attributed to frailty, rather than their existing conditions or disability.

Frailty is a medical condition. You should therefore consider any frailty-related needs when establishing the individual’s new level of entitlement. You should remember that individuals do not require a formal diagnosis for their needs to be relevant for Scottish Adult DLA.

Frailty can be used to describe the individual’s overall resilience in terms of how they recover from health conditions and illness or manage their disability. Individuals with frailty may have long-term conditions or a disability of which frailty is a progression or consequence. Frailty can also be present as a new and unrelated health condition. The impact of frailty should be considered as to how this affects the individual’s overall health and wellbeing and how this may increase the individual’s care needs. Frailty is not an inevitable or sole consequence of age.

You should use decision-making tools, such as case discussion, if

• you think an individual might have underreported their needs
• you are unsure how frailty might affect an individual’s needs.

When establishing the individual’s level of need, supporting information:

• is just one of several decision-making tools
• should not be the default step to take.

Rather, you should choose the action based on what’s most appropriate in the review at hand. As part of that consideration, you should consider what’s best for the individual. For example, a quick phone call to the individual to ask a follow-up question might be better than the individual having to:

• collect supporting information from their wider support network
• wait a number of weeks until your request for supporting information has been answered by the contact the individual has provided.

If you decide that gathering supporting information is the most appropriate decision making tool, you need to decide which source would be best placed to provide the information you need. This can be a professional or a member of the individual’s wider support network. Crucially, requesting supporting information should be done with the goal of more fully understand the individual’s new level of needs. The aim here is not to “verify” what the individual has told us.