Assessment of applicantions of the impairment component of Income Support

​​​​Request 717233515

Please see the below queries regarding the assessment of applicants for the Impairment Component of Income Support:

A. 

Are staff members who assess impairment component claims required to hold any form of medical qualification to make these decisions?

If assessors are not required to have any medical qualifications, what qualifications or training are provided to them to enable them to accurately assess a claimant’s level of impairment?

B.

Are there any guidance or policy documents to guide impairment component claims assessors? If these exist, please provide copies. If these do not exist, please clarify the process by which assessors weigh up evidence and make decisions on impairment component claims.

C. 

Are impairment component claim decisions audited on a regular basis? If so, please provide details of the audit or quality control process.

D.

For the purpose of the statements and point scoring system in Schedule 2, Income Support (Jersey) Regulations 2007, must prompting or supervision be by a professional carer or can it be from an informal carer (e.g. family member or friend)?

For example, considering activity 14 (maintaining appearance and hygiene), if a claimant required daily prompting or supervision to maintain normal standards of appearance and hygiene (and sufficient medical evidence was provided), would the claimant score 20 points even if this support was provided by a family member or friend?

E.

Is evidence provided by informal carers (e.g. family and friends) of a claimant such as a signed statement detailing the care provided considered in the decision making process or can only medical evidence be considered?

F.

Are decisions made on the basis of the care or support that a claimant RECEIVES or the care and support that a claimant REQUIRES?

For example considering activity 14 (maintaining appearance and hygiene), if a claimant required daily prompting or supervision to maintain normal standards of appearance and hygiene but didn’t have access to this support every day so was frequently unkempt and unclean, would they score 20 points?

H.

How are fluctuating conditions considered by the assessment process? On what proportion of days must a descriptor apply for the claimant to score points?

For example considering activity 3 (rising from sitting in an upright chair with a back but no arms without assistance), if a claimant needs to hold onto something to stand around 70% of the time but on occasional good days they can stand unaided, how many points would they score?

In another example, considering activity 2 (standing without the support of another person), if a claimant cannot stand for more than 10 minutes without support from another person on 50% of days but on the other 50% of days they can stand for around 20 minutes, would they be awarded 15 or 6 points?

I.

What ‘reasonable adjustments’ are available to impairment component claimants who may struggle with the assessment process due to their disability?

Response

A. Officers who assess claims for the impairment component are not required to have medical qualifications. They undergo an intensive six-week training program facilitated by experienced assessors who have extensive knowledge of impairment assessments.

B. The Income Support Policy Guideline is publicly available here at gov.je​. Section 8 covers the Impairment Component

The following internal guidance is provided for staff and appointed medical board doctors. Copies of these are attached;
Guide for Determining Officers.pdf

Ailment Guide, Decision Tables and TOT's.pdf

Impairment Component.pdf
Clinical Cost Element Guide.pdf

C. Assessments are regularly audited by Senior Determining Officers who have extensive experience of the impairment component assessments and procedures. This ensures that the advisors adhere to guidance and legislation and can identify and address any gaps in their knowledge or understanding.

When completing an audit of an impairment assessment the following is checked:

• Was the assessment form completed correctly (this is the form completed by the staff member completing the assessment)

• Has the full scope of guidance documents, been applied

• Has all available evidence been used

• Has the correct Impairment rate been awarded

• Have the correct points been awarded

D. The care can be provided by a professional carer, informal carer or family member

E. All evidence submitted is considered in the assessment process. Including that from informal carers.

F. The assessment of the personal care element of the impairment component is based on the care the claimant requires. For further information on this please see Section 8 of the publicly available Income Support Policy Guidelines. Also, for the scope of Activity 14 see Section 5.1 of the Guide for approved Doctors and Determining Officers

H. To understand how fluctuating conditions are considered for the impairment component assessments, please refer to Section 3.1 of the Guide for approved Doctors and Determining Officers 

I.  When completing the form, anyone can assist the claimant (not just someone involved in their care). Provided that these persons complete the relevant part of the form confirming they have completed it on the claimant’s behalf based on the answers they have provided.

When challenging an assessment, the claimant or any other relevant adult in the household has the right to request a redetermination. 

There is also the alternative that where a claimant is unable to act for themselves someone else can be appointed to act on the claimant’s behalf under Article 9 of the Income Support (General Provisions) (Jersey) Order 2008.​