Making a Decision on a Claim

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  • #39003
    DJM
    Participant

    Our operations manager wants to use ATLAS to make “automated” decisions (apologies if I’ve got the terminology wrong, it’s not my area!), but our director is firmly of the opinion that “someone” (as in a person, not an automated process) has to make a decision on a claim.

    I’ve been asked to find supporting evidence for the director’s view. I’ve looked in the CPAG Welfare Benefits/TCs handbook 2011/12; Chap 42 talks about “decision makers” and them being “officers of the LA”.

    What Reg is being used in the CPAG Handbook? I’ve tried to find the caselaw quoted in the footnote but can’t locate it.

    #110523
    Anonymous
    Guest

    HB decisions are made by the “relevant authority”, which means the Council as a corporate body. The Tribunal Procedure Rules refer to the “decision maker” which again means the Council as a corporate body. The decision-making job role is not a statutory office, so the law is not referring to a natural person.

    By way of contrast, there used to be a statutory function of Adjudication Officer for DWP benefits (there isn’t any more), and certain faud activities may only be carried out by a natural person who has been authorised to do that work.

    But in normal everyday HB decision-making the legal personality who makes decisions is the Council.

    So my view would be that you could as a matter of law automate the ATLAS process, whether that is a good idea or not in terms of quality and accuracy is another matter.

    #110525
    Kevin D
    Participant

    {Posted without having seen PB’s post}

    I wonder if “automated decisions” is synonymous with “decisions made by way of mechanical operation”? Yearly upratings are by way of mechanical operation and those are plainly “decisions”. Or, at least to date, no one has successfully argued they are not “decisions”.

    [2010] AACR 27 (aka CH/2297/2009) looked at this in the context of how is a claimant meant to know whether a decision has been made by way of a mechanical operation; distinguished from a hands-on assessment by a real human being. There was no suggestion that a computerised yearly uprating resulted in a “decision” not having that status. On the other hand, it wasn’t (apparently) argued.

    In law, HB/CTB decisions are made by the LA. But, to my knowledge, there is no legal authority that has found any difference in status between a “human” decision and a decision made by way of a mechanical operation. In terms of determining which individual officer made the decision, tricky. Is it:

    1) the one that instructs a member of staff to undertake a “mass calc”?

    2) if different, the one who updates the parameters?

    3) if different, the one who has to undertake any other IT prep work?

    4) if different, the one who pushes the button to commence the “run”?

    Finally, does it matter? Does the requirement for decisions to be made by the LA stop there, or does it mean there must be a human individual? I shudder to think of the possible arguments that could arise.

    NB: On the term “decision maker”; Rule 1 of the FtTRs says it “…means the maker of a decision against which an appeal has been brought;”. As Peter noted, this means the LA, not the individual officer where HB/CTB is concerned.

    #110528
    DJM
    Participant

    Hi Peter and Kevin

    Thank you so much, these responses are really helpful.

    I knew I could rely on my colleagues at HBInfo!

    #110542
    Amanda JB
    Participant

    Apart from year end upratings etc there are other mass-recalc which LA’s adopt, such as significant birthdays, HA rent increases to name a couple, none of these decisions are done manual, or by an individual, doing automoted chnages via Atlas do not seem to be any different.

    If you think of all the possible scanarios you will probably find some that your LA adopt, if so ask your Director why those are any different.

    #110549
    d-stainsby
    Participant

    Well to throw a cat amongst the pigeons, it is arguable that social security decisions may lawfully be fully automated, but not HB/CTB decisions for the reasons outlined below.

    S2 of the Social Security Act 1998 refers specifically to the use of computers in decision making

    2.—(1) Any decision, determination or assessment falling to be made or certificate falling to be issued by the Secretary of State under or by virtue of a relevant enactment, or in relation to a war pension, may be made or issued not only by an officer of his acting under his authority but also–
    (a) by a computer for whose operation such an officer is responsible; and
    (b) in the case of a decision, determination or assessment that may be made or a certificate that may be issued by a person providing services to the Secretary of State, by a computer for whose operation such a person is responsible.

    (2) In this section “relevant enactment” means any enactment contained in-
    (a) Chapter II of this Part;
    (b) the Social Security Contributions and Benefits Act 1992 (“the Contributions and Benefits Act”);
    (c) the Administration Act;
    (d) the Child Support Act;
    (e) the Social Security (Incapacity for Work) Act 1994;
    (f) the Jobseekers Act 1995 (“the Jobseekers Act”);
    (g) the Child Support Act 1995; or
    (h) the Social Security (Recovery of Benefits) Act 1997 [1; or
    (i) the State Pension Credit Act 2002].

    I concede that entitlement to housing benefit and council tax benefit falls to be determined under a relevant act as defined by S2, but there is ne reference to a local authority in S2. Reference is only made to the Secretary of State. S134 and S139 of the Administration Act provides for HB/CTB to be determined and funded by the local authority, not the Secretary of State. It is therefore arguable that the concessions in the 1998 Act for the use of computers do not extend to local authorities administering HB/CTB.

    Mr Commissioner Walker QC noted at para 10 of R(IS)2/96 that):

    “…the computer could not itself adjudicate. It could record either that there had been an adjudication or, and perhaps and, the consequences of that adjudication. It was still necessary for some human thought to determine what the relevant facts were and apply to them the relevant law. That could not be done by the computer. “

    R(IS)2/96 was obviously decided before the 1998 Act came into force, but it seems to me that determinations necessary for a decision must still be made by a human being notwithstanding S2 of the 1998 Act. S2 may well not apply to HB/CTB in any case, and so LA’s are not legally authorised to delegate decision making to computers.

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