The computer says no

Automated answers on electronic forms could be denying claimants their benefits, writes Gary Vaux

Electronically completed medical reports are increasingly used by the Department for Work and Pensions when deciding incapacity for work claims.

The examining medical officers, who are on contract to the DWP, can access a computer programme that lets them use both their own words and prepared text from a drop-down menu when compiling a report (an IB85) on a claimant’s condition. The decision-maker at the DWP relies heavily on this report so it is vital that claimants and decision-makers alike should have confidence in the contents.

But this confidence can be misplaced, as recent social security commissioner decisions have shown.

Examining medical officers do not sign electronically prepared IB85s. A commissioner has ruled that the lack of a signature does not invalidate the report as evidence [CIB/3743/04 (to be reported as R(IB)7/05)]. But commissioners have criticised the content of electronically prepared IB85 reports for several reasons. In one example, the commissioner said that taking an entry in the IB85 as a positive finding when it is merely an electronic default can mislead. This related to an entry reading “claimant states no other problems” in Box 1 headed “Diagnosis”. This entry appears automatically in the box unless the doctor stops it (CIB/476/05).

The commissioner in the same case highlighted a problem with a standard phrase in the computer memory bank that can be activated easily in a report. Once activated, the software in the computer will automatically suggest the phrase in a number of contexts. Unless the doctor acts to stop this, or goes back and corrects an error in Box 7, that error will repeat itself.

The programme “suggests” text for some sections, based on previous information that the claimant has given to earlier questions. Unless the doctor manually overrides them, the medical report will contain these statements as if they were the answers given by the claimant instead of ones generated by the computer. Decision-makers and tribunals would have no way of knowing that the right questions may not even have been asked, let alone answered in a way that the computer has “suggested”.

In another case, a commissioner agreed with the tribunal’s view that the electronically prepared IB85 report was unreliable. This was based on its finding that some of the list of entries in Box 7 were incorrect. The commissioner also commented on the inattention of the doctor completing the form particularly in respect to the “automated selective carry forward” of phrases  (CIB/664/05).

Another commissioner held the view that tribunals ought to satisfy themselves that reports presented to them in this form really do represent considered clinical findings and opinions by the doctor rather than automatically generated or default answers. Tribunals should identify and deal with apparent discrepancies (CIB/511/05).

The good news is that the DWP is trying to make the form more reliable and acceptable to tribunals. But if your client has been refused incapacity benefit or income support on the strength of one of these reports, it is worth making a challenge if you think that it was the computer and not the doctor that said “no”.

Gary Vaux is head of money advice, Hertfordshire Council. He is unable to answer queries by post or telephone. If you have a question to be answered please write to him c/o Community Care