Assessing disability: A six‐nation study of disability pension claim processing and appeals

This article studies disability pension benefit claim processing and appeal procedures in six countries — the United Kingdom, Germany, Sweden, the Netherlands, the United States of America, and Canada. It examines eligibility requirements and programme goals, focusing on how those countries assess a claimant's disability. Among these six countries, there were variations between the burdens on the agency and those on the claimant to compile evidence to support the claim. In addition, the use of agency doctors, or referrals to outside physicians, was often predictive of how this burden was distributed. The countries use similar procedures to make initial disability assessments; however, they differ in how they structure the process: whether it is centralized or decentralized, whether teams or individual decision makers are used, and whether the decision makers have specialized training or rely on experts. The study also notes variations in the appeals process. All countries have considered adopting or discarding an internal administrative review of eligibility decisions; the debate continues on whether an internal review is of any value. With or without it, all six countries allow at least one level of appeal on both factual and legal issues. Some countries use specialized tribunals, while others use courts to hear post‐agency appeals. The article concludes with observations and recommendations applicable generally to disability pension benefit claim processing and appeals.