Terms & Conditions

[Neil Adamson]

We have a lady who has just gone into hospital and we know from the outset that the absence will just exceed 52 weeks.

I know we can consider a longer absence but my understanding of this scenario is if something occurs to prevent the claimant returning. The fact that we know from the outset that the period will be greater than 52 weeks (and it is only days in excess) is leading me to the decision that no award should be made?

Or do we just tell them to have a home visit in the next 52 weeks!

[Anonymous]

The DWP HB/CTB Manual states:

A person whose absence…is ‘unlikely to substantially exceed 52 weeks’* also qualifies. This may be considered only in exceptional circumstances. It should not be interpreted as the normal rule for all or any particular groups of claimant.

* Unlikely to substantially exceed 52 weeks’ should be interpreted as a total absence of up to about 15 months.

No mention of anything occuring to prevent the claimant from returning, so it would seem to me that you can pay the maximum 52 weeks, if you consider that the circumstances are exceptional.

[Neil Adamson]

The GM does refer to as an example somebody being able to return home due to an unanticipated event.

I’m not convinced that the fact that the fact that the absence will only just exceed 52 weeks is “exceptional” although I am happy to be persuaded otherwise as it seems harsh not to pay?

[Anonymous]

I dont see how you can possibly tell for certain that a person going into hospital now will be discharged on a given date, so I would award HB for the full 52 weeks from the outset.

Having said that, the issue of how long the person is likely to be absent (and continued entitlement) should be judged on a week by week basis (see CH/1237/2004)

The day of entering hospital and the day of discharge do not count towards the 52 week period, only complete days of absence (midnight to midnight) are relvant (R(S)1/66)

Exceptional circumstances for the purposes of awarding 52 weeks benefit where absence is likely to exceed but not substantialy exceed 52 weeks is not defined, but given that going into hospital for a year pretty exceptional of itself, it should not be too difficult to find circumstances to jutify paying the benefit.

[Neil Adamson]

Thank you for that.

We have actually been given her discharge date in 2007!

However I think there is enough here to venture down the exceptional path.

[Author]

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