A13/06 Underlying entitlement

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  • #22560
    Anonymous
    Guest

    Q) Where there is a change in circs and the claim is suspended, we write out for further info and give the clmt a month to respond. No reply so the claim is terminated creating an overpayment.

    Does the claimant then have another month from the termination decision to supply information/evidence for underlying entitlement?
    Opinions are split on this one…….

    Cheers

    #8572
    markp
    Participant

    Strictly no time limit but you would invite claimant to supply details, giving a month, await reply (or not) and then make a decision. If no, or insufficient, income and savings details are supplied then, to my mind, gross OP stands.

    Do I know what I'm doing? The jury's out on that........................

    #8573
    Anonymous
    Guest

    The letter we send when suspending a claim says the following:

    “I need further information so I can work out your claim based on your new circumstances. I also need this information to calculate any overpaid benefit.”

    This (loosley) means we are giving them 1 month to provide information so we can process their change of circs, AND to calculate their underlying entitlement.

    Hope that helps!

    Sam

    #8574
    Anonymous
    Guest

    Thanks for the replies. Just to clarify – where the claim has been suspended and subsequently terminated, does the claimant have a month [i:d9d7ba57b6]from the termination date [/i:d9d7ba57b6]to supply info/evidence to calculate underlying entitlement?

    Cheers

    Andy[/i]

    #8575
    GHE
    Participant

    once you have created an overpayment, they have a month from the date of this decision to provide info/ appeal as well as the month from the suspension date. Until there is an overpayment there is nothing to apply ue to. It seems futile i know as you have already asked them in the month the claim was suspended but rules are rules!

    #8576
    Karen
    Participant

    what we do is:

    1) suspend case and request info
    2) if not returned within 14 days – issue suspension reminder
    3) if not returned within 14 days – terminate claim, giving appeal rights and 1 month to supply further info
    4) if received within the 1 month from termination, calculate UE
    5) if nothing received after the 1 month, then no UE can be calculated
    5) if information provided after the 1 month from the date of termination, they would need to show good cause as to the reason for the late supply of information

    hope that helps ๐Ÿ˜†

    #8577
    jmembery
    Participant

    No I donโ€™t think so.
    You are using reg 11 of the DMA Regs.

    1) Identify that there may be an overpayment so you suspend and request info to calculate entitlement to benefit, including any UE.
    2) Send a reminder after two weeks if you want.
    3) One month after 1) above you can make your decision on entitlement using evidence supplied by claimant (if any). This may create an overpayment
    4) Claimant has one month to appeal.

    If, as part of the appeal, the claimant supplies evidence you originally requested I see no reason why you cannot revisit the UE decision and award some. Although A13 suggests the claimant must have โ€œgood causeโ€ for not providing the evidence originally.

    #8578
    seanosul
    Participant

    [quote:b84ca0b4b4=”spencers”]The letter we send when suspending a claim says the following:

    “I need further information so I can work out your claim based on your new circumstances. I also need this information to calculate any overpaid benefit.”

    Sam[/quote:b84ca0b4b4]

    I would suggest you say that “you need this information to reduce the amount of overpaid benefit”. The way it is wrtitten now would discourage responses.

    #8579
    Anonymous
    Guest

    Thanks for all your help folks. Slightly split opinion just like we had here. Why cant things ever be simple?

    Thanks again.

    Andy ๐Ÿ™„

    #8580
    Anonymous
    Guest

    Andy
    You really ought to know better than to ask that sort of question!! ๐Ÿ˜‰ 8)

    #8581
    Anonymous
    Guest

    I know, what was I thinking?! Benefits, simple, crazy fool!… ๐Ÿ˜†

    #8582
    GHE
    Participant

    Just to complicate matters further, in the overpayment guidance manual it says that if ue is refused (i assume because they were out of time) and they make a new claim then When a claimant requests backdating, this must always be considered before underlying entitlement.

    this may be where the confusion around backdaing and A13/2006 arises

    #8583
    Sharen
    Participant

    Hi

    I don’t know if this is any help but I recently had this reply from the DWP for a similar query:

    ‘Underlying entitlement is not something that can be “offered” to the
    claimant. It must be taken into account in all overpayments. It is part of
    the process of calculating the amount of the overpayment as prescribed in
    regulation 104 of the Housing Benefit Regulations and regulation 90 of the
    Council Tax Benefit Regulations.

    It is also important to remember that if a claimant comes off IS or JSA(IB), and is entitled to an extended payment, HB/CTB ends; it is not a change of circumstances.

    In either case, you do not need to request information twice, once to
    calculate revised entitlement or a new claim and once to consider underlying entitlement. If the claimant fails to provide enough information in the first place, there is nothing that requires you to ask for it again.

    Calculating underlying entitlement is a one off calculation. Once the
    details have been supplied or not supplied, the correct and final
    overpayment amount should be calculated. If information comes to light after this has been completed and outside the time limits, the LA would not need to revisit the overpayment calculation.

    However, the claimant may ask for a backdated decision to be made, which should be considered, following the normal backdating rules. You do not need to recalculate underlying entitlement every time fresh details come to light which could affect the overpayment period’.

    #8584
    seanosul
    Participant

    [quote:15eb5a9b2f]However, the claimant may ask for a backdated decision to be made, which should be considered, following the normal backdating rules. You do not need to recalculate underlying entitlement every time fresh details come to light which could affect the overpayment period’.[/quote:15eb5a9b2f]

    I would disagree as any fresh evidence (especially if it increased the overpayment) would highlight that the original calculation was incorrect as UE is part of the calculation of the overpayment. What grounds are there for not considering evidence relevant to the calculation of correct benefit entitlement?

    #8585
    Anonymous
    Guest

    The Adelphi (great oracle that it is) said:

    [quote:e9434ce65e]…if a claimant comes off IS or JSA(IB), and is entitled to an extended payment, HB/CTB ends; it is not a change of circumstances[/quote:e9434ce65e]

    So…chap goes to the Jobcentre Plus to sign off, and the nice helpful person behind the counter says “Would you like to claim an extended payment?”. The chap says “Yes, please”, makes a statement and the JC+ officer says “Thanks very much, we’ll take care of it from here”.

    Trouble is, the JC+, for whatever reason, don’t notify us of the cessation of JSA or the entitlement to an EPP, so we keep paying maximum benefit. Six months later, we carry out a postal intervention and discover the claimant started work, so we calculate an overpayment. It’s not LA error, it’s not DWP error (no legal duty to inform us), so it must be recoverable.

    Can we recover from the claimant? No, coming off JSA when you are entitled to an EPP is not a change of circumstances, so the claimant has no obligation to notify us.

    Wonder if the Adelphi would agree to that one…

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