Terms & Conditions

[walmslm]

2 scenarios here – please advise the correct one (or suggest alternatives!)

Notification received (at the same time) from DWP that a customer’s IS entitlement has ended and then been reinstated (with a gap)

Scenario 1 – We write out to the customer asking for proof of their income for the gap in IS entitlement. No reply is received within 1CM so the claim is terminated just for the gap period. The claim continues as a live claim from the date IS was re-instated

Scenario 2 – We write out to the customer for proof of income for the gap period. No reply is received so we terminate from the Monday following end date of IS. The customer must then re-apply for HB based on his/her IS entitlement

I think that people will suggest scenario 2 is legislatively correct even though scenario 1 seems a lot more common sense?

[Anonymous]

You are right Walmslm.
Scenarion 1 – sensible, and, I believe, fair – though I know not everyone will agree with that 😉
Scenario 2 – legally correct – unless entitlement to Extended Payment on termination of JSA / IS etc. – when it ends HB / CTB anyway.

Hmmm 8)

[Kevin D]

Woohaaaah! Hmmm….

Scenario 1 may *appear* be the sensible pragmatic approach…. but I venture to say it is not sensible at all.

This earlier thread probably covers most of it:

new.hbinfo.org.com/forum/viewtopic.php?t=6784

In summary, if there is no claim, any monies paid are not legally by way of HB (or CTB). This means NONE of the HB/CTB rules apply. There can never be any “overpayment” in terms of HB/CTB. And, there is no (legal) basis for claiming subsidy against such expenditure…..

If any incentive is needed to avoid claiming subsidy incorrectly, take a long look at [b:475ad71561]LB Lambeth v DWP (2005)[/b:475ad71561]:

http://www.bailii.org/ew/cases/EWHC/Admin/2005/637.html

Probably not the answer you’d like, but definitely a new claim is needed.

Regards

[walmslm]

As a further issue then –

Say for example we receive notification today that a customer’s entitlement to IS ended for 1 week in April 2003 (it was a long fraud investigation for example!)

We have had no contact from the customer since the date in 2004 and present time

We invite the customer to supply income proof for this period but receive no contact.

Using the previous thinking then we would be right to terminate benefit all the way back to April 2003?

[cfowkes]

We suspend payment and send suspension letter, a claim form for the customer to complete and a request for details of income for the gap period. If the claim proves to be continuous the claim form is not used, if not continuous claim form is used.

It may seem inappropriate to ask the customer to complete forms that may not be used but until we know if we are dealing with changes of circumstance or a new claim we cover all options.

I am glad this topic has raised it’s head again because I am aware that some LAs just apply notional income for the gap period and don’t suspend, terminate or ask for a new claim. I thought we may be the last LA that still asks for a new claim when there are gaps in IS/JSA (IB).

[walmslm]

Should read no contact from customer since the date in 2003

[Kevin D]

[quote:907e6abd49]Say for example we receive notification today that a customer’s entitlement to IS ended for 1 week in April 2003 (it was a long fraud investigation for example!)

We have had no contact from the customer since the date in 200(3) and present time

We invite the customer to supply income proof for this period but receive no contact.

Using the previous thinking then we would be right to terminate benefit all the way back to April 2003?[/quote:907e6abd49]

Nuts as it may be, I think that is correct. Although, underlying entitlement would be applicable for any subsequent overpayments periods (or part periods) for which there was enough evidence to assess.

Regards

[Anonymous]

Perhaps I ought to clarify earlier post.

Scenario 2 is definately correct……

Doesn’t mean to say its sensible though!! 😉 – and as Kevin points out, lots of Underlying Entitlement (if evidence supplied) will reduce o/p 8)

[Chris Robbins]

Have I missed something here? Since benefit periods ended the regs changed so that end of entitlement to IS/JSA became a change of circumstances (unless an EP was paid) rather than a reason for terminating claims for HB/CTB.
On that footing my understanding of this scenario is that if you find out about a break in IS/JSA entitlement but it is now back in payment you would NOT terminate the HB/CTB claim but would simply have a potential O/P period to deal with by writing for details of income etc for the period of the break and superseding for that period based on the response (or lack of it).

[Chris Robbins]

Have I missed something here? Since benefit periods ended the regs changed so that end of entitlement to IS/JSA became a change of circumstances (unless an EP was paid) rather than a reason for terminating claims for HB/CTB.
On that footing my understanding of this scenario is that if you find out about a break in IS/JSA entitlement but it is now back in payment you would NOT terminate the HB/CTB claim but would simply have a potential O/P period to deal with by writing for details of income etc for the period of the break and superseding for that period based on the response (or lack of it).

[Kevin D]

Chris,

So long as there is no break in entitlement, no problem. But, a change of circs relies on there being continuous entitlement (whether IS/JSA(IB) etc, or “standard” or a combination).

If the sequence is “entitlement” to “nil” to “entitlement”, I don’t see how the original claim can stay live for the second period of entitlement. The first change of circs (to “nil”) ends the award of HB/CTB. As the claim (distinguished from award) has previously been decided, it is defunct per the CSPSSA 2000. Once an award has been broken, a new claim is needed because the original claim no longer exists. In my opinion, this applies irrespective of when the “nil” period is identified.

In my view, [b:c4dc67db67]CH/0269/2006[/b:c4dc67db67] supports this analysis – as discussed on new.hbinfo.org.com/forum/viewtopic.php?t=6784.

If it was just a case of a few admin technicalities, there wouldn’t be much of a problem in LAs continuing payments and just creating “nil” entitlement periods. BUT, as already stated, the payments will no longer be HB/CTB. So, no HB/CTB regs apply at all (in any respect) and the LA runs the risk of being unable to (legally) obtain subsidy for such payments.

Regards

[Neil Adamson]

Would go for two but with the provision that if I heard nothing from the claimant I would treat anything paid from the point IS is again in payment as u/e. I would effectivley end claim from the paid to point with no new benefit being paid until a new claim is received.

[paul_edmund]

I say would option 2 is the only one you can currently follow within the regulations. Another thing worth noting, unless I have completely lost the plot is people have mentioned that HB / CTB would stop if EPP applies, however what about HBR77 (2006 regs). As I read this regulation HB / CTB also stops where they would have met the EPP conditions, the only thing they failed to do is notify us or the DWP within 4 weeks. This regulation also has the effect of ending benefit entitlement.

[Anonymous]

Sometimes I think we just have to go with the spirit of the law and be done with it. Surely it’s not DWP’s intention that people should have to reclaim for a period they’ve already been paid for, and which would automatically be given to them if they did? Regulations are often badly drafted and contradictory so I tend to look at the intention behind them unless there is serious danger that I am acting [i:d283f0be08]ultra vires[/i:d283f0be08].

[paul_edmund]

Would generally agree, however whatever the intention where the legislation is clear what choice do you have as they say.

[Author]

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