Terms & Conditions

[Anonymous]

This has probably been discussed before but here goes,

Claimants can submit a claim in advance I understand that however, does the regulation still apply if a nil entitlement decision has been made on the application that came in?

or

Can you make the nil entitlement decision and then if a change in circumstance is received within the 13 or 17 weeks can you action the change without completing a new application form?

I was under the impression that once a nil entitlement decision had been made the claim for benefit ends. The options above don’t fit into my understanding of this reg!

Please help!!!!!!!!!!!!!!!!!

😡

[APT]

Having had a quick read of the regs I would say that the second option would require a fresh claim*

The wording of (83) (10) talks about the claimant not being entitled in the benefit week following the claim and then where the “relevant authority is of the opinion that unless there is a change of circumstances he will be entitled”. I think that this refers to any changes of circumstance over and above those already mentioned at the point of claim.

Hence if an advance claim is made because the claimant is due to end work in 10 weeks time, they don’t qualify in the benefit week immediately following due to income, the LA would need to be aware of further CoCs between then and ten weeks time (change of address or receipt of capital, say).

*The issue about the new claim, however, is one that can fall under the “a claim must be one that satisfies the LA” which means there might not be a need for a full claim form to be completed, dependant on the circumstances of the case.

[Anonymous]

I was always of the opinion that you couldn’t “reopen” a claim for a subsequent change of circs. But I could never back it up.

And then I found it. Schedule 7 para 2 to the Child Support, Pensions and Social Security Act 2000. This prescribes that once a decision has been made (a correct decision, of course) that there is no entitlement on a new claim, that decision cannot be superseded. If you decide (for example) that the claimant’s income is too high and they come back a month later and say, “well my wages have gone down now”, a new claim is needed.

If they say “my wages have gone down” [i:7207665566]before [/i:7207665566]the claim is decided then the advance claim provision can come into play, but not after.

Cheers,

Darren

[Anonymous]

Thanks for that. You have confirmed what I thought.

The only way the procedure would work as I see it is that on nil entitlement claims a decision would not be made until the 13 or 17 weeks is up. And this would surely affect bvpi’s.

Looks like I will have to have the HB section explain their procedure again, as to me it doesn’t appear to work!!

[Anonymous]

Just another thought here but would it make a difference if a decision was made on the claim (nil Ent) and the HB section delayed in notifying the clmt of the decision until 13 or 17 weeks later?

[Anonymous]

We delay actually calculating the claim until the week before entitlement starts but then fiddle around with receipt dates and claim dates so that our BVPI doesn’t suffer (Northgate site)

[Anonymous]

That’s would be the logical thing to do in regards to this reg but in this case the procedure that has been written takes into account changes of circumstances which the claimant advises the HB section of during the 13 or 17 weeks. Not changes which are known when the claim is submitted.

[Kevin D]

I agree with APT & Darren.

For sas & Chris, I think it can be argued, quite reasonably, that you can deal with an advance claim straight away.

Sch 7 para 2 of the CSPSSA 2000 uses the word “decision”. On that basis, I see nothing wrong with dealing with an advance claim that initially gives nil entitlement, but from the tenth week there is entitlement – SO LONG AS IT IS PART OF THE [b:45e2eecaf8]SAME DECISION[/b:45e2eecaf8]. In line with Darren’s observatioin, I think the following is true:

[b:45e2eecaf8][u:45e2eecaf8]Scenario 1[/u:45e2eecaf8][/b:45e2eecaf8]

Claim made: decision made that there is no entitlement “now” AND no future entitlement is identified.

In this scenario, the claim ends – there must be a new claim for any further entitlement (as observed by Darren).

[b:45e2eecaf8][u:45e2eecaf8]Scenario 2[/u:45e2eecaf8][/b:45e2eecaf8]

Claim made: decision made that there is no entitlement “now”, BUT future entitlement is identified within 13 weeks.

So long as both periods of calculation form part of the SAME [u:45e2eecaf8]decision[/u:45e2eecaf8], no new claim is needed. And, in my view, you don’t need to delay assessing the claim.

If it is argued that the effect of the CSPSSA rules out “scenario 2”, then HBR 86(10)&(11) can never have effect because the CSPSSA overrides the regs. That, may yet prove to be the correct legal postion. However, until / unless there is a CD that suggests otherwise, I’d tend to go with an interpretation that allows “scenario 2”.

Regards

[cgeorgiou]

Hi,

I have a claim that was made because clt stopped work due to sickness but did not give this information on the claim form. This claim was assessed using the payslips provided which resulted in nil ent. She later (within 13 weeks) provided a statement and payslips that explained she was on sick leave when she made her claim and did not receive half pay till now. As we did not know the true circs when she put in her claim and this is not a change in circs apart from her earnings reducing at a later date, can we still treat this as an advance claim?

[Kevin D]

If I’m reading it correctly, the situation is analagous to “Scenario 1”. If so, my view is that a new claim is needed.

[Author]

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