Terms & Conditions

[Anonymous]

I have an unprocessed h/b claim where for the first two weeks of the claim we need income details but the person then goes on to JSA(IB).

Should we pay the claim from the effective date after JSA starts and write for income details for the first few weeks ?

If we do not receive income details I would need to make a decsion that we will not pay the first part of the claim, but as we would have already made a decison to pay the claim using JSA I cannot make the first part of the claim defective- any suggestions ?

[lord smeagol]

Adverse inference for those first 2 weeks and then ‘correct it’ when/if the info is provided? Not strictly the correct way to go about things though.

Any reason why you are not writing for the info first before considering the claim in its entirety? – BVPI considerations perhaps?

Regards

Mike Cannon

[Kevin D]

Mike’s approach makes absolute sense. And that’s where benefit rules make a mockery of common sense…..

However, there may be a way around it…..

The difficulty with Mike’s approach is that you are deciding a claim AND that there is, initially, nil entitlement. That would have the effect of nullifying the claim ([b:fc801a6f26]para 2, Sch 7; CSPSSA 2000[/b:fc801a6f26]) and, therefore, a new (yes, another) claim would be needed for the JSA period onwards.

BUT, a convoluted interpretation of [b:fc801a6f26]HBR 86(10)[/b:fc801a6f26] may assist. Basically, you simply treat the existing claim as an advance claim (ignoring any reference to the “standard” period in terms of a “decision”).

Notify the clmt as normal (for the JSA period); but send a covering letter requiring further info (i.e. circs) for the standard period. If such info is received within one month, simply revise the start date. If not, original decision stands.

NB: Wonder why JSA started late? Did the clmt get pay-in-lieu / holiday pay? If so, that would count as earnings.

Hope the above helps.

[Author]

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