Terms & Conditions

[junderwo]

I have a case where a pensioner has had an intervention by visit but they could not be contacted. The claim has been suspended and subsequently terminated from 5.7.04. Outside the calendar month to request a revision the pensioner has reclaimed on 3.11.04. What action should be taken:

1. Using the new rules pay from 5.7.04?
2. Using the new rules pay from 12.7.04 (taking effective date of claim to be 5.7.04)?
3. Do the new rules not apply and pay from 8.11.04?

THANKS

[Anonymous]

As far as I understand it, the new rules allow you to automatically backdate claims made by pensioners after October 2004 for 52 weeks. The rules definitely apply, and as these allow you to go all the way back to November 2003, I would be inclined to pay the claim from 5th July 2004.

[Darren Tompkins]

As far as I can tell the pensioner has to prove that they satisfied the conditions for HB/CTB continuously from the date of claim to the date the claim was actually received.

Circular A29 says “the prescribed time for claiming HB/CTB for a person who has attained the qualifying age for State Pension Credit (the qualifying age), is the day the person is entitled to HB/CTB (apart from the condition of making a claim at the time the entitlement arose) and a period of 12 months thereafter”.

By not responding to your intervention and delaying their re-claim by 4 months I would suggest that the customer has not satisfied the condition of making a claim at the time the entitlement arose, and so cannot prove they coninuously meet the conditions.

As a result I would be tempted to only pay from the 08 November (Monday following date received). However, I’m not certain about this and would probably seek further guidance from the DWP before deciding.

[Anonymous]

I can see Darren’s point. The customer doesn’t fulfil all the criteria for claiming HB/CTb apart from making a claim as they failed to comply with a request for a visit.
But you could also look at it that he would be entitled to HB had he made a claim in July (immediatley following termination) so he is entitled to having his claim treated as being made on 5 July 2004.

I’ve been going between the two options and i prefer option 2 and that you should treat him as claiming in July and starting his new claim from 5 July 2004 – it seems to meet that it is what the regs are supposed to do, maximise benefit for pensioners etc.

Having said that if you choose option 1 i think you could still look at the customers reasons for failing to contact etc and either revise the decision to end benefit or award backdating to the new claim, if he has good reasons

[Kevin D]

Depending on when notifications were sent out etc, there is another consideration for CTB.

If there was CTB entitlement originally, and this was withdrawn from the CTAX account at the time of the claim being terminated, then the LA may still need to consider underlying entitlement just for CTB.

One of the difficulties with CTB is that once it has been awarded to the end of the year, any termination will mean even “future” CTB is an overpayment (CTBR 83/84).

Thought I’d throw that spanner into the works…. 🙂

Regards

[junderwo]

This is the reply from the Adelphi:

“I think that the you should apply the new prescribed time for claiming rules in HB from 3/11/04. That is, on that date you have powers to (in effect) go back 12 months from the reclaim date provided you/the claimant can establish entitlement for that period. The history of the previous claim termination would only be relevant were it to cast doubt over entitlement for that period and those doubts still exist now.”

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