Terms & Conditions

[arenton]

Hello All,

I wonder if i can ask advice on Underlying Entitlement, and in particular in relation to when a claimant reports a change of circumstances during their ongoing claim?

I understand in principle that WHENEVER an overpayment is created we must attempt to reduce it by applying underlying entitlement.

When claimants report a change in circs to us we have a “”Change of Circs” form which they fill in and sign and they supply us with the relevant verification. We assume that apart from what they tell us on the Ch of Circs form – all other details of their claim remain the same, and we ask them to sign a declaration which states –

“I declare that the updated information I have given on this form is correct and complete. This information together with the information on my claim form correctly represents my circumstances as they are at the present time. ……..I know that I must let you know in writing about any change in my circumstances which may affect my claim”

What i want to know is- if a claimant reports a change which causes an overpayment- have we correctly considered underlying entitlement?

Or, to correctly consider underlying entitlement- do we need to request details of all other aspects of the claim and give them a month to supply them etc?

An example would be- claimant reports an increase in wages which happened 2 months ago. This is all they tell us and they sign our change of circs form. Can we just re-calc their entitlement with the higher wages and notify them of their overpayment? Or, because an overpayment is created- do we have to ask the claimant for verification of all aspects of his claim before we seek to recover the overpayment??

Any opinions would be most welcome.

Thanks

[Anonymous]

Hi…I’ll have a go….!

You have info that clmt’s income has increased. Clmt has declared that all other aspects of claim remain the same.

You shld at this stage consider whether UE is appropriate. However, as you have already recd the correct income details (and clmt declared everything else is the same), you can just do a normal supersession without having to rely on Reg 104 as it flows automatically from the supersession process.

Does that make sense?!

[arenton]

Thanks Andy C,

That was what i’d hoped, but would it make any difference if we do not have a declaration signed?

eg person writes in – says “my wages have changed- here’s the payslips”.

As i say- we would assume this was his only change – and the other details of his ongoing claim remain as they were.

Can we still just process that change, then recover the resulting overpayment? Or because an overpayment is created- do we need to take further action to ensure the other details of his claim are unchanged- in order to fully consider underlying entitlement?

What do you (and/ or others) advise??

[markp]

Based on what you’ve got I would process the change and recover OP etc.

There is only one declared change, the earnings so therefore you should revise/supersede as appropriate and U/E does not come into this particular scenario.

I like it when they’re that straightforward!

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

[Stalbansbenefits]

Funnily enough, Northgate/SX3 have just issued a bundle of documents, one of which relates to a consultation they carried out in respect of circular A13. It includes the following ‘advice’ they received from the DWP…

[quote:d158e9affe]LAs should suspend claims in all cases where underlying entitlement should be considered. Even where a notified change in circumstance is provided with evidence of the new circumstances, unless the LA has been told by the claimant that there are no other changes in circumstances, then the claim should be suspended rather than the change processed as it may lead to the creation of an overpayment[/quote:d158e9affe]

😯

[arenton]

Thanks for your contributions, but that last one about the Northgate/DWP advice is exactly my problem.

If an overpayment results from a reported Change of Circs- how far do you need to go in considering Underlying Entitlement?

Take no further action- you have calculated entitlment on details given,

OR,

Need to check again all aspects of claim to ensure nothing else has changed which they have neglected to tell you – surely not necessary??

I think we will try and go with the first option until we are told otherwise or we will end up just getting claimants to complete full application forms again each time they tell us of a change.

[Anonymous]

A Renton
Think you are right

Calculate gross overpayment, and notify claimant
Give a reasonable amount of time (one month?) for claimant to supply info of what income was during o/p period. If necessary include seperate letter with o/p notif – depends if you feel what your letters say – if they are ok, you may not need to.
Sit and wait for reply. If after one month no reply, gross o/p becomes net o/p start recovery. If reply, calculate u/e and notify claimant of net overpayment. 8)

[arenton]

Thanks for that Jon,

But really what i am suggesting is [b:a0329467eb]NOT [/b:a0329467eb]to contact the claimant after we have calculated the change of circs they have told us of- just act on their declared change- assume all other aspects of their claim are the same as before- send them a notification, and if no appeal comes in- seek recovery of the overpayment one month after the notification was sent.

Do you think that approach will satisfy the requirement to consider underlying entitlement?? ie we have already made a decision on [b:a0329467eb]entitlement[/b:a0329467eb] in the overpayment period (which they can appeal against), so do we need to do further work to consider [b:a0329467eb]Underlying Entitlement.[/b:a0329467eb] ?

Or are we required- as you suggest- to send a letter asking for further claim details to be confirmed?

[Anonymous]

I do remember somewhere that the LA should invite the claimant to give information that could establish U/E, and therefore net down the o/p. I cannot recall it being a matter that is referred to in legislation (but may be wrong on that – so many hits taken on tin hat that memory starting to go fast!!) but rather as a matter of good practice.
Perhaps the DWP Overpayment guide?

Duh! 😳 8)

[RobBox]

I would go with the option of treating the change as a single change and doing a supersession bases on the new information. All other information would not change unless advised by the claimant. Surely there is no opportunity for underlying entitlement to come into the assessment. If other elements of a claimants claim have changed it is their responsibility to tell us anyway?

For what its worth, I think we are all starting to try and chase our own tails with attempting to second guess what is or isn’t the intention of some badly written bits of Regulations or DWP advice. Assessment Officers here groan every time a different interpretation is giving for something they thought they had got sorted and day to day work is becoming very, very difficult.

Aren’t we supposed to be in a time of simplification!

[Kevin D]

I entirely agree with Rob.

Besides, so long as there is continuing entitlement, it wouldn’t be underlying entitlement – it would be actual entitlement.

[arenton]

Thanks for all your replies folks,

That is what i was hoping to hear!!!

I think we will go as is suggested- treat entitlement as entitlement, and not worry about underlying entitlement when changes are notified by the claimant.

But i think if overpayments are created from results of fraud investigations, or HBMS etc- [b:fd3f44ec97]then[/b:fd3f44ec97] we will ask claimants for details for possible U/Ent.

Cheers

[arenton]

Hello again,

Having said what i said in my last post – i have just received advice from the DWP- this is what they say on the subject-

“I am afraid that underlying entitlement must be considered on all overpayments, whether benefit has ceased or it is an ongoing claim………

……..For example, some LAs are getting their receptionists to ask claimants if they have had any other changes in their circumstances, when they go into the LA to report a change. They get them to sign they have had no other changes and so they can then calculate the overpayment (including considering underlying entitlement) and issue the decision notice immediately. This cuts down the processing time dramatically………….

If however the claimant writes in and reports a change, the LA would need to write out and ask them if they have had any other changes in their circumstances over the potential overpayment period, in order to calculate underlying entitlement. They must give the claimant one month to respond. In a lot of cases where the claimant reports a change of circumstances, the LA will have to write out for further information/evidence in order to process that change. If they ask the claimant for details of their correct circumstances from the date they had the change, they will be satisfying the underlying entitlement process at the same time, and will be able to calculate the final overpayment amount when the claimant responds. This again would reduce the processing times.”

This would suggest that unless a declaration is signed confirming no further changes, we are supposed to write out to confirm the other details of the claim (which i had hoped not to have to do!!!).

[Anonymous]

There is nothing like a good practical answer from the Adelphi and this is n…… l… o.. 😯

Please fill in the missing words. 8)

[RobBox]

Someone, somewhere is having a laugh at the expense of all local authorities.

[Author]

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