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Impact of back-dated claim for Severe Disability Premium

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1 year 9 months ago #271707 by woody34
My daughter is on IR ESA (Support Group) and PIP (enhanced daily living and enhanced mobility). For various reasons I needed to look at what would happen if my daughter, was forced to make a claim for Universal Credit.

The last review for her ESA was in August 2018 (awarded in October 2018), so it's been a while since the last review.

I am appointee for her benefits. In March 2018 she moved from home into her own flat (pays rent but received housing benefit / allowance), and DWP were informed of this. I guess this means she should then have started receiving severe disability premium? She was (and is) already getting "extra money because of the Disability Income Guarantee" - i think this is the enhanced disability premium? In total she gets £135 including about £40 extra because of being in the support group.

When I found out that to get transitional protection when she is migrated to UC, she needs to be receiving (or is it really eligible for?) severe disability premium, I checked she was definitely getting it, but there is nothing about this in her award letter - the only additional amounts are the those I've mentioned above, and they didn't change after moving into her flat.

Am I correct she should be getting an extra £69.40 severe disability premium because of being on ESA, and receiving enhanced daily living component of PIP, and living alone in her own flat? Am I correct this should be backdated to March 2018 when she moved in? Where can I find the historical rates of SDP that applied since she March 2018?

The reason she might have failed to be awarded SDP following the review in October 2018 is because, being appointee, my address is on the ESA review claim form - though I did put in the notes on the form that she was living at least 5 days a week in her own flat, and I gave the address of her flat.

So it seems I could make a back-dated claim, but to do so raises the following questions:

1. If I ask for SDP to be paid / back-dated, could this cause the ESA claim to be reviewed - so I have to fill all the forms in again? Would this mean she would then be forced to claim Universal Credit immediately?

2. If she received £16,000 or more, would they automatically assume she had £16,000 savings and stop her claim? This could be disastrous.

3. If her claim was stopped, am I correct that would mean she'd then have to claim UC when her savings went down, and as a result of no longer receiving ESA she would lose her entitlement to transitional protection for the severe disability premium? That's £285 a month I think - which means she could lose more money that she gains by claiming the back-dates severe disability premium.

4. How long are claims taking for SDP these days? I'm worried that if they take more than, say, 8 weeks to award back-dated SDP, that could means she'd receive a lump sum of more than £16,000. If it took longer than 15 weeks, then the lumpsum added to her £500 overdraft would means she'd then have over £16000 in savings.

5. Can I say how long I want to back-date the claim, or would it be automatically back-dated to the date she moved into her flat?

6. If I don't claim the SDP, I'm worried that when migrated onto UC, they will realise she was entitled to SDP, and automatically award arrears of SDP exceeding £16000, and therefore immediately stop her claim to UC (meaning she loses transitional protection). Is this a valid concern?

7. Because her flat is in a different council area, could she now be forced to claim UC, even though she moved to her flat back in March 2018 (when I believe neither council area was part of Universal Credit).

Strange, but true, the implications of the possibility my daughter is owed back-dated SDP is causing real anxiety for me!

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1 year 9 months ago #271760 by Gary
Hi woody34

I have done numerous SDP reviews without any implications. If you have any doubts then contact your Welfare Rights Organisation for help; advicelocal.uk .

SDP: the SDP became payable from the first day that all three of the following applied.

1. You had an award of ESA and we’re receiving or were entitled to receive Income Related ESA or Pension Credit.

2. You had an award of PIP Daily Living

3. You met the criteria for payment of the SD Premium, namely that you lived alone or were considered to be living alone and no one receives Carers Allowance against your PIP award.

In regards to your query about lump sum award and transitional protection, I raised this query with the DWP and received the following reply;

As per UC eligibility criteria arrears of benefit, Tax Credits or compensation for non-payment of £5,000 or more paid due to official error or error of law can be disregarded for the length of the Universal Credit award.

The disregard applies to claimants who receive a payment of arrears or compensation:

~ whilst in receipt of Universal credit
~ whilst in receipt of a Legacy benefit and migrate to Universal Credit with a gap of less than a month between awards of benefit

This longer disregard will only be available on a transitional basis and will only apply to payments of arrears or compensation which relate to a period before Legacy benefits are abolished. Once migration to Universal Credit is complete and Legacy benefits are abolished, a standard 12-month disregard will apply to all new benefit arrears and compensation payments whether or not they are due to official error or errors of law.

Gary

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: CampbellKitty, woody34

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1 year 9 months ago #271773 by woody34
Many thanks for your kind help.

From how you describe eligibility for SDP, it sound like any arrears would probably be from either date she moved into her flat, or the date of the review in August 2018 (the decision for that was made in October). Am I correct that means there would be no option for me to ask DWP to back-date the SDP for a shorter date?

About the criterion that she lives alone - does it matter that (at least to begin with) she used to spend 1 or 2 days a week at home rather than in her flat? She has always paid rent in her flat and lives entirely alone there (well except that I visit and speak to her on the phone).

I might not fully understand some of the technical words in your reply, so please can you help by answering these questions:

Am I correct that the words "as per" means the same disregard rule applies for the length of the legacy ESA award she currently has, not just for any future UC award?

Does the disregard mean she wouldn't have her benefit reduced at all while it applies?

What does "the length of the ... award" mean? If her ESA or the equivalent on UC is reviewed (ie. a new decision is made after she has been asked to submit review forms), does that become a new award so that the disregard no longer applies?

It says the "disregard will only be available on a transitional basis". Does that mean that if her benefit rates increase (eg annually due to inflation), they will work out the benefit she would have had if the disregard hadn't applied, and only give her an increase if that is more than she's currently getting? If so, since her savings would be likely to reduce over time, how will they know how much savings she has at the time benefit rates are increased?

When it suggests there needs to be a gap of less than a month between her current award and a future award of UC, is that based on the date she makes a claim from UC? - what if there is gap of more than a month because of how long DWP take to process the claim? Or else, would the legacy ESA continue in any case until UC was awarded, so there would be no gap.

Is it possible that, because I gave my address (as her appointee) (rather than the address of her flat) on the review form in August 2018, they could decide no official error or error in law had been made, but still award arrears of benefit? The review form I completed does make it clear she is living alone in her flat, and I gave the address of her flat in the additional notes section of the form. Although I sent a letter to DWP when she moved into her flat in March 2018 it wasn't acknowledged, so I don't know if they received it.

Presumably if they decide there was no error, but still awarded arrears, there would be no disregard at all (or perhaps just a 12 month disregard)?

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1 year 9 months ago #271808 by Gary
Hi Woody34

You need to have a word with your local Welfare Rights organisation who can take all your circumstances into consideration; you can find your local Welfare Rights Organisation to help you with advice by clicking on the link below and putting in your post code, it will then come up with a MAP with a list of agencies. advicelocal.uk

I will try and answer your questions;

1) You cannot dictate when you want any arrears paid from, the backdate will be from when your daughter qualifies for the backdated payment. I have known payments to go back 4 years.

2) No, if your daughter main abode is away from her parents then that is the address.

3) yes you are correct, As per UC eligibility criteria arrears of benefit, Tax Credits or compensation for non-payment of £5,000 or more paid due to official error or error of law can be disregarded for the length of the Universal Credit award.

4) You are correct, your daughters benefits will not reduce whilst she is in receipt of the benefit.

5) With ESA you will be re-assessed at some stage, when you are re-assessed if you stay in the same group then the length of the award carries on.

6) You are correct, when you get transitional protection (TP), your benefits will stay at the same amount year after year until your TP award becomes less than a claimant without a TP. DWP has access to numerous records, they do rely claimants to be honest but they also have access to numerous databases

7) when you apply for UC, it takes 5 weeks for a claim to be put in payment, when you see your workcoach, you can request an advanced payment but this has to be repaid over time usually between 1 - 2 years.

Can't answer your last question, you would have to ask DWP.

All I can say is you have to open and honest, I have never had any trouble getting backpay for an official error where SDP have been missed. When ever I do a benefit maximisation I always look for the missed SDP/EDP if someone is claiming a legacy benefit.

Gary

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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1 year 9 months ago #271851 by woody34
HI Gary,

Thanks again - I will try to find a suitable local advisor, but there don't actually seem to be any in my area except Citizens Advice - and I'm not sure if they cover this.

About what DWP said: "The disregard applies to claimants who receive a payment of arrears or compensation:
~ whilst in receipt of a Legacy benefit and migrate to Universal Credit with a gap of less than a month between awards of benefit

I'm worried about your reply (7) if it takes 5 weeks to make a claim when migrating from ESA to UC, doesn't that automatically mean there will be a gap of more than a month - and so the disregard will automatically stop applying? It's likely she will be forced onto UC before long due to mandatory migration now rolling out.

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1 year 9 months ago #271854 by Gary
Hi woody34

I have asked this question to our consultants who have informed me that providing you apply for UC whilst IR ESA is still live then you should be placed in the LCW/LCWRA group without having to go through the assessment phase.

The issue is that some claimants have found that the UC department are refusing to include the LCW or LCWRA Element from the start of the UC award, on the grounds that the claimant’s review Work Capability Assessment is overdue – and therefore their ‘unfit for work’ status on their ESA is not carried forward to their UC claim.

We believe that this is wrong! 

What is important to note is that, once a decision has been made that a claimant is in the WRAG or the Support Group, then, even if the recommended review date comes and goes without the claimant being put through another WCA, the DWP cannot take away that status (ie supersede the decision) simply because someone has not yet been re-assessed! 

Regulation 6 (2)(r) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 states that an ESA decision may be superseded if a Healthcare Professional has provided the decision maker with medical evidence. 

In other words, a decision maker cannot remove the WRAG or Support Component unless a further WCA has taken place. 


1. Regulation 19 of the UC (Transitional Provisions) Regulations 2014 makes it clear that those who move from ESA onto UC (and who have not been found fit for work), are to have:

The LCW Element included in their UC assessment from the start of their UC award if they were in receipt of the Work Related Activity Component in their ESA award, or
The LCWRA Element included in their UC assessment from the start of their UC award if they were in receipt of the Support Component in their ESA award.

This means that the work capability decision MUST be transferred across from an ESA award to a UC one.


2. Regulation 6(2)(r) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 (for IR-ESA) and Reg 26 of the Universal Credit, PIP, JSA and ESA (Decisions and Appeals) Regulations 2013 (for UC and New-Style ESA), both say that decisions on the WRAG/Support group for ESA and on the Limited Capability for Work/Work Related Activity in UC cannot be superseded - ie taken away - without evidence from a Healthcare Professional.

Therefore, even where the WCA review date has passed, the DWP cannot refuse to include a LCW /LCWRA Element in the UC assessment until a review WCA has been completed ie evidence from a Healthcare Professional received.

Gary

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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