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Forum Home  →  Discussion  →  Disability benefits  →  Thread

PIP not a qualifying benefit?

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geep
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I was just checking the rules about backdating after a qualifying benefit is awarded. P1149 of the CPAG book says that PIP is only a qualifying benefit for entitlement to CA. But on p234 PIP is listed as a qualifying benefit for the SDP. This is confusing, can anyone shed some light on it for me, please?

And just to explain the context of the case I’m referring to:

The client is over pension age but has applied for PIP because the end of his DLA award was less then 12 months ago. He is waiting for a decision on his PIP claim.

At the moment he doesn’t receive any PC because the combination of his SP and private pension is higher than his PC applicable amount, but once he has been awarded PIP he will qualify for the SDP and his combined pension income will be just under his PC applicable amount - and should therefore be awarded some PC. So, that’s why I was looking at whether I should get him to claim PC now (even though he won’t qualify) so that it will be backdated to the start date of his PIP claim. And then I read page 1149 which seems to say that PIP is not a qualifying benefit for this purpose…

And a related issue: if I can get his PC backdated, will his HB also be backdated to the same date? Do I have to do anything now to make sure he doesn’t miss out on that backdate of HB or can I just wait until PIP/SDP is awarded?

Thanks

Tom B (WRAMAS)
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Yes he should claim PC now. If it is likely to be refused, he can then make a new claim when a PIP decision is issued and request backdating to the date of the earlier claim.

PC can usually only be backdated for 3 months and it appears most PIP claims are taking far longer than 3 months!

If he is already in receipt of HB then he will not need to do anything apart from notify the LA if PIP is awarded. If he does not receive HB at present then he should make a protective claim as above.

Edmund Shepherd
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I concur. Get the claims in to protect the date of claim. You can ask for DWP/local authority to stockpile the claims. In practice, they won’t do this for long, but provided the claims are in, you can have them revised once PIP is awarded. Another part of my brain is telling me a new claim must be made now and another after PIP is awarded. The two claims are then linked.

So yes, claim now.

geep
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“Yes he should claim PC now. If it is likely to be refused, he can then make a new claim when a PIP decision is issued and request backdating to the date of the earlier claim.

PC can usually only be backdated for 3 months and it appears most PIP claims are taking far longer than 3 months!

If he is already in receipt of HB then he will not need to do anything apart from notify the LA if PIP is awarded. If he does not receive HB at present then he should make a protective claim as above.”

Thanks!

So, he should claim PC now, but it will be backdated three months from the date of the PIP decision, not to the date of the unsuccessful PC claim? Also, the PC claim is started over the phone, and the questions they ask will prevent the claim going any further, will that count as an attempted claim or do I need to insist that they send a written decision saying that he doesn’t currently qualify for PC?

He does currently receive HB, although it is suspended (we expect it to restart though). When we inform the LA of his PIP award, will they backdate his increased HB applicable amount to the start date of the PIP claim?

Edmund Shepherd
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“So, he should claim PC now, but it will be backdated three months from the date of the PIP decision, not to the date of the unsuccessful PC claim?”

If PIP is claimed before PC, if a PIP decision is favourable, it is backdated to the date of claim.

“the PC claim is started over the phone, and the questions they ask will prevent the claim going any further”

Why would it stop the claim going any further? The telephone operator can’t gatekeep a benefit. The claimant has the right to have the claim formally decided, so tell him to ignore the check into potential entitlement and get a claim in regardless of what the Pension Service tries to do.

If your client were prevented from completing his claim by DWP, then you could argue that he tried and it might work, but better to push for a decision, which demonstrates without doubt that a claim was made.

“When we inform the LA of his PIP award, will they backdate his increased HB applicable amount to the start date of the PIP claim?”

Provided he tells the LA within one month of the decision, it should be backdated. See CPAG p.142.

geep
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Yes, the PIP claim went in first, as he hasn’t tried to claim PC yet.

CPAG p1149 says that one of the criteria for backdating is ‘the qualifying benefit was claimed no later than 10 days after your original claim’. But my client claimed the qualifying benefit (PIP) before claiming PC, so does he still meet this criteria?

I’m still not sure why p1149 says that PIP is not a qualifying benefit!

Tom B (WRAMAS)
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geep - 23 October 2014 01:33 PM

Yes, the PIP claim went in first, as he hasn’t tried to claim PC yet.

CPAG p1149 says that one of the criteria for backdating is ‘the qualifying benefit was claimed no later than 10 days after your original claim’. But my client claimed the qualifying benefit (PIP) before claiming PC, so does he still meet this criteria?

I’m still not sure why p1149 says that PIP is not a qualifying benefit!

From a cursory look at the legislation it appears the Claims & Payments regs refer to the list of qualifying benefits found in the Conts & Benefits Act which has not been amended to include PIP.

One thing to note is that a subsequent update to the CPAG handbook after the para beginning ‘Generally a qualifying benefit is any benefit (except PIP)’ is…

“However, it is understood that in practice the DWP is prepared to treat PIP as if it were a qualifying benefit”

although I’m not sure of the reference to this.

Tom B (WRAMAS)
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Also if you’re experiencing problems getting the PC claim line to accept a claim, you could always complete a paper PC1 form:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/271823/pc1_print.pdf

benefitsadviser
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The DWP call centres are not the gatekeepers to benefit awards?

Ive lost count of the amount of times my clients have been told they cant claim this or that by frontline staff when ringing them up.

One client of mine got AA, and the SDP triggered GPC. Pension service told her and me both that she cant have an SDP as she has to be on Pension Credit in the first place for the SDP to apply.

Carts and horses spring to mind…..

Edmund Shepherd
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DWP and HMRC do gatekeep benefits. We will all have stories to tell on this one. However, that is not their role and I do my best to steel people to insist on submitting a claim.

Jon Blackwell
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benefitsadviser - 23 October 2014 03:38 PM

The DWP call centres are not the gatekeepers to benefit awards?

One client of mine got AA, and the SDP triggered GPC. Pension service told her and me both that she cant have an SDP as she has to be on Pension Credit in the first place for the SDP to apply.

Carts and horses spring to mind…..

Pension service seem very keen on this particular error - I wonder if there’s something wrong with the scripts/guidance?

 

 

 

benefitsadviser
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I agree Edmund. You are correct : They shouldnt but they do. They get ahead of themselves

Ive lost count of the numbers of clients who are told by their JSA adviser that “They” are going to sanction their benefit when we all know that its the role of a Decision maker to consider whether a sanction applies or not.

1964
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We’ve been known to role-play clients through making a claim (in the hope of getting around the ‘you can’t make a claim’ scenario). Sometimes it works (when all else fails we’ll make the claim from our office with the client present).

geep
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So, I tried to make the PC claim over the phone, and guess what happened?! I said I wanted written confirmation of the decision even if their first set of questions told them that he wouldn’t be eligible. They said they couldn’t do this due to the new set of initial questions that they started using a few months ago.

Then I asked if I would get a written decision if I submitted the paper form instead and she said yes, ‘because those are dealt with differently’. She also said the PC would only be backdated 3 months from the PIP decision. This is incorrect, right? I hope so because the PIP is going to take more than 3 months to process and I don’t want the client to lose out.

I’ve submitted the paper PC form now.

Jon Shaw
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tbidmead - 23 October 2014 02:04 PM
geep - 23 October 2014 01:33 PM

Yes, the PIP claim went in first, as he hasn’t tried to claim PC yet.

CPAG p1149 says that one of the criteria for backdating is ‘the qualifying benefit was claimed no later than 10 days after your original claim’. But my client claimed the qualifying benefit (PIP) before claiming PC, so does he still meet this criteria?

I’m still not sure why p1149 says that PIP is not a qualifying benefit!

From a cursory look at the legislation it appears the Claims & Payments regs refer to the list of qualifying benefits found in the Conts & Benefits Act which has not been amended to include PIP.

One thing to note is that a subsequent update to the CPAG handbook after the para beginning ‘Generally a qualifying benefit is any benefit (except PIP)’ is…

“However, it is understood that in practice the DWP is prepared to treat PIP as if it were a qualifying benefit”

although I’m not sure of the reference to this.

Hi all,

PIP is not a qualifying benefit for the purposes of backdating a new PC claim beyond three months. This is because it was not included in the list of ‘relevant benefits’ in Reg 6(22) of the Claims and Payments Regulations (SI 1987/1968) so as to be a ‘qualifying benefit’ for this purpose. The reason that it is a qualifying benefit for extra CA backdating is that the CA rule makes reference to ‘any benefit referred to in the list in s70(2) of the Contributions and Benefits Act’ and PIP was added to the list. When we pointed this out to DWP, they satated it was an error and would be amended but not until some time in 2015(?!)

They also stated that they would ‘treat it as a qualifying benefit until then’ (hence the amendment to the handbook that tbidmead refers to above). There really isn’t a basis for this that I can see (DWP referred to their intention in their reply). As such I think you have to ask for the PC claim not to be decided until a PIP decision is made. If this request is refused (and PC refused) reclaim once PIP has been awarded and request backdating, asking for compensation equivalent to the amount of PC lost if backdating is refused.

There is a paragraph about the situation in this article: http://www.cpag.org.uk/content/pip-process-problems-and-pragmatism

The difference for HB is that it is a supersession after the award of a qualifying benfit, and this refers to benefits listed in s8(3) of the Social Security Act 1998 - amended to include PIP. See Reg 7(2)(i) and 8(14) of the HB Decisions and Appeals Regs (SI 2001/1002).

Hope that makes sense. We would be interested to hear what PC do with this, given law and guidance both say they cannot backdate beyond three months at present.

Jon

geep
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Thanks, Jon. I just want to check one thing, though… If I ask them to hold off on making the decision, will I still be able to lock down a date to which the PC should be backdated? I thought the whole point of getting a decision now was to secure a date for backdating.

Does PIP not being classed as a qualifying benefit in the regs create a catch 22? I need a PC decision to secure a date, but can’t get a decision because PIP won’t secure a backdate to that date if more than 3 months have passed by the time the PIP is awarded.