DLA overpayment

Has anyone got a got of the leaflet sent with an award of dla and a copy of an uprating dla letter - we have an appointment for a dla overpayment without the appeal papers next week and need a copy to check out with the client why she thought you had to tell them about being in hospital at 12 weeks not 4

Thanks

Leaflet DLA95 01/14 (Notes for people getting Disability Living Allowance):

Page 3

NHS Hospital or hospice

Disability Living Allowance may only be payable for the first 28 days if you are receiving free inpatient treatment in a NHS hospital or hospice.  You must tell us straight away if you go into, or come out of a NHS hospital or hospice.

Children under 16 in a NHS Hospital or hospice

Disability Living Allowance may only be payable for the first 84 days if the child is receiving free inpatient treatment in a NHS hospital or hospice.  You must tell us straight away if you (sic) go into, or come out of a NHS hospital or hospice.

It looks like she has read the wrong paragraph.  It would have been clearer if the final sentence had used the words ‘the child’ rather than you.

Sorry to hijack this post but could you let me know what it says about informing DLA if you start work? I’ve got an overpayment appeal where fraud investigator says “you must inform us if you start work” and quotes it as being in this leaflet - DLA95.

Page 3 again

You must tell us if your illness or disability changes, or the amount of help you need changes.

For example,

You may need more or less help after an operation, or

You may need more help to manage at work, or

Your condition has improved enough for you to think of starting or returning to work.

Is there proof that your client was sent a copy of DLA95?

Thanks

No - no proof she was sent the leaflet.  The Fraud Investigator says you MUST inform them if you start work whereas what the leaflet actually says is “if your condition has improved such that you think you can start work..”. Its a surveillance case.  She doesn’t think her condition had improved.

Jo Woodcock - 28 November 2014 01:07 PM

Thanks

No - no proof she was sent the leaflet.  The Fraud Investigator says you MUST inform them if you start work whereas what the leaflet actually says is “if your condition has improved such that you think you can start work..”. Its a surveillance case.  She doesn’t think her condition had improved.

DLA and work - always causes problems for poor old Fraud Officers.  They just can’t get their heades around DLA at all.

Of course,  It is possible for a persons condition to deteriorate and they still start work because a sympathetic employer accepts that they are capable of doing everything needed despite the disability. 

To make it clearer - the DWP could just state - report if you start, stop or change employment.

cheers - I meant to say thanks earlier but the connection here can be a bit erratic - its probably the sun today

P.E.T.E - 28 November 2014 02:39 PM

Jo Woodcock - 28 November 2014 01:07 PM

DLA and work - always causes problems for poor old Fraud Officers.  They just can’t get their heades around DLA at all.

Of course,  It is possible for a persons condition to deteriorate and they still start work because a sympathetic employer accepts that they are capable of doing everything needed despite the disability. 

To make it clearer - the DWP could just state - report if you start, stop or change employment

 

 

Jo Woodcock - 28 November 2014 03:03 PM

P.E.T.E - 28 November 2014 02:39 PM

Jo Woodcock - 28 November 2014 01:07 PM

DLA and work - always causes problems for poor old Fraud Officers.  They just can’t get their heades around DLA at all.

Of course,  It is possible for a persons condition to deteriorate and they still start work because a sympathetic employer accepts that they are capable of doing everything needed despite the disability. 

To make it clearer - the DWP could just state - report if you start, stop or change employment

 

Yes totally agree. There’s nothing in a DLA claim form to ask a claimant if they are working or not but then later they try and argue you should disclose if you start work. My client just got high rate mob and job was only 2 hrs a day and didn’t involve walking My claimant says she looked on line and saw on a government website that you can claim DLA and work (as we know you can).

There is no mention of work in the original claim form, they dont ask

How can reporting starting work be a legal requirement?

I was always under the impression that the instructions given was was guidance, not actual law?

The instructions change very regularly (at least annually), so it is essential to see a copy of the ones which applied during the period of the alleged OP/change of circs. 

Too often someone at DWP relies on a copy of instructions which didn’t apply at the time in question. 

In one case I dealt with, they even produced a copy of the instructions for use in Northern Ireland (for someone living in southern England!) and then spectacularly failed to comply with Directions to produce the relevant one for Great Britain and to also send a PO to the Tribunal (despite the DWP office being opposite the Tribunal venue).

Agree with what Neil and others have said. All too often, it seems to me, that attitude of fraud investigators is that all claimants are at it and that those who remain entitled to whatever benefit they are receiving do so only by virtue of the fact that investigators have, at least for the present, been unable to establish exactly what fraud is being committed.

Had one case in the not too distant past where the fraud investigators were absolutely furious when a tribunal accepted my submission that the admission of non-disclosure they had extracted in respect of the IS overpayment (client had, unfortunately, failed to declare her earnings and was bang-to-rights on that score) was of no real value for the alleged DLA overpayment if the claimant continued to meet the qualifying criteria in fact. What was even more amusing was that the original ‘lifetime’ award of high rate mobility was based on the claimant’s statement of a walking ability of 150 yards before the onset of severe discomfort and the fact that she was now 66 - so that without any evidence of a change of circumstances, what had become an indefinite award was, in reality, a lifetime award (i.e. a DM - or if it came to it - a tribunal, might well and reasonably have come to a different conclusion about entitlement on renewal, but that wasn’t a possibility).

But there’s an important point here - it may not have been stated because it’s obvious to those who’ve contributed so far - but it’s worth spelling out…..

For DLA, AA or PIP, the question of what was on the information leaflet and whether the claimant disclosed or should have disclosed is only of importance at the point where there has in fact been a change of circumstances sufficient to reduce entitlement. It’s sometimes possible to lose sight of this bit of wood for the trees - and whilst technical arguments as to whether there has been any change sufficient to meet the requirements that would permit the DWP to revise or supersede are worth making, the majority of tribunals will want to be satisfied as to the claimant’s ‘true’ level of entitlement as at the date of the alleged overpayment.

Of course, it’s always worth being able to make arguments as to whether the wording of the DWP’s information leaflets was sufficient to impose a duty to disclose in case you can’t establish that the claimant remained entitled (or in case the tribunal doesn’t accept your case where the entitlement issue could reasonably go either way) but in the majority of cases the ‘actual entitlement’ argument should be the first line of defence.