How to claim UC

Log in to the online journal and do an immediate reclaim as soon as claim is closed. The 3 month relevant period will still be running. The UC50 should be issued 29 days after Fit Note first provided so has client received one?

I think DWP are wrong to close the claim in this circumstance - they are supposed to make a nominal award of 1p and keep the claim open.. That is my understanding of UC Regulations 2013 regulation 28(7).

DWP Guidance gives an example of this at ADM Chapter F5: The LCWRA element at paragraph F5070

csmk - 20 December 2019 08:40 AM

DWP Guidance gives an example of this at ADM Chapter F5: The LCWRA element at paragraph F5070

I think the example is problematic in that it states that the DM decides that Adele has LCWRA and therefore keeps the claim open during the assessment period by making a 1p award. This is illogical because until the WCA is done the DM is not in a position to make this decision (unless the claimant is entitled to be automatically treated as having LCWRA, but even then DWP require the UC50 to be completed before confirming this).

I don’t think this is what the legislation intends. I think the claim should be kept open during the relevant period if the claimant might have LCWRA and this would result in entitlement. If the award of LCWRA would not result in any entitlement anyway then I think it’s OK to close the claim.

Others who are better able to follow the legislation than I am may be able to confirm.

In practice claims are being closed during the assessment period and the pragmatic response seems to be to make an immediate reclaim.

I’ve been reading the example as if it is implied that the LCWRA element was determined after a WCA, though I definitely see your point. The next section of the example goes on to say that there’s a penny entitlement if the claimant would have been entitled to the LCWRA, if not for the waiting period. Regardless, if we take out the sentence that the DM makes a determination that Adele has LCWRA, then it makes sense from what Reg 28 says.

I agree, the claim should be kept open and not closed at all and I think my colleague got this confirmed with expert advice when we were confused about this. We’ve generally had to escalate it if a claim has been closed and then claim is reopened after doing this with penny entitlement pending WCA outcome. I’d definitely go with making a new claim though in case of escalation delays or disputes being lost for half a year.

roecab - 19 December 2019 05:37 PM

We have a client, part of a couple, both work and our client is off sick, getting SSP but even when this stops they will will still have income that is just over the limit, and do not qualify for UC, however if they had the work allowance included then they would be.

As they have not had any entitlement for two months the client tells us that the UC claim has been closed.

How does our client ever get to the WCA, as he cannot submit a MED3 to a closed claim - as if he is assessed as LCW then can get the work allowance, and if assessed as LCWRAG would get both the work allowance and the element

Another issue he has 2 ‘spare rooms’ but we cannot look at DHP as no housing costs as no UC claim

Any ideas greatly welcomed.

Cheers

Would advise in this specific instance putting in a MR and escalating via MP at the same time giving them a copy of the MR sub. Otherwise it will drag on without any resolution for months and months. 

We had one a few months ago, client’s UC claim had been open since the spring of 2018. Bizarrely it was closed at the point client was having a WCA.

We helped client submit a MR, simultaneously we escalated via MP, which got stuff sorted within a fortnight. At the point we submitted MR we did not know the outcome of WCA. We just knew it had happened.

Transpired our client had actually been found to have LCWRA.

When we looked at the Shadow journal obtained by SAR we could see the DWP workers notes to each other.

One memorable note went along the lines of he has been found to have LCWRA, but i can’t do anything because the claim has been closed. Unfortunately, it did not occur to the workers concerned to reopen the case and revise the decision of their own volition etc etc. 

In this thread, Charles thought that the regs appear to cover situations where entitlement would be NIL due to the actual LCW/LCWRA element not being included, rather than due to the work allowance not being applied. Given that view, it may be worth emphasising in arguments that it would be the hypothetical LCWRA element that brings the entitlement, rather than the work allowance on its own?

Do others think that simply doing a rapid reclaim will achieve the same end without the aggravation of MR etc.?

I don’t think you can do a rapid reclaim if an award was never in payment as there is nothing to reclaim - it is just a new claim so therefore you have to MR the original claim to protect the date of claim.

Daphne - 02 January 2020 12:55 PM

I don’t think you can do a rapid reclaim if an award was never in payment as there is nothing to reclaim - it is just a new claim so therefore you have to MR the original claim to protect the date of claim.

Thanks, Daphne. I can see the logic of that.

I’m not so sure. In the old live service, there was statutory provision for a rapid reclaim (it wasn’t technically a reclaim at all, as a claim wasn’t needed). However, in full service UC, a rapid reclaim is a regular new claim. It’s just that UC have your details already, so the claim is simply a matter of confirming there have not been changes, hence the term “rapid” reclaim. I see no reason why that couldn’t take place in a case where no award had ever been in place. I haven’t experienced this though.

Charles - 03 January 2020 12:55 AM

I’m not so sure. In the old live service, there was statutory provision for a rapid reclaim (it wasn’t technically a reclaim at all, as a claim wasn’t needed). However, in full service UC, a rapid reclaim is a regular new claim. It’s just that UC have your details already, so the claim is simply a matter of confirming there have not been changes, hence the term “rapid” reclaim. I see no reason why that couldn’t take place in a case where no award had ever been in place. I haven’t experienced this though.

The key question then is if a claimant has the claim closed closed as a result of a nil entitlement and they access their journal and do a rapid reclaim does this preserve the start date for the relevant period in respect of entitlement to be paid LCWRA? I think it would. Obviously this might happen more than once before getting to the fourth assessment period and the start of LCWRA payment.

I’m just trying to see if there is a pragmatic work around which avoids the inevitable delays of making an MR and waiting for a decision (although I recognise that DWP should be challenged when they are not applying the legislation correctly).

My understanding - and this is second hand rather than me seeing it personally - is that the rapid reclaim button only appears on a up and running award when there is a nil entitlement assessment period. When the claim has been closed with no award made there is no facility for that so it has to be a normal claim

Ianb - 20 December 2019 11:00 AM

csmk - 20 December 2019 08:40 AM

DWP Guidance gives an example of this at ADM Chapter F5: The LCWRA element at paragraph F5070

I think the example is problematic in that it states that the DM decides that Adele has LCWRA and therefore keeps the claim open during the assessment period by making a 1p award. This is illogical because until the WCA is done the DM is not in a position to make this decision (unless the claimant is entitled to be automatically treated as having LCWRA, but even then DWP require the UC50 to be completed before confirming this).

I don’t think this is what the legislation intends. I think the claim should be kept open during the relevant period if the claimant might have LCWRA and this would result in entitlement. If the award of LCWRA would not result in any entitlement anyway then I think it’s OK to close the claim.

Others who are better able to follow the legislation than I am may be able to confirm.

In practice claims are being closed during the assessment period and the pragmatic response seems to be to make an immediate reclaim.

My understanding of this has changed over time, but I now disagree with this. The following is my understanding of how things are supposed (!) to work:

1. Claimants who have declared a health condition or disability are not supposed to have their claim decided and closed due to earnings/income until a WCA has been carried out. See the following on page 1 of the Spotlight I’ve attached to this post: “Claimants on the health journey at any point from day 1 to the date of the determination of the WCA outcome must not have their claim closed when entitlement is nil due to income, earnings or both.”

2. Claimants who are found to have LCW/LCWRA will retrospectively get the work allowance included from the start, and do not have to wait for the relevant period to end. See this post from MareeH.

3. Due to the above two points, there is no necessity for a 1p award in cases where entitlement is nil due to the lack of a work allowance. The claim should be kept ‘alive’, with no decision being made, until the WCA is carried out, at which point the work allowance will be backdated.
There is only a need for the ‘1p award rule’ when entitlement is nil due to the LCWRA element not being included during the relevant period, as in such cases there will not otherwise be entitlement to UC to enable the relevant period to begin.

As always, Charles, that’s very helpful. If I understand your argument the 1p award only becomes applicable if the WCA has been completed but the LCWRA has not yet been put into payment because the relevant period is not yet complete.

The attachment is very helpful.

I suspect actual practice dealing with claims to be somewhat different!

Ianb - 16 January 2020 07:40 PM

If I understand your argument the 1p award only becomes applicable if the WCA has been completed but the LCWRA has not yet been put into payment because the relevant period is not yet complete.

I believe the relevant period can only start, and subsist, while there is a live award of UC (hence the need for Reg. 28(3) to remove that requirement in some cases).

If that is the case, then even if 3 months have passed before the WCA takes place, a 1p award for the earlier APs will be needed. Without it, the relevant period will never have started.

Thanks Charles. Apologies, I hadn’t taken in your previous post properly. I follow your argument now.

Charles. In an earlier post in this thread you attached a spotlight document. Where are these to be found? Annoyingly the document has no date so it’s impossible to establish how current it is.

The Spotlight you quoted is very clear that the claim must not be closed due to nil earnings at any point during the WCA process.

Compare with this deposited paper http://data.parliament.uk/DepositedPapers/Files/DEP2019-0980/25._Claim_closure_v11.0.pdf
Here it is noted that “The system will automatically advise to close the claim when an award is nilled due to earnings.” but nowhere can I see advice that the claim should be kept open if WCA is in process.

Ianb - 21 January 2020 10:03 PM

Charles. In an earlier post in this thread you attached a spotlight document. Where are these to be found? Annoyingly the document has no date so it’s impossible to establish how current it is.

They generally come to light from specific FOI requests, a few are linked throughout this thread. DWP quote, from https://www.rightsnet.org.uk/forums/viewreply/69719/

“Spotlight products are designed to support the service and policy level guidance for a short period. There are no plans to put Spotlights into the public domain at the present time.”

Yes, I got this from a FoI request. See here.

I made a FoI request myself just a few days ago requesting they release all Spotlight guidance here.

Thanks, Jon and Charles. There should really be something more interesting for us to be reading at this time of evening!

Charles - 21 January 2020 10:33 PM

Yes, I got this from a FoI request. See here.

I made a FoI request myself just a few days ago requesting they release all Spotlight guidance here.

Thanks Charles, interesting stuff.

Do you think it’s a coincidence or just plain bad luck that this statement relating to closing a UC claim due to earnings unfortunately falls onto the next page, so isn’t obviously linked to the instructions on the previous page?

IMPORTANT - for anyone on the health journey, who has yet to have their WCA or waiting the decision from that WCA, must not have their claim closed.

How does this interact with reg 41/permitted work?

Essentially considering a circumstance where someone becomes long term sick and would reasonably expect to stop working in the future. Early claim to UC both to reduce the 5 week wait, and potentially the relevant period for LCWRA. 

I’m guessing that nil/1p award will not be put in place if the client’s work/earnings are above the threshold, as they could not be called for a WCA in any case?
Presumably the claim would be closed as soon as the relevant earnings were registered. If the claim does run on for a few days, and a health condition/fit note was submitted on day 1, would the relevant period still be reduced accordingly on a reclaim?

However, the relevant period would still start if the claimant is otherwise entitled to UC (say because HC are high enough), and declares health/submits fit note.

If they have earnings over the threshold, they’ll be treated as not having limited capability for work, so yes, the 1p award rule will not apply, and the claim should be closed immediately.

As a fresh claim is required (whether DWP keep it alive on their system or not), and there was no entitlement from the first claim, the relevant period can only start when the fresh claim is made.

If there was entitlement to UC in that first month, I’m not sure what would happen. I think the legislation supports your suggestion that the relevant period should start from the beginning of the claim, but DWP could (and probably will) argue that it is impossible to “provide evidence of having limited capability for work” if you are treated as not having limited capability for work.

If they were getting PIP then a WCA can be carried out regardless of earnings and as your spotlight shows in this post Charles - https://www.rightsnet.org.uk/forums/viewthread/15383/#73095 - the claim should not be closed if pending the WCA the entitlement is nil due to earnings.

I’ve got someone I’m helping with a UC claim at the moment whose hours have dropped due to ill-health - there is no entitlement unless she gets a work allowance but they are keeping the claim open until the result of the WCA. And then if work allowance applies it goes from start of claim.

Or am I missing something?

Daphne - 11 February 2020 03:21 PM

And then if work allowance applies it goes from start of claim.

As I posted in another thread we have been told by DWP that the Work Allowance is only applied from the date of the WCA decision (or date LCWRA element starts, if earlier). I think this is illogical and it should apply from the start of assessment period in which the health condition is notified. However I still cannot find the rule or guidance that makes clear when the WA should commence. I wonder if there is inconsistent practice.

Daphne - 11 February 2020 03:21 PM

If they were getting PIP then a WCA can be carried out regardless of earnings and as your spotlight shows in this post Charles - https://www.rightsnet.org.uk/forums/viewthread/15383/#73095 - the claim should not be closed if pending the WCA the entitlement is nil due to earnings.

I’ve got someone I’m helping with a UC claim at the moment whose hours have dropped due to ill-health - there is no entitlement unless she gets a work allowance but they are keeping the claim open until the result of the WCA. And then if work allowance applies it goes from start of claim.

Or am I missing something?

Yes, I think this is right. I was only talking about cases without PIP.