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PIP suspended during ESA fraud investigation
Just a quick one - had a call to our helpline from a man who stated that he has been IUC for benefit fraud (working while getting ESA) but his ESA is still in payment but his PIP has been suspended. The Gov.UK states what happens if committed of benefit fraud (sanctionable and non-sanctionable) but I cannot find anything about during the process ie before a decision is made.
Any ideas?
Thanks :)
Just a quick one - had a call to our helpline from a man who stated that he has been IUC for benefit fraud (working while getting ESA) but his ESA is still in payment but his PIP has been suspended. The Gov.UK states what happens if committed of benefit fraud (sanctionable and non-sanctionable) but I cannot find anything about during the process ie before a decision is made.
Any ideas?
Thanks :)
my only thought is that the DWP are confused…......which wouldn’t surprise any of us. If he’s suspected of not being entitled to ESA, it is, surely, ESA which should be suspended.
You might need more info, though an ongoing fraud investigation can make it hard to obtain any.
There’s some general points here (under section 5) about DWP suspending benefits when there’s a genuine doubt about entitlement:
http://www.advicenow.org.uk/guides/how-deal-interview-under-caution
I suppose we could imagine scenarios where that the facts suggest that the claimant did not have his claimed level of health restrictions for a certain past period, in which he also worked, which lead them to suspect he does not yet meet the long term conditions for an award of PIP, while they do accept he has LCW for the current period… seems unlikely though.
Thank you. Seem to be receiving lots of benefit fraud calls today!
Also worthwhile checking whether it might be permitted work, as I’ve had cases in the past where DWP has swept into action over work which they already knew was allowed.
Yes, another call today was a PIP IUC when the claimant had told ESA (and PIP) in January 2016 that he had started work.
Need some clarity around whether the claimant is confused about the two benefits (sometimes the case) but also whether this was an IUC which was just an information gathering exercise? If the latter then it’s perfectly possible ESA would not be suspended as a decision as to whether there is anything at all to look at has yet to be made. PIP could be suspended/ended because of many things. Could just be a coincidence.
“The work undertaken is not compatable with the level of DLA/PIP awarded” or words to that effect, is one of DWP’s standard reasons for disallowing an award of DLA/PIP when there has been an investigation (inc. an IUC).
In such cases both ESA & DLA/PIP are often both suspended pending an entitlement (and subsequent overpayment) decision.
I have a case currently where the claimant started work under ESA permitted work (with all relevant PW1 forms etc completed, record of appointments with Jobcentre adviser about starting the job etc etc available) and DWP still tried to argue at tribunal the claimant had failed to notify ESA they had started work! The tribunal was not difficult to win!!
As part of the investigation DLA was suspended and eventually disallowed and we are now awaiting a hearing dated for the DLA appeal. It is a case where DWP are basically arguing ‘some one with your disability (a rare genetic condition) couldn’t do the job you are doing’. I had one last year where the condition was Polio (from age 2). No attempt by investigating officers / decision makers to actually address the qualifying criteria for DLA/PIP - Yes, the quality of decisions in these type of cases really can be that bad.
Remember the revision or supersession threshold in DA Regs. 3(5)(c); or 6(2)(a)(i) & 7(2)(c)(ii) [the provisions usually argued by DWP in such cases] sets a very high hurdle for the DWP to cross and discharge the burden of proof. They just don’t seem to understand that!
The IUCs and other information gathering appointments make me laugh as, whenever I have accompanied to take notes, or indeed just acquired transcripts, it’s immediately apparent that the people asking questions have literally no idea as to the relevant legislation. Especially true of DLA, PIP and AA as the interviewers are, at best, from a wholly means-tested background. The process is increasingly about pressuring people into statements under duress to confess to whatever to just make it go away. An intimation of the possibility of a fraud prosecution is often enough even when there’s literally no evidence to support the suggestion.
Had a client who stood up to it in my presence and it was hugely entertaining.
“We have video evidence of you walking.”
“That’s not exactly news mate. I can walk. I don’t deny it. I’ll do you a little demo. now if you like!”
“We have several videos on different occasions of you walking by yourself.”
“And…”?
“You get DLA mobility because you need help on unfamiliar routes though”.
“So, how do you know whether I was on a familiar or unfamiliar route?”
Stunned silence 😊
The IUCs and other information gathering appointments make me laugh as, whenever I have accompanied to take notes, or indeed just acquired transcripts, it’s immediately apparent that the people asking questions have literally no idea as to the relevant legislation. Especially true of DLA, PIP and AA as the interviewers are, at best, from a wholly means-tested background. The process is increasingly about pressuring people into statements under duress to confess to whatever to just make it go away. An intimation of the possibility of a fraud prosecution is often enough even when there’s literally no evidence to support the suggestion.
That sums it up!
Haven’t yet seen an IUC where the progress of the interview has not follow the standard format that, presumably, investigating officers were taught on a training course (no need to ask questions relevant to the qualifying conditions / facts). Questions are almost all directed towards failure to disclose or misrepresentation! Don’t bother me with facts. Cart before horse. etc!
And consider the cost to the public purse of investigation / decision making / appeal & tribunal hearing.
I have to say that were they serious about so-called information gathering or fraud then they could not usually have chosen less competent or qualified people to ask the questions. It would be easy to blame this on the cuts to home-visiting leading to fraud officers being involved in mundane matters beyond their remit/experience but the truth is more complex as this level of incompetence has been going on for some time.
Client of mine was told “they were lucky not to be prosecuted” as they had 9 grand in savings, and there was going to be a huge housing benefit overpayment due to undeclared tariff income.
Client was 72 years of age…..
IUC officer said during interview"Who told you the rules were different for pensioners? they dont know what they are talking about”
Happy days…...