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Forum Home  →  Discussion  →  Universal credit administration  →  Thread

Temporary absence SOLELY for medical reasons?

ZBUC
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Welfare rights team (UC advice project) - Mind in the City, Hackney and Waltham Forest

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Joined: 8 November 2019

Hey everyone,

I have a question about section 11 temporary leave rules for UC in regards to medical exemption: does travel for medical reason need to be pre-authorised before the claimant leaves the UK? Or is the claimant allowed to travel for one month before informing the DWP that they are in fact abroad for medical treatment that is likely to last longer than one month?

Context:  Claimant suffers from some health problems that they’ve been struggling to get help with on the NHS. They went to the US to visit family, and while there got help for this medical issue. They had pre-booked an appointment for this issue, before travelling. The treatment ended up needing more than a month. When they left, they had told UC that there going for 1 month to visit family. Will it be possible for them to extend their stay there on medical grounds without losing their UC?

I know that per section 11 of the 2013 UC regs medical exemption travel is allowed ‘solely’ for medical reasons, so if someone travels for another reason and happens to fall ill, they don’t normally get the medical exemption. But in this case, the client had a pre-existing health issue that they had booked an appointment for before travelling, although they had not informed UC of this beforehand.

Does anyone have any ideas about this?

Thank you!

 

.

 

[ Edited: 18 Feb 2022 at 06:02 pm by ZBUC ]
HB Anorak
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Benefits consultant/trainer - hbanorak.co.uk, East London

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I don’t read it as narrowly as that.  I think all that matters is that the sole reason for the absence NOW is that it is connected with treatment etc.  If the claimant would not have been planning to return by now generally, and they happen to get ill at the same time, they aren’t covered, but if illness is the thing that is solely responsible for preventing them from returning as planned I would say Reg 11(3) is satisfied.

Paul Stockton
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Epping Forest CAB

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HB Anorak - 18 February 2022 10:28 PM

I don’t read it as narrowly as that.  I think all that matters is that the sole reason for the absence NOW is that it is connected with treatment etc.  If the claimant would not have been planning to return by now generally, and they happen to get ill at the same time, they aren’t covered, but if illness is the thing that is solely responsible for preventing them from returning as planned I would say Reg 11(3) is satisfied.

That’s a possible argument but I’m afraid I read the regulation differently. The wording is: “This paragraph applies where the absence is not expected to exceed, and does not exceed, 6 months and is solely in connection with—

(a)the person undergoing—
(i)treatment for an illness “

So “the absence” has to be “solely” for treatment. It seems to me that “the absence” means “the whole of the absence”, not “the absence once the claimant starts treatment.” And the client here has already accepted that the absence was not solely for treatment - in fact they’ve told UC the initial absence was solely for a different reason.

Peter Turville
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Welfare rights worker - Oxford Community Work Agency

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From experience of a few cases UC take a (very) narrow interpretation. For example, in a case where client stayed with relatives while attending a limited number of out-patient consultations with significant periods between consultations, travelled out a couple of weeks before the first appt. and back a while after final appt DWP did not accept that travel was solely in connection with medical treatment - but argued the main or a significant purpose was to visit relatives and simply took advantage of that visit to seek treatment. Our client had evidence of all the appointments (inc. initial contact before departure), payment for consultations, clinical notes, medication prescribed (and paid for) etc.

Staying with relatives seems to be a fatal response in DWP’s eyes when considering ‘solely’ - so in-patient / hotel receipts and travel immediately before/after treatment required!? Any suggestion that the period abroad was initially to visit relatives or took advantage of some pre-planned medical treatment to visit relatives is likely to lead to a negative decision.

Of course a claimant may be able to successfully challenge a negative decision based on the facts.