Benefits being stopped and massive bill

[caro]

I'm looking for advice for a lady (let's call her Mandy) I know who was called to an interview under caution which was regarding overpayments of council tax and income support.

 

Mandy, who is in her late 40's has always lived with her parents until her father went into a home with dementia a few years ago, and then her mother until she died last year. Her father also died this year and she has no other immediate family.

 

Mandy has epilepsy which is quite well controlled and Menieres Disease. She had a tough time at school with bullying and left with no qualifications. She had a couple of attempts to go to work but after a couple of weeks each time she couldn't cope, probably because of the MD. She is a real worrier and is physically sick when stressed - and she's had a lot of stress lately.

 

It's been difficult for her to cope since her mother died as she's on her own, and her mother looked after everything to do with bills and finances. She had the foresight to sign their bungalow over to Mandy in the 1980's so she wouldn't need to worry about inheritance tax etc when the time came.

 

With her mum's help Mandy claimed income support as she had no other income and no money of her own. Whether this was right for her is another matter, but that's what she got (although I haven't seen the paperwork to confirm that this is correct).

 

Now comes the problem.

 

In 2008 Mandy's mother's health was declining so it was difficult for her to get out. She opened a joint building society account with Mandy's name on it so that her daughter could go and withdraw money if needed. Neither of them thought of it as anything but the mother's money, but of course the DWP and council see things a bit differently. Even talking to her today Mandy referred to it as her mum's money and she just took it out for her when she told her to.

 

The account has got more in it than Mandy is entitled to if claiming benefits. Mandy is a very genuine and honest person. The morning she gets a bill she rushes to pay it. Won't even leave it until the afternoon. I went to her house today and found she is paying huge phone bills because she doesn't know about different call plans, much less how to change to a better deal. Her gas and electric bills are horrific but she just pays them not realising that there are better deals. She is not financially savvy and certainly not intentionally a benefit cheat. Of course now they are demanding the money back. £28,000 and they're stopping her benefits.

 

I've been doing a bit of research on benefits and think Mandy may have been entitled to other benefits - maybe DLA or ESA. I think she was just claiming the wrong thing and if she'd claimed something like this she wouldn't be in this mess.

 

I've got her call plan changed on her phone and am going to sort out a new supplier for gas and electric for her, but need help with the real problem.

 

Is there anyway that Mandy can demonstrate that she didn't think it was her money in the BS which is why she claimed, or that she was in fact claiming the wrong benefits?

 

Technically I can see she owes the money, but morally it seems wrong for a vulnerable lady to have to cope with this genuine mistake. I doubt her mother realised the implication of the joint account either.

[caro]

Hi,

 

Because she claims income support, she can't claim ESA. If her IS is due to disability, she will eventually get switched over to ESA. She can claim DLA if she has care and /or mobility needs which have lasted for 3 months and will last for another 6. The help has to be reasonable - she doesn't need to be getting it.

 

Thanks for replying Nys.

 

The thing is she shouldn't have been getting IS, and now she has inherited her parents money is over the threshold. She didn't realise any of this.

 

Could she get ESA though? What do you call mobility needs? She can walk ok, although when the MD is bad so is her balance, and she can't travel on public transport. She doesn't have any need for personal care. I don't know much about Menieres apart from what she's told me today and I've read on the internet. I'm not sure about the epilepsy either with her being alone. We had a family member with epilepsy who died when he had a seizure when he was alone and choked to death. Is it safe to be on her own?

 

I'm going to SAR the DWP and the council as she has no paperwork relating to any of this, although they say they'll be writing to her in the next 6 weeks. I'm also thinking of getting her to make a doctors appointment and going with her to see what support and services might be available for her.

 

One other thing she's told me. She went to court in the 80's, was declared disabled and got a green card. I gather these no longer exist and she threw it out, but I wonder if it might help her with a claim.

 

It's hard to know where to start.

[caro]

Thanks for looking in Antone.

 

So are you saying that despite her incapacity to work she wouldn't be eligible for ESA?

 

What about the green card that she used to have? I think I read that meant contributions were paid for her?

 

Or does her capital mean she couldn't get it anyway?

 

As for DLA, she is mobile so does that mean she wouldn't be eligible despite a court agreeing she's disabled?

 

I'm aware that there have been recent changes to a lot of equality law including disability.

 

Does this mean that despite her difficulties, Mandy would be expected to live off her capital until such time as she falls below the threshold?

 

Sorry for all the questions, but I'm trying to get my head round this.

 

She's very lucky that her parents have provided for her, but she could have a long life ahead of her and once that's gone I'm afraid she'd have nothing to fall back on and no way of replacing it. For example her bungalow is quite dated and although my husband helps her with odd jobs he says the roof needs looking at and I think the electrics are quite old and might need replacing. Once that money's gone she could have years with nothing to deal with this kind of essential maintenance. Plus of course there's the small matter of repaying £28k.

 

Shouldn't this have been picked up before? Surely the DWP should have questioned this before now or made sure of Mandy's entitlement. How often would she have re-applied?

[caro]

Mobility is about being outside. I get lower mobility because whilst I can walk, I am at risk of putting myself in danger - can't cross roads without help, wander off because I can't follow directions, etc.

 

Thanks again. I think this is something worth taking further.

[caro]

Thank you all so much for the support. I was concerned that because Mandy has money there may not be much sympathy for her problems but she really desperately needs help both now and to secure her future. Although I've known Mandy for a while it's my husband she's turned to for help as she trusts him and knows she can rely on him. He gets calls from her most days. He used to take her and her mother shopping, and still takes her, and if they've needed help with the bungalow he's helped with odd jobs, but he suggested to her that I get involved because he knows I'm better placed to help her with these issues. I'm a bit concerned that what family she has may think we're poking our noses in something that isn't our business, but Mandy is happy that we're helping her, and said she finds it easier to talk to a woman.

 

P1, your thoughts are the same as mine. If she hasn't had what she should have, could that be offset against what she shouldn't have had? I hadn't thought about who may have filled in forms, but it's a fair point and I will be sending a SAR to both DWP and the council. Reading about DLA though I'm less sure that she'll qualify as she is mobile and doesn't need care as such. I've told her that I'll look into it, but she needs to be prepared to have medicals and lots of questions, but we'll be there to help her.

 

Regarding her learning problems, Mandy can read and write but finds it difficult to understand complex issues. She doesn't particularly volunteer information but if asked is quite open. I guess she doesn't necessarily realise the importance of some of the information. I always thought she had learning difficulties but have no proof of this so it's something else I need to establish properly, which is why I want to see her doctor with her to try and get the facts. I'm hoping for his help and support, and maybe get social services to make sure she gets suitable support and proper advice. They're better placed to know what's available and what she might be entitled to.

 

When her mother died a family member was executor of the will, but a solicitor dealt with her father's estate. This seems to have come to light when her father died which makes me wonder about why it didn't come to light when her mother died. I guess it doesn't really matter.

 

Once again thanks for the support. I agree with P1, we'll have a fight but then that's nothing new for us caggers!!

[caro]

Missed your post as I was posting at the same time taxii. I will PM you my email addy as I'm sure that it would help to see the criteria used for awarding points if you can get them to me. Thank you so much.

[caro]

Would the fact she needs help with things like sorting finances, taking shopping, transport etc count do you think? It's support she needs as much as anything as she doesn't know how to deal with things - like she'll just pay a massive phone bill. Just changing the call plan will save her about £30 a month, She told me she knew it was expensive but just didn't know how to deal with it. From what I've read about DLA I'm not sure things like that would count.

[caro]

This is what I don't understand either P1. As you say kids with ADHD get allowances. and I know people on benefits who apparently can't work - unless it's on the side working under cars, moving furniture around, etc etc, but from what I've read I just don't get how they get it. They obviously know how to work the system to their advantage. This is why I want to get the doctor involved and perhaps SS. Don't get me wrong, I'm sure that most people who claim are entirely genuine.

 

Having lost a family member who choked when he had a fit while he was on his own, I think perhaps the epilepsy could well be an area to focus on. I'll get Mandy to make an appointment with the doctor and go with her to have a chat with him about what he thinks she needs. The Menieres is something I'm not familiar with and I don't know how severe it is in Mandy's case and the risks that has too.

[caro]

Caro - I think from what you have said about this lady that she may need someone to act on her behalf in a more official capacity. Someone can apply to the DWP to be her appointee for the purpose of her benefit administration. An appointee takes over all aspects of a person's claim. They do all the form completion, all the written and telephone correspondance and payment can be made to the appointee also. Anyone can be an appointee - it does not have to be a family member. The DWP will assess whether she requires one and whether the applicant is suitable. If she can manage her own affairs, then she won't need an appointee but may need a representative.

 

I'll discuss this with her whether she wants it to be me. I don't want to cause problems with the family who have been helping her since her mother's death,

 

A rep can be anyone of her choosing but a rep only covers one piece of business and she will need to write a letter of authority for that person, and she will need to sign any documents or requests - such as a SAR. (they don't charge for SAR's either - I'll attach a DWP SAR form to the bottom of this post too)

 

Thanks for that. I didn't realise they had their own SAR or that there was no charge.

 

I would definately recommend an appliation to DLA. The guidebooks are in my benefit A-Z (D)

 

Thanks. I'll take a look.

 

 

ESA would not be possible in that she would not be paid the benefit itself because she would not have paid sufficient NI contributions in the qualifying years (which is why she is on income support rather than incapacity benefit) and she is presently over the threshold for income related ESA. She can still apply however and if successful she will get her NI paid - but she wouldn't get any benefit until she fell below the capital limit again. Which may be quite soon if paying off an overpayment. The descriptors for points changed in March and can be located here in schedules 1 and 2. You may also find the ESA guides helpful - in my benefit A-Z (E) . If you pm me your email addy, I'll also send you the ESA Handbook for Medical Services - I can't put it on CAG as it exceeds the upload.

 

You should have my email addy now Erika.

 

Unless the account with her mother was set up for her to administer it on her mother's behalf (set up this way with the building society), it's unlikely they will accept that it was not a joint account in the normal sense. However, if it was only her mothers money that was paid into the account, and none of her own money was paid in there, she may be able to use this angle for argument that the money contained therein was not hers and it was solely set up as a joint account for the purpose of her assisting her mother. It would be even better if you could prove that her mother was unable to manage it herself.

 

I know for sure that one payment which is about 95% of the balance was her mother's and I think there's a chance I could prove that. I'll speak to Mandy and try and find out more.

 

If she is going to appeal against this overpayment, she only has one month in which to do it from the date they decided she was overpaid. There is an absolute time limit of 13 months for a late appeal, however if she is over the one month she will need to explain why she was late in submitting her appeal and it would then be up to the tribunal service whether they would accept a late appeal. You can find case law for benefits by searching here .

Her interview was last week and they've said they'll write to her in the next 6 weeks so I think we're ok on time, but I think I've got my work cut out!!

This is all way outside my comfort zone so I can't tell you how much your support means. I know Mandy will be grateful too. This has been worrying her so much.

 

 

 

 

[caro]

Hi Caro, this is a very sad account and it sounds like Mandy has good friends in you and your husband.

 

Firstly does Mandy have a nominated next of kin? if not I agree with Erica that she should have someone to support and act on her behalf in an official capacity.

 

At the moment she doesn't.

 

Menieres Disease is debilitating, from the NHS Choices web site,

 

Ménière's disease is a rare disorder that affects the inner ear. It can cause vertigo, tinnitus, hearing loss, and aural fullness (feeling of pressure in your ear). See Ménière's disease - symptoms for more information about these symptoms.

 

Including Epilepsy, and the medication required to maintain some sort of normal function, I believe that Mandy should be being monitored closely by her GP.

 

Has she grieved for the death of her parents? is she experiencing any sort of depression following their death?

 

I think her father's death has had less impact as his dementia meant he'd not been such a part of her life for a while, but she's really struggled without her mother as she'd been the one who took care of things and made the decisions. Now it's down to Mandy herself and she's certainly found this hard, especially going home to an empty house. It's been hard for her.

 

She has spent the best part of her adult life with her parents and is now alone, no wonder she is out of touch with certain things.

She has every right to ask for help from her GP if she feels depressed, and her GP must have some idea about her mental capacity to cope with daily living.

 

You're right. We need to see him and get his input on this.

 

Sorry, I'm not clued up on the Benefits side but looks like there is plenty of help being offered here.

 

There is but the medical side is also important as it impacts on what benefits she might be entitled to so thanks for looking in.

[caro]

Mr C has had a phone call from Mandy to say she's had a letter saying her benefits have been stopped. At his request she has also spoken to her family member who is happy for us to get involved so that's a relief, although I think I may ask for her phone number and check she's genuinely ok with it. I'm going to see Mandy tomorrow to see what the letter says. I'll also take the SAR for her to sign. I'm thinking that maybe I should tick all the boxes as I've no idea what there might be. Does that sound reasonable?

 

I'm thinking I might suggest that I be her representative. I don't think I'd be comfortable with being appointee.

[caro]

Actually I've just printed off the SAR kindly provided by Erika and can see there are some that clearly aren't relevant!

[caro]

I can't believe in all of this that the "family member" is not taking any sort of responsibility to help Mandy?

 

Well done Caro for what you and your hubby are doing but I would make sure that you have something in writing to say that this family member agrees to what you are doing, or they may come out of the woodwork later down the line and be a whole different person!! I would definately have a contact number for this person so that they can be kept informed throughout.

A representitive may be better.

 

Mandys GP would only be able to share relevant information with you if Mandy was with you and in agreement.

 

The family member went with Mandy to the interview and thought that the money would probably have to be paid back. She may well be right but that's no reason not to put up a fight in my book. As Mandy herself says she's not clued up on things like this (like I am ) but at least I know where to look for help. The lady has a very responsible job as well as a family and she does help in other ways. Since Mandy's mum died she has been there for her, helping with funeral arrangements and lots of practical ways, but we're just round the corner so closer at hand.

 

 

I went to see Mandy tonight and the letter from the benefits office is pathetic. It says benefits are stopped from November 5th due to a change in circumstances that they weren't informed about, and they want the information they've requested in 28 days in the enclosed envelope. They don't say what info they want and there was no enclosed envelope. I'm going round tomorrow dinnertime so we can phone the benefits office to see what they want. We've also completed the SAR form and Mandy has agree that I can represent her so I'll knock up a letter tonight for her to sign and we'll send it with the SAR tomorrow.

 

Apparently Mandy hasn't had any epileptic seizures since 1992 so that's good, but she says her MD has made her feel quite ill today and she had to go to bed. She's convinced the worry is making her feel worse and she looks stressed out. I've got a couple of days off work coming up so Mandy's making an appointment with her doctor so I can go to with her - see if he can advise about her medical conditions and if he can advise on any other agencies that might be able to help.

[caro]

Yes it is and I called today. Basically it's a bog standard letter they send out when they stop benefits. The guy said they don't need any info and Mandy doesn't need to do anything. I asked for confirmation of this in writing because I didn't want them coming back and say Mandy had her chance to respond but didn't. Eventually I was put through to someone else who told me I need the local office but they couldn't give me the number and would get someone to call back. They called back and eventually I was given the number of the benefits fraud investigator who interviewed Mandy last week.

 

She was quite curt with me when I asked if Mandy would receive any letter with the outcome of the meeting. She said a report was being typed which would go to an ajudicator (I think) for a decision and Mandy was told this could take 6 weeks. She really didn't want to know me and asked if I was the lady with Mandy last week and virtually what did it have to do with me. I explained that I was helping Mandy as I had a bit more knowledge about these things than the other lady. She said it had all been gone over at the meeting because Mandy hadn't declared her income. I explained that I did understand the situation and she seemed to become a bit less hostile. I asked if it would be acceptable for Mandy to apply for other benefits in the meantime which she said would be fine. I also told her we were sending a SAR and a letter stating that I was Mandy's representative if that was ok. She said yes of course that would be fine and seemed much more amenable by the end of the call.

 

So I guess we just have to wait.....

[caro]

Thanks for your input Becca. I think you're probably right about the learning difficulties, and I've tried to speak to Mandy about it. She tells me the only help she had at school was help with her writing in secondary school, but of course things were different in those days. I have a feeling she's going to need some kind of assessment and intend to speak to her doctor when I take her back for a check up. I wonder too about a social worker but I've a feeling that Mandy might be reluctant. I'm finding I need to introduce new ideas slowly and let Mandy digest them, ask questions and accept them, before moving on to something new. Even then she can seem ok and then have a bit of a wobble and start worrying again.

 

On a day to day basis she's fine in the safety of her own home and the village we live in, but would be lost outside the immediate area - in every sense of the word. My husband took her to buy a stamp and envelope to return a form to the district council, and she came out of the shop with a padded envelope which was obviously inappropriate.

 

The way I see it Mandy has been protected all her life by her mother, and now she's gone she's not equipped to deal with things that most of us take for granted.

 

Her application for 25% discount off her council tax for single occupancy has gone in, and we're a good way through the DLA application. A friend can complete a statement to support the application, and I think I'll see if her doctor might add something too.

[caro]

I've let this slide a bit, but not the application for DLA needs to be in for Friday, so just finishing off. I've spoken to Mandy's doctor today who confirms that Mandy was diagnosed with learning difficulties in 1963, and that he considers them to be mild to moderate. He's also agreed to fill in the part of a form, which he'll do tomorrow.

 

I'm currently writing a piece for additional info to back up the claim and trying to explain a bit about Mandy. I have a question.

 

Mandy says she can't go on a bus because of her epilepsy. This is something I've heard before, but I'm not convinced that this is the case. It seems Mandy's only had one seizure many years ago and apart from that it's been managed with medication. Surely she should be able to use public transport?

 

She's probably be too scared to do it, but just wanted to know if it's right or not. I'm sure I've heard of epileptics being able to drive cars if they haven't had a fit for a year or so.

[caro]

Thanks both. That's as I thought.

 

Don't worry becca. As a family I don't think we mind helping out, but at the end of the day Mandy is not our responsibility and we have our own lives to lead and problems to deal with.

 

Incidentally, none of her family have yet invited her for Christmas.

[caro]

Is that the driver telling her she can't use it, or her saying herself that she can't manage?

 

I don't think she's ever tried Nys. My husband's cousin had epilepsy and also said he couldn't go on buses so maybe it's something that historically epilepsy sufferers were advised.

 

Yes. If you're fir free for one year, you can drive. if you have another fit during that year, you're banned for another 6 months. (or 10 months in my dad's case...)

 

HB - yes, that is correct. If you've been refused a driving licence for reasons other than drugs or alcohol, you're entitled to a bus pass.

 

Handy to know.

[caro]

Thanks becca.

 

We're happy to help Mandy through this time, and grateful for the support here. This is new territory for us, but she does need a more formal network to make sure she gets the support she needs in the future.

 

Merry Christmas and Happy New Year to you and yours too.

[caro]

I can't offer any brilliant advice Caro, but I just wanted to say I think what you and your husband are doing for this lady is fantastic. I really hope everything works out for her.

 

As my dad would say, there but for the sake of God go I. People on CAG help each other all the time.

 

Have you contacted social services adult support care? They will know what benefits she is entitled to and will help her fill out the forms that she requires. She will also be entitled to a support worker. Just a thought

 

I haven't done yet, but feel that this is really needed. I think Mandy will resist though and will take some convincing. She's just been here and said that she thinks she's surprised a lot of people that she can manage on her own. In some ways she does, but I really think she'll resist help from strangers. I need to work out how to deal with this and get her to accept help. I'll enlist the help of her lovely doctor for this as I'm sure he'll help.

 

They may also offer her direct payments for a carer.

 

Well we'll hopefully find out in the not too distant future. In the new year I want to try and find out about what help is out there that might help Mandy.

 

The doctor has filled in part of the form confirming her problems, including that she has a learning disability. It was a great relief that he did that as I only assumed this and had nothing concrete to confirm that.

 

For now the DLA form has just gone in the post. It went in the 1st class freepost envelope they provided so hope it gets there for tomorrow which is the last day it should be in for. If it's not on time I hope they'll accept any delay due to xmas post. Mandy's relative is apparently fine with us helping but has asked to be kept informed of what's going on so I've scanned the form and will print her off a copy.

 

Mandy has had a phone call from her family today to invite her for Christmas day. I've a feeling they may have been holding out to see if we offered. We wouldn't have seen her alone, but I do confess I like a family Christmas.

[caro]

A whole lot of info arrived on Christmas Eve relating to Mandy's SAR. There are clerical and computerised records relating to income support, and clerical records relating to Incapacity Benefit and Severe Disablement Allowance. There is no separate computer record for SDA. They are currently having difficulty in obtaining the Incapacity Benefit computer record. They apologise for the inconvenience and will send it asap. There is also a folder with 37 A4 pages of DWP abbreviations!!!! Any I've tried to look up so far haven't been on there.

 

I've had a quick flick through and included are application forms for various benefits including Incapacity for Work decision maker's scoresheets, which suggest that Mandy is 20% disabled but needs to be 80% disabled to qualify. However it focuses on her Meniere's Disease. There seems to be no mention of learning disabilities, although one of the assessors has made a note that she's "not very bright". There was no assessment for mental health issues as this wasn't claimed for. The last assessment for Incapacity for Work seems to have been 2006.

 

One thing I have picked up is that Mandy was getting about £25 for disability on top of the standard £65 for IS. Does that suggest that she may qualify for DLA?

 

In 2005 the Determination on Incapacity a couple of boxes are ticked.

 

• Not for disallowance
  
• Meets incapacity threshold
  

Then there's a handwritten number 15 circled.

 

I'm going to need help deciphering this lot, but wondering if it's worth worrying about yet. The way I see it we're waiting on 2 things now.

 

1. The decision following the interview under caution.

2. The decision on the DLA application.

 

The first is a long time coming, but how long might we expect to wait for the DLA application? I guess with xmas it could be a couple of weeks longer than normal,

Edited December 27, 2011 by caro

[caro]

Thanks for all the help. I think I need to spend more time looking at this to get my head round what Mandy's been getting. There certainly hasn't been a car.

 

I can't see anything at all relating to DLA, but from the look of the computer records she's had IB since 1995 and there's also mention of a disability premium. It was Severe Disablement Allowance which wasn't allowed.

 

I thought the DLA form was bad enough, but these records are a thousand times worse to try and understand.

 

I can't understand why there's never been any mention of a learning disability either. I wonder if her family may have had old-fashioned attitudes towards this and tried to keep it quiet.

[caro]

Thank you Mikey. That helps explain a lot. I'll take a better look over the next couple of days and see if I can unravel it, but I don't think she's had SDA.

 

Do you know what a green card meant in the 80's?

[caro]

Thank you so much Mikey. So hopefully that should show a level of disability, but it remains to be seen if it's enough for Mandy to qualify for DLA.

[caro]

Thanks Nyst. I'm just trying to fit the pieces together to understand the bigger picture, so I feel I need to understand everything.

 

Mandy told me that she got the green card after a court case which proved she was disabled, so I thought it might be relevant.