ESA C+IR nightmare..advice please

[greendykes]

I have been on ESA since June 2009. I am separated from my husband, have been since 2008. I am on ESA due to mental health issues. Yesterday I had a welfare officer visit me to see what other benefits I might be entitled to. Then I discovered the bombshell. I thought I was only on contribution ESA but she told me I was on C+IR still don't understand this. Anyway seemingly I should have declared that my husband still pays money into joint account to cover all household bills. I just happened to still have the form that was completed after my telephone claim by DSS. It does say that I told them that I received 1200 a month from my ex. BUT this WO said I had declared it in the wrong place. It was printed in the section that said "Any other money received". Well the WO said I had to contact the DSS right away and explain that I did not declare this income!! If I didn't do this then she would have too. My CPN came round today, I hadn't slept and was very upset(not good for my health). So he phoned them today for me. I now have to send all the bank statements since 2009. Question how can I been on both Contributions and Income related ESA. Can I be done for fraud? Any advice appreciated, I can't stop crying.

[ErikaPNP]

Telephone claim? You did declare it, the DWP put it in the wrong place. I know JSA can be both income based and contribution based where the contributions are insufficient to pay the minimum the law says a person needs to live on and where the claim is a joint claim; yours is not a joint claim. But in any case as you have been on it for longer than a year, it will soon only be income based - if it isn't already, perhaps the WO has it wrong.

 

I'm going to mark your thread for the attention of an ESA expert re the CB/IB claim as they may know something that I don't. I'm also going to remove your signature as the information contained is no longer the case and hasn't been for some time.

[greendykes]

Thank you really appreciate it. Sorry about signature have not been on for a while, forgot it was even there. The other thing is the house I live in belongs to my husband (ex), the mortgage and title deeds are in his name only, as are most of the utility bills. Bad move on my part BUT we had finally agreed that since he caused my mental health issues I could stay here until my health improves and he would cover all the Household bills. The account the money goes into has running cost for both this house and the house he lives in.

[antone]

Erika asked me to take a look at this. And as she said, you did declare the money. It was a telephone claim - you didn't choose where to put it on the claim form, they did. On the information you've given here, I'm a little puzzled about what your WO is telling you.

 

This is a single claim, correct? You're not claiming for your estranged husband. In this case it is possible for a claim to ESA to involve both an IR and a C component and, indeed, they are calculated separately. Unfortunately this is a bit complex to explain.

 

When you claim ESA, you must claim ESA©. You may optionally claim ESA(IR) if you wish. It sounds like you made a claim for both, which is perfectly normal. If you meet the conditions for ESA© that's what you'll be paid. These conditions are related only to your NI conts, and when they work out the amount you are due, the only income taken into account is your own income from employment or from a pension. Your partner's income doesn't affect your payments, nor do any savings you may have. It is paid at a fixed rate. The payments your estranged husband makes would not be relevant to ESA©.

 

ESA(IR) isn't based on your NI, but does take into account your income from all sources, partner's income, savings and so on. The payments your estranged husband makes would be relevant to ESA(IR). This, presumably, is what has spooked your WO.

 

You can be on both ESA© and ESA(IR). If you meet the contribution conditions, you'll be awarded ESA©, which always takes precedence. In some cases, though, the fixed amount of ESA© is not as much as the law says you need to live on, so ESA(IR) will make up the difference. In other cases, the amount you'd receive from IR is the same as the amount you receive on C, in which case you are normally treated as being on ESA©.

 

Examples:

 

Jane is 40, has worked full time for the last 10 years, and is single. Unfortunately, she is now unable to work due to a health condition. She makes a claim for ESA. She has no savings and no other income.

 

• She meets the contribution conditions for C. She is entitled to £71 per week ESA©
  
• She also meets the conditions for IR, as she has no other income. She is entitled to ESA(IR) at £71 per week
  
• She is thus paid C at £71 per week, although also has underlying entitlement to IR. She is on ESA©
  

 

Jane's health condition deteriorates, and she claims DLA. She's awarded DLA at Middle Rate Care. As she lives alone, this entitles her to the Severe Disability Premium of ESA. Premiums are not available on ESA©.

 

• She's still entitled to her £71 ESA©
  
• But she's also entitled to £50 (made up figure for this example) SDP
  
• So she now gets £121 per week
  
• Of which £71 is C and £50 is IR
  

 

Sorry about all of that technical stuff, but it is important. It's how someone can be on both C and IR at the same time. I'll think some more about this tomorrow and see if I can't give some advice that is less, well, technocratic.

[greendykes]

Antone, thank your for your reply. It is a single claim. How would I know how much my claim is made up of Contributions and how much is made up of IR. Would this make a difference? I dont know what do do next. I don't have the bank statements will have to contact the back? Will this take the usual 4 weeks to get, do I have to SAR the bank, will DWP wait?? I can't think straight.

[Nystagmite]

You should have an award letter. On the last page, it says how they worked out why you have been awarded the rates you have. The rate you've been awarded would be on the first page.

[speedfreek]

You sure Nysty?

 

It's always been something I've wondered about and I've checked all my award notices and it doesn't tell me.

 

In fact it was only when I queried my lack of Christmas bonus was I informed of both.

 

Now on the question of the mistake and why advice was given to inform the DWP of this mistake.

 

If there has been an over payment (for whatever reason) and that over payment is continuing then do you

 

a, pretend you haven't seen it and carry on

 

b, notify the DWP and get it stopped and the correct benefit paid

 

Now once you know it is occurring path a, is fraud! Plain simple fraud and even in this case where the overpayment we think is an official error it will start accruing fraudulent payments from the date discovered. A good welfare rights officer knows this and the advice to notify them is good. They can not and will not represent somebody willfully committing fraud. They will once the DWP have been notified of the error fight tooth and nail for the fact that this is an official error and protect the person who informed them as official error = no fault of the person claiming = no recoverable amount.

 

Edit 2 even if this is fraud they have a duty to stop more fraudulent payments as the more there is the worse it may be when discovered. See again the good character as notifying should be helpful in mitigating any repercussions.

 

It also gives more weight to the argument that is an official error and also the good character of the person who reported it.

 

Remember fraud is recoverable whilst and official error is not! But once realised you really start to be on shaky ground if you fail to inform them as soon as you know.

 

Edit although it might be worth clarifying with the WO who advised you exactly their view on who they think made the mistake and why! Just so that you are clear.

 

The DWP were over paying my ESA as I'd lost my SDP premium after my DLA award for MRC dropped to LRC. I called them up and said you're over paying me. They said no we're right you should get it. So I called DLA said have I won my appeal for MRC they said no and ESA can see that I'm on LRC. So I call ESA and say are you really really sure explain that's my second call to them I've checked blah blah blah. Hey presto ESA say it's an official error and we will not chase.

 

So being honest I've just passed Go and collected literally £200

Edited July 19, 2012 by speedfreek

[greendykes]

Thanks guys for your posts. I looked at my letters still not any wiser what percentage is re CONs and IR. I have tried to find some info on Internet, still no luck. My CPN is just as confused, we are trying to draft a letter explaining this but struggling! I just want to clarify what exactly my entitlement was and if they took the income I declared on the form into account. Can't afford to pay back any over payment in a lump sum.. As I said this is a nightmare, I have worked since I was 16 until I was 45 really thought I had paid enough NI when I put claim in.

[speedfreek]

When you say Welfare Officer what exactly do you mean and who are they employed by?

 

Sorry I assumed a welfare rights worker but I now realise it could be somebody else as it's a pretty broad term.

 

The other question is did they just say inform them or did they also offer to help you with it?

 

If they didn't offer help can you/your CPN talk to any charities or welfare rights or the CAB locally and ask their advice and assistance to double check things if it was not offered by the welfare officer you saw?

 

You would need to have anything the DWP come back with (if there is an overpayment) checked for correctness by somebody anyway - not very good at maths the DWP at the best of times.

 

May be worth holding off the letter for a couple of days and seeking a second opinion. Even if it's just advice on the best way of doing things?

 

You've already notified them I see by telephone so you've got a bit of time to put things in place to help.

Edited July 19, 2012 by speedfreek

[Nystagmite]

You sure Nysty?

 

I'm sure mine did. I don't receive ESA © and it states that I've not paid enough NI and that I'm entitled to ESA (IR), how much and why.

[greendykes]

Speedfreak, the WO was attached to my Mental Health team buts work for the council. Exact words were " They need to be informed, better coming from you BUT if you dont do it I will have too. I do realise she has a job to do BUT such a bolt out of the blue! She left me in tears, so much my CPN had to come down and calm me down. Nystagmite..my letter say's my claim is on my contibutions then say's IR but against IR it said nothing was taken into account! Still confused..

[speedfreek]

Speedfreak, the WO was attached to my Mental Health team buts work for the council. Exact words were " They need to be informed, better coming from you BUT if you dont do it I will have too. I do realise she has a job to do BUT such a bolt out of the blue! She left me in tears, so much my CPN had to come down and calm me down. Nystagmite..my letter say's my claim is on my contibutions then say's IR but against IR it said nothing was taken into account! Still confused..

 

All I can say is that whilst maybe it seemed a little insensitive or it came as a shock to you they were correct. Mistakes happen!

 

As I said above if you didn't inform them now you know about it, that mistake then turns into something else i.e. intentional fraud which would have been far worse than what is happening now.

 

You've done the right thing and the fact that you've contacted them as soon as it was pointed out to you 1, it adds to the fact that you are of good character and it was a genuine mistake 2, any overpayment (if there is one recoverable) will not get any bigger. Although it's probably not great for you at the moment and it's causing you distress it's far better it's sorted out now! Probably doesn't seam that way but it is.

 

Basically now you've informed them it's a waiting game as the DWP will have to gather evidence to see what has occurred, if there has been an overpayment and how much has been over payed and finally if the overpayment is recoverable.

 

I'd hold off on that letter and use this time to try and seek advice. As I think knowing what exactly has happened and what will/may happen next will get you prepared and help take some of the worry out of it.

 

Ring round (or get your CPN too do it) some of the local advice agencies to get everything checked out as they should be able to tell you everything you need to know. It may even be worth while informing this WO that you've informed the DWP as they told you too and asking if they can can help you (or put you in touch with somebody who can) as it's causing you a lot of distress. That's a judgment call really and you may find a local welfare rights or CAB easier for you to deal with.

 

I have to use these folks all the time and trust me whilst you'll still be a bit frantic just having their support and having everything explained so that you can prepare makes it all a bit more manageable.

[MIKEY DABODEE]

What is the £1200 for ?

if you have children and it maintenance for them, it may be disregarded anyway

if you declared it on the input doc thats the document that was completed over the phone and sent to you to sign when you made your claim, there will be a copy in your case paper then it will be O/E

So any overpayment raised should be written off