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Mixed age couple - getting PC reinstated after PIP MR successful
My clients are a mixed aged couple who were previously on PC Guarantee as they both are disabled, and the applicable amount included 2 x SDPs and 1 CP (Mr for looking after Mrs).
Last year Mrs received a PIP review but failed it, the decision coming through in February. Mr’s PC stopped as they lost their premia. It took a long time to gather info from consultants, but the MR reinstated the DL component and the decision letter came through about a week ago.
The problem is how to get them back onto PC.
The HB is back in payment. They have been told by the Pension Service that they can’t claim PC because of being mixed age. They can’t claim UC (which we don’t want anyway) because of the SDPs.
I have registered an MR/ review on both the CA and PC decisions as it was the DWP’s PIP error that caused the loss of entitlement and it is unjust that the couple should lose out. I have also completed a new CA app online, but, it won’t cover the whole of the period if they stick to the 3 month time limit for backdating.
Can anyone advise please?
Thanks
I think it isn’t a matter of a new claim for either but revision of decisions to stop each claim which you have requested so should be OK.
Has the HB claim been backdated to cover entitlement to 14 May 2019?
If so, then they should be covered by the savings provisions that allow a new PC claim with backdating also.
Sorry, but I don’t understand what you mean by the “savings provisions”. Could you explain, please?
The savings provisions in Article 4 of the commencement order that introduced the changes allow for claims after 15 May 2019 for MAC’s.
These have the effect that if someone is found to be entitled to PC, HB or both with effect on 14 May 2019, then a claim for either PC and/or HB can be made at any time afterwards provding their chain of entitlement is unbroken.
I can’t recall the provision of the top of my head but the HB Regulations do seem to allow for a revision going back to the date of the previous award being disallowed, if the reason for the previous HB claim being disallowed related to a qualifying benefit as here.
As such, if the HB claim has been fully backdated and covers 14 May 2019, then your clients can make a new PC claim and ask for 3 months backdating.
It’s regulation 4(7C) of the Housing Benefit and Council Tax Benefit (Decisions and Appeals) Regulations 2001 that should be applied to the HB revision.
There doesn’t seem to be similar provisions in the D&A Regs for PC so I don’t see how you can seek a revision back to the date of the disallowance of the original award of PC - hence the need to make a new claim for PC and seek 3-months backdating.
Can they not anyway request a supersession of the decision to close the PC award or am I misreading this?
Linked benefits
Introduction
04360 In a case wherethereceipt of or entitlementto a benefit(“benefit 1”)is a condition of entitle mentto another benefit, allo wance or advantage(“benefit 2”) a specialrule may apply. SS CS(D&A) Regs,reg7A(2)
Effective date
04361 Where benefit 1 is superseded on the grounds of a relevant change of circumstances then
1. where the decisionto be superseded is neither
1.1 a disability benefit decision or
1.2 an employment and support allowance where there has been been a Limited Capability for work determination or
1.3 an incapacity benefit decision where there has been an incapacity determination and
2. the result is not advantageous to the claimant and
3. the effect (on benefit 1) is that either
3.1 it ceases to be payable or
3.2 it becomes payable at a lower rate
then the effective date of any consequent supersession of benefit 2 will be the same as the effective date as of the supersession of benefit 1, namely the date the change of circumstances affecting benefit 1 occurred.
Note: This applies to IS, JSA and SPC.
Can they not anyway request a supersession of the decision to close the PC award or am I misreading this?
Linked benefits
Introduction
04360 In a case wherethereceipt of or entitlementto a benefit(“benefit 1”)is a condition of entitle mentto another benefit, allo wance or advantage(“benefit 2”) a specialrule may apply. SS CS(D&A) Regs,reg7A(2).
Isn’t that the wrong way around as it were? That’s saying where the qualifying benefit ceases to be payable, then the date to supersede entitlement to the other benefit is taken from the same date as the qualifying benefit ceases.
But now you’ve got me wondering whether reg.6(2)(b) of the SS&CS; (D&A) Regs 1999 might work here?
(2) A decision under section 10 may be made on the Secretary of State’s [F1or the Board’s] own initiative or on an application made for the purpose on the basis that the decision to be superseded— (b)is a decision of the Secretary of State [F5or the Board or an officer of the Board] other than a decision to which sub-paragraph (d) refers and—
(i)the decision was erroneous in point of law, or it was made in ignorance of, or was based upon a mistake as to, some material fact; and
(ii)an application for a supersession was received by the Secretary of State [F6or the Board], or the decision by the Secretary of State [F6or the Board] to act on his [F7or their] own initiative was taken, more than one month after the date of notification of the decision which is to be superseded or after the expiry of such longer period of time as may have been allowed under regulation 4;
The mistake as to a material fact is eligibility for PIP, which caused the original PC award to be closed due to loss of severe disability addition. Now that PIP eligibility hjas been restored, it’s clear that the original decision was wrong in law due to this mistake and the application to change it must, by definition, be outside of the time limits for revision.
Thoughts?
You may be right. Although it’s guidance I did (and still do) have difficulty getting my head around what is meant!
Generally a supersession cannot be done on a decision to terminate a benefit, as a fresh claim is required.
As Paul said further up, a decision terminating HB can be revised if PIP is reinstated as here. However, there is no such rule for PC. The traditional answer would have been to reclaim PC, and get it backdated all the way to the day after the old award ended. This can be done under r6(19)of the Social Security (Claims & Payments) Regs 1987.
(There happens to be a complication here that they missed an amendment to those regs when PIP was introduced. See this post for more details.)
This could leave mixed-aged couples with a problem, because no new claims for PC can be made. However, in this case there is no issue, seeing as the claim will be backdated to well before 15/5/19. Even if the complication I mentioned above does turn out to be a problem, the normal 3 months backdate can still be done, and that still takes us back to before 15/5/19.
Generally a supersession cannot be done on a decision to terminate a benefit, as a fresh claim is required.
As Paul said further up, a decision terminating HB can be revised if PIP is reinstated as here. However, there is no such rule for PC. The traditional answer would have been to reclaim PC, and get it backdated all the way to the day after the old award ended. This can be done under r6(19)of the Social Security (Claims & Payments) Regs 1987.
(There happens to be a complication here that they missed an amendment to those regs when PIP was introduced. See this post for more details.)
This could leave mixed-aged couples with a problem, because no new claims for PC can be made. However, in this case there is no issue, seeing as the claim will be backdated to well before 15/5/19. Even if the complication I mentioned above does turn out to be a problem, the normal 3 months backdate can still be done, and that still takes us back to before 15/5/19.
Pension Service told us yesterday that reg.6(19) can still be used to get PC claim restarted if entitlement is contingent on a qualifyng benefit, provided there are no gaps in entitlment.