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Our FOIs: Universal Credit - Changes in Circumstances
Below are a selection of FOIs we have, over the past few years, sent to the DWP with the answers
We hope you find these useful.

Just click on the FOI you are interested in to see the full question and the answer.


QUESTION
In para 3.23 of the Benefit Overpayment Recovery Staff Guide, regulation 8(3) of "the Universal Credit Regulations (Overpayments and Recovery) 2013" is quoted.
I have looked for this in www.legislation.gov.uk - and looked for an alternative ie "the Universal Credit (Overpayments and Recovery) Regulations 2013" but cannot find such a regulation.
I'm just wondering if this has been transcribed incorrectly in this guide and if so could you supply the correct name of that regulation; if not tell me where I can find it?

ANSWER
The information you requested can be found in The Social Security (Overpayments and Recovery) Regulations 2013: Click here
The Benefit Overpayment Recovery Staff Guide will be amended to reflect this.
Click here to see the original FOI.



QUESTION
We have been hearing that when a couple on Full service Universal Credit separate they have been unable to access their own journal histories. This has meant claimants having to take screenshots before they unlink their claims. Furthermore we have heard that DWP also appear to have difficulty accessing this information following separation.
Could you please supply any documentation relating to the procedure when claims are unlinked that would explain why this happens; plus any guidance for DWP staff as to what they should do if they are unable to access information on a claimant's journal.

ANSWER
I can confirm that the act of splitting a claim immediately means that neither partner have access to information in the portal from before the split. This is to protect the data and the claimant. In addition, Case Managers are still able to access old versions of the journal while the system default is to the current version.
Click here to see the full FOI.



QUESTION
I am writing to ask if there is any guidance for decision makers / work coaches / service centres etc to protect terminally ill claimants from having to be aware of their prognosis in order to benefit from the various concessions in UC (such as having the Limited Capability for Work Related Activity Element added from start of illness; no work related requirements in Claimant Commitment) .
In some circumstances, the claimant is not made aware of their prognosis, either because they do not want to know or because it would be harmful to the claimant if they were made aware. The DS1500 form asks the doctor to confirm if the patient is aware of their condition and/or prognosis and, if unaware, the name and address of the patient’s representative who is requesting the DS1500. The PIP, Disability Living Allowance and ESA departments have special arrangements whereby they use discretion and deal with claimants sensitively and carefully, without disclosing their prognosis.
We have been unable to find any guidance on how the UC department should deal with this type of situation. The processes do not appear to allow for this type of flexibility or special arrangements as:

  • In a digital service area, the claimant will be expected to complete their claim online and they will need to answer:
    ‘Have you been diagnosed with a terminal illness? What is your prognosis?’

  • If they are already on UC and need to report their diagnosis as a change of circumstances, presumably the UC dept will ask for the same information.

  • Any information will be logged on the journal and is visible to the claimant.

The explicit consent rules require that the claimant is specific about what they are authorising someone to deal with the DWP on their behalf about – it could be very difficult to manage this process without the claimant being made aware of their diagnosis.
Another issue could be the process requiring the claimant to attend the jobcentre. If making a new claim, the normal procedure is for the claimant to attend a new claim interview. A discussion about the claimant commitment should not be required if the information that the special rules should apply is available, as there should be no work related requirements. But, there is a risk that if the claimant is not aware of their prognosis and has not therefore provided the relevant information on their claim, they will be expected to attend a new claim interview to discuss their claimant commitment and this could put their health at risk (eg. if undergoing cancer treatment they may be more prone to infection so should avoid public places). And they may be required by the claiming process to book and attend a verification interview at the jobcentre. Again, this may not be appropriate. They should request a home visit instead - but as with the issue above, if they are not aware of their prognosis the home visit might not be agreed.
Please could you supply any guidance that explains how a terminally ill claimants can go through the above processes when they are not aware of their prognosis.

ANSWER
We make all of our work coaches and relevant staff aware during their training that claimants may not know about their prognosis or condition. Therefore, they are aware that they should not record or refer to the nature or detail of the illness on the full service journal or in discussions, unless requested by the claimant.
We check our systems as a matter of course to see whether we already hold a DS1500 submitted for another claim. This is the same process as under ESA, and if a DS1500 is already held, we reuse it for the UC claim.
We do not need to change the consent rules in UC to support these claimants, as we can already accept information directly from claimant representatives, such as from claimant appointees and third party organisations representing the claimant.
Click here to see the written guidance on Terminal Illness available to all staff at the Department for Work and Pensions.
Click here to see the original FOI.

 



QUESTION
If a claimant's UC entitlement for any MAP is adjusted- for example because of an error, or a late notified change of circumstances, or a fact discovered late, I understand that the award calculation for that MAP will be adjusted on the journal accordingly.
Please could you tell me where the information on the original award assessment is stored and how a claimant can obtain this?

ANSWER
Claimants can access their account on-line and view all their statements for each assessment period (which includes each component, deductions and adjustments where appropriate).
When we revise an award following verification of housing costs or savings, we issue a new statement which replaces the original one. The previous statements are not saved on the claimant’s journal.
If a claimant wants to see additional personal information we hold on UC IT systems, they can request this through a Subject Access Request.

QUESTION
In respect of the Subject Access Request, I looked at the Information Commissioners' Office website and found some information on this page.

It says that:
1) it can take up to 40 days - will this be the case with requests about previous UC awards? and
2) that some organisations charge a fee for the information - do DWP do this and if so how much? and
3) that a third party can make these requests - so would DWP accept an authorisation under the Explicit Consent rules?
4) that the information required in the request is:
"your full name, address and contact telephone number; any information used by the organisation to identify or distinguish you from others of the same name (account numbers, unique ID's etc); details of the specific information you require and any relevant dates"

- so would the following be sufficient:
the claimant's name, address, NI number, and a sentence such as- "Please send the original - ie pre-adjustment - award and calculation (including elements, income, deductions) in respect of the monthly assessment periods xx/xx/xxxx to xx/xx/xxxx and xx/xx/xxxx to xx/xx/xxx

ANSWER

1. DWP will send the personal information asked for as soon as possible. This will usually be within 40 days from when we get the request, as long as the request gives us enough information to identify the individual and the information asked for. We do this for all requests for information regardless of the DWP administered benefit including Universal Credit award information.

2. DWP does not charge a fee for processing a request for personal information.

3. DWP does accept requests for personal information made on someone else’s behalf; as long as we are satisfied the third party making the request has the individual’s consent to make the request on their behalf and to receive the individual’s information. You can find more information about this here.

4. If there is sufficient information in the wording of the request to identify the individual and to locate the personal information asked for, we will be able to process the request. If it is insufficient, we will ask for more information to ensure we are releasing the information to the right person and can locate the right information.
Click here to see the original FOI.



QUESTION
In a meeting of Social Security Committee 15 December 2016, Neil Couling was asked by Pauline McNeill:
".... One of the perceived benefits of the universal credit system is that a claim can be left open for six months after a claimant has found work. That obviously benefits people who are on zero-hours contracts or in seasonal work. Why has the practice of keeping universal credit claims live for six months been discontinued in the full service without prior consultation?"
Neil Couling replied:
"It has not been discontinued; we just have a different way of doing it. Technically, in one sense, it could be argued that, in the full service offering, a claim is open for 14 months. All that we do is ask the claimant, if they come back to us, to click a button that says, “Reclaim—none of my data has changed”, and we stand the claim back up."

I understand that a claimant whose circumstances change such that their earnings become too high for a UC claim can return to UC in this manner in the Full Service, but am flummoxed by the reference to the claim being technically open for 14 months.

Please could you supply the regulations that this has come from.

ANSWER
The legislative reference you have asked for relates to the Fifth Principle of the Data Protection Act which states:
“Personal data processed for any purpose or purposes shall not be kept for longer than necessary for that purpose or those purposes.”
This is established Departmental data retention policy as formulated under the Data Protection Act. All new claims for Universal Credit are subject to this policy in a time and manner the Secretary of State decides.
Depending on the data involved the Department will decide how long that data needs to be retained, according to the retention policy, whether it be 6 months or 14 months or any other period of time. But for Universal Credit, new claims will be held open for 14 months if there are no changes in circumstances.
Click here to see the original FOI.



QUESTION
If a person comes off UC or has their award terminated, are their journal entries saved anywhere and could they ask the DWP to retrieve these, for example if they needed to prove that they had notified a change of circs / provided information / done what was required of them in terms of work search requirements?

ANSWER
Universal Credit claims are kept open for 6 months in live service. The UC claimant can then retrieve their data via a Data Protection Act request.
Universal Credit full service accounts can currently be accessed indefinitely.
Click here to see the original FOI.



QUESTION:
Under UC regulations, when a UC claimant receives earnings which are high enough to mean they have a zero entitlement to UC in that Monthly Assessment Period, they still count as a "UC claimant" for 6 months and cannot claim certain legacy benefits in this time. However, if their earnings reduce such that they would be entitled to some UC in the monthly assessment period in which they are paid lower earnings, and the DWP becomes aware of this, they can go back onto UC. What I am not sure of is whether HMRC will continue to "feed" earnings information to DWP via HMRC during this 6 month period or whether the onus is entirely on the claimant to notify of their earnings reduction?

ANSWER:
We confirm that HMRC will continue to feed earnings information to DWP during the six month period when the person continues to be classified as a "UC claimant", as prescribed by the Universal Credit (Transitional Provisions) (Amendment) Regulations 2015, which are due to come into force on 16 November 2015.

The legislation does not place an onus on the claimant to notify a drop in earnings. When DWP receives information from HMRC about a drop in earnings which indicate that UC would be payable again, before making payment we will first contact the claimant asking them to confirm their current circumstances, in case there has been any other change that would affect the amount of the award.

Guidance here



QUESTION:
We understand that normally a UC claimant in digital service areas is expected to receive and send all communications digitally via their online account. However, some claimants will be unable to do this - for example if they have no online access or have run out of credit on their mobile phone.
Please could you send me any guidance for DWP staff on what they should do, in the digital service (either pilot or "full" service)

a) When a claimant sends a letter to notify of a change in circumstances, or requests a variation in their claimant commitment, or asks a question.
b) When a claimant uses the UC helpline to notify of a change in circumstances, or requests a variation in their claimant commitment, or asks a question
c) When a Work Coach or other DWP staff member is unable to contact the claimant digitally
d) When a Work Coach or other DWP staff member has sent information digitally to the claimant but receives no reply or the claimant has not acted on it

ANSWER:
a) Upon receiving a letter, the work coach or agent will contact the claimant online or, where required, by phone or by letter to book a face to face meeting. The purpose of this meeting will be to discuss their Claimant Commitment and look at the impact of the change/variation; this may result in a new Claimant Commitment being created which is tailored to their new circumstances.
b) The Service Centre agent will firstly make the claimant aware of the online functions to enable them to notify a change in circumstances, request a variation in their claimant commitment, or ask a question online. If the claimant has access to their online account, the agent will talk the claimant through the process to do this.
c) If claimants cannot be contacted online, or do not respond to information sent, DWP staff will attempt to contact the claimant by phone or a letter will be sent.
d) Universal Credit claims are made online via www.gov.uk/apply-universalcredit.

Further DWP Response:
Universal Credit full service is an intuitive system and so traditional forms of guidance are not provided to staff. As part of their preparation for delivering Universal Credit full service, all DWP case managers and work coaches undertake learning specifically designed to help them provide support to claimants who are not able to self-serve using the online portal. This covers how they would identify someone who is in need of support and how they would go about providing the appropriate assistance. This may include coaching the claimant in person or over the phone, or, where necessary, acting as an agent by proxy or arranging a home visit.
If the letter received asks a question, the work coach or agent will provide a response via the claimant’s online account, unless they specifically requested a telephone call or letter response.

If the claimant is unable or unwilling to action the change online, the agent will action the change on the telephone, they will explain to the claimant they must view details of the change on their online account and accept this.

If the claimant still doesn’t take the action needed, the claimant may be referred for a sanction.
A low level sanction will apply to claimants who are subject to all work related requirements and work preparation and work focused interview requirements who without good reason fail to:

  • undertake specified work search action

  • comply with a work preparation requirement

  • comply with a work-focused/work search interview requirement

  • comply with a requirement to provide evidence or confirm compliance

  • comply with a connected requirement relating to interviews and verification compliance including the provision of information and evidence

  • comply with a requirement to report a specified change of circumstance (this will relate to failure to report the loss of a job).


If a claimant needs support to do this, help is available by the following means:
  • telephone

  • face to face support from a partner organisation

  • in the office

  • exceptionally, through a home visit


The DWP state no such guidance exists as the full service is an 'intuitive' service and traditional forms of guidance are not provided.

Click here to see the original FOI.

 



QUESTION:
Please could you explain what happens with the HB payments for a UC claimant who is in specified accommodation, when that person moves into general let (and therefore is entitled to have their housing cost element included in their UC rather than being paid HB).
As UC will be calculated based on the housing cost element being included for the whole of the MAP in which they have moved, is there an overpayment of any HB paid in that MAP? And is it recoverable? Or will the HB paid up to date of move be allowed, as it is for a different address?

ANSWER:
When a UC claimant claims for housings costs they are paid for the circumstances that are relevant on the last day of their assessment period. See here.
When a UC claimant leaves specified accommodation HB will cease in accordance with Housing Benefit Regulations 2006, Regulation 79, which governs the date of which change of circumstances take effect. There is no overpayment in these circumstances. See here.



QUESTION:
DWP guidance A4153 specifies those who can notify DWP of a change in circumstance: "A4153 A change of circumstances can be notified by 1. the claimant 2. the appointee 3. Any person who is an authorised representative for the claimant 4. A representative or agent of the Secretary of State … Note: This list is not exhaustive. The legislation does not specify who may apply for supersession on a change of circumstances."
But what isn't clear is whether the DWP is obliged to act on any notification by someone not on the list - for example a claimant's landlord where the claimant has not provided authorisation.
Could you point me in the direction of legislation or guidance which states whether the DWP is obliged to take note of information from whatever source?

ANSWER:
There is no specific legislation which says the DWP is obliged to take note of information from whatever source. The DWP will take note of all information received because it may affect benefit entitlement and awards. Of course it will only do that if it is relevant.
There is legislation which ensures that relevant information is acted upon.
This legislation is found in the Social Security Act 1998 – see sections 9 and 10 here
You will see that these sections provide for the Secretary of State to make regulations and these can be found in Part 3 of The Universal Credit, Personal Independence Payment, Jobseeker’s Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations 2013.
So, we assume that if a landlord notified the DWP of a rent increase and it was relevant because, for example, that might impact on entitlement, then it would be acted upon.

Click here to see the original FOI.



QUESTION:
Please can we have the guidance surrounding the precise process that happens at DWP when a Universal Credit claimant submits a self-certification or fit note to DWP, and what to do when it appears to fail?

ANSWER:
In answer to your first question regarding the procedure when a fit note is handed into DWP for a Universal Credit claimant, I would like to explain what the Universal Credit definition is of a fit note:
“The fit note is used by a doctor to give more information about someone's medical condition and their ability to work. It can also be used to show why someone can't work due to illness or injury. A fit note is needed after 7 calendar days of sickness. The fit note replaced the sick note from 6 April 2010”

Universal Credit guidance has been collated from various sources within the Universal Credit Knowledge Management (UCKM) database. I have listed below the relevant areas within the guidance that I think maybe of interest to you and included the full documents into attachments below.

Below is a summary of what the guidance states:
1. The UCKM content item Setting work related requirements states Work Coaches may identify circumstances when the claimant's work search and availability requirements will be temporarily switched off, for example if a claimant sends a self-certificate/medical evidence report of an illness of up to 14 days.

Another piece of relevant UCKM guidance of interest is Switching off requirements - Temporary absence for Medical Treatment.

Guidance on receiving a statement of fitness for work is in the following pieces of UCKM guidance:

  • Receipt of a statement of fitness for work or Return to Work Plan - explains what happens when a Statement of Fitness for Work (SoFFW) is received.

  • Actions when no Statement of Fitness for Work has been received - explains what happens when a SoFFW isn’t received and what actions are taken.

  • Action on the 8th day of sickness the claimant is contacted by telephone to see if a new SoFFW is needed.

  • Contacting a claimant about their Statement of Fitness for Work describes the action to take when a claimant has not sent in a SoFFW after being sent a reminder 7 days before it was due to expire.


Q: Please could you provide DWP guidelines on the time within which DWP should send these forms to claimants (especially UC35); and on what a claimant should do if, despite sending repeated fit notes, they hear nothing?

2. The piece of UCKM guidance Referring a claimant to a work capability assessment indicates the form UC35, which is the example referred to, is sent after 28 days of sickness.
If a claimant doesn’t receive a form they’ve requested, they should contact Universal Credit to request a duplicate as soon as possible.
The relevant piece of UCKM for contacting Universal Credit is Contacting Universal Credit overview and relevant information is available on https://www.gov.uk/universalcredit .
If a claimant requests a duplicate UC50 the relevant piece of UCKM guidance is Duplicate UC50 medical/health questionnaire requested.
3. The UCKM piece Referring a claimant to a work capability assessment refers to Health Disability Assessment Services rather than ‘medical services’. The Centre for Health and Disability Assessment (CHDA) replaced ATOS in February 2015. Unfortunately, we are unable to provide a contact number or address as this organisation is acting on behalf of DWP and all enquiries must be made through DWP. A claimant can contact CHDA regarding their Work Capability Assessment on the telephone number that is enclosed at the bottom of their letter inviting them along to participate in an assessment.


Q: Fit notes et cetera have been submitted to Mail Opening Unit at Wolverhampton. Is this the correct address?
Fit notes are submitted to the general Mail Handling Unit at Wolverhampton.

Guidance Part 1 and Part 2
More information on conditionality within UC claims can be found here.
Find out more here about what happens when a UC claimant becomes sick.

 



QUESTION
Various UC documents allude to an "Account Developer"'s discretion in referring a claimant for a Work Capability Assessment where the "fit note" covers 28 days or more.
Please could you supply the guidance that Account Developers (or others) are to follow in determining when it is appropriate to refer a claimant or a Work Capability Assessment where the "fit note" covers 28 days or more?

And any letters/documents for DWP to send to a claimant where either:
a) they have specifically requested a WCA but it has been decided this is not appropriate or
b) they have not specifically requested a WCA and it has been decided this is not appropriate.

ANSWER
"The following attachments provide guidance for the Account Developers to follow in determining what is appropriate when referring a claimant for a Work Capability assessment where the fit note covers 28 days or more. The attachments include the Health Conditions and Disabilities Hub, Health Conditions and Disabilities from day 1 to day 29 and What to do when a Claimant Reports a Health Condition to address when they have specifically requested a WCA but it has been decided this is not appropriate and/or they have not specifically requested a WCA and it has been decided this is not appropriate. "
(Click on the links above plus UCKM1 and UCKM2 - these go into more detail.)


IMPORTANT NOTE
There was nothing in any of these documents to suggest the AD has discretion whether or not to refer the claimant for a Work Capability Assessment at Day 29.
For example, from 'Annex A.1 -Health conditions and disabilities – day 1 to day 29' - "At day 29 providing the claimant has a current Fit Note, he or she must be referred for a Work Capability Assessment (WCA)."
But it is sometimes possible to refer earlier than Day 29 - from Annex A.2 'Health conditions and disabilities hub - at a glance'-
"In some circumstances, a claimant can be referred for a WCA immediately when the health condition or disability is reported."

The following extracts give more detail in what the AD actually has to do at Day 29:

From 'Universal Credit Knowledge Management (UCKM) Part 2 - "Referring a claimant to a Work Capability Assessment

Summary
How to make a Work Capability Assessment referral or re-referral:

An account developer (AD) may identify that a Work Capability Assessment (WCA) referral or rereferral is required for one of the following reasons:

  • the claimant can be treated as having Limited Capability for Work (LCW) or Limited Capability for Work and Work Related Activity (LCWRA) or LCWRA due to a terminal illness (these must be referred immediately)

  • the claimant has reached the 28th day of sickness

  • the claimant failed to return a UC50 and good cause was accepted

  • the claimant didn’t attend a WCA and good cause was accepted

  • a re-referral is required when the claimant is within 2 months of the end of their prognosis

Introduction and overview of the Medical Services Referral System
The Medical Services Referral System (MSRS) enables Universal Credit to register and monitor electronic WCA referrals to the Centre for Health and Disability Assessments (CHDA). MSRS is used to:
  • register electronic WCA referrals

  • monitor the progress of WCA referrals to and from the CHDA

  • view cases and WCA referrals and outcomes to action as appropriate

There is no automatic interface between the Universal Credit Agent Portal and MSRS. Agents are required to enter data manually to MSRS.

Initial clerical Work Capability Assessment referral
The AD locates and prints all the information relating to the claimant’s sickness from the Document Repository System (DRS). Supporting documents may include:
  • the Statement of Fitness for Work (SoFFW) or Return to Work Plan (RtWP)

  • further medical evidence received since the first day of sickness

  • DS1500

  • MATB1

  • UC65 relating to the current period of sickness

  • any information regarding reconsiderations or appeals for the current period of sickness (recorded on a UC6 and/or tribunal documents)

  • UC50

The AD completes a UC55 Medical Services Jacket and includes the following information:
  • the Special Indicator/UCB marker with information found in the Unacceptable Customer Behaviour (UCB) Portal (the referral will be rejected if the information is not completed - see Staff Protection List for guidance)

  • the benefit type, including Statutory Sick Pay (SSP) and the claimant’s personal details found in the Agent Portal Claim admin summary page (the Agent Portal is accessed through CAMLite and the Claim admin summary page will show whether appointee details are held for the claimant)

  • appointee details, held in the ‘Customer representative’ tab on the Customer details screen in CAMLite

  • the name of the owning office and team (if not already known use FIND)

  • the first day of the current period of sickness from the CAMLite task

  • the diagnosed cause of the current sickness and/or disability found in the information recorded using the Manual Data Gather Tool (MDGT) stored on DRS (the AD needs to be aware there could be more than one reason for sickness and they may need to check the SoFFW or RtWP)

  • GP details found in the information recorded using the MDGTl

  • the ‘Mental health related disability’ indicator using information from the Incapacity Reference Guide (IRG) or the SoFFW or RtWP (see operational guidance ‘Using the Incapacity Reference Guide’

  • claimants with mental health related sickness are treated sensitively during the WCA)

  • the referral details with the referral type (see table below), the date of the referral and if the claimant has LCW or LCWRA.

The AD identifies which Assessment Centre the referral is to be sent to by accessing DA Healthcare Provider addresses.
The AD then returns to this guidance and sends the UC55 and all relevant documents to the Assessment Centre via the standard courier process (purple polylope).
The AD then creates a Work Services Platform (WSP) task:
Creating a Work Services Platform task for the Work Coach Task Team
The AD creates a WSP task for the Work Coach Task Team.
The task details depends on whether the claimant is terminally ill, treated as having LCW/LCWRA or has reached the 28th day of sickness:
(eg:)
For claimants who have reached the 28th day of sickness:
  • Target: Work Coach Task Team

  • Start : Immediate

  • Notes: ‘Claimant reported sick from (--/--/--). 28th day of sickness now reached. Claimant referred for WCA on (--/--/--)

All referrals
In WSP, the AD navigates to the claimant’s record in the Personal section and:
1. Changes the WCA action radio button to ‘Yes’.
2. Selects ‘Assessment pending’ from the dropdown list.
3. Saves and closes the claimant’s record.

The AD then creates one of the following CAMLite tasks for the return of the referral:
(eg, where not terminally ill nor "treated as LCW")
Task Type: Health Condition
  • Sub Type: WCA Referral

  • Start Task From: 12 weeks from issue of WCA referral

  • SLA: 3 days

Notes will be either:
  • WCA outcome – claimant reported sick from (dd/mm/yyyy). (or)

  • WCA referral made (clerically/via MSRS) on (dd/mm/yyyy). (or)

  • Has WCA referral outcome been received?

The AD updates CAMLite Contact history with the referral details and exits all claimant records.

Notifying the claimant
The AD accesses the UC35 Notification letter (located in Supporting documents for sick and disabled), completes it and posts to the claimant to inform them they will shortly receive a questionnaire to complete as part of their WCA.

Click here to see the original FOI.