Employment and Support Allowance - Non-intentional prescription fraud

Dovah_diva

zzzLazyDaisy wrote: »

But going forward, paying for prescriptions is not good advice

I'll re-phrase. Going forward, start getting your prescriptions legally - whether that be paying for them, or applying for the appropriate exemption.

Twp1989

epitome wrote: »

This is not correct, the OP has a letter saying how much ESA IR he would have got but it goes on to say "however since you are eligible for ESA C....." This implies that his ESA C pays the same or more than his ESA IR, in which case he has no ESA IR at all. The letters clearly say -always- that you get C or you get IR the letters never say "both".

OP answer these questions

Do you have a partner?
Do you have more than £6000 in savings?
What does the letter say your award £££ for ESA IR would be & ESA C is?

When you apply for a HC1 help with health costs you can ask that it is backdated.

If I were you I would only speak to the pharmacy to make them aware of their lack of knowledge, they should have understood the letter has to say ESA Income Related.

I would then apply for a backdated HC1 form and this process will likely flag up to NHS the errors that have been occuring and then NHS can ask you about it if they want to.


What were you on or doing before ESA started? How long have you been ticking the box for free prescriptions? How many prescriptions and dental treatments optician treatments have you had free?

Hi,

In answer to your questions:
- No I don't have a partner
- No I don't have £6000 in savings
- The letter says that both ESA IR and ESA CB are the same amount: £56.20

I was working before I was on the ESA. I went on to ESA in February when I left my job through mental illness. I've been ticking the box unawares since about March 2013. I believe I've had approximately 10 free prescriptions and 1 lot of dental treatment free too.

missapril75

So you will have an entitlement to free prescriptions then - it would just have needed the official application and the official confirmation.

Get it and then if anything ever happens about the earlier ones you have your proof that you would have been due them anyway and explain the misunderstanding.

There is a principle about Fraud that involves getting something that wasn't due

rogerblack

You cannot commit non-intentional fraud - it's not possible.
Fraud has the key element of intent.
You can be wrongly found of committing fraud - or guilty of other offences, but not fraud.

Twp1989

Thanks guys. Just to update, I've had a conversation with the NHS Business Services Department today and made it clear that this was a mistake and that I wish to rectify the issue and that I am happy and willing to pay anything I may owe. They have referred me to my local NHS body and I have to give them a call on Monday and just explain everything again and stress that this was not intentional and that I am willing to cooperate.

With regards to the Low Income Scheme, I will look into doing that on Monday too, I've picked up an HC1 form and will be sending it off Monday.

Once again thank you everyone for your help and support with this!

epitome

Because both amounts are the same that means you are on ESA C not ESA IR (but you knew that already...this is for the benefit of joff81)

Ok, make sure you ask that your HC1 aplication is backdated as far as possible or to the start of your ESA claim.

Although not guilty of intentional fraud, he would still be liable to pay back the costs of the prescriptions and treatment as he has had something "he was not due". He won't be due them free until he has a backdated HC1 allowed. If he deliberately did this by deliberatly refusing to apply on an HC1 then he would be guilty of fraud. It's not a question of "He would have been eligible had he applied so that's ok then"... It is obtaining something without the permissions to do so.

Twp1989

epitome wrote: »

Because both amounts are the same that means you are on ESA C not ESA IR (but you knew that already...this is for the benefit of joff81)

Ok, make sure you ask that your HC1 aplication is backdated as far as possible or to the start of your ESA claim.

Although not guilty of intentional fraud, he would still be liable to pay back the costs of the prescriptions and treatment as he has had something "he was not due". He won't be due them free until he has a backdated HC1 allowed. If he deliberately did this by deliberatly refusing to apply on an HC1 then he would be guilty of fraud. It's not a question of "He would have been eligible had he applied so that's ok then"... It is obtaining something without the permissions to do so.

In reply to this, I didn't do this deliberately and I didn't avoid filling out an HC1 form on purpose because I didn't even know about the HC1 form, or the Low Income Scheme and even I had known, I didn't know the criteria for eligibility for it until I read about such a thing on this forum. Like I've already said, all this was unintentional and I did not purposely avoid paying for my medication or filling out the relevant form in order to benefit myself in any way - Hence why I am declaring what I've done and am openly asking for help to resolve this.

jacques_chirac

On the facts given there is no indication of fraud. However the NHS do have the power to impose a civil penalty where you have wrongfully claimed, there is no requirement for the claim to be fraudulent. I can't say how likely they are to do this, all I can suggest is being honest as you have been here.

dookar

Twp1989 wrote: »

Originally, I was led to believe that if I was on ESA that I could claim free NHS prescriptions

led to believe by whom?

Twp1989

dookar wrote: »

led to believe by whom?

The pharmacy themselves - I went to them when I was awarded my ESA and asked if that entitled me to free medication. They said yes it did and all I had to show was my ESA claim letter as proof.