Employment and Support Allowance - Non-intentional prescription fraud

dookar

I'd suggest that if the people responsible for collecting the payment told you were exempt from charges you'd have a good case

Twp1989

dookar wrote: »

I'd suggest that if the people responsible for collecting the payment told you were exempt from charges you'd have a good case

I believe I was misled by the pharmacy because they generalized the ESA as making me eligible for free medication, they didn't query which form of ESA I was on and never made me aware of the fact I had to be on Income-based ESA to waive the charges. Also, they never once queried me everytime I went to collect medication and just placed the paper in front of me and told me to fill it out and sign it. When I showed my proof of ESA, they didn't read the documents, they just took one look and said "Oh, yeah, ESA, that's fine." I have been going by their word ever since without a second thought.

epitome

Twp1989 wrote: »

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.

I know you didn't do it deliberately, you have already said so on the thread. What I said was a general reply to an earlier comment on the thread which made it sound like doing this would have no consequences. I wanted to make it clear that you have received something that you were not due and so will have to pay it back...it is not a case of "oh you would have qualified anyway had you known so that's alright then". The civil penalty as someone just mentioned of £50 is probably also due but whether the NHS will issue you with one is another question

Twp1989 wrote: »

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.

Twp1989 wrote: »

I believe I was misled by the pharmacy because they generalized the ESA as making me eligible for free medication, they didn't query which form of ESA I was on and never made me aware of the fact I had to be on Income-based ESA to waive the charges. Also, they never once queried me everytime I went to collect medication and just placed the paper in front of me and told me to fill it out and sign it. When I showed my proof of ESA, they didn't read the documents, they just took one look and said "Oh, yeah, ESA, that's fine." I have been going by their word ever since without a second thought.

At the end of the day it is your responsibility to read the box you are ticking and signing for and to know what type of ESA you are on. The chemists actions in your case will just back you up that it was not intentional. And this is the reason I said earlier in the thread that if I were you, the only thing I would say to the chemist would be to make them aware if they are going to offer a service to customers of reading their award letters to advise them if they can get free prescriptions they should learn how to read those letters.

GlasweJen

Opticians/pharmacists/dentists can only ask you to tick a box and sign a declaration. Counter fraud services have been clamping down and I've had 3 people come in to complain because they've been caught out claiming that they have a tax credit exemption when they don't, they just claim tax credits.

Your benefit claim has nothing to do with us. Often the type of benefit your on is 4 pages in and half way down the page - I'm too time pressed to know all of my customers exemption. You are asked to fill out a form/back of a prescription and I know for a fact that prescriptions/opticians yellow vouchers and dentist blue vouchers all say "I/my partner is in receipt of income based ESA" or at least they do in Scotland. It's really not our problem if you don't read the form properly.

missapril75

Just to throw something else into the mix....

The OP claimed both types of ESA and the decision letter apparently refers to entitlement to the income based version, meaning it was applied for.

The following advice is taken from NHS.UK

...it's worth claiming income-related ESA as it entitles you to help with other costs, such as full help with Housing Benefit and Council Tax Benefit, free prescriptions, free school meals and other help.

The OP HAS claimed income-related ESA and even been advised of entitlement to it.


Any recovery action or attempt at imposing a penalty would surely be "laughed out of court" if challenged.



Not suggesting it would go to court, of course, it's just an expression.


But key would be challenging any penalty or demand for repayment.

Twp1989

missapril75 wrote: »

Just to throw something else into the mix....

The OP claimed both types of ESA and the decision letter apparently refers to entitlement to the income based version, meaning it was applied for.

The following advice is taken from NHS UK
The OP HAS claimed income-related ESA and even been advised of entitlement to it.


Any recovery action or attempt at imposing a penalty would surely be "laughed out of court" if challenged.



Not suggesting it would go to court, of course, it's just an expression.


But key would be challenging any penalty or demand for repayment.

Just to clarify things, the letter actually says "Your Income-based amount is £XXX so you WOULD HAVE BEEN entitled to £XXX. However, because you are entitled to Contribution-based ESA, we will pay you £XXX"

Saversue

Please stop worrying. It does sound like you should have been entitled to free prescriptions.
If you are asked to pay anything back ( this happened to someone I know ) they were just asked for what was owing and giving the option of paying the cost of a pre-payment certificate, which is much cheaper if you have 3 or more items per month. They come as 3 month or 12 month.

Twp1989

Saversue wrote: »

Please stop worrying. It does sound like you should have been entitled to free prescriptions.
If you are asked to pay anything back ( this happened to someone I know ) they were just asked for what was owing and giving the option of paying the cost of a pre-payment certificate, which is much cheaper if you have 3 or more items per month. They come as 3 month or 12 month.

Do you happen to know how your friend was informed that they had to pay back the costs? Did they realise they had made the mistake themselves or was it the other way around?

Saversue

Twp1989 wrote: »

Do you happen to know how your friend was informed that they had to pay back the costs? Did they realise they had made the mistake themselves or was it the other way around?

It was a friend's husband and he just got a letter out of the blue saying that he had signed to form saying he didn't need to pay - don't know which box - but think he might of said - had a prepayment card - and random checks had showed he didn't have one. Showed all the dates he did and when he stopped purchasing one ( they had money troubles and were in danger of loosing their house at the time)

Said no action would be taken if he paid back the owing money, but if not further action would be taken. HTH's

Twp1989

Saversue wrote: »

It was a friend's husband and he just got a letter out of the blue saying that he had signed to form saying he didn't need to pay - don't know which box - but think he might of said - had a prepayment card - and random checks had showed he didn't have one. Showed all the dates he did and when he stopped purchasing one ( they had money troubles and were in danger of loosing their house at the time)

Said no action would be taken if he paid back the owing money, but if not further action would be taken. HTH's

Thanks a lot, this really helps. I've been worrying myself sick over this and having anxiety and depression it's not good for me to be worrying like I have, lost so much sleep the past few nights. You're a saviour! :A