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Carers Premium Overpayment
dizzyfairy
Posts: 4 Newbie
I have been dealing with a friend's finances to the best of my ability for close to a year now and have today come across a possible problem which I guess I have overlooked!
Married couple aged over 60, under pension age. Both in receipt of ESA.
Her ESA:
Living expenses for you and your partner £114.85
Extra money because you are severely disabled £62.45
Extra money because you are both carers £69.90
Extra money because of the disability income guarantee £22.85
Extra money because you are in the support group £36.55
Total Income Related Amount £306.60
_______________________________________
He get's ESA of £109.65 per week (contribution based)
Extra money because you are both carers £69.90 is made up of £34.95 per week each for a Carers Premium as they have both cared / attended to each others needs over the years.
However, he has not been caring for her for 35 hours + since around February 2017 after a hospital admission and a cancer diagnosis. He is home now, but been bed bound since returning home in May 2017.
We notified relevant ESA people of hospital admission for ESA and DLA etc. As he was on a lower amount of DLA, I applied for PIP under terminal illness rule and this was awarded at Enhanced Rate for both Daily Living and Mobility.
I remember the carers department writing to her to ask if she was still caring for him after we notified of his hospital admission. I completed a form putting dates of admission, time etc. and dates he came out. There was no letter of a similar nature for him about whether he was caring for her still.
She is unable to deal with any of her finances, so I have taken it upon myself to deal with everything - something I have found very hard to do!
I guess I need to inform them of the fact he has not been caring for his wife since February 2017, this is around 47 weeks and could equal an overpayment of £1642.65. I am no benefit expert but I realise this is a severe overpayment!
They already wrote off a DLA overpayment as despite me writing to them to inform of his hospital admission, they continued to pay DLA, but since I could prove the letter was sent and signed for, they wrote off the overpayment of about £600.
I am questioning though why, ESA didn't realise the CP might not be payable given he was in hospital?
The claimant is not yet aware of this problem as I have only realised it myself this afternoon.
Married couple aged over 60, under pension age. Both in receipt of ESA.
Her ESA:
Living expenses for you and your partner £114.85
Extra money because you are severely disabled £62.45
Extra money because you are both carers £69.90
Extra money because of the disability income guarantee £22.85
Extra money because you are in the support group £36.55
Total Income Related Amount £306.60
_______________________________________
He get's ESA of £109.65 per week (contribution based)
Extra money because you are both carers £69.90 is made up of £34.95 per week each for a Carers Premium as they have both cared / attended to each others needs over the years.
However, he has not been caring for her for 35 hours + since around February 2017 after a hospital admission and a cancer diagnosis. He is home now, but been bed bound since returning home in May 2017.
We notified relevant ESA people of hospital admission for ESA and DLA etc. As he was on a lower amount of DLA, I applied for PIP under terminal illness rule and this was awarded at Enhanced Rate for both Daily Living and Mobility.
I remember the carers department writing to her to ask if she was still caring for him after we notified of his hospital admission. I completed a form putting dates of admission, time etc. and dates he came out. There was no letter of a similar nature for him about whether he was caring for her still.
She is unable to deal with any of her finances, so I have taken it upon myself to deal with everything - something I have found very hard to do!
I guess I need to inform them of the fact he has not been caring for his wife since February 2017, this is around 47 weeks and could equal an overpayment of £1642.65. I am no benefit expert but I realise this is a severe overpayment!
They already wrote off a DLA overpayment as despite me writing to them to inform of his hospital admission, they continued to pay DLA, but since I could prove the letter was sent and signed for, they wrote off the overpayment of about £600.
I am questioning though why, ESA didn't realise the CP might not be payable given he was in hospital?
The claimant is not yet aware of this problem as I have only realised it myself this afternoon.
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Comments
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Claiming Carers Allowance and SDP is a problem because you can't claim both of them. If you claim Carers Allowance they you don't qualify for SDP, as that's one of the rules to claiming it. No one claims carers allowance for you. This will be an overpayment too. I would advice them or yourself to ring DWP to report this. Are you their appointee?dizzyfairy wrote: »I have been dealing with a friend's finances to the best of my ability for close to a year now and have today come across a possible problem which I guess I have overlooked!
Married couple aged over 60, under pension age. Both in receipt of ESA.
Her ESA:
Living expenses for you and your partner £114.85
Extra money because you are severely disabled £62.45
Extra money because you are both carers £69.90
Extra money because of the disability income guarantee £22.85
Extra money because you are in the support group £36.55
Total Income Related Amount £306.60
_______________________________________
He get's ESA of £109.65 per week (contribution based)
Extra money because you are both carers £69.90 is made up of £34.95 per week each for a Carers Premium as they have both cared / attended to each others needs over the years.
However, he has not been caring for her for 35 hours + since around February 2017 after a hospital admission and a cancer diagnosis. He is home now, but been bed bound since returning home in May 2017.
We notified relevant ESA people of hospital admission for ESA and DLA etc. As he was on a lower amount of DLA, I applied for PIP under terminal illness rule and this was awarded at Enhanced Rate for both Daily Living and Mobility.
I remember the carers department writing to her to ask if she was still caring for him after we notified of his hospital admission. I completed a form putting dates of admission, time etc. and dates he came out. There was no letter of a similar nature for him about whether he was caring for her still.
She is unable to deal with any of her finances, so I have taken it upon myself to deal with everything - something I have found very hard to do!
I guess I need to inform them of the fact he has not been caring for his wife since February 2017, this is around 47 weeks and could equal an overpayment of £1642.65. I am no benefit expert but I realise this is a severe overpayment!
They already wrote off a DLA overpayment as despite me writing to them to inform of his hospital admission, they continued to pay DLA, but since I could prove the letter was sent and signed for, they wrote off the overpayment of about £600.
I am questioning though why, ESA didn't realise the CP might not be payable given he was in hospital?
The claimant is not yet aware of this problem as I have only realised it myself this afternoon.0 -
poppy12345 wrote: »Claiming Carers Allowance and SDP is a problem because you can't claim both of them. If you claim Carers Allowance they you don't qualify for SDP, as that's one of the rules to claiming it. No one claims carers allowance for you. This will be an overpayment too. I would advice them or yourself to ring DWP to report this. Are you their appointee?
I don't think this is applicable as the husband was claiming contribution based ESA and this is an overlapping benefit with CA so he would only have been awarded the Carer's element which means the wife could be awarded the SDP and counted as living alone because of the husband's DLA/PIP award.
Was the contribution based ESA counted as income for the income based award for the wife?0 -
poppy12345 wrote: »Claiming Carers Allowance and SDP is a problem because you can't claim both of them. If you claim Carers Allowance they you don't qualify for SDP, as that's one of the rules to claiming it. No one claims carers allowance for you. This will be an overpayment too. I would advice them or yourself to ring DWP to report this. Are you their appointee?
I'm not the appointee, sadly just a friend whose someone got roped into doing many things... stressful is not the word!pmlindyloo wrote: »I don't think this is applicable as the husband was claiming contribution based ESA and this is an overlapping benefit with CA so he would only have been awarded the Carer's element which means the wife could be awarded the SDP and counted as living alone because of the husband's DLA/PIP award.
Was the contribution based ESA counted as income for the income based award for the wife?
Yes, I think so. On her ESA letter it says 'Other income for your household' = ESA for your partner £109.65
From June 2017 the award was £144.91 then it changed from November 2017 to £213.91 which was quite a jump for some reason. He was awarded Enhanced PIP in June 2017 on terminal illness grounds.
She was switched to PIP from DLA in September 2017 and went from High Rate Care to Enhanced Daily Living and Low Rate Mobility to Enhanced Mobility.
He also gets a small private pension of approx. £112 per month.
I am not sure if it makes any difference but she is registered as blind also and has been for several years.0 -
You can still be paid the premium for 12 weeks when the carer goes into hospital so the overpayment may not be so bad.
Since their claim is complicated it may be worth getting a benefits check up from CAB or AgeUK to make sure they have the correct award.0 -
This is a complicated question.
EDIT: The award of SDP at single rate appears to be correct as there is one paid CA and one underlying CA.
The mention of additional 12 weeks CA entitlement when a carer goes into hospital is interesting and should definately be discussed with his CA when you phone to announce his ceased to care. oh sorry... I think you mean the ESA CP run-on for 12 weeks after a CA has ceased because carer went into hospital...I don't know anything about this can you expand on it please? The maximum CP run-on I know about is 8 weeks.
****************************************************
£1600 seems a lot to you but to DWP it is not a lot, worst case scenario the ESA claimant will have to pay it back.
As far as I know she is allowed to continue to care for him when he is in hospital. When they are in hospital for more than 28 days, I believe the DLA stops and the knock-on effect is that CA also has to stop.
So my questions are ... on her CA claim was there a break in her claim for the time he was in hospital?
Did his DLA stop when in hospital? if it did this should correlate with a break in her CA claim.
He claims ESA Conts
She claims ESA IR..when did her ESA begin?
He does not get paid CA because he has ESA(C)
Does she get paid CA £62.70? and is it weekly or 4 weekly paid?
When did her CA begin?
What dates was her very first payment of CA covering and how much was paid, and how much if any was held back by other benefits..which other benefits were they?
How much is her ESA per fortnight (in her bank)? or per week.
First thing to do is phone his CA and announce the ceased to care from Feb 2017. There will be no overpayment of CA as he does not receive it. Ask how long it will take them to close the CA claim.
Phone her CA and ask if there is any break in her carer claim for the hospital period and how much she gets paid on CA and if it is weekly or 4 weekly paid.
Once you know his CA has been closed, it may be on the same phone call that you know, then phone her ESA and announce the end date of his CA. There will be a overpayment of ESA that has to be re-paid.
Come back here with answers, I will advise further... there may be other questions but I can't think of them right now.
One way to lower an overpayment is to point out to the department an under payment that has occured in the past (you would be surprised at how many claims are underpaid)...some of my questions are leading towards trying to find an underpayment on her ESA or her CA it will be difficult to identify such an underpayment over the internet like this but not impossible as long as you ask the questions I want you to ask.0 -
This is a complicated question.
EDIT: The award of SDP at single rate appears to be correct as there is one paid CA and one underlying CA.
The mention of additional 12 weeks CA entitlement when a carer goes into hospital is interesting and should definately be discussed with his CA when you phone to announce his ceased to care. oh sorry... I think you mean the ESA CP run-on for 12 weeks after a CA has ceased because carer went into hospital...I don't know anything about this can you expand on it please? The maximum CP run-on I know about is 8 weeks.
****************************************************
£1600 seems a lot to you but to DWP it is not a lot, worst case scenario the ESA claimant will have to pay it back.
As far as I know she is allowed to continue to care for him when he is in hospital. When they are in hospital for more than 28 days, I believe the DLA stops and the knock-on effect is that CA also has to stop.
So my questions are ... on her CA claim was there a break in her claim for the time he was in hospital?
Did his DLA stop when in hospital? if it did this should correlate with a break in her CA claim.
He claims ESA Conts
She claims ESA IR..when did her ESA begin?
He does not get paid CA because he has ESA(C)
Does she get paid CA £62.70? and is it weekly or 4 weekly paid?
When did her CA begin?
What dates was her very first payment of CA covering and how much was paid, and how much if any was held back by other benefits..which other benefits were they?
How much is her ESA per fortnight (in her bank)? or per week.
First thing to do is phone his CA and announce the ceased to care from Feb 2017. There will be no overpayment of CA as he does not receive it. Ask how long it will take them to close the CA claim.
Phone her CA and ask if there is any break in her carer claim for the hospital period and how much she gets paid on CA and if it is weekly or 4 weekly paid.
Once you know his CA has been closed, it may be on the same phone call that you know, then phone her ESA and announce the end date of his CA. There will be a overpayment of ESA that has to be re-paid.
Come back here with answers, I will advise further... there may be other questions but I can't think of them right now.
One way to lower an overpayment is to point out to the department an under payment that has occured in the past (you would be surprised at how many claims are underpaid)...some of my questions are leading towards trying to find an underpayment on her ESA or her CA it will be difficult to identify such an underpayment over the internet like this but not impossible as long as you ask the questions I want you to ask.
I can tell you her ESA is £213.91 from November 2017. As per my first post made up of what I wrote, minus his ESA of £109.65.
She migrated from Incapacity Benefit in 2013, him also in 2012.
I can't tell you when either of them began getting CA for each other, as there is no paperwork around for me to look at. I'll be honest and say it was more than chaos when I took over things early last year. His admission to hospital was sudden and he didn't return home for about 12 weeks. His wife practically moved into the hospital with him as they are so dependent on each other, thankfully the hospital staff were so kind given her needs and disabilities. I took it on myself to inform the DWP of admission dates etc. by letter which is why there was a overpayment of his DLA, because the letter was never actioned, this was written off when I could prove the letter sent was signed for.
I tried to call the CA unit this morning but they told me to ring ESA as it was about premiums. I did and explained the situation and they are sending out some forms to be filled out. I suspect these will be the same forms I completed for her when they wrote to check she was still caring for him.
My hard drive where all my letters were stored and scanned crashed two months ago, so lost a lot of what was saved, going to do a SAR with the DWP for her for back copies of all letters.
At least now they have been informed of a possible overpayment, so will see how it pans out.
I was under the impression that the 'Extra money because you are severely disabled £62.45' was not paid to people who were getting a carers premium.
I shall keep you posted. Thanks for your help.0 -
Your first post says 306.60 - 109.65 =£196.65 per week which would be correct under the circumstances. They are allowed single SDP because no-one gets paid carers allowance to care for her. They are still entitled to both carer premiums.
There is not much point phoning ESA because they can't remove the 2nd carer premium until CA has made a decision to close his claim.
I just had a thought...they might get lucky...the ESA OP may be written off...we will have to wait and see.
You would ask CA by phone, when his and her CA started, and you could look at her bank statement to see if her CA is £62.70 a week or £250.80 every 4 weeks.
And if there is a break in her CA claim for the hospital period.
If her CA started after her ESA started then you would ask CA by phone for the details of her first payment of CA i.e. period, how much was paid and held back and against which other benefit.0 -
I just had a thought...they might get lucky...the ESA OP may be written off...we will have to wait and see.
You would ask CA by phone, when his and her CA started, and you could look at her bank statement to see if her CA is £62.70 a week or £250.80 every 4 weeks.
And if there is a break in her CA claim for the hospital period.
If her CA started after her ESA started then you would ask CA by phone for the details of her first payment of CA i.e. period, how much was paid and held back and against which other benefit.
She is not paid CA as a separate entry into her bank, I know that as I have been checking her statements for months and his. What she got was ESA, broken down into the above.
He sadly passed away yesterday, obviously I have now informed the DWP of this. I'll keep you posted as to what happens.0 -
Oh dear, sorry to hear sad news.
...
You will need to ask her CA if her CA is still a live claim as caring for him.... If it is live but not paying anything that will be because it is the same as his CA was ...called underlying entitlement to CA.
If they both have underlying entitlement to CA that means the Severe Disability Premium should not be £62.45 it should be £124.90
Once you confirm the above, phone ESA ... you should ask them to look at the SDP decision again on her claim that it should be couples rate £124.90 a week. because both had underlying CA, not CA in payment.
Her CA if live, will continue for 8 weeks after his death. When it finishes you should phone ESA to tell them it has closed.
Also beware when phoning ESA you will get through to call centre who may not be very knowledgeable, what I say is correct, if both underlying then SDP should have been £124....make sure you ask for a call back from ESA processing who should know more about it.0
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