DLA Claim Fraud...

Legacy_user

Hi Guys,

Hopefully posting in the correct forum. Just looking for some advice as I have just received a potentially life changing letter and I am worried sick

When I was a kid I was diagnosed with a bone condition in my hip which caused me to be in and out of hospital for quite a number of years.

In 1994 my parents successfully applied for Disability Living Allowance which at the the time was awarded indefinitely. Over the years the condition which affected me as a kid turned to Arthritis which has hampered me as an adult (now 34 years old).

Fast forward to 2010 and I receive a form asking me to fill in so they can look at my claim again which I did. I was then assessed by a doctor who submitted a report and concluded that I was still entitled to DLA.

Last April my boss at work received a call from the DWP asking him if they can meet with him for an interview about me. He agreed and advised them that my job wasn't manual and that I took 8 strong painkillers per day in order to manage the pain. He also advised them that my duties sometimes involved meeting clients in their own homes.

In December last year I received a letter advising that again my claim had been reviewed and it was now suspended.

Until today I had heard nothing more. The letter I received today states that my claim has been "superseded" and they have decided that was not entitled to DLA from the date I started my job in April 2012. They state that I was under surveillance for a period of 3 weeks in October 2016 and found that I was able to carry shopping bags and get in and out of my vehicle without any significant issues. Whilst I agree that sometimes I am indeed able to carry shopping and get in and out of my car, in order to do this I need to take 8 extremely strong painkillers per day!!

The letter states that as I am able to live independently and able to meet clients in their own homes they feel they have sufficient evidence to stop my claim from 2012. In the letter they also attached my current job description which confirms that I do indeed meet clients in their own homes however the job I applied for and obtained was a completely different role which was completely office based until I was promoted to my current role in 2015!

Apologies for the long winded back story but what I am trying to establish here is the likely outcome? DWP are claiming that my condition has significantly improved since 2012 and that I have essentially been committing benefit fraud since then.

I'm aware that I will have to repay the money paid since 2012 but what else can happen here? Am I looking at a prison sentence or at least a court appearance and name dragged through the papers etc??

Any advice is much appreciated.

Thanks in advance.

sevenhills

Jaffa83 wrote: »

Until today I had heard nothing more. The letter I received today states that my claim has been "superseded" and they have decided that was not entitled to DLA from the date I started my job in April 2012. They state that I was under surveillance for a period of 3 weeks in October 2016 and found that I was able to carry shopping bags and get in and out of my vehicle without any significant issues. Whilst I agree that sometimes I am indeed able to carry shopping and get in and out of my car, in order to do this I need to take 8 extremely strong painkillers per day!!

The letter states that as I am able to live independently and able to meet clients in their own homes they feel they have sufficient evidence to stop my claim from 2012.

It does sound like you are living independently, a take a 90 year old shopping, he can carry the bags; he does use around 10 shopping bags, where as I would only use 2/3

tomtom256

Jaffa83 wrote: »

Hi Guys,

Hopefully posting in the correct forum. Just looking for some advice as I have just received a potentially life changing letter and I am worried sick

When I was a kid I was diagnosed with a bone condition in my hip which caused me to be in and out of hospital for quite a number of years.

In 1994 my parents successfully applied for Disability Living Allowance which at the the time was awarded indefinitely. Over the years the condition which affected me as a kid turned to Arthritis which has hampered me as an adult (now 34 years old).

Fast forward to 2010 and I receive a form asking me to fill in so they can look at my claim again which I did. I was then assessed by a doctor who submitted a report and concluded that I was still entitled to DLA.

Last April my boss at work received a call from the DWP asking him if they can meet with him for an interview about me. He agreed and advised them that my job wasn't manual and that I took 8 strong painkillers per day in order to manage the pain. He also advised them that my duties sometimes involved meeting clients in their own homes.

In December last year I received a letter advising that again my claim had been reviewed and it was now suspended.

Until today I had heard nothing more. The letter I received today states that my claim has been "superseded" and they have decided that was not entitled to DLA from the date I started my job in April 2012. They state that I was under surveillance for a period of 3 weeks in October 2016 and found that I was able to carry shopping bags and get in and out of my vehicle without any significant issues. Whilst I agree that sometimes I am indeed able to carry shopping and get in and out of my car, in order to do this I need to take 8 extremely strong painkillers per day!!

The letter states that as I am able to live independently and able to meet clients in their own homes they feel they have sufficient evidence to stop my claim from 2012. In the letter they also attached my current job description which confirms that I do indeed meet clients in their own homes however the job I applied for and obtained was a completely different role which was completely office based until I was promoted to my current role in 2015!

Apologies for the long winded back story but what I am trying to establish here is the likely outcome? DWP are claiming that my condition has significantly improved since 2012 and that I have essentially been committing benefit fraud since then.

I'm aware that I will have to repay the money paid since 2012 but what else can happen here? Am I looking at a prison sentence or at least a court appearance and name dragged through the papers etc??

Any advice is much appreciated.

Thanks in advance.

Have you been interviewed under caution?

This that would not happen without a full fraud investigation with authorised surveillance, followed by said interview under caution.

Have you missed part of the story out?

System

No. The letter I received today states that they sent me 2 letters inviting me to an interview but I genuinely didn't receive these letters. I moved house last summer (they were notified) but im guessing that they've sent these letters to my old address.

kingfisherblue

Although you have to take painkillers, that in itself is not enough to warrant an award. Nor is having arthritis. I've had it in my knees since I was 23, and also have it in my hips and spine. It's starting to become more of a problem in my hands now.

Having said that, it is possible to claim DLA or PIP (which is replacing DLA for adults), and still work. However, the reason that you receive a disability benefit must not contradict your work.

It appears that you have been observed moving around fairly freely, contradicting your claim. Many people have arthritis and manage to live their lives without any disability benefits. Can you honestly say that you still fit the criteria?

You agree that you will have to repay the money received since 2012, so it sounds as though you are aware that you no longer qualify. It's going to be quite a considerable sum though. Personally, I wouldn't rely on strangers on the internet. I would be taking legal advice. You might have legal cover on your house insurance.

tomtom256

Jaffa83 wrote: »

No. The letter I received today states that they sent me 2 letters inviting me to an interview but I genuinely didn't receive these letters. I moved house last summer (they were notified) but im guessing that they've sent these letters to my old address.

In that case the DWP may take you to court for benefit fraud, depends on what the fraud investigator recommends and if CPS are willing to take it forward.

System

I have an appointment to see a solicitor but it's not until the 30th. I am beside myself with worry. That's why I'm posting here looking for advice.

speedfreek1000

Although DLA is an In-work and Out of work benefit to assist people with the extra cost of disability.... the DWP have been known to take the view that work ends a DLA claim.

1st thing you have to do is ask them for a mandatory reconsideration (Mandy) of the decision to end your benefit. Do this within 30 days of the date on that letter. 1st by telephone then follow that up with a letter.

This Mandy will probably be rubber stamped so you then formally appeal to the |Tribunal Service.

Now unless you are formally charged with benefit fraud you do not need a solicitor. They maybe actually more of a hinderer than help so you'd be better off with something welfare rights like the CAB or another local organisation who know benefits.


Now here's where it gets a bit grey and nasty.

But the DWP may try and raise and enforce/recover an overpayment which legally they can now do. You need to appeal this too.

Resign yourself to a long and unfair fight but..... its up to the DWP to prove that you were not eligible for DLA from point X with evidence and not just speculation. All you have to do is refute that stating I was the same or worse therefore I was eligible and still am.

I'd throw in Subject Access Requests (SAR) for your GP/Hospital medical record now (if you haven't already got them) as they take time and collate what you need. I'd also put together all your previous (SAR the DWP if you need them) DLA application forms and decision letters. Think about and sort out how that proves you are eligible for DLA at the rate you were on.

Once you formally appeal wait for the DWP submission and work out how it denies your claim then refute it. It really isn't that hard!

I was down graded to LRC + LRM on my last DLA review so asked for a Mandy then appealed. My argument was nothing had changed and that the DWP were arguing against against LRC (which they had conceded and awarded) instead of MRC which was what I was arguing no change on. Got MRC + LRM indefinite award even though I didn't turn up for the face to face tribunal.