DWP Investigation

Targaryan

DWP are investigating my husbands claim for ESA. He is in the support group of contribution ESA. He has been in invalidity benefit, then incapacity benefit and finally ESA since 1992/93. He has also been getting a long term sickness benefit from his work. The DWP are not sure we have declared this benefit, although we are convinced we have. But 27 years is a long time ago. We could potentially be looking at 27 years of overpayment. As you can imagine this is giving us sleepless nights. Will the DWP still have records from 27 years ago? Can they make us sell our house? We are seriously scared.

poppy12345

What sort of sickness benefit is it?

Targaryan

It’s a long term sickness benefit payed by his employer. Although he hasn’t worked for 27 years they have continued to pay this

Robbie64

By "long term sickess benefit from his work", do you mean a works or private pension? Was he medically retired? I'm assuming he is no longer employed by the company?

If it is a works pension then it shouldn't have any effect on anyone who was receiving Incapacity Benefit before the law changed on 6 April 2001. When the law changed, any new claim to Incapacity Benefit was affected if the works / private pension exceeded £85 per week. The rule was that for every £1 a private pension is above £85 Incapacity Benefit was reduced by 50p. If a person was entitled to IB before 06/04/01 then transitional protection ensured that no deduction was applied to the IB claim.

When the person was required to migrate from IB to ESA this transitional protection continued to apply if the migration was successful. The transitional protection was intended to last until April 2020 (i.e. earlier this year), at which point the same £85 + 50% rule was going to apply to these claimants. I don't know if this  April 2020 rule ever changed though I'm not aware of it having done so. If this is still the case any potential overpayment should only be applied from April this year. Note though that the claim must have continued without a break throughout the period on or after 06/04/01 unless a new claim can be linked back to a previous claim.

If you can check what the money / benefit is that he receives from his work is I might be able to help further.

Targaryan

Thank you Robbie
Im really not sure if it is a pension. He is still employed by the company, and has never received notice or resigned, although he last worked in 1992. He originally had sick leave, and then this long term sickness benefit kicked in. I was under the impression it was a perk offered by the company at that time. All the paperwork came from Unum, and his payslip still comes from his company. It sounds pathetic, but it’s so long ago, neither of us can remember very much.

Robbie64

It's either a works pension or a health insurance payment. I had to check Unum and notice they are an insurance company that pays various benefits on behalf of an employer to an employee. However, looking at their website, most of their sickness payments seem to be for a short term (up to 52 weeks) period. I assume they must also be able to pay out long term benefits as in the case of your husband.

I've checked the Decision Makers Guide for the rules about Transition Protection as applied to Incapacity Benefit (and therefore by extension to ESA) and it only covers payments which are a periodical (ongoing) payment made under a personal pension scheme, an occupational or public service pension scheme made in connection with the ending of a person's employment or an ongoing periodical permament health insurance payment made in respect to a former employee on the termination of employment. There's nothing mentioned about someone who is still an employee.

Targaryan

I guess it’s quite unusual for someone to still be an employee after that period of time. I looked up long term sickness cover on the Unum website, and did see reference to similar schemes. 

Our real concern is that we will be asked to repay 27 years of benefit. We are certain we have declared this money, but have no way to prove it. 27 years ago we didn’t have home photocopy machines, and weren’t so suspicious..... it would be a huge sum, more than the value of our house, and it’s making hubby ill with the worry. The issues with COVID are slowing everything done, which is adding to the worry. 

poppy12345

You need to find out what sort of sickness benefit it is. I don't know how long DWP keep information for, others will know.

If the worst does happen and you do have to repay it back, you definitely won't have to sell your house for this. A payment plan can be arranged.

Targaryan

It looks like it’s a health insurance payment, but I have no other information at all. The DWP did tell us they were going to try and find our old records, but now we have data laws, I’m not sure they would still have the old records. 

We would be paying this for the rest of our lives, and it still wouldn’t be paid off! Would they expect us to repay the 27 years?

sammyjammy

How much is the payment he receives from the company?  Even if there is an overpayment it may not be the whole payment.  If DWP don't have the records I don't see how they can prove you didn't tell them?  Try not to worry, it won't help, you won't have to sell your house and as has been said you agree a payment plan that you can afford if and when they say you owe anything.

Targaryan

He now receives approx £604 per month.
This is what we think, regarding the records.