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Box C1.1 Summary of rules on deciding and paying benefit claims

Claims and decisions

1. In order to be entitled to an award of a particular benefit at a particular rate, it is almost always

the case that a person must make a claim for that benefit.1 _{Entitlement to an award for a period}

before a claim is submitted is extremely limited, so those who do not claim on time often miss out

on money they may have been entitled to had they acted more quickly.2 _{Claims are completed in}

various ways (on paper claim forms which can be posted to DWP, via telephone with details given, then confirmed to the claimant in writing or online). Sometimes, it will be necessary for further questions to be asked of the claimant, or further information provided after the initial claim form is completed.

2. Once a claim for a benefit is made, it is the duty of a decision maker at the DWP to make a decision on whether the person making the claim meets the statutory conditions for an award of benefit, and, if so, at what rate, and from which date.3 _{There is no statutory time limit within}

which a claim must receive a decision. However, the general duty is that decisions must be made as soon as reasonably practicable. What counts as ‘reasonably practicable’ can depend on the volume of other claims currently outstanding, the resources of the Department, and the urgency of a particular case.

3. Following a decision that a claimant is entitled to a particular amount from a particular date,

notice of the decision must be sent to the claimant.4 _{The decision then needs to be implemented}

as soon as reasonably possible – e.g. payment should be made.5

4. Broadly speaking, similar principles apply for claims of tax credits.6

1 _{Section 1, Social Security Administration Act 1992.}

2 _{See for example Regulation 19 of Social Security (Claims and Payments) Regulations 1987 (SI No. 1968)} 3 _{Section 8, Social Security Act 1998.}

4 _{Regulation 28, Social Security and Child Support (Decisions and Appeals) Regulations 1999 (SI No. 991).} 5 _{Regulation 20, Social Security (Claims and Payments) Regulations 1987 (SI No. 1968).}

Box C1.2 DWP targets for processing claims

The DWP Business Plan in 2010-2011 had targets for ‘Average Actual Clearance Time’ of claims for

IS, ESA and JSA as per the table below.7 _{These targets were dropped from subsequent Business}

Plans.

DWP Business Plan (2010-2011) - Average Actual Clearance Time Targets Benefit Average Actual Clearance Time

JSA 9 days

IS 11 days

ESA 14 days

Ministerial answers to questions in the House of Commons now reveal that the targets are to

process a certain percentage of all claims for a particular benefit within a fixed number of days.8

Clearance time targets as per Ministerial answer

Benefit November 2013 – % of claims to be processed within X number of days:

JSA 90% within 16 days

IS 90% within 13 days

ESA 85% within 16 days

Note that, because the target times are different (the 2010-2011 time is an average of all claims and the 2013 one is a target that a fixed % are done within the specified number of days), it is not possible to compare them.

In terms of performance against the target measure now used, figures are available for the period

April 2010 to September 2013.9 _{For ESA, the target was met in the last four months of that period (as}

well as at other points). For IS, the target was hit consistently over the last ten months of the period (again, as well as at other points). For JSA, the picture is similar.

Box C1.3 HMRC Targets on Payment Times

HMRC are responsible for the administration of Child Benefit and of tax credits. The HMRC Business

Plan 2014-2016 sets out targets for how long processing new claims should take, as follows: 10

‘For our benefits and credits customers we will continue to:

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7 _{‘Jobcentre Plus Business Plan 2010 – 2011’, DWP, page 16. Retrieved 15th October 2014, via http://webarchive.nationalarchives.gov.}

uk/20130102205834/http://www.dwp.gov.uk/docs/jpbp-1011.pdf.

8 _{Hansard, House of Commons, 6 November 2013, Column 188W.} 9 _{Hansard, House of Commons, 6 November 2013, Columns 188W to 196W.}

10 _{‘HMRC business plan: 2014 to 2016’, 14 April 2014, Section 4.2. Retrieved 15th October 2014, via https://www.gov.uk/government/publications/}

Box C1.4 Rules on short-term benefit advances

1. The main situation in which short-term benefit advances (STBAs) can be made by the DWP is where a person: 11

•

•

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2. ‘Financial need’ is defined as the situation where there is a serious risk of damage to the health or safety of the claimant or a member of their benefit family (e.g. claimant’s partner and any children for whom claimant or partner is responsible for whom they could in theory claim Child Benefit) due to non-payment of the benefit.

3. An STBA can be requested either via a telephone call or in person at a local Jobcentre Plus. 4. People making claims for benefits are not given any information by the Jobcentre, in the course

of making their claim, that an STBA may be payable if they are in financial need whilst awaiting a decision and payment on that claim. Nor are there posters or other information leaflets available at Jobcentres. A search of the ‘.gov.uk’ website for ‘short term advance’ does not reveal any

information.13 _{The detailed guidance issued to decision makers is not published by the DWP}

online.

5. When an STBA is requested, DWP guidance suggests that the decision maker should first consider whether it is possible to make a full decision on the benefit claim and put it into payment.

6. Decisions on STBAs are not communicated to claimants in writing, and there is no right of appeal against a refusal to make an STBA.

7. There is no provision for interim payments of tax credits prior to a decision to award being made.

11 _{Regulation 5, Social Security (Payment on Account of Benefit) Regulations 2013 (SI No. 383).}

12 _{All the main means tested benefits, IS, irESA, ibJSA, SPC etc., are eligible benefits. The main exclusions are HB, DLA, AA, PIP and CTC/CB.} 13 _{https://www.gov.uk/search?q=short+term+advance (search conducted 26th June 2014).}

Box C1.5 Urgent payments in delay cases – reduction in provision

Prior to April 2013, where a person was experiencing hardship because a claim for benefit had been made but had yet to be decided and an award put into payment, a common solution was the obtaining of a Social Fund Crisis Loan (known as an ‘alignment payment’).

As indicated in Box C1.4, when an STBA is requested then the decision maker will first consider whether the benefit can simply be awarded. The data in the table below compares the volume of alignment payments made in previous tax years with the volume of the combined total of STBA payments and cases where a request for an STBA payment led to an immediate award.

The number of Crisis Loans for Alignment peaked at 1,162,500 in 2010/11 and then fell to 834,500 in 2012/13. By contrast, in 2013/14, the first full year under the new system, the DWP responded positively to just 177,401 STBA requests - either awarding an STBA (79,773 cases) or accelerating payment of the main benefit that the applicant was waiting for (97,628 cases).

Part of the explanation is that many fewer people are applying for STBAs (335,036 in 2013/14). Unless there has been a huge decrease in the need or demand for such payments, which seems very unlikely in the current economic climate, this strongly suggests that a large number of potential applicants are either unaware of the existence of STBAs or are being deterred from applying.

1. Figures are from a response to an FOI request to the DWP (#3207) on 10 September 2014. 2. Figures for April 1 to Nov 29 2013 are from the response to a written PQ by Mr Godsiff MP on 6

January 2014. Data for the remainder of the financial year are from FoI 3207 (see footnote 1). 3. This includes the total number of STBAs ‘referred to the decision maker and allowed’ and the

total number of STBA requests that were ‘refused because the primary benefit can be paid’. 4. The footnote to the FOI request states that ‘due to differences between Crisis Loans and Short

Term Benefit Advances, it is impossible to directly compare these advances to Crisis Loans for alignment to benefit’.

Crisis loan alignment payments1 _{Total number of awards}

2007/08 690,000 2008/09 865,800 2009/10 1,099,600 2010/11 1,162,500 2011/12 971,400 2012/13 834,500 STBA payments 2,3,4 2013/14 177,401