D e p a r t m e n t f o r W o r k a n d P e n s i o n s
D E C I S I O N M A K I N G A N D A P P E A L S
Decision Makers Guide
Volume 1 Amendment 58 – February 2019
1. This letter provides details on Amendment 58; the changes have already been incorporated in to the Intranet and Internet versions of the DMG.
2. PDF amendment packages are also available on the Internet (see link below). These can be printed with the amended pages being reproduced in full. Each page will contain the amendment number in the footer. https://www.gov.uk/government/publications/decision-makers-guide-vols-4-5-6-and-7-jobseekers-allowance-and-income-support-staff-guide
Note: When printing PDF packages set the print properties to Duplex/Long Edge in order to produce double sided prints.
3. Amendment 58 affects Chapters 1, 2 and 4. The changes: Chapter 1 - expand the guidance at DMG 01405.
Chapter 2 – amend the date for claiming social fund funeral and maternity payments at DMG 02543.
Chapter 4 - remove out of date guidance on mortgages and loans. 4. If using a PDF amendment package remove the sheets as stated in the left
hand column of the Remove and Insert table below and insert the new sheets as stated in the right hand column (note the record of amendments at the back of the Volume).
Remove
Insert
Chapter 1 Chapter 1 01402 – 01419 (1 page) 01402 – 01419 (1 page) Chapter 2 Chapter 2 02541 – 02563 (1 page) 02541 – 02563 (1 page) Chapter 4 Chapter 3 Conts 04392 – Conts 04860 (3 pages) Conts 04392 – Conts 04860 (2 pages) 04511 – 04549 (3 pages) 04511 – 04549 (1 page) 04655 – 04686 (3 pages) 04655 – 04686 (1 page) 04696 – 04703 (1 page) 04696 – 04703 (1 page)
b e c ar ef ul i n a s s e s si n g t h e s e m att er s o n writt e n e vi d e n c e al o n e. It m a y b e
n e c e s s ar y t o i nt er vi e w t h e cl ai m a nt t o g et cl arifi c ati o n or f urt h er i nf or m ati o n.
0 1 4 0 2 If it i s cl e ar fr o m t h e c a s e p a p er s t h at a cl ai m a nt h a s pr e vi o u sl y m a d e st at e m e nt s
w hi c h h a v e pr o v e d t o b e i n c orr e ct, t h e D M i s e ntitl e d t o r e g ar d e vi d e n c e pr o vi d e d b y
t h at cl ai m a nt criti c all y, r e g ar dl e s s of w h et h er t h e s e st at e m e nt s w er e g e n ui n e err or s
or att e m pt s t o mi sl e a d.
E x a m pl e
A n I B cl ai m a nt i s cl ai mi n g f or a p art n er w h o h a s e ar ni n g s w hi c h h e st at e s ar e t h e
s a m e e a c h m o nt h. T h e p a p er s s h o w t h at o n o c c a si o n hi s p art n er h a s n ot t ol d hi m of
o v erti m e a n d b o n u s p a y m e nt s. T h e o v er p a y m e nt s ar e n ot r e c o v er a bl e b e c a u s e t h e
cl ai m a nt di d n ot k n o w t h e f a ct s a n d c o ul d n ot b e e x p e ct e d t o di s cl o s e t h e a d diti o n al
e ar ni n g s. T h e D M c a n n ot r el y o n t h e cl ai m a nt' s e vi d e n c e a n d a s k s t o s e e t h e p a y
sli p s e a c h m o nt h.
0 1 4 0 3 - 0 1 4 0 4
B ur d e n of pr o of
0 1 4 0 5 A cl e ar u n d er st a n di n g of w h er e t h e b ur d e n of pr o of li e s h el p s t h e D M t o w ei g h t h e
e vi d e n c e a n d d e ci d e w h et h er f urt h er e v i d e n c e s h o ul d b e s o u g ht. D M s s h o ul d n ot e
t h at
1. i niti all y t h e b ur d e n li e s wit h t h e cl ai ma nt t o pr o v e t h at t h e c o n diti o n s f or a
cl ai m or a p pli c ati o n ar e s ati sfi e d 1 b ut t h e y s h o ul d d o a s m u c h a s p o s si bl e t o
e n s ur e t h at t h e cl ai m a nt h a s e v er y o p p ort u nit y t o pr o vi d e all r el e v a nt
e vi d e n c e a n d w h er e t h e i nf or m ati o n i s a v ail a bl e t o t h e m r at h er t h a n t h e
cl ai m a nt, t h e n t h e y m u st t a k e t h e n e c e s s ar y st e p s t o e n a bl e it t o b e tr a c e d
2. w h er e t h e y wi s h t o s h o w t h at a n e x c e pti o n t o a c o n diti o n of e ntitl e m e nt i s n ot
s ati sfi e d, t h e b ur d e n of pr o of r e st s wit h t h e m 2
3. t h er e i s n o pr e s u m pti o n i n f a v o ur of t h e cl ai m a nt t h o u g h f or II D B t h e cl ai m a nt
i s n or m all y pr e s u m e d t o h a v e t h e P D if h e h a s w or k e d i n t h e pr e s cri b e d
o c c u p ati o n; f or e x a m pl e, a c ott o n w e a v er wit h b y s si n o si s ( s e e D M G C h a pt er
6 7 f or f ull g ui d a n c e)
4. w h er e a n all e g ati o n i s d e ni e d b y t h e cl ai m a nt it i s g e n er all y f or D M s t o pr o v e
t h e f a ct s.
5. t h e b ur d e n of pr o vi n g t h at t h e c o n diti o n s f or r e vi si o n or s u p er s e s si o n ar e
s ati sfi e d li e s wit h t h e p er s o n w h o a p pli e s f or r e vi si o n or s u p er s e s si o n
6. i n o v er p a y m e nt c a s e s t h e b ur d e n of pr o of f or t h e p ur p o s e s of d et er mi ni n g t h e
s u m t o b e r e c o v er e d f all s o n t h e m 3 ( s e e D M G C h a pt er 0 9).
7. w h er e a cri mi n al c o urt c o n vi ct s a p er s o n of a n off e n c e r el at e d t o o bt ai ni n g or
r e c ei vi n g b e n efit, t h at c o n vi cti o n s hift s t h e b ur d e n of pr o of r el ati n g t o t h e
s a m e b e n efit a n d p eri o d at i s s u e fr o m t h e m t o t h e cl ai m a nt 4 .
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
Note 1: An example of 2. is where there is a claim for a SF funeral payment, it is for the DM to show that the claimant is not entitled because a close relative is not in receipt of a qualifying benefit.
Note 2: Where 5. applies the question of whether the conditions for revision or supersession are satisfied must be considered separately from the question of whether the decision should be revised or superseded.
1 R(SB) 2/83(T); 2 Department for Social Development v Kerr [2004] UKHL 23; 3 SS A Act 92, s 71; CS Act 91, s 16 - 19 & s 71; R(SB) 34/83; 4 R(S) 2/80
01406 - 01419
Vol 1 Amendment 58 February 2019
0 2 5 4 1 A cl ai m f or M A w hi c h i s
1. m a d e b et w e e n t h e 1 4t h w e e k b ef or e t h e E W C a n d
2. m a d e u p t o t h e b e gi n ni n g of t h e 6t h w e e k b ef or e t h e E W C a n d
3. tr e at e d a s a cl ai m f or I B or S D A
will b e a cl ai m i n a d v a n c e f or t h o s e b e n efit s . T h e cl ai m c a n b e tr e at e d a s a cl ai m f or
I B u p t o t h e 1 4t h d a y f oll o wi n g t h e A D C.
I B - f ail ur e t o s ati sf y c o ntri b uti o n c o n diti o n s
0 2 5 4 2 W h er e a cl ai m f or I B i s m a d e a n d t h e D M i s s ati sfi e d t h at
1. t h e c o ntri b uti o n c o n diti o n s ar e n ot m et a n d
2. wit hi n t hr e e m o nt h s t h e c o n diti o n s w o ul d b e s ati sfi e d f or a PI W b e gi n ni n g i n a
l at er b e n efit y e ar
t h e D M m a y tr e at t h e cl ai m a s m a d e f or a p eri o d st arti n g wit h t h e fir st d a y o n w hi c h
t h e c o n diti o n s ar e s ati sfi e d a n d a w ar d b e n efit1 .
1 S S ( C & P) R e g s, r e g 1 3
S F f u n e r al a n d m at er nit y p a y m e nt s
0 2 5 4 3 A n a d v a n c e cl ai m f or a f u n er al or m at er nit y p a y m e nt c a n b e m a d e u p t o t hr e e
m o nt h s b ef or e t h e n or m al ti m e f or cl ai mi n g b e gi n s 1 . T h e n or m al ti m e f or cl ai mi n g i s
1. f or m at er nit y p a y m e nt s – t h e p eri o d b e gi n ni n g
1. 1 el e v e n w e e k s b ef or e t h e fir st d a y of t h e E W C a n d e n di n g si x m o nt h s
aft er t h e A D C 2 o r
1. 2 wit h t h e d at e o n w hi c h t h e cl ai m a nt b e c o m e s r e s p o n si bl e f or t h e c hil d
a n d e n di n g 6 m o nt h s aft er t h at d at e 3 o r
1. 3 wit h t h e d at e o n w hi c h a q u alif yi n g or d er i s m a d e a n d e n di n g 6 m o nt h s
aft er t h at d at e 4 or
1. 4 wit h t h e d at e o n w hi c h t h e g u ar di a n s hi p t a k e s eff e ct a n d e n di n g 6
m o nt h s aft er t h at d at e 5 or
1. 5 wit h t h e d at e o n w hi c h t h e c hil d i s pl a c e d wit h t h e cl ai m a nt or t h e
cl ai m a nt’ s p art n er f or a d o pti o n a n d e n di n g 6 m o nt h s aft er t h at d at e 6 or
1. 6 wit h t h e d at e o n w hi c h t h e a d o pti o n 7
1. 6. a t a k e s eff e ct i n r e s p e ct of a n a d o pti o n u n d er pr e s cri b e d
l e gi sl ati o n8 or
1. 6. b i s r e c o g ni s e d u n d er pr e s cri b e d l e gi sl ati o n a n d e n di n g 6
m o nt h s aft er t h at d at e 9
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
2. f or f u n er al p a y m e nt s - t h e p eri o d b e gi n ni n g wit h t h e d at e of d e at h a n d
e n di n g si x m o nt h s aft er t h e d at e of t h e f u n er al 1 0 .
1 S S ( C & P) R e g s, r e g 1 3( 1); 2 r e g 1 9( 1), S c h 4( 8) & S F M F E ( G e n) R e g s, r e g 5( 3)( a); 3 r e g 5( 3)( b);
4 r e g 5( 3)( c); 5 r e g 5( 3)( d); 6 R e g 5( 3)( e); 7 R e g 5( 3)(f); 8 A d o pti o n a n d C hil d r e n A ct 2 0 0 2,
s 6 6( 1)( c), ( d) & ( e); 9 s 6 6( 1)( e); 1 0 S S ( C & P) R e g s, r e g 1 9( 1) & S c h 4( 9)
0 2 5 4 4 T h e D M s h o ul d
1. d e ci d e w h et h er a cl ai m w hi c h h a s b e e n m a d e t o o e arl y c a n b e a c c e pt e d a s
a n a d v a n c e cl ai m a n d
2. if t h e cl ai m i s n ot a c c e pt e d a s a n a d v an c e cl ai m, di s all o w it b e c a u s e it h a s
b e e n m a d e o ut si d e t h e n or m al ti m e li mit s.
0 2 5 4 5 T h e D M s h o ul d a c c e pt t h at a n a d v a n c e cl ai m h a s b e e n m a d e w h er e t h e e vi d e n c e
s h o w s t h at t h e c o n diti o n s f or e ntitl e m e nt will b e s ati sfi e d
1. f or m at er nit y p a y m e nt s - o n t h e fir st d a y of t h e el e v e nt h w e e k b ef or e t h e
E W C
2. f or f u n er al p a y m e nt s - o n t h e d at e of t h e f u n er al.
B e n efit will b e p ai d o n t h at d a y, s u bj e ct t o all t h e c o n diti o n s f or e ntitl e m e nt b ei n g
s ati sfi e d1 .
1 S S ( C & P) R e g s, r e g 1 3( 1)( b)
0 2 5 4 6 - 0 2 5 5 9
S P C
M a ki n g a cl ai m b ef or e att ai ni n g q u alif yi n g a g e
[ S e e M e m o D M G 0 1/ 1 9]
0 2 5 6 0 A cl ai m f or S P C m a y b e m a d e, a n d t h at cl ai m m a y b e d et er mi n e d, at a n y ti m e wit hi n
t h e a d v a n c e p eri o d1 .
1 S S ( C & P) R e g s, r e g 4 E( 1)
0 2 5 6 1 T h e a d v a n c e p eri o d b e gi n s o n t h e d at e f o ur m o nt h s b ef or e t h e d a y o n w hi c h t h e
cl ai m a nt att ai n s t h e q u alif yi n g a g e a n d e n d s o n t h e d a y b ef or e t h e cl ai m a nt r e a c h e s
t h at a g e1 .
1 S S ( C & P) R e g s, r e g 4 E( 2)
0 2 5 6 2 W h er e a cl ai m m a d e wit hi n t h e a d v a n c e p eri o d i s d ef e cti v e, t h e cl ai m a nt m a y
c orr e ct t h e d ef e ct at a n y ti m e b ef or e t h e e n d of t h e a d v a n c e p eri o d 1 .
1 S S ( C & P) R e g s, r e g 4 E( 3)
0 2 5 6 3 W h er e a cl ai m f or S P C i s m a d e d uri n g t h e a d v a n c e p eri o d t h e i nf or m ati o n or
e vi d e n c e r e q uir e d b y t h e S e cr et ar y of St at e i n or d er t o d e ci d e w h et h er t o s et a n AI P
or t h e l e n gt h of t h e AI P t h e ti m e wit hi n w hi c h t h e cl ai m a nt m u st pr o vi d e t h at
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
Special rules - late or unpaid contributions ............................................ 04392
Special rules - Attendance Allowance and Disability Living Allowance
Advantageous change ................................................................................. 04395
Terminally ill ................................................................................................. 04402
Renewal claims ....................................................................................... 04403
Special rules - Industrial Injuries scheme benefits
Disablement determinations made before 5.7.99 ........................................ 04405
Disablement decisions made after 5.7.99 .................................................... 04407
Recrudescence of a prescribed disease ...................................................... 04408
Worsening after assessment period has ended .......................................... 04410
Worsening during an assessment period .................................................... 04412
Worsening in accident cases - no loss of faculty decision made
before 5.7.99 ........................................................................................... 04414
Claimant's condition has deteriorated .......................................................... 04417
Claimant's condition is unchanged .............................................................. 04418
Claimant's condition has improved .............................................................. 04419
Diagnosis or loss of faculty in doubt ............................................................ 04420
Posthumous claims ...................................................................................... 04425
Superseding current assessments and awards ...................................... 04426
Special rules - Incapacity Benefit and Severe Disablement Allowance
IB and SDA decisions - medical examination .............................................. 04430
Effective date ................................................................................................ 04433
Change in the rate of IB ............................................................................... 04440
Advance PCA testing ................................................................................... 04441
Medical evidence expires ............................................................................. 04450
Own occupation test ............................................................................... 04453
Personal capability assessment ............................................................. 04454
Effective date .......................................................................................... 04456
Medical evidence received after PCA carried out ................................... 04457
Special Rules common to Income Support and Jobseeker’s Allowance
General effective date rule ........................................................................... 04500
Advantageous change notified outside the time limits ................................. 04501
Vol 1 Amendment 58 February 2019
Changes not requiring supersession
Repayment of a student loan .................................................................. 04506
Alteration of component rates ................................................................. 04507
Age changes ........................................................................................... 04510
Change from IS to JSA or JSA to IS ............................................................ 04511
Special rules relating to Income Support
Introduction ................................................................................................... 04550
IS - change of circumstances - the general rule .......................................... 04551
Periods of temporary residence in connection with training ........................ 04555
Exceptions to the general rule - IS ............................................................... 04556
Change ceases to apply ............................................................................... 04557
IS and residential care breaks ..................................................................... 04558
Supersession resulting from payment of income ......................................... 04560
Reduction in IS ............................................................................................. 04561
Incomplete evidence - housing costs ........................................................... 04570
Incomplete evidence - other issues ............................................................. 04571
Special rules relating to Jobseeker’s Allowance
Change of circumstances - the general rule ................................................ 04580
Exceptions to the general rule ...................................................................... 04581
Change ceases to apply ............................................................................... 04582
Payment of income....................................................................................... 04583
Reduction in Jobseeker’s allowance ............................................................ 04584
Determinations on incomplete evidence ...................................................... 04585
Young people - sanctions ............................................................................. 04586
Sanctions ...................................................................................................... 04587
Supersession of JSA(Cont) awards ............................................................. 04590
Special rules - State Pension Credit
Information and Evidence ............................................................................ 04600
At the end of an assessed income period ............................................ 04601
Changes in retirement provision ........................................................... 04603
Vol 1 Amendment 58 February 2019
Rapid Review ............................................................................................... 04604
Supersession - assessed income periods ................................................... 04611
Supersession at the end of the assessed income period ............................ 04615
Information provided within time limits ................................................. 04617
Information provided late ...................................................................... 04618
SPC superseded but assessed income period cannot be set ............. 04620
Supersession - incomplete evidence
Housing costs ....................................................................................... 04630
Additional amount for the severely disabled ........................................ 04631
Supersession - change of circumstances
General effective date rule ................................................................... 04640
Change of circumstances - the general rule ........................................ 04642
Advantageous change notified outside time limits ............................... 04643
Exceptions to the general rule .............................................................. 04646
Changes in income ............................................................................... 04647
Prisoners .............................................................................................. 04648
Change of benefit week ........................................................................ 04649
Claimant ceases to be a patient ........................................................... 04650
Death of the claimant ............................................................................ 04653
Uprating ................................................................................................ 04680
Supersession on change of election - deferred entitlement ................. 04685
Special rules - ESA, IS, JSA and SPC
Housing costs - service charge adjustments ............................................... 04687
Special rules - Employment and Support Allowance ............................. 04696
Exceptions .................................................................................................... 04699
Other exceptions .......................................................................................... 04700
Other effective date rules ............................................................................. 04701
Non-dependent entitled to ESA .................................................................... 04702
Failure determination ................................................................................... 04703
Receipt of HCP report and cases where no examination is carried out ...... 04705
Terminally ill ................................................................................................. 04710
Vol 1 Amendment 58 February 2019
Treated as having LCW – medical evidence expires ................................... 04711
ESA appeal withdrawn, struck out or dismissed .......................................... 04714
Previous PLCW less than 13 weeks ............................................................ 04717
ESA and residential care breaks .................................................................. 04720
Supersession of BB, Cat A or Cat B RP, RP and SP – Class 2 contributions ................................................................................. 04751
Suspension and termination of benefit
Hardship ....................................................................................................... 04800
Loss of contact with claimant ....................................................................... 04802
Immediate suspension ................................................................................. 04810
Suspension where a question arises as to whether benefit should be revised or superseded .......................................................................... 04817
Suspension where an appeal is pending ..................................................... 04818
Notification ............................................................................................ 04821
When benefit suspended must be paid - appeal no longer pending .... 04822
Suspension where an appeal is pending against a decision in a different case ............................................................................................. 04830
What happens if the suspension is lifted ...................................................... 04840
Suspension where information has been requested .................................... 04841
Termination following suspension ................................................................ 04846
When is it appropriate to extend the time limit ............................................. 04850
Date from which benefit is terminated .......................................................... 04852
Suspension where claimant fails to have a medical examination ................ 04857
Termination where claimant fails to have a medical examination ............... 04860
Vol 1 Amendment 58 February 2019
C h a n g e fr o m I S t o J S A or J S A t o I S
0 4 5 1 1 W h er e
1. a p er s o n i s a w ar d e d I S or J S A (“t h e e xi sti n g a w ar d”) a n d
2. if t h at a w ar d di d n ot e xi st a n a w ard c o ul d b e m a d e f or J S A or I S (“t h e
alt er n ati v e b e n efit”) w er e a cl ai m m a d e f or it
t h e n w h e n a cl ai m i s m a d e f or t h e alt er n ati v e b e n efit, t h e D M m a y s u p er s e d e t h e
e xi sti n g a w ar d t o bri n g it t o a n e n d 1 .
1 S S C S ( D & A) R e g s, r e g 1 4 A( 1) & ( 2)
0 4 5 1 2 W h er e D M G 0 4 5 1 1 a p pli e s t h e e xi sti n g a w ar d e n d s o n t h e d a y i m m e di at el y b ef or e
t h e fir st d a y o n w hi c h t h e a w ar d of t h e alt er n ati v e b e n efit t a k e s eff e ct1 .
1 S S C S ( D & A) R e g s, r e g 1 4 A( 3)
0 4 5 1 3 W h er e t h e alt er n ati v e b e n efit i s J S A, t h e p er s o n d o e s n ot h a v e t o s er v e w aiti n g
d a y s 1 .
N ot e: S e e D M G 0 4 7 0 1 f or g ui d a n c e o n E S A
1 S S C S ( D & A) R e g s, r e g 1 4 A( 4); J S A A ct 9 5, S c h 1, p a r a 4
0 4 5 1 4 - 0 4 5 4 9
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
0 4 6 5 5 - 0 4 6 7 9
U pr ati n g
0 4 6 8 0 U pr ati n g of S P C will n ot n or m all y r e q uir e a s u p er s e s si o n d e ci si o n. W h er e r at e s ar e
c h a n g e d o n u pr ati n g, t h e a m o u nt of b e n efit p a y a bl e a n d t h e a w ar d will b e t h e n e w
a m o u nt wit h o ut t h e n e e d f or a n y f urt h er d e ci si o n of t h e D M1 .
B ut s e e D M G 0 4 6 8 1 f or a n e x c e pti o n t o t hi s r ul e.
1 S S A A ct 9 2, s 1 5 9 B
0 4 6 8 1 T h er e i s a n e x c e pti o n 1 w h er e t h e a p pr o pri at e mi ni m u m g u ar a nt e e i n cl u d e s a n
a d diti o n al a m o u nt f or f or m er cl ai m a nt s of I S or J S A(I B) 2 ( k n o w n a s t h e tr a n siti o n al
a m o u nt - s e e D M G 7 8 1 2 0 et s e q f or g ui d a n c e o n w h e n t hi s a d diti o n al a m o u nt
a p pli e s).
1 S S C S ( D & A) R e g s, r e g 1 4( 5); 2 S P C R e g s, S c h I, p a r a 6
0 4 6 8 2 W h er e D M G 0 4 6 8 1 a p pli e s, u pr ati n g will n e e d t o b e c arri e d o ut b y m e a n s of
s u p er s e s si o n 1 .
1 S S C S ( D & A) R e g s, r e g 1 4( 6)
0 4 6 8 3 – 0 4 6 8 4
S u p er s e s si o n o n c h a n g e of el e cti o n - d ef err e d e ntitl e m e nt
0 4 6 8 5 T h e D M m a y s u p er s e d e 1 a d e ci si o n a w ar di n g S P C w h er e
1. t h e cl ai m a nt or p art n er m a k e s or i s tr e at e d a s h a vi n g m a d e a n el e cti o n f or a
l u m p s u m2 o r
2. a l u m p s u m i s r e p ai d aft er t h e p er s o n c h a n g e s t h eir el e cti o n t o a n i n cr e a s e of
C at A or C at B R P, S A P, G R B or S P 3 .
S e e D M G C h a pt er 7 5 f or g ui d a n c e a b o ut d ef erri n g e ntitl e m e nt a n d m a ki n g
el e cti o n s.
1 S S C S ( D & A) R e g s, r e g 6( 2)( o) o r r e g 6( 2)( o o); 2 S S C B A ct 9 2, S c h 5, p a r a A 1 o r 3 C; S c h 5 A, p a r a 1;
S S ( D ef R P, S A P & G R B) ( Mi s c Pr o v s) R e g s, S c h 1, p a r a 1 2 o r 1 7; P e n si o n s A ct 2 0 1 4, s 8( 2), s 8( 4) & s 1 0;
3 D ef R P R e gs 0 5, r e g 5; S S ( D ef R P, S A P & G R B) ( Mis c Pr o vs) R e gs, S c h 1, p ar a 2 0 D;
S P R e g s, r e g 4 4 & r e g 6; P e n si o n s A ct 2 0 1 4, s 1 0
0 4 6 8 6 W h er e D M G 0 4 6 8 5 a p pli e s, t h e n e w d e ci si o n i s eff e cti v e 1 fr o m
1. t h e d a y o n w hi c h t h e l u m p s u m or p a y m e nt o n a c c o u nt of a l u m p s u m i s p ai d
or r e p ai d w h er e t h at i s t h e p a y d a y or
2. t h e f oll o wi n g p a y d a y.
1 S S C S ( D & A) R e g s, r e g 7( 7 A)
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
Example
The claimant is a single woman who was 60 on 8.5.05 and who deferred her RP for twelve months. She has capital of £8,000. On 8.5.06 she claims RP and SPC but does not immediately make an election on her deferral option. SPC is awarded to the claimant, taking into account her RP and £4.00 deemed weekly income due to her capital. On 5.6.06 the claimant elects to receive increments. The decision awarding RP is revised to include increments. The decision awarding SPC is also revised to take into account the claimant’s increased RP. On 26.6.06 the claimant realises she would have been better off taking a lump sum so she changes her election. As she is liable for tax, the claimant receives a lump sum of £7,200 rather than the amount of £8,000 she would have received if she were not liable for tax. Of the claimant’s total capital of £15,200, the amount of £8,000 (the gross amount of the lump sum) is disregarded. The decision awarding SPC is superseded to reduce the amount of deemed weekly income to be taken into account to £3.00.
Vol 1 Amendment 58 February 2019
S p e ci al r ul e s - E m pl o y m e nt a n d S u p p ort All o w a n c e
0 4 6 9 6 T h e g e n er al r ul e i s t h at a n E S A s u p er s e s si o n d e ci si o n o n t h e gr o u n d s t h at t h er e
h a s b e e n a r el e v a nt c h a n g e of cir c u m st a n c e s t a k e s eff e ct fr o m t h e fir st d a y of t h e
b e n efit w e e k i n w hi c h t h e c h a n g e o c c ur s 1 .
1 S S C S ( D & A) R e g s, r e g 7( 1)( a); S c h 3 C, p a r a 1
0 4 6 9 7 “ B e n efit w e e k” m e a n s t h e p eri o d of s e v e n d a y s e n di n g o n
1. t h e d a y b ef or e t h e fir st d a y of t h e fir st b e n efit w e e k f oll o wi n g t h e d at e of cl ai m
or
2. t h e l a st d a y of E S A p a y m e nt w h ere it i s p ai d f or l e s s t h a n a w e e k 1
1 E S A R e g s, r e g 2( 1); S S C S ( D & A) R e g s, r e g 7( 3)( d)
0 4 6 9 8 Ot h er s u p er s e s si o n d e ci si o n s w h er e 1
1. t h e s u p er s e s si o n i s o n t h e gr o u n d s th at t h e d e ci si o n t o b e s u p er s e d e d
1. 1 i s a D M' s d e ci si o n w hi c h i s err o n e o u s i n l a w2
1. 2 i s a d e ci si o n a w ar di n g E S A w h er e t h e cl ai m a nt or a f a mil y m e m b er
b e c o m e s e ntitl e d t o a q u alif yi n g b e n efit 3
1. 3 i s a d e ci si o n a w ar di n g E S A w h er e t h e S D P c a n n ot b e i n cl u d e d i n t h e
a w ar d b e c a u s e t h er e i s a n o n- d e p e n d a nt, a n d t h e n o n- d e p e n d a nt i s
a w ar d e d a q u alif yi n g b e n efit 4
1. 4 i s a s i n D M G 0 4 2 9 2 (r ei nt er pr et ati o n of t h e l a w)5
al s o t a k e eff e ct fr o m t h e fir st d a y of t h e b e n efit w e e k.
1 S S C S ( D & A) R e g s, S c h 3 C, p a r a s 9 & 1 0; 2 r e g 6( 2)( b); 3 r e g 6( 2)( e); 4 r e g 6( 2)( e e); 5 r e g 7( 6);
E x c e pti o n s
0 4 6 9 9 T h e g e n er al r ul e i n D M G 0 4 6 9 6 d o e s n ot a p pl y
1. w h er e t h e c h a n g e i s t o t h e cl ai m a nt' s a d v a nt a g e, a n d w a s n otifi e d o ut si d e t h e
o n e m o nt h ti m e li mit 1 - s e e D M G 0 4 5 0 1 1. w hi c h al s o a p pli e s t o E S A
2. w h er e t h e c h a n g e i s b e c a u s e t h e cl ai m a nt i s t er mi n all y ill 2 - s e e D M G 0 4 7 1 0.
1 S S C S ( D & A) R e g s, r e g 7( 2)( b)(i); 2 r e g 7( 2)( b e)
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
Ot h er e x c e pti o n s
0 4 7 0 0 T h e g ui d a n c e at D M G 0 4 5 5 6 1 1 ., 3 2 ., 43 ., 54 . a n d 7. o n e x c e pti o n s t o t h e g e n er al
r ul e i n D M G 0 4 6 9 6 al s o a p pl y t o E S A. I n t h e se c a s e s t h e d e ci si o n i s eff e cti v e fr o m
t h e d at e of t h e c h a n g e5 .
1 W R A ct 0 7, S c h 1, p a r a 6( 1)( a); 2 E S A R e g s, r e g 1 5 6( 6)( d) o r ( h); 3 S c h 5, p a r a 1 2; 4 p a r a 3;
5 S S C S ( D & A) R e g s, S c h 3 C, p a r a 2 & 3
Ot h er eff e cti v e d at e r ul e s
0 4 7 0 1 G ui d a n c e o n eff e cti v e d at e r ul e s f or
1. s u p er s e s si o n i n i n c a p a cit y c a s e s 1 ( s e e D M G 0 4 2 3 1 - 0 4 2 4 5)
2. s u p er s e s si o n of a Ft T or U T f or err or of f a ct 2 ( s e e D M G 0 4 3 3 7 - 0 4 3 4 0)
3. c h a n g e b et w e e n b e n efit s i n cl u di n g w aiti n g d a y s 3 ( s e e D M G 0 4 5 1 1 - 0 4 5 1 3)
4. p a y m e nt of i n c o m e 4 ( s e e D M G 0 4 5 6 0)
5. r e d u cti o n of b e n efit f oll o wi n g s u p er s e s si o n 5 ( s e e D M G 0 4 5 6 1 - 0 4 5 6 2)
6. c h a n g e c e a s e s t o a p pl y 6 ( s e e D M G 0 4 5 5 7)
al s o a p pl y t o E S A.
1 S S C S ( D & A) R e g s, S c h 3 C, p a r a 7; 2 p a r a 8; 3 r e g 1 4 A ; W R A ct 0 7, S c h 2, p a r a 2; 4 E S A R e g s, r e g 9 3;
S S C S ( D & A) R e g s, S c h 3 C, p a r a 4; 5 p a r a 5; 6 p a r a 6;
N o n- d e p e n d a nt e ntitl e d t o E S A
0 4 7 0 2 W h er e t h e r el e v a nt c h a n g e i s t h at
1. t h e cl ai m a nt h a s a n o n- d e p e n d a nt a n d
2. t h e n o n- d e p e n d a nt b e c o m e s e ntitl e d t o m ai n p h a s e E S A
t h e s u p er s e s si o n d e ci si o n i s eff e cti v e fr o m t h e d at e t h e m ai n p h a s e E S A i s fir st p ai d
t o t h e n o n- d e p e n d a nt1 .
1 S S C S ( D & A) R e g s, r e g 7( 1 7 H)
F ail ur e d et er mi n ati o n
0 4 7 0 3 A d e ci si o n a w ar di n g E S A m a y b e s u p er s e d e d w h er e t h er e h a s b e e n a f ail ur e
d et er mi n ati o n 1 . A f ail ur e d et er mi n ati o n i s a d eter mi n ati o n b y t h e D M t h at t h e
cl ai m a nt h a s f ail e d wit h o ut g o o d c a u s e t o s ati sf y a r e q uir e m e nt t o t a k e p art i n a WfI
or u n d ert a k e W R A 2 . T h e s u p er s e s si o n d e ci si o n t a k e s eff e ct fr o m3
1. t h e fir st d a y of t h e b e n efit w e e k i n w hi c h t h e f ail ur e d et er mi n ati o n i s m a d e
w h er e, o n t h e d at e of t h e d et er mi n ati o n, t h e cl ai m a nt h a s n ot b e e n p ai d E S A
si n c e t h e f ail ur e t o w hi c h t h at d et er mi n ati o n r el at e s or
V ol 1 A m e n d m e nt 5 8 F e br u ar y 2 0 1 9
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