Disability benefit awards in the age of coronavirus

Fixed-term awards – the normal process

Disability benefits are often awarded for a fixed period. Unless either the award is superseded or a further claim decided before the end date, entitlement ends without a further decision. A new claim can be made up to six months before the award ends.1

DLA and AA claimants should be sent a renewal claim form to complete six months before their award ends. Most PIP claimants have a ‘review’ (see below), normally starting a year before their award ends.2 If not, the DWP reminds the claimant to make a renewal claim about three months before the award ends.

Any claimant can request a supersession of her/his existing award – eg, if her/his circumstances have changed. Caselaw confirms that a change to the expected length of the claimant’s needs can be a relevant change of circumstances.3 Claimants should always be advised that requesting a supersession risks the DWP deciding to reduce the level of the existing award.

The only way to be certain that an award has been extended or a new claim decided is if a decision has been notified in writing to the claimant. This article looks at what the DWP has said, and tactics if awards have not yet been extended.

DWP announcements

On 23 March, the DWP announced that (due to the coronavirus pandemic) disability benefit ‘reviews’ and ‘reassessments’ are suspended until at least 23 June 2020.4 There are also changes to DLA and AA renewal claims, even though these terms are not normally used by the DWP in relation to DLA or AA.

This followed an announcement that all face-to-face assessments for disability benefits are suspended until at least 17 June 2020 (for new claims and reviews).5 Note that telephone assessments continue. A PIP claim can be refused (or an existing award removed) if a claimant fails to take part ‘without good reason’.6

Information in addition to the claim form can be required for DLA or AA, but there is no power to refuse a claim if it is not provided.7 DLA and AA awards can be suspended and terminated if information or evidence is not provided.8

At the time of writing, a message on the DLA helpline said there is no need to return renewal forms, as awards will be ‘automatically extended for six months’. The PIP helpline says that the DWP will extend awards already being reviewed. In both cases, the decision will be notified in writing, so must be a supersession decision extending the award.9 The AA helpline is silent on what will happen.

CPAG is aware of some callers to the helplines being told not to worry and that no action is needed, and their awards then ending. The remainder of this article considers the possible situations, and what the law allows the DWP to do.

Ongoing PIP review or renewal claim already made

If a PIP claimant has been sent an ‘AR1’ form, then there is an ongoing ‘review’. Unless the claimant notified a change, the DWP has commenced action (gathering evidence) with a view to superseding the award.10 While at the time of writing a message on the PIP enquiry line advised that there is no need to return the review form, advisers should check whether the claimant has been notified in writing that her/his award has been extended, and how long the award still has left to run. The best advice is to return the form as soon as possible and take part in any assessment, unless the DWP is very clear about exactly when a decision extending the claimant’s award will be made and notified in writing.

If there may not be a decision on a review (or a renewal claim) before the award ends, advisers can contact the DWP and point out the intention to extend awards. Returning the review form and taking part in any assessment should result in either a supersession of, or a refusal to supersede, the awarding decision.

There is also nothing to prevent the DWP from superseding an award based on information provided in relation to a renewal claim. So it may be worth clearly stating that the client’s circumstances have changed, even if the only obvious change is that the client is no longer expected to recover by the award’s end date.

If relevant (particularly if the client is still awaiting an assessment date), consider arguing that there is already enough information to make a decision. A well-completed PIP review form or DLA/AA renewal claim alone may be enough to show that the claimant’s needs are expected to continue beyond the end date. Any available supporting evidence can also be submitted.

If there is still no decision, then a complaint should be made and the client’s MP involved. This can be done before the award runs out, particularly if there is no clear sense of what will happen and when.

If the award does end, an ex gratia payment can be requested, particularly if the delay in making a decision is due either to the DWP or COVID-19. Once a decision is made, any award should start from the day after the previous award ended, at the latest. If there is any doubt that the review/renewal claim is still being considered, a protective new claim can be made.

If there is no review or renewal form

If it is under six months until an award ends, and a client has either not received or not yet returned a DLA/AA renewal form, or has not been sent a PIP review form, a new claim should be made.11 At present this is the best advice for all claimants, unless the DWP has confirmed to the claimant that her/his award will be extended and when the decision will be made and notified in writing. It appears that such decisions must be supersessions extending the award, although the grounds to supersede in the absence of any input from the claimant are unclear.

If there is a case for an increased award, a claim should be made or the form returned as soon as possible. The claimant or appointee should be advised that the DWP may not agree that the award should increase.

PIP awards are generally reviewed a year before they end, unless the claimant’s needs were expected to reduce over time. This suggests that awards not being reviewed will not be automatically extended (although, at the time of writing, the DWP’s practice appears inconsistent). Given the current issues with supporting clients to compete forms, and delays to assessments, a new claim should probably be made close to six months before a PIP award’s end date.

If it is still more than six months until an award ends, a supersession can be requested, but with the risk of a reduced award.

If an award has already ended

The best action to take will depend on whether any review or renewal claim form was returned before the award ended. If it was, then the information above applies and the priority will be getting an early decision and making a complaint.

There will be little value in also making a new claim if the review or renewal claim is still being considered. This should be checked as a priority, and a new claim made if not.

If no new claim has been made, this should be done immediately. Claimants may be able to get an ex gratia payment pending a decision – eg, if the DWP accepts that it did not send out a DLA/AA renewal form or, for PIP, a reminder to claim again.

It is also arguable (although the argument is untested) that the claimant can also request a supersession of the awarding decision (whether made by the DWP or a tribunal) on the grounds of a change of circumstances, even though that award has already ended.12 Claimants requesting a supersession more than a month after their award has ended will need to give reasons for the late request, in order to ensure that their eventual entitlement is continuous.13

Please be aware that welfare rights law and guidance change frequently. Older Bulletin articles may be out of date. Use keywords or the search function to find more recent material on this topic.