Benefits for carers

If you want a decision about your benefit to be looked at again or if you decide to appeal to a tribunal, you must take action within certain time limits. These are called deadlines. The rules are quite strict. Unless there is a good reason for delay, you may find that missing a deadline will prevent you from taking any further action.

If you want a decision to be looked at again you have to ask the Department for Work and Pensions (DWP) within one month of the date on the letter telling you about the decision.

If you want to appeal to a tribunal, you have one month from the date the written decision was sent to you or, if you have already asked for the decision to be looked at again, one month (a calendar month) from the date on the letter saying whether or not the decision has been changed.

If you want more information about the reasons for the decision that has been made you need to ask for a 'written statement of reasons' within one month of being sent the decision. If you are sent written reasons within that month, you have an extra 14 days in which to ask for the decision to be looked at again or in which to appeal against it. If the reasons are not sent within the month, you will have 14 days from whenever they are sent.

If you have asked for more information about the reasons for the decision over the telephone or when you visited a benefits office, make sure that you ask for the decision to be looked at again, or appeal, within the one month time limit, because you will not necessarily receive an extra 14 days.

Sometimes it is not clear from the decision letter whether you have already been provided with written reasons. If you're not sure whether you're going to get an extra 14 days, be very careful to ask for the decision to be looked at again or appeal within the one-month time limit.

If you've missed the deadline

In some cases you may be able to get the decision looked at again, or make your appeal, even if the one-month deadline has expired. The time limit cannot be extended for more than one year after the deadline has expired. If a deadline has been missed, contact the DWP.

It is possible to appeal to a tribunal against many decisions about a claim for benefit, but in some cases an appeal will not be possible. The following examples provide a guide to the decisions which can be appealed against and those which can only be looked at again.

The following sorts of decision can be appealed:

• whether you are entitled to the benefit, or the rate you are entitled to,
• whether you have been overpaid benefit and have to pay it back,
• whether your claim has been made in a valid way, or
• whether your benefit can be backdated.

The following sorts of decision cannot be appealed:

• whether your payment of benefit should be suspended,
• whether you should receive an interim payment of benefit,
• whether someone can be your appointee (someone who acts on the claimant’s behalf for benefit purposes), or
• whether your claim for one benefit can be treated as a claim for a different benefit.

There are different rules for challenging decisions about some of the payments from the Social Fund. For more information about the Social Fund see External links.

Even if a decision cannot be appealed against, you can ask for it to be looked at again.

Whether to appeal or get the decision looked at again

If you're unhappy with the decision that has been made about your claim, you will need to decide whether you want to appeal to a tribunal straightaway, or whether you want to ask for the decision to be looked at again. You can ask for the decision to be looked at again first of all, and then if you are unhappy with that decision, appeal.

The advantages of asking for the decision to be looked at again first are:

• you may receive a favourable decision more quickly than if you appeal to a tribunal,
• you may avoid the inconvenience or stress of attending a tribunal hearing, and
• if the decision-maker has looked at the decision again and you are still unhappy with the decision, you can still appeal to a tribunal.

The disadvantage of asking for the decision to be looked at again first is that if you have not got any further evidence to send or you cannot point out any obvious mistakes in the decision, it is unlikely that the decision will be changed at the appeal stage by the Department for Work and Pensions (DWP). This means that an appeal may be the best way of proceeding and you would only be delaying matters if you first ask for the decision to be looked at again.

Whether to ask for reasons for the decision

In many cases the letter informing you of the decision about your claim for benefit will be quite brief and you will want to get more information. Asking for reasons may therefore be a good idea.

You can telephone or visit a benefits office in person to ask for an explanation. However, if you do so, to remember that the one-month time limit for challenging the decision will apply. If you ask for written reasons the time limit can be extended by 14 days.

If you do not get reasons for the decision, or the reasons are quite brief, you will find much more information in the case papers. The case papers are all the written material that the decision-maker has used to make the decision. It includes the claim form, any medical reports and letters sent by you. These are sent out by the DWP after you have asked for an appeal. If you would like to see the case papers at an earlier stage, you can ask for them to be sent to you.

If you're unsure about whether to challenge a decision, or how to challenge a decision, try to get some professional advice. For details of where to seek professional advice see External links.

If you want your benefit claim to be looked at again or you have appealed to a tribunal, get your evidence together as soon as you can.

What type of evidence would be useful?

It is best to start by looking at the reasons for the decision. This will help you to decide what kind of evidence might be available to support your case.

Any notes or a diary you have kept about the amount or sort of care you provide could be extremely useful if there is a dispute about the number of hours you spend giving care. It will give the Department for Work and Pensions (DWP) or the tribunal a good picture of your daily routine.

Copies of award letters notifying the person you are looking after of their award of Disability Living Allowance (DLA), Attendance Allowance (AA) or other benefits can help if there is a dispute about whether or not they are getting a qualifying benefit or about dates.

You can clarify the amount of your earnings, or the period for which the earnings are paid, by providing copies of your contract of employment, payslips or a letter from your employer.

A diary can be helpful to confirm the dates on which you have taken a break from caring or the frequency of those breaks. It can also be helpful for showing the dates that you, or the person you are looking after, have been in hospital or in a care home.

If there is a dispute about your hours of study you might find it useful to get some confirmation of the hours the university expects you to study, or a letter from one of your lecturers to explain why you can complete the coursework with fewer hours of study than other students.

Evidence from people who know you

Family, friends or other carers may be prepared to go to a tribunal hearing to give evidence. Even if they are unable to do so, any written evidence they can provide might be helpful. For instance, they might be able to provide confirmation of the dates when you have taken breaks from caring because they helped to provide alternative care.

Your family, friends or other carers should put their name and address on any letters or notes that they provide as evidence, and they should sign and date any written evidence. Family, friends or carers do not need to write information in a formal way, but the clearer it is, the more likely it is to help.

If you would like to get the decision about your benefit claim changed you may find it helpful to get advice about how to do this or find someone to represent you at an appeal tribunal.

A solicitor or other adviser may be able to:

• give you the information you need about the rules for the benefit you're claiming,
• advise you about how to challenge any deadlines and what evidence it would be useful to provide when challenging a benefit decision, and
• represent you at a tribunal or advise you about the procedure at a tribunal.

You can get help finding a solicitor or adviser from Community Legal Advice or your local law centre.

Advice about the law

You may be able to argue your case on a common-sense basis and provide evidence to show that the decision is wrong because it has been based on inaccurate information.

Sometimes there are more complex legal reasons for your benefit being refused. It is particularly important to find some help if:

• you do not fully understand the case papers, or
• you do not know how to argue against the reasons given by the Department for Work and Pensions (DWP) for refusing your claim.

The following organisations may be able to help:

• Citizens Advice Bureau.
• A local law centre.
• A local authority welfare rights service. Contact the local authority to see if there is one in the area.
• A firm of solicitors that specialises in welfare benefits. The person you look after may qualify for public funding (legal aid). Please note that this does not cover the cost of representation at a tribunal.
• A voluntary organisation such as a carers centre or the Disability Information and Advice Line (DIAL).
• If the person you look after has a particular health condition (for example, multiple sclerosis or autism) there may be local and/or national organisations that can offer information and advice to help argue their case.

There are two ways for you to challenge a decision. You can ask for the decision to be looked at again, or you can appeal against the decision.

If you want the decision to be looked at again by the Department for Work and Pensions (DWP) you can telephone or visit a benefits office to ask for your decision to be looked at again, but it is normally better to put the request in writing. If you have telephoned or visited an office it is a good idea to confirm in writing that you want the decision to be looked at again.

Explain in writing why you think the decision is wrong. If possible, send any further evidence you have with your written request. If the evidence is not available yet, mention in your letter that you will send it as soon as you can. Keep a copy of your letters and any further evidence.

If you want to appeal you will need to appeal in writing, normally using an appeal form. This is contained in leaflet GL24 "If you think our decision is wrong" (PDF, 163Kb). This leaflet also contains information about the appeals process. You can obtain this form from a benefits office or advice organisations.

On the appeal form you will need to provide the following information before signing and dating the form:

• Your name, address, telephone number, date of birth and National Insurance number.
• Whether you have arranged for someone to represent you at the appeal and, if so, the representative’s contact details. If you want a representative but do not yet have one, you will be able to supply this information at a later date.
• The name of the benefit you are appealing about and the date of the decision.
• The reasons why you disagree with the decision (these should be as specific as possible).

If you have any further information or evidence available at this stage, you can send it with the appeal form. This can increase the chance of the DWP changing the decision before the case goes to an appeal tribunal.

Be careful to make sure the benefits office receives the appeal within one month of the date on the letter telling you about the decision.

Common questions

If I haven't got the right form to request an appeal, can I just send a letter?

If you are near the deadline for appealing but you do not have the right form you could send a letter. If all the information listed above is included in the letter then the DWP will almost always accept the appeal as valid.

I filled in an appeal form but missed out some important information. What should I do?

The DWP may return the appeal form or appeal letter to you asking you to provide any information you left out. You should be allowed at least 14 days to return this. Even if the DWP has not asked for further information, you can still send further information that you think is important. You should send it as soon as possible.

One of the ways to challenge a decision is to ask the Department for Work and Pensions (DWP) to look at the decision again. When you ask the DWP to look at a decision again, a decision-maker within the DWP will examine all the case papers. The case papers are the forms you have completed, reports and any letters or other documents you have sent. Having looked at the case papers the decision-maker will inform you of the outcome and whether a different decision has been made.

You do not have to go and explain your case in person. The decision-maker will base their decision on the case papers.

If you have been refused a benefit then you will need to send in more evidence to show why you think you are entitled to benefit. It may be that the DWP has made the decision without knowing all the facts. Explain what you think the facts are.

You may find it helpful to get a professional to help you challenge the decision.

If you have been refused a benefit then you have one month to ask the DWP to look at the decision again. If the DWP then agrees that you're entitled to the benefit you will be paid the benefit from the day you first claimed it.

If a decision has been made on your claim and it was based on an official error then the decision can be looked at again at any time and if the benefit is awarded, it will be paid from the date of the original claim.

You may want to challenge a benefit decision by appealing to an appeal tribunal. An appeal tribunal is independent from the Department for Work and Pensions (DWP). Appeals are organised by the Tribunals Service. The Tribunals Service also employs the tribunal members who make the decisions at appeal hearings.

The enquiry form

Once you have requested an appeal against a benefit decision, the Tribunals Service will send you an enquiry form asking whether you want an oral or paper hearing.

The enquiry form also asks whether you have any more evidence to send and if there are any particular dates you would be unable to attend an oral hearing if you have asked for one. It also asks whether you need an interpreter or any other special arrangements. You must return the enquiry form within 14 days. The appeal may not go ahead if the form is not returned in time.

The DWP will prepare the case papers and send one copy to you and one to the Tribunals Service.

Oral hearings and paper hearings

An oral hearing is a tribunal where you appear in person and explain why you think the decision on the benefit you have claimed is wrong. The tribunal will ask you questions about the facts in your case. You can take someone with you for support and you can ask other people to give evidence about your case.

A paper hearing is one you do not attend. The tribunal looks at all the information in the case papers and makes a decision based on that information. The case papers include the claim form, any letters that have been sent by you and any other reports or documents that are relevant.

Why oral hearings are best

In most cases you have a better chance of success if you choose to go to an oral hearing. This is because most of us are better at explaining things by talking to people than by putting things in writing. Also, the tribunal will be able to ask you questions and may raise points that you did not know were relevant.

You may be able to find someone to represent you at the appeal hearing. A specialist advice worker from an advice centre may be able to do this. If you do have a representative you would normally still need to attend the hearing with the representative. This is because you may need to answer questions about the facts in your case and a representative cannot do this for you.

If a specialist advice worker cannot represent you, they may be able to help you to prepare for the tribunal. The representative may also be able to help put your argument about the decision in writing.

The enquiry form asks you to say if you will be sending further evidence and, if so, by what date. Try to get any evidence to the Tribunals Service by the date you have given. This is especially important if you have asked for a paper hearing because you will not necessarily know when that hearing is going to take place.

If you have chosen an oral hearing you should be given at least 14 days' notice of the date, unless you have agreed to less notice.

At the appeal hearing

The tribunal at an oral hearing will be made up of a legally qualified person and they will be the chairman or chairwoman of the hearing.

The rules of procedure are not very strict. The chairman or woman of the tribunal decides who speaks and when, but the chair must make sure that you get a fair chance to put forward your case. You will be asked questions about your case and you will be given the opportunity to explain your situation.

The decision is usually made on the same day and you will be given a short decision notice which will tell you what decision has been made by the tribunal.

You can ask for a decision to be looked at again at any time if there has been an official error.

For benefits other than child benefit and Guardian's Allowance, this means an error made by an officer of the Department for Work and Pensions (DWP), a local authority or Her Majesty’s Revenue and Customs (HMRC). It also means someone acting on behalf of, or providing services to, a local authority. Finally, other than for Housing Benefit and Council Tax Benefit, it also includes errors made by someone providing services to the DWP.

The following errors of law may have occurred:

• The decision-maker already had a certain piece of evidence when they made the decision on the case, but they failed to take it into account even though it was relevant.
• The DWP, local authority or HMRC had written evidence of entitlement, but failed to give it to the decision-maker dealing with the claim when the earlier decision was made.

If the law has changed since the decision-maker made the decision, this does not count as an error of law.

In order to argue that there is an official error you must show that no one else caused or contributed to the error. This means that it will not be classed as an official error if you or your representative caused or contributed to the error in any way.

If you are unhappy about the way in which your claim for benefit has been processed or the way in which you have been treated, you may wish to make a complaint.

Complaints about the Department for Work and Pensions

You would normally need to take the following action if your complaint is about the service from the Department for Work and Pensions (DWP):

• First, contact the person who was dealing with your claim or that person’s manager. There is no need to wait until there has been a decision on the claim.
• If you are not satisfied, you can then ask for the details of the district manager of that benefit office and contact them with your complaint.
• If you are still not satisfied, you can contact the chief executive of the DWP. The district manager will give you the contact details.
• If you are still not happy you can then ask the independent case examiner to look at your complaint, particularly if it involves failure to follow proper procedures, excessive delay or poor customer service. You should normally contact the independent case examiner no later than six months after the final response is received from the DWP. The independent case examiner can be reached on 0845 606 0777 (textphone 0151 801 8888).

At any stage you can ask your MP to take up the complaint on your behalf. He or she may agree to refer the matter to the Parliamentary and Health Service Ombudsman. The Ombudsman would investigate your case if they think you may have experienced injustice because of the action or inaction of the DWP.

Common questions

Will I be entitled to any compensation?

The DWP will sometimes agree to pay you compensation. It uses an official guide to help calculate the amount you should be paid. Ask to be compensated not only for any benefit you have lost, but also for interest on the arrears of benefit and to cover any expenses such as telephone calls. You can also ask for payment to compensate you for any hardship or distress caused by the mistake.

What if I want to complain about a delay?

The DWP has target times in which to process claims for different benefits. If the claim takes too long to process, you may be entitled to compensation.

How can I complain about how an appeal was handled?
If the complaint is to do with the way your appeal has been processed (for example, you were not sent paperwork) contact the Tribunals Service.

If you're concerned about the way in which members of a tribunal behaved during an appeal hearing, you would need to contact the chair of the region where the tribunal was heard. To find out who this is, contact the Tribunals Service.

Sometimes people are paid more benefit than they are entitled to. An overpayment of benefit may be made because the Department for Work and Pensions (DWP) made a mistake. It might also be caused by you making a mistake or contributing to a mistake being made. You might do this in two ways. You might fail to disclose something that should have been told to the DWP or you might have misrepresented an important fact. Sometimes the DWP can recover the overpayment. This means that they ask you to pay it back.

How the Department for Work and Pensions decides if there has been an overpayment

The DWP can look into whether someone has been overpaid for various reasons. These might include the DWP finding out that Disability Living Allowance (DLA) or Attendance Allowance (AA) has stopped being paid to the person you are looking after. It might also be because they think that you have become a full-time student or that your earnings have increased above the earnings limit.

It will then investigate to see whether you contributed to the error that caused the overpayment in some way, even if it was not deliberate on your part. Unless the money is legally recoverable (because you failed to disclose information or misrepresented information) you will not have to pay the overpayment back. If you believe you are being wrongly asked to repay money, seek advice from a welfare benefits specialist or legal advice service.

If you fail to tell the DWP about a change of circumstances, the DWP may decide that at a particular date in the past you should have realised it was necessary to contact the DWP. If this happens the DWP will calculate the overpayment from the date that it thinks you should have notified it of the change of circumstances.

How overpayment is reclaimed by the Department for Work and Pensions

The DWP may decide not to recover the overpayment, if it is quite small. The DWP may also decide not to recover all or some of the overpayment if they accept that you acted in good faith and that recovery would cause hardship.

A recoverable overpayment can be deducted from your ongoing benefit payments. In some cases the DWP may want to take proceedings in court against you to recover the money. This rarely happens.

You can challenge the decision that you have been paid the wrong amount or that it can be recovered from you. You can also challenge decisions about the amount of the overpayment or the period of time it covers.

Many overpayments are caused by innocent mistakes. Just because there has been an overpayment does not mean that you have acted dishonestly. However, if the DWP believes fraud is involved it could decide to prosecute you. Alternatively, you may be given the option of paying a penalty, which would be 30% of the overpayment.

If you are accused of acting dishonestly or fraudulently you'll need to get legal advice as soon as possible.

If you have given the Department for Work and Pensions (DWP) incorrect information about yourself or your circumstances, the DWP may argue that you have misrepresented important facts. The DWP may then argue that this has caused it to pay you too much benefit. This is called an overpayment. You may be asked to pay some or all of the overpayment back.

Important facts

Anything that affects entitlement to your benefit could count as an important fact. What an important fact is will depend on individual circumstances in each case. Even if you honestly thought the information you gave was correct, if it is later found to be incorrect, that would count as misrepresentation.

Example

When Jackson completed his form for Carer’s Allowance he put on the form that he was studying for 15 hours each week. Although Jackson only has lectures for 15 hours each week, he has to study for longer than this to complete his course and he is legally a full-time student. Jackson did not intend to mislead anyone but he has misrepresented a material fact.

Checks

If someone helped you to complete a claim form and they did not realise that the contents were incorrect, you may be able to argue that the misrepresentation was not your fault. However, the DWP will normally expect you to have done your best to check that the contents were correct before you signed the form.

Even if you have misrepresented some important fact, it may not have caused the overpayment, or may have only caused some of it. You therefore need to find out why you were paid too much benefit. For instance, it is possible that the benefits office obtained the correct information from elsewhere about your entitlement to benefit, but failed to act upon it and it was this failure to act by the DWP that caused the overpayment. If this was the case then all or part of the overpayment may not be recoverable.

If the DWP makes a decision that you have been overpaid and that the overpayment is recoverable from you, you can challenge the decision. It may be a good idea to get legal help with challenging an overpayment decision if possible.

When challenging a decision to recover an overpayment it has to be decided whether it was a misrepresentation of information that caused an overpayment or whether the overpayment was caused solely by an official error.

Some of the key points you may wish to raise if you are challenging a misrepresentation overpayment decision are:

• the nature of the information you gave to the DWP in relation to the benefit,
• where you sent the information and when, and 
• whether you have any proof that you have provided information, such as receipts for documents handed in at a benefit office or recorded delivery receipts.

If you fail to inform the Department for Work and Pensions (DWP) about an important fact about yourself or your circumstances this is called failure to disclose. If the failure to disclose causes the DWP to make a wrong decision about your claim you could be overpaid benefit and the DWP may recover the overpaid benefit from you.

Anything that affects your entitlement to the benefit could count as an important fact. What an important fact is will depend on individual circumstances in each case.

You are expected to disclose a fact if the DWP told you that it is the type of fact you need to report to them and you knew of the fact in question. The DWP lists the sort of facts you should be told about in the letters and leaflets it sends out with each benefit claim.

Your responsibility

Even if the DWP did not tell you that the fact that caused the overpayment was one that should be disclosed, you still need to inform the DWP of any changes that might affect entitlement to benefit.

If you knew about the fact, and the fact was some change in your circumstances, and it was reasonable to expect you to believe the change might affect your benefit, then it is your duty to inform the DWP of the fact. If you do not do so it is considered to be a failure to disclose and any overpayment will be recoverable from you.

If the DWP makes a decision that you have been overpaid and that the overpayment is recoverable from you, your can challenge the decision. It may be a good idea to get legal help with challenging an overpayment decision if possible.

When challenging a decision to recover an overpayment, what needs to be decided is whether it was a failure to disclose information that caused an overpayment or whether the overpayment was caused solely by an official error.

Some of the key points you may wish to raise if you are challenging a failure to disclose overpayment decision are:

• the nature of the information you gave to the DWP in relation to the benefit,
• where you sent the information and when, and
• whether you have any proof that you have provided information, such as receipts for documents handed in at a benefit office or recorded delivery receipts.