1 department for work and pensions dee solanki jonathan chater dwp north london district general...
TRANSCRIPT
1 Department for Work and Pensions
Dee SolankiJonathan Chater
DWP North London District
General Welfare Benefit Awareness and Changes
21st of May 2014London Councils office
2 Department for Work and Pensions
Key Points
• Fire and Bomb alarms Tests• Fire exits• Toilets• Refreshments• Mobile phones• Schedule of the day• Handouts
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Subjects Covered:
• Introduction to welfare benefits
• Job Seekers Allowance (JSA)
• Employment Support Allowance (ESA)
• Access to Work
• Carers Allowance (CA) Comfort Break – 15 mins
• Universal Credit (UC)
• Social Fund Reform (Local Welfare Provision)
• Personal Independence Payment (PIP)
• AOB Session to a close
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Who deals with which benefit
• Pension Centre• Pension Credit• State Pension• Winter Fuel Payments
Jobcentre Plus• Bereavement Payment• ESA• JSA• Income Support• Universal Credit
Disability Benefits Centre
• Attendance Allowance• Personal Independence
Payment• Disability Living Allowance
for ChildrenCarer’s Allowance Unit• Carer’s Allowance
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Difference Between Contributions and Income Based JSA
Contribution-based JSA
• Paid enough Class 1 National Insurance Contributions in the last two tax years.
• Can be paid for 182 days (approximately 6 months)
• Income or savings don’t usually affect how much a claimant can receive (unless they get money from a part time job or an occupational or private pension.
• Having a partner who works would not affect how much a claimant can receive.
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Income Based JSA
• If, as an employee, not enough National Insurance contributions have been paid, a claimant can apply for income based JSA.
• It is means tested so income and savings can affect how much a claimant can receive.
• Must have less than £16,000 in savings.• If a claimant has a partner they must both work, on
average, less than 24 hours per week (less than 16 hours for individuals).
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JSA Conditions of Entitlement
To qualify for Jobseekers Allowance a claimant must meet the conditions attached to receiving the benefit.A claimant must:
– Be available for employment;– Be actively seeking employment;– Have a current Jobseekers Agreement (or Claimant
Commitment); and– Comply with any reasonable conditions that an
advisor has requested.
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Exceptions to the Requirement to be Immediately Available
• Providing a service e.g. community work, acting as a JP or member of an appeal tribunal (paid or unpaid) – must be willing to take up employment on 24 hours notice.
• Undertaking voluntary work – must be willing to take up employment on one weeks notice and job interview 48 hours notice.
• Caring responsibilities – must be willing to take up employment of at least 16 hrs per week on weeks notice and attend job interview 48 hours notice.
• Part-time workers must be willing and able to take up employment immediately following period of notice they are required to give employer.
• Caring responsibilities for a child – must be willing and able to take up employment of at least 16 hours per week on being given 28 days notice and attend job interview within one week.
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Jobseekers Agreement
At the beginning of a claim the advisor will check if there are any doubts about whether a job seeker has satisfied the entitlement conditions and agree a Jobseekers Agreement (JSAG).
From December 2013 the JSAG has been replaced by the JSA Claimant Commitment (CC).
The CC is used by claimants to detail the steps that they will take to have the best prospects of finding work.
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Actively Seeking Employment
• The specific steps a claimant is required to do on a weekly basis is recorded on the JSAG (or Claimant Commitment).
• Any restrictions on a claimant which have been accepted are also recorded on the JSAG (or Claimant Commitment).
• Some claimants may ask someone else to seek work on their behalf or assist them with their efforts to find work – because of a mental or physical condition they cannot be expected to take reasonable steps without help.
• Some claimants may have limited skills in English and they too may ask a friend or relative to search for them.
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Reasonable Conditions as Required by Work Coach
These could include activities such as:
• Taking part in a particular employment programme.
• Applying for, or accepting, a place on a programme or scheme.
• Complying with a job seekers direction.
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JCP Offer - Programmes and support available to claimants:-
• Flexible Adviser Interventions (JSA, ESA WRAG and lone parents claiming Income Support or ESA WRAG with youngest child aged 3 or 4)
• Jobsearch Support• Work preparation support - lone parents (from 16 years), partners & carers• Flexible Support Fund – discretionary payments to help remove barriers to work• Skills Provision inc Skills Conditionality• European Social Fund – Skills Support for the Unemployed / Redundant• Disability Employment Advisers including Work Choice (new / retention)• Mandatory Work Activity (JSA only)• Careers Advice & Skills screening including National Careers Service• Local Non-contracted provision• Help with costs including childcare & replacement care costs (using the flexible support fund)• Low Value provision – to fund specific training requests• Modern apprenticeships (signposting)• Youth Contract
Get Britain Working Measures:• Work Clubs • Work Together (Voluntary Work)• Work Experience (some 16/17 year olds, 18-24 from 13 weeks up till starting on the WP and 25+ with no recent work
experience)• New Enterprise Allowance Enterprise Clubs • sector based work academies – England and Scotland only
Work Programme:North / West London: Ingeus (UK) Ltd, Maximus Employment and Training, Reed in PartnershipEast / South London:- Seetec, CDG, A4e
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Income Support
• To qualify for Income Support you must be all of the following:
• between 16 and Pension Credit qualifying age,
• pregnant, or a carer, or a lone parent with a child under 5 or, in some cases, unable to work because you’re sick or disabled,
• you have no income or a low income working less than 16 hours a week (and your partner works no more than 24 hours a week),
• living in England, Scotland and Wales - there are different rules for Northern Ireland,
• You can claim Child Tax Credit if you claim Income Support and have children.
• Lone Parents claiming Income Support are required to attend Work Focused Interviews at the Jobcentre and those whose youngest child is aged 3 or 4 are required to undertake work related activity as agreed with their Work Coach to prepare for work.
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Employment Support Allowance (ESA)
• ESA was introduced in 2008• Replaced Incapacity Benefit, Income Support paid on the grounds of incapacity and Severe Disablement Allowance• Support for Claimants whilst they are unable to work due to illnesses and/or disability including financial support and help to prepare for a future return to work
– Support Group– Work Related Activity Group
• Permitted Work• Work Programme• JCP Offer
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I receive my first payment.
WRAG
I attend my WFI.
Reconsideration-The outcome of
decision is looked at again upon
claimants request
I receive a letter telling me what will happen next, explaining the importance of completing the ESA50 questionnaire, providing
any additional information and attending the WCA
appointment.
The Decision Maker calls to discuss my entitlement to ESA. I can discuss the
reasons for the decision and provide further evidence. I am advised of my options and if I wish to claim JSA I am transferred to someone who takes my claim details.
Someone calls to arrange a
WCA appointment at an Assessment
Centre.
I receive a letter informing me of
my benefit award.
The Jobcentre contacts me to
arrange a Work
FocussedInterview
(WFI).
ALLOWED
I attend the Assessment Centre for a face to face assessment
with AtosHealthcare.
I receive an ESA50
questionnaire to fill out.
I ring Jobcentre Plus to claim ESA.
They take information to complete my
claim and explain what will happen
next.
DISALLOWED
I receive a letter informing me of the benefit disallowance
and the WCA outcome.
I receive a call from the Decision Maker to tell me the outcome of my assessment and
what will happen next.
Dissatisfied claimant appeals against the 2nd
decision.
I receive a notification
advising me to appeal against the decision by
logging an appeal via HMCTS
I have know received the 2nd
decision letterNew Touch point (step) in process
Existing/unchanged Touch point (step in process)
Key:
1
2
3
4 5
10
1112
13 1416
8
15
6
7
8SUPPORT GROUP
(i) If the Decision Maker (DM) accepts the new evidence over the telephone, after seeking advice from the HCP, & allows the claim, a separate Allowance call will be made.
If the DM requests written evidence & subsequently allows the claim a DM will make a separate Allowance call.(ii) If the DM on reconsideration accepts the new evidence & allows the claim then an award letter is prompted.(iii) If the appeal is allowed then an award letter is prompted.
(i) (ii)
(iii)
Note:
End to end ESA process for new claimants
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Work Programme
• This scheme is designed to assist claimants for a period of up to two years.
• Support is tailored to give such support as is considered appropriate and reasonable in the claimant’s circumstances.
• This support may include work search support, provision of skills training and work placements.
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Work Programme
• If a claimant fails to attend or participate in the Work Programme (without good reason), then JSA and National Insurance Credits can be stopped for four or thirteen weeks.
• While a claimant is participating in the Work Programme they do not receive any further assistance from Jobcentre Plus (JCP) in terms of extra support with Flexible Support Fund, referrals to training or job opportunities, or any other help.
• They are simply required to attend the JCP on a fortnightly basis for signing. If there are doubts in respect of actively seeking or availability there Work Programme provider is contacted before any further action is taken.
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Work Programme Eligibility
• Mainstream 25 plus claimants are referred after 12 months on JSA.
• Mainstream 18-24 claimants are referred after 9 months on JSA.
• JSA NEET – any 18 year old who is not in education, employment or training for a 6 months period directly prior to their claim for JSA are referred after 6 months on JSA.
• JSA Early Access include claimants who are prison leavers (Day One) those who have claimed JSA 22 months out of the last 24 and those who previously claimed Incapacity Benefits prior to claiming JSA (After three months).
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Work Programme – Deferrals and Exemptions
• A claimant can be deferred referral to the Work Programme for up to three months.
• This can be for a variety of reasons including imminent job start, outcome of an interview still pending, currently on training, etc.
• A claimant can also be exempt for a variety of reasons including pregnancy, victim of domestic violence, etc.
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The New Disputes Process
When a decision has been made that a person is not eligible for benefit or that benefit would not be paid for a certain period, a claimant has a number of options, they can:– Ask for an explanation.– Ask for a written statement of reasons for the
decision.– Ask for the decision to be looked at again to see if it
can be changed (reconsideration). This is an opportunity for a claimant to highlight facts which they think may have been overlooked or they may have some information which affects the decision.
– Appeal against the decision.
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The New Disputes ProcessFrom October 2013 some changes to the process have been introduced, the key changes are:
– Mandatory Reconsideration – a claimant must give Department for Work and Pensions (DWP) the opportunity to reconsider a decision before they can make an appeal. They will be issued with a Mandatory Reconsideration Notice (MRN) with a full explanation of the Decision Makers reasoning once this has taken place.
– If, after the MRN, a claimant still thinks the decision is wrong and they want to appeal they must lodge their appeal direct with Her Majesty’s Courts and Tribunals Service (HMCTS) and not with DWP. A copy of the MRN must be enclosed with their appeal.
All appeals for decisions made on or after 28th Oct 2013 must be lodged directly with HMCTS.
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Access to Work• Access to Work was introduced in June 1994
• Is a National Programme delivered by Department for Work and Pensions
• To help overcome barriers that disabled people come across when moving onto or retaining employment.
• Provides a grant to cover additional costs over and above the requirements of making “reasonable adjustments” which an employer is legally obliged to provide under the “Equality Act 2010”
• A flexible programme that focuses on the needs of the individual.
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Reasonable Adjustments
1. Changes to the ways in which things are done in the organisation
2. Changes to overcome the barriers created by the physical features of the workplace
3. To provide extra / auxiliary equipment
There are 3 main considerations when determining what reasonable adjustments could be put in place for an employee.
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Benefits of Access to Work• Encourages greater independence
• Promotes work as being the best route to inclusion for disabled people
• Enables disabled people to work on a more equal basis with non disabled colleagues
• Encourages employers to recruit and retain disabled people by offering practical help.
• Provides advice to disabled people and their employers
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Eligibility Criteria
• Have a disability or health condition that has a long term, adverse affect on their ability to carry out their job
• Be over 16 years old
• Be in, or about to start, paid employment (including self employment)
• Live and work in Great Britain
• Not be claiming Incapacity Benefit or ESA once they are in work (with the exception of higher permitted work)
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Types of Help
There are seven main elements within Access to Work:
• Special Aids and Equipment (SAE)
• Adaptations to Premises and equipment (APE)
• Travel to Work (TtW)
• Travel in Work (TiW)
• Support Worker (SW)
• Communication Support at Interview (CSI)
• Mental Health Support Service (MHSS)
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Mental Health Support Service
Support is available for people with mental health conditions who are either:
• Going into work• Absent from work as a result of a mental health condition• Finding work difficult as a result of a mental health condition
The support available from Access to Work includes:
• An assessment of needs• A personalised six month support plan, with detailed steps
designed to keep a person in, or help them to return to work• Signposting to relevant intervention and support services
This service is provided for Access to Work by Remploy
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Examples of Mental Health SupportCoping strategies
This could cover a range of strategies and will depend on the individual’s job role, their condition and how this impacts their work. For example:
• Keeping a mood diary • Using memory aids such as Mind Maps, checklists• Relaxation techniques when under pressure• Developing a Wellbeing Recovery Action Plan• Cognitive Behavioural techniques
Reasonable adjustments• Development of Flexible working, phased return, etc.• Putting in place a buddy or mentor• Temporary reduction in targets or reallocation• Additional time to complete certain aspects of job role• Regular formalised 121 meetings to review concerns
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Access to Work Grants
The level of grant will depend on:
• Whether the applicant is employed or self employed
• How long they have been in their job
• The type of help required
• The size of company they work for
Access to Work provides the grant with which to procure the support that is needed, it does not provide the support itself.
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Cost Sharing
• 0 – 49 attract no cost share
• 50 – 249 £500 Threshold and 20% of the costs thereafter
• Over 250 £1000 Threshold and 20% of the costs thereafter
• Costs above £10,000 will normally be met by Access to Work
• If there is a general business benefit a contribution will be sought in addition to any compulsory cost share
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Permitted Work
• Customers on Permitted Work Higher Level and Supported Permitted Work and Permitted Work PCA Exempt are eligible for Access to Work.
• Support will be limited to a maximum of 52 weeks in line with Permitted Work Higher Level time limit.
• After a 52 week break, customers can re apply for Access to Work support for a further 52 weeks.
• Customers on Permitted Work Lower Level are not eligible.
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Access to Work for Work Experience under the Youth Contract
• For claimants aged 18 to 24 Years
• Resident in Great Britain (England, Scotland or Wales)
• All AtW Youth Contract Work Experience applications will be centralised
• All AtW Youth Contract Work Experience applications must be made via a Jobcentre Plus Adviser
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Self-Arranged Work Experience
• Must help the individual move closer to the labour market job
• Have a realistic prospect of securing paid employment after the placement has ended.
• Can last between 2-8 weeks
• All self arranged work experience placements for Jobcentre Plus (JCP) claimants must be arranged in accordance with JCP guidance; non claimants apply direct to Access to Work
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Apprenticeships
• People serving apprenticeships are eligible for AtW support as they receive a wage and have a contract of employment.
• National Minimum Wage rates do not apply to people on apprenticeships.
• If the apprentice stays with the same employer when qualified, cost sharing status will remain unchanged for the whole of the AtW period of three years from the beginning of the apprenticeship.
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New Enterprise Allowance Programme
• Claimants who are in receipt of Job Seeker’s Allowance and who start on the New Enterprise Allowance programme will be able to apply for Access to Work support.
• If eligible for Access to Work, support will be available for customer while participating on New Enterprise Allowance and where appropriate, this support will continue when you move into self employment.
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Sector Based Work Academies• From 9th December 2013 claimants who start a new
sector-based work academy opportunity will be able to apply for Access to Work support for the work-experience element only.
• This is available in England & Scotland only
• Claimants will be referred to Access to Work by Jobcentreplus Advisors who are arranging the placement.
• To be eligible, claimants must, have a disability or health condition that has a long-term negative effect on their ability to do work experience (long-term means lasting or likely to last for at least 12 months), and – be aged 18 or over,– live in England or Scotland and: you– about to start a sector-based work academy work
experience placement.
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Drive to get more disabled people into mainstream jobs
• Supported Internships
• Traineeships
• Sector-based work academies
• Self-Made Work Trials
• Work Experience placements
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Who can “Access to Work” support?
• Claimants moving into employment
• Claimants undertaking certain types of Permitted Work
• Claimants about to start the mentoring phase of New Enterprise Allowance
• Claimants commencing a Work Trial
• Claimants about to start work experience under the Job Centre Youth Contract
• Claimants taking part in Work Programme and Work Choice
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How to Apply• Disabled employee makes the application.
• Telephone based service - alternative arrangements can be made if appropriate.
• Contact the Customer Service Team on 0345 268 8489 The team will take basic information and pass to an ATW Adviser.
• The ATW Adviser will contact the customer within 24 hours and progress the application.
• Once support is agreed the customer will sign a Customer Declaration Form.
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Further InformationAccess to Work information can be found on the internet at
• www.gov.uk/access-to-work • Access to Work Factsheet
• Employer’s Guide to Access to Work
You can contact the Customer Service Team on:Telephone: 0345 268 8489Textphone: 0845 608 8753
Email: [email protected]
This presentation is intended to be a general guide to the principles underpinning the Access to Work programme and is not a full and authoritative statement of the law
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Carer’s Allowance can be paid to carerswho look after someone who gets:Attendance Allowance(either lower or higher rate)
Disability Living Allowance(middle or higher rate personal care component)
Personal Independence Payment(standard or enhance rate daily living component)
Armed Forces Independence Payment
Constant Attendance Allowance at or above the normal maximum rate with an Industrial Injuries Disablement Benefit, or basic (full day) rate with a War Disablement Pension
The carer & disabled person do not have to reside together
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Carer’s Allowance
The carer must
• be aged 16 over • provide care for that person for at least 35 hours a
week• not be on a full time course of further education
(21 hours or more)• be present in GB (104 weeks of last 156 weeks) • not earn more than £100 per week
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Additional Benefit
• Carers entitled to Carers Allowance, and in receipt of certain benefits, may get extra amounts added to their other benefit
• This is known as a carer premium or carer addition
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How to apply
• Claim Carer’s Allowance on-lineor to download a claim form: www.gov.uk/carers-allowance/how-to-claim
• Request a form by telephone: 0845 608 4321 or contact the Carer’s Allowance Unit
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• Will replace a range of income-related working age benefits with a single payment that provides both in-work and out-of-work support
• Designed to ensure that work will always pay
• Expect Universal Credit to begin in 2013, with existing claims transferred to the new system by the end of 2017
• Tougher sanctions regime will be introduced ahead of Universal Credit
• Aspects of the Social Fund will be incorporated within Universal Credit while others will be delivered by Local Authorities in England and devolved administrations in Scotland and Wales
Universal Credit - overview
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Payments are paid to different adults in a household and for various periods
Universal Credit is a single monthly payment to each household (Though we will retain the ability to pay more frequently or to split payment in exceptional circumstances)
Conditionality: some benefit claimants are capable of working but have no obligations to look for work
Universal Credit will personalise conditions according to people’s capability and circumstances
Work incentives can be very low, benefits are reduced to take account of earnings but different benefits have different rules
Universal Credit will ensure that work pays. Financial support will be reduced at a consistent and predictable rate and people will generally keep a higher proportion of their earnings
The welfare system has more than 30 benefits each with their own rules and criteria
Universal Credit provides a new single online system of means-tested support for working-age people who are in or out of work
How is Universal Credit different?Current System Universal Credit
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Personal Independence Payment
Universal Credit
How are we simplifying the system?
Current system
Pension Credit, Child Benefit, Carer’s Allowance (will remain)
Income related JSAIncome related ESAIncome Support (including SMI)Working Tax CreditsChild Tax CreditsHousing Benefit
Disability Living Allowance
Contributory JSA and ESA (still considering how these will work)
Council Tax Benefit (DCLG still considering how this will work)
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Social Fund reform
• Existing Social Fund been in place over 20 years – not kept pace with wider welfare reform.
• From April 2013:
• Community Care Grants and Crisis Loans for general living expenses will be abolished. Funding will be transferred to local authorities in England and to the Devolved Administrations in Scotland and Wales to establish alternative provision.
• Crisis Loans for alignment to benefit and Interim Payments of benefit will be replaced by Short Term Advances of benefit and will be administered by DWP from April 2013
• From October 2013:
• Budgeting Loans will be replaced by Budgeting Advances and be paid as part of Universal Credit. (From April 2013 in UC Pathfinder areas.)
• Regulated Social Fund (Funeral Payments, Sure Start Maternity Grants and Cold Weather Payments) will continue with Universal Credit as a qualifying benefit.
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Background
The expected level of the cap is:
• £500 per week for couples and lone parents and • £350 per week for single adults.
Until the introduction of Universal Credit the cap will be delivered by Local Authorities and deducted from Housing Benefit. People not in receipt of Housing Benefit will not see a reduction in their benefit income.
From May 2012 all individuals likely to be impacted by the cap will be sent a direct mail letter offering them support to get into employment or closer to the labour market.
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Discretionary Housing Payment
• The total amount of Discretionary Housing Payment funding for 2013/14 is £180 million.
• • In total we have allocated an additional £55 million to the Discretionary Housing Payment budget this year to help those affected by the removal of the spare room subsidy. This includes £25 million aimed specifically at supporting disabled people who live in significantly adapted accommodation.
• • It also includes £35 million in-year funding to help claimants affected by changes to Housing Benefit in the social sector who need extra support.
• • There will also be £165 million available in 2014/15, to ensure that councils can offer ongoing support and make long term awards where appropriate
• We have announced a grace period whereby the benefit cap will not be applied for 39 weeks to those who have been in work for the previous 12 months. This will allow people time to find alternative employment or consider other options to avoid the impacts of the cap.
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Which benefits are included in the cap calculation
• Bereavement Allowance/Widowed Parent’s Allowance
• Carer’s Allowance
• Child Benefit
• Child Tax Credit
• Employment and Support Allowance (except where it is paid with the support component)
• Guardian’s Allowance
• Housing Benefit
• Incapacity Benefit
• Income Support
• Jobseeker's Allowance
• Maternity Allowance
• Severe Disablement Allowance
• Widow’s Benefit
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Which benefits are disregarded in the cap calculation
• Bereavement payment• Council Tax benefit or the replacement, localised support for Council Tax• Discretionary Housing Payments• Social Fund Payments – All one off payments
Budgeting Loans Cold Weather Payments Community Care Grants Crisis Loans Funeral Payments Sure Start Maternity Grants Winter Fuel Payments
• Statutory Adoption Pay – paid by employers• Statutory Maternity Pay – paid by employers• Statutory Paternity Pay – paid by employers• Statutory Sick Pay – paid by employers
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The following households will be exempt from the cap:
• Attendance Allowance• Disability Living Allowance or the replacement benefit Personal
Independence Payment• The support component of ESA • Industrial Injuries Disablement Benefit (IIDB)• War Widows or Widowers pension• Entitled to Working Tax Credit (do not have to be in receipt of WTC)
Exemptions
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• Personal Independence Payment (PIP) has replaced Disability Living Allowance (DLA) for eligible claimants from 8 April 2013
• DLA was introduced in 1992 and has not been reviewed since
• Complex and confusing to claim
• Little independent evidence/involvement
• No systematic process to review whether an award remains correct
• Financially unsustainable in the long term
• Current benefit not in step with the needs of a 21st century welfare system
Introduction to Personal Independence Payment
PIP Toolkit - Quick Guide
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Similarities Differences
• Extra-costs cash benefit
• Not means-tested or taxable
• Two components
• Payable both in and out of work
• Maintains links to passported benefits where
possible
• Special rules for terminally ill people
• 3 month qualifying period and 9 month prospective
test
• New assessment criteria
• Individual assessment and face-to-face consultation
• Planned interventions
• Reconsiderations process
Similarities and Differences between DLA and PIP
PIP Toolkit – Differences and Similarities
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Components and Eligibility• PIP will be made up of two components – daily living
and mobility
• Each can be paid at standard rate, or enhanced rate for those with the greatest needs
• The PIP assessment criteria will consider the individuals’ ability to carry out a range of everyday activities
• Individuals will receive a point score for each activity, depending on how well they can carry them out and the help they need to do them
• The total scores for each component determine whether a component is payable, and if so, whether at the standard or enhanced rate
Enhanced
Standard
Enhanced
Standard
Daily Living Mobility
8 points
12 points
Not Entitled Not Entitled
PIP Toolkit – Conditions of Entitlement
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Assessment Criteria
PIP Toolkit – Assessment Criteria
Daily living component (activities 1-10) Mobility component (activities 11-12)
Standard rate = 8 pointsEnhanced rate = 12 points
Standard rate = 8 pointsEnhanced rate = 12 points
Activity Possible points
Activity Possible points
1. Preparing food 0-8 11. Planning and following journeys 0-12
2. Taking nutrition 0-10 12. Moving around 0-12
3. Managing therapy or monitoring a health condition
0-8
4. Washing and bathing 0-8
5. Managing toilet needs or incontinence
0-8
6. Dressing and undressing 0-8
7. Communicating verbally 0-12
8. Reading and understanding signs, symbols and words
0-8
9. Engaging with other people face-to-face
0-8
10. Making budgeting decisions 0-6
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Reliably
• In order to satisfy a descriptor, the claimant must be able to carry out the activity as described in the descriptor reliably.
• ‘Reliably’ means whether they can do so:– Safely – in a fashion that is unlikely to cause harm to themselves
or to another person. – To a necessary and appropriate standard – given the nature of
the activity. – Repeatedly – as often as is reasonably required. – In a timely manner – in a reasonable time period.
• This is not covered in Regulations, but will form an important part of the assessment. It will be in guidance for assessment providers and Case Managers.
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Passporting to other benefits and services• Many DLA claimants are receiving other benefits, such as ESA
– Most DLA claimants receiving Incapacity Benefit will have already been reassessed for Employment and Support Allowance by the time they need to make a claim to PIP
– Claimants receiving DLA or PIP won’t be migrated to Universal Credit until later in the UC rollout
– Households where someone is in receipt of DLA/PIP are exempt from the new Benefit Cap
• Most existing passporting arrangements have been maintained for PIP
– receipt of the Daily Living component (either rate) means that their carer may be entitled to Carer’s Allowance
– Motability scheme will work with PIP in the same way as it does with DLA
• Changes in entitlement may affect other benefits or support that the claimant or carer receives
PIP Toolkit – Passporting
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Timetable for PIP replacing DLAFrom 28 October, natural reassessment started in Wales,
West Midlands, East Midlands and East Anglia for• those with fixed period DLA awards coming up for
renewal• children who turn 16 years old on or after 7 October
2013 (unless they have been awarded DLA under the Special Rules for terminal illness)
• those where there is a report of a change in the DLA claimant’s health condition or disability
• existing DLA claimants aged 16-64 who wish to make a PIP claim.
• From 13 January 2014, reassessment areas extend to postcodes beginning: DG, EH, TD and ML in southern Scotland and parts of the borders.
• From 3 February, areas further extend to include postcodes beginning: CA, DL, HG, LA and YO in the north of England.
October2013
PIP Toolkit – Reassessing existing DLA claimants
PIP Toolkit – Postcode Map
January 2014
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Timetable for PIP replacing DLA
• From October 2015
– DWP begin to invite remaining DLA claimants to claim PIP who were aged between 16 and 64 on the day that PIP was introduced (8 April 2013
PIP Toolkit – Reassessing existing DLA claimants
PIP Toolkit – PIP checker
• Once selected for reassessment, claimants will be asked to claim PIP
– If they do, then their DLA award will normally continue until a decision on the PIP claim is made
– If they don’t claim PIP then their DLA claim will end
Further decisions on extending natural reassessment will be taken and communicated to the rest of the country in due course and will be informed by the experience of introducing reassessment in a gradual way first.
October2015
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Thinking about claiming1
New Claims
Existing DLA claimants
Information is available that explains the eligibility criteria and helps the claimant decide if they want to make a claim. GPs and
Healthcare Professionals
Family & Friends
SupportOrganisations
Online
Leaflets DWP
From October 2015 all the remaining claimants in receipt of a DLA award will be invited to make a claim to PIP. We will select those recipients of DLA in receipt of an indefinite award or fixed term award, and notify them about what they need to do to claim PIP.If they choose not to claim PIP then their DLA would end.
Existing DLA claimants will be asked at some point after October 2013 if they want to claim PIP.
From October 2013 there will be reassessment to PIP of fixed period DLA awards coming up for renewal, young people turning 16 or where DLA claimants with indefinite awards report a change in their condition
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Making a claim2
Claims are made via a telephone call (0800) to DWP
• The claimant’s personal and contact details
• Residency details (known as residency and presence)
• Relevant periods spent in hospital, residential care
• Claims under special rules for terminally ill people, and
• Payment (bank account) details
DWP will identify communication needs (such as alternative formats) and consider if the claimant needs additional support
DWP will explain what happens next
A form is posted to the claimant. It is individually addressed and barcoded to speed up processing
DWP checks basic eligibility conditions – if not met then a disallowance letter will be issued
The initial information required to make a claim to PIP will be basic information covering:
PIP Toolkit – How to Claim
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How your disability affects you3
Claimants may ask someone, such as a family member or support organisation to help them complete the form
The form allows the claimant to explain how their condition affects them in their own words
Some disabled people have fluctuating conditions, that affect them in different ways on ‘good and bad’ days, so they can use the form to explain this
The form and any supporting evidence is returned to DWP in a freepost envelope
Any additional evidence that may help support the claim can be returned with this form
PIP Toolkit – Completing the form
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Assessment 4
The claim information, completed form and any additional evidence is passed over to the health professional
Some assessments may be completed at this stage– such as if someone is claiming under the special rules for the terminally ill or where the written evidence is sufficient
Most will be asked to attend a face-to-face consultation
They will decide if there is a need for any further evidence and will make all the arrangements to get this
PIP Toolkit – Assessment Process and Providers
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Assessment 4
Face-to-face consultation not requiredClaimant will be contacted to invite them to a face-
to-face consultation
Claimants can contact the health professional to ask questions about the consultation or rearrange appointments
The health professional will ask the claimant to explain how their condition affects them on a day to day basis. The claimant may also be able to provide additional evidence
The health professional sends a report back to the DWP to help inform their decision
The health professional reviews all the evidence against a set of everyday activities and clear descriptors to assess the challenges faced by the individual
Face-to-face consultation required
Claimant attends face-to-face consultation with health professional
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Decision 5
The DWP Case Manager reviews the evidence they’ve received – including the report from the health professional
They make a reasoned decision on entitlement, level of award and the length of any award
Claimants can call DWP to ask for more information about the decision
A decision letter is posted to the claimant
If a claim has been disallowed, or an existing award reduced, then the Case Manager will try to call the claimant to explain the decision
PIP Toolkit – Decision and Payment
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• Awards of PIP will be based upon the claimant’s circumstances and will look at the impact of their disability or health condition on their daily lives
• If someone is awarded PIP we will tell them how long the award is for
• We will write to them to tell them how and when they need to tell us about any change in circumstances
• Claimants will have their award regularly reviewed
• When someone’s award comes to an end, they can decide to make a further claim to PIP, if they still have needs arising from their health condition or disability.
• If someone is given a longer award we will contact them occasionally to see if their needs have changed over time.
Reviewing Awards
PIP Toolkit – Reviewing Awards
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Disputes
• The change to the appeals process for DWP consists of the following key elements
– mandatory reconsideration of decisions prior to appeal
– direct lodgement of appeals with HMCTS
– time limits for DWP to return appeal responses to HMCTS.
• DWP will introduce mandatory reconsideration and direct lodgement for PIP from April 2013.
PIP Toolkit – Disputes
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PIP Toolkit list of contents
Core Products Fact sheets
• Introduction to PIP Toolkit
• Quick Guide
• PIP Timeline
• Claimant Journey
• External PIP white brand presentation and speaker notes
• Sample forms and notifications
• Leaflets
• PIP Communications Products and Timeline
• Sample Assessment Provider notifications
• Conditions of Entitlement • Assessment Criteria • The difference between PIP and DLA • Introducing PIP for new claimants (from April 2013)• Reassessing existing DLA claimants for PIP (from
Oct 2013)• How to Claim PIP• Completing the How your disability affects you
form • Assessment Process • Decision and Payment • Reviewing Awards • Special Rules for Terminally Ill People • Young People approaching age 16• People approaching age 65 and over • Passporting to other benefits • Vulnerable Claimants (includes signposting) • Disputes Process
Key Black – Version 1 January 13Red – Version 2 post January 13
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Thank Youfor attending
Dee Solanki & Jonathan Chater
Dee Solanki: 07717271360