Department for Work and Pensions

3. Mr A complains that between 2018 and 2019, DWP sanctioned him incorrectly and underpaid him benefits. Mr A contends DWP’s compensation offer is not enough due to the financial hardship he faced as a result of its actions.

4. Mr A says he had to borrow money and use credit cards as he was in financial hardship.

5. Mr A would like an apology and money he claims to be owed, including interest accrued and losses he incurred.

6. Mr A would also like DWP to make service improvements, especially to its mental health policy.

7. On 18 September 2017, DWP stopped Mr A’s Employment and Support Allowance (ESA), as he had not attended a Work Capability Assessment (WCA) on 30 August 2018. Mr A says he did not attend due to stress and court cases. He requested a Mandatory Reconsideration (MR) of the decision to stop his benefit. MR is the first step in the statutory appeals route.

8. On 9 October, Mr A received a first payment of Job Seekers Allowance (JSA) from a claim for the period 22 to 26 September 2017. He then began receiving fortnightly payments.

9. On 25 October, DWP made an MR decision for the 18 September 2017 ESA decision. It only made changes when Mr A provided evidence of his appointment with a solicitor. On the basis of this new evidence, DWP reviewed the decision on 6 December and reinstated ESA.

10. On 24 February 2018, Mr A failed to attend another WCA as he was unwell. This resulted in his ESA being stopped from that date. The decision meant DWP considered Mr A to have been overpaid ESA from 24 to 27 February 2018.

11. In March 2018, Universal Credit (UC) replaced all income-related benefits, including JSA and ESA. Claims could still be made for contributions-based ESA and JSA, now known as New Style ESA and New Style JSA.

12. On 5 March, DWP notified Mr A it would stop his ESA, as he had not attended WCA on 24 February 2018.

13. On 14 March, Mr A submitted an MR to overturn DWP’s decision to stop his ESA. On the same day, he made a claim for New Style JSA.

14. On 21 March, DWP completed an MR decision relating to its 5 March notification to close his ESA claim. It decided nothing would change, and his claim would remain closed.

15. On 29 March, Mr A called the UC helpline. It advised him he could not claim New Style JSA and would need to complete a UC claim. Mr A told helpline staff he needed support to complete a UC claim by telephone. He spoke to a team leader, who advised this was not possible. Mr A said he needed emergency funds and help. The team leader terminated the call.

16. On 5 April, Mr A completed a UC claim form on the telephone, and an adviser informed Mr A he would receive an advance payment.

17. On 19 April, DWP made the UC advance payment.

18. On 30 April, DWP reconsidered its 5 March MR decision and decided to backdate Mr A’s UC claim to 6 March 2018. Mr A complained by telephone that he had been starving from lack of food since 27 February 2018, i.e. when his ESA payments stopped.

19. On 14 May, DWP reviewed its MR decision of 5 March and decided Mr A had had good reason not to attend the WCA on 24 February. It awarded ESA for the period 28 February to 5 March 2018.

20. On 25 June, a senior operations manager emailed Mr A in response to his request to escalate his complaint. The manager advised Mr A the complaint could be escalated to the Independent Case Examiner (ICE). Mr A did not do so at this time.

21. Mr A says he attended a WCA on 9 July 2018 but had an anxiety attack and left. Another appointment was made for 2 August 2018. Mr A did not attend due to the anxiety attack he had suffered on 9 July.

22. Almost a year later, on 21 May 2019, Mr A attended a WCA under scrutiny. The resulting report was forwarded to DWP, which on 23 May 2019 decided Mr A had had limited capability for work related activity (LCWRA) from 6 March 2018. DWP made an arrears payment of the LCWRA component of £3,611.52 for the period 6 June 2018 to 5 May 2019.

23. On 31 May, Mr A emailed DWP’s ministerial correspondence team saying he wanted to make a complaint. He noted DWP had not paid him correctly for over a year.

24. On 20 June, a complaint resolution manager (CRM) wrote to Mr A and told him he had received a response regarding the complaint of 25 June 2018.

25. On 24 June, Mr A replied to the CRM and said the response had not addressed his complaint that he had been underpaid for over a year, causing him extreme financial turmoil and debt.

26. On 8 August, the CRM wrote to Mr A and apologised for the distress DWP had caused and offered a consolatory payment of £200.

27. On 18 September, Mr A contacted DWP and said £200 was not enough. On 19 December, Mr A asked to escalate his complaint.

28. On 10 March 2020 (the following year), a DWP manager told Mr A in writing they would make a referral to the special payment team to review Mr A’s benefit. They also apologised for the delay in doing so.

29. On 5 June, the above team completed its review, and DWP decided not to pay any more consolatory payments. The review also highlighted that when the original consolatory payment decision was made on this case, on 12 December 2019, the decision maker was not aware the CRM had already made a £200 special payment. Mr A had therefore been offered £400, plus £50 for the poor handling of the telephone call on 29 March 2018.

30. On 9 June, DWP apologised for the delay in providing a response to the escalation request of 19 December 2019 and offered £125 for the delay and inconvenience.

31. On 1 July, Mr A raised his complaint with ICE. ICE identified failings in the way DWP had managed his claim but did not recommend any more financial compensation for this. ICE recognised additional failings to those DWP had already accepted. It offered £75 to compensate the impact of those failings. This means Mr A has received £650 in total.

34. Mr A complains DWP treated him unfairly, and this meant he was sanctioned incorrectly and underpaid between 2017 and 2019.

35. We can see Mr A was receiving ESA and, from the start of his claim, DWP systems showed he had a mental health condition. DWP stopped his ESA on 18 September 2017 because Mr A was unable to attend a WCA. Mr A gave reasons for not attending, which DWP eventually accepted through an MR.

36. DWP reinstated Mr A’s ESA claim on 13 December, starting from 6 December 2017. Mr A also received backdated ESA for 13 to 21 September 2017, covering the period after his ESA stopped on 12 September 2017.

37. During Mr A’s MR for ESA, he made a claim for JSA and received payments covering the period 22 September to 5 December 2017.

38. Another appointment for a WCA was made for 24 February 2018, but Mr A was unable to attend as he was unwell on that date. Mr A’s ESA was stopped as of 24 February 2018, but payments to him continued until 27 February 2019. This meant Mr A was overpaid.

39. On 14 March 2018, Mr A requested an MR of the decision to stop his ESA. On 21 March 2018, DWP refused the MR request. On 14 May 2018, after Mr A appealed to HM Courts and Tribunals Service (HMCTS), DWP revised its decision, reinstated ESA, and paid arrears from 28 February to 5 March 2018.

40. DWP’s MR process, explained on its website, says:

‘The benefits office that gave you the original benefit decision will reconsider it. When they’ve reconsidered it, you’ll get a letter called a “mandatory reconsideration notice” telling you whether they’ve changed the decision. The mandatory reconsideration notice will explain the reasons for that decision and the evidence it was based on.’

41. Although we can see DWP handled Mr A’s MR in line with the above guidance, ICE identified it failed to support him when he did not attend the WCA on 24 February 2018.

42. ICE’s Report said DWP should have considered Mr A’s mental health and provided a home visit. DWP’s ‘Fail to attend or participate in WCA’ says:

‘When a claimant has a mental health flag set on the system the decision maker should check if the claimant has attended or received any of the following: • A safeguard visit for non-attendance at mandatory interviews.

• A telephone call from DWP collecting good cause information for the failure to attend the WCA; and • A returned BF223.’

43. We can see DWP should have considered arranging a home visit for Mr A. DWP therefore did not follow its own guidance when considering Mr A’s mental health and whether it impacted on his ability to attend WCAs.

44. In our view, the evidence shows DWP made mistakes by not considering Mr A’s mental health and his ability to attend WCAs. We have considered the impact of this failing.

45. We have formed a view of the impact DWP’s error caused. We looked at this carefully, as although Mr A does not dispute the fault ICE identified, and DWP recognised, he does not consider the financial compensation offered enough to put right the impact that fault caused. Mr A says he did not have enough food and had to use credit cards to survive, causing him financial hardship.

46. In our view, DWP’s error caused Mr A to miss the opportunity for a home visit to make sure he was well and to establish at an earlier stage why he did not attend the WCA on 24 February 2018.

47. Although this was a missed opportunity, overall, we cannot see anything to suggest the impact Mr A describes probably would have been avoided had the mistake not happened. The only difference is Mr A may have had a chance to explain to DWP why he was unable to attend the WCA. DWP would then have needed to consider Mr A’s explanation, given during the home visit, for not having been able to attend the WCA.

48. We cannot speculate about what Mr A might have said or how DWP might have considered that information. We cannot therefore reach any overall view on the likelihood DWP would have come to a different conclusion about his reasons for missing the WCA had it followed its own policy and offered Mr A a home visit in the first place. We do think this missed opportunity will have caused Mr A avoidable frustration.

49. ICE identified a number of other failings in DWP’s communications with Mr A. It found his complaint was justified due to the delay in DWP’s responses and complaint handling. We can see DWP delayed in responding to Mr A’s complaint by six months. It also took responsibility for not handling a call appropriately, and terminating it.

50. This is not in line with DWP’s ‘Our Customer Charter’, sections ‘Right treatment’ and ‘Keeping you informed’, which say:

‘You can trust us to: • do what we say we will do • be helpful, polite, and treat you fairly and with respect

We will: • deal with your request the first time you contact us, or as soon as we can • tell you what will happen next, and by when • keep you updated of progress.’

51. We agree with ICE this is evidence of fault. In our view, these failings caused Mr A undue worry and distress. Mr A made the call to DWP on 29 March 2019 in an effort to resolve his benefits situation, but it caused him to have a negative experience, adding to his worry. We can see the delay in responding to Mr A’s communication caused more distress still, as he was hoping DWP would make him a significant consolatory payment due to the debt and interest charges he had incurred.

52. We understand Mr A felt worried and upset in this situation. Having thought carefully about this, we can see the consolatory payment DWP offered now puts right the mistakes outlined above.

53. There is nothing to suggest that if the mistakes set out above had not happened, Mr A’s benefits would have looked any different. We can also see he was successful in appealing DWP decisions. Yet had the above mistakes not happened, Mr A may not have experienced undue worry and distress in claiming his benefits and complaining about the service he had received.

54. ICE did not make any further recommendations to compensate Mr A’s complaint as it was satisfied DWP’s error only led to short-term worry and delay in its communications, as set out above. There was no outstanding financial loss either, because the benefits had already been backdated.

55. Mr A tells us he has not received compensation for all impacts these errors caused. We have thought about these impacts in turn.

56. The most significant impact Mr A describes is experiencing financial hardship in the period when he received no benefits. We understand he is upset at how long this period lasted.

57. We can see he learned of the decision to stop his ESA on the 5 March 2018 and he requested an MR on 14 March 2018. Mr A made no further contact with anyone until he called the UC helpline on 29 March 2018. We have seen nothing to suggest he could not have claimed UC sooner than that date.

58. We can see from this contact DWP told Mr A he needed to complete a UC claim. After further contact on 3 April 2018, Mr A received support in completing the claim form by telephone on 5 April 2018. This was the first time Mr A learned about advance payments (these can be made to support claimants who cannot manage until their first UC payment) and how they might ease the hardship he described. However, when the adviser tried to explain how advance payments work, Mr A terminated the call.

59. DWP again offered Mr A an advance payment on 9 April 2018, but he refused, saying he did not want charity. Instead, he said he wanted a backdated payment from 27 February 2018. Mr A began receiving UC at the end of April, and DWP reinstated ESA on 19 May 2018.

60. We can see Mr A says he was in financial hardship during that time, and we have no doubt this was a stressful period for him. Having looked at the evidence available, we can see there was no contact from Mr A to DWP that would have allowed it to act any more swiftly or effectively than it did. DWP could not have processed any claim for UC until Mr A had made one. It responded appropriately to his descriptions of hardship in offering him an advance payment that would have resolved those difficulties.

61. DWP has therefore acted in line with its Charter, which says it will ‘be helpful, polite, and treat you fairly and with respect, try to understand your circumstances, and follow processes correctly’.

62. We can see DWP also acted in line with our Principles, which say, ‘Public bodies should provide clear and timely information about methods by which people can appeal or complain’. They also say, ‘Public bodies should treat people with sensitivity, bearing in mind their individual needs, and respond flexibly to the circumstances of the case’.

63. Mr A’s second reason the current financial compensation of £575 is not appropriate is that he has incurred a significant financial loss.

64. We can see Mr A requested an MR every time DWP stopped his ESA. We can see he was successful in overturning these decisions and getting backdated pay to cover any gaps. There are therefore no outstanding benefits owed to Mr A, and he has not lost any benefits.

65. DWP’s ‘Financial Redress for Maladministration [fault]’, 2017, says: ‘There are three special payment categories under which individuals can be awarded financial redress in response to DWP maladministration [fault]’. These are: Category 1: Loss of statutory entitlement Category 2: Actual financial loss or costs Category 3: Consolatory payments.

66. As explained above, Mr A received all outstanding benefits, and the stop in his benefits was not due to a fault but his failure to attend a WCA appointment. We understand Mr A accrued charges and interest from the use of his credit cards because he was without benefits for some time, and this must have been upsetting.

67. Also as explained above, we cannot say whether anyone committed a fault that resulted in the stopping of his benefits. We can also see DWP offered Mr A an advance payment of UC at the time, which he refused but which would have meant he could have avoided the interest and charges in question. We cannot therefore see any sign of direct financial loss DWP should compensate.

68. We have found that the impact DWP’s error caused is the emotional impact of frustration and distress, as recognised above. Mr A’s complaint for financial redress falls under the ‘consolatory payments’ category of DWP’s ‘Financial Redress for Maladministration [fault]’. It says:

‘5.13 Consolatory payments usually range between £25 and £500, although lower or higher payments may be appropriate having considered the individual circumstances of a case, in the context of the guiding principles’.

69. DWP offered financial compensation of £375 for its overall failings relating to the complaint. Mr A was then paid an extra £200 in error. The complaint handler paid Mr A this sum without realising it had already been paid.

70. We can see ICE recommended a further £75 for fault relating to DWP’s failure to follow its own Six Point Plan, which supports customers expressing suicidal ideation. Mr A has not asked us to consider a complaint about DWP’s failure to follow the Six Point Plan, so we will not comment on this specifically.

71. Taking all the above into account, we consider a total of £575, along with an apology, more than enough to correct the emotional impact of its mistake. This is in line with DWP’s ‘Financial Redress for Maladministration [fault]’ and our ‘Guidance on Financial Remedy’.

72. The evidence available to us suggests DWP need not do any more to put things right. We will therefore take no further action.

1. The Parliamentary and Health Service Ombudsman has carefully considered Mr A’s complaint about the Department for Work and Pensions (DWP). We were sorry to learn the reasons for Mr A’s complaint and the impact he describes while he was not in receipt of any benefits.

2. After reviewing the evidence Mr A and DWP provided, we can see that although DWP made a mistake, it has already done enough to put right the impact that error caused. We have therefore decided to take no further action. We will explain our reasons in this statement.