11. Mr T complains DWP incorrectly told him his LCWRA payments would be backdated to the date he made his UC claim in December 2021. As mentioned above, Mr T contacted DWP on 17 December to make a telephone claim for UC. He declared a health condition which he said limited his capability for work.
12. LCWRA is a payment which is made to claimants who DWP consider having severe health problems that means they are unable to undertake any work or work-related activity.
13. When someone declares a health condition that means they are unable to work, DWP usually ask for a fit note from a doctor, ask the claimant to complete a questionnaire and, following this, refer the claimant for a work capability assessment (WCA). After the assessment, DWP usually decides whether a claimant is entitled to LCWRA payments.
14. DWP sent a questionnaire to Mr T on 20 January 2022. DWP needed to wait for Mr T to return this before it could decide whether he needed to be referred for a WCA and, later, accept his claim for LCWRA payments.
15. Between January and April 2022, Mr T made over 200 calls to the DWP. A large amount of the calls were terminated because of Mr T’s behaviour towards staff. When staff were able to speak to Mr T, he said he was unable to complete the questionnaire because of his poor mental health.
16. On 12 April, following further phone calls, DWP looked at the information Mr T provided and it decided he was entitled to LCWRA payments, even though he had not completed a WCA. This is because the evidence the DWP had seen showed there was a high possibility of a substantial risk to Mr T’s physical and mental health because of the information he had provided during the frequent phone calls.
17. DWP wrote to Mr T on the same day to explain the LCWRA payment had been awarded and he would start to receive payments three months after the date he made his claim and first gave evidence to DWP of his health condition (17 December 2021). DWP noted Mr T told it about his mental health condition when he first made a claim for UC on 17 December 2021, this meant the LCWRA payments would start from 17 March 2022 after the three month wait period.
18. Mr T contacted DWP on 14 April 2022 and he was told the LCWRA payment had been awarded. He was also told his payments would be backdated. There was no further explanation given.
19. DWP guidance on relevant periods for LCWRA says claimants have to wait a three month period before LCWRA payments can be included in the UC award. The wait period starts from the date the claimant declared their health condition.
20. The same guidance also says the relevant wait period (three months) applies in every case except where:
• the claimant is terminally ill • there has been a previous award of UC which included LCWRA and either: • The claimant becomes a single or joint claimant • The claimant’s UC award ends because their income exceeded their entitlement and they claim again within six months • the claimant has a continuous claim from ESA to UC.
21. We have considered these exceptions and cannot see Mr T fell into any of these categories. This means, as per the DWP guidance referred to above, Mr T was only eligible to receive LCWRA payments three months after his claim was made. As set out earlier, this means he would be eligible for LCWRA payments from 17 March 2022 and, because DWP made its decision after this date, it would only need to backdate payments to this date. As such, we do not consider there are indications of failings by DWP with regard to its decision to pay Mr T LCWRA payments from 17 March.
22. We can see Mr T had calls with DWP 11 February and 14 April 2022 respectively. During these calls, Mr T has told us he was told his LCWRA payments would be backdated. We recognise one of these calls took place before DWP had made a decision about whether he was eligible for LCRWA payments, and one call was after this decision.
23. We have also considered Mr T’s concerns about the information he was given on the phone by DWP’s staff. During its investigation, ICE listened to the calls with DWP and it confirmed Mr T was given vague information about the backdating of LCWRA payments during phone calls on 11 February and 14 April 2022. We noted the advisers did not specifically say when the payments would be backdated to.
24. DWP’s ‘Our customer charter’ says it will provide customs with the correct information, explain things clearly if it gives an outcome a customer is unhappy with, and say sorry and put things right if it makes a mistake.
25. During the complaints process DWP accepted its staff had given Mr T information that was unclear about how far back his LCWRA payments would be backdated. It told Mr T he was not eligible to receive LCWRA payments from the date of his claim but rather, from three months after his claim.
26. It also said it would pay Mr T £75 in recognition the impact of its mistakes. As explained earlier, Mr T escalated his complaint to ICE who recommended DWP increase this payment to £200. This was paid to Mr T on 20 July 2023.
27. Mr T has told us DWP’s incorrect advice caused him to self-harm his face, and he has required surgery since. He says he wants DWP to pay for this surgery.
28. We recognise DWP’s advice caused Mr T significant distress. It is clear he believed he would receive LCWRA payments backdated to December, rather than March, and this meant he received less money than he was expecting. This was understandably distressing for him.
29. We cannot say on the balance of probabilities that Mr T would not have self-harmed had it not been for DWP’s mistakes, as there may have been other influencing factors.
30. Our ‘UK Central Government Complaint Standards’ say we expect organisations to provide a meaningful apology and, where possible, provide a remedy that aims to return anyone affected to a position they would have been if the failings or mistakes had not occurred. If this is not possible, we expect any remedy to compensate them appropriately.
31. DWP’s ‘Financial redress for maladministration: staff guide’ says most cases will be put right with a sincere apology and an explanation of what happened. In some instances, it will also make a consolatory payment in recognition that it did not handle things as well as it could have.
32. DWP’s financial remedy of £200 falls within ‘Level 2’ of our ‘Severity of Injustice Scale’. We think payments in our ‘Level 2’ range (£120 to £550) are appropriate in instances where the impact of mistakes is distress, worry, annoyance, or similar. We would not expect the emotional impact to affect the person’s day to day functioning or ability to live a normal life for a period from one to two weeks up to around six months.
33. With DWP’s ‘Our customer charter’ and ‘Financial redress for maladministration: staff guide’, and our own ‘UK Central Government Complaint Standards’ and ‘Severity of Injustice Scale’ in mind, we consider DWP has already done enough to put things right for Mr T. This is because it has apologised for, and explained, its mistake, and made an appropriate financial remedy in recognition of the impact its mistake had.
34. Therefore, we have decided to take no further action.
35. We are sorry to learn about the impact the experience has had on Mr T and we hope to reassure the DWP followed the correct process when considering his claim for LCRWA but it has also put right it’s failings in the way it communicated with him.