Department for Work and Pensions

6. Mr and Dr A complain that DWP has not done enough to support them with Carer’s Allowance, Attendance Allowance, and SMI.

7. They feel that it did not offer enough guarantee that returning an application for Attendance Allowance would not affect any claim for financial loss arising from them not receiving the form from DWP sooner, and requests for SMI were ignored.

8. Mr and Dr A tell us DWP has caused them stress and this had an impact on their physical health.

9. They tell us that this had a financial impact as they have been forced to live on their savings and State Pension, and this lack of funds has affected them being able to build a new business.

10. They say that the whole process has been mentally, physically and emotionally exhausting for them both.

11. Mr and Dr A would like DWP to offer help in getting any benefits might be entitled to, in particular Carer’s Allowance and SMI, and for payment of any such benefits to be backdated.

12. Mr and Dr A were told by DWP in November 2018 that Dr A was receiving income that affected their entitlement to Pension Credit, and caused an overpayment. They complained to DWP about how it handled this, but Mr A has told us this part of the complaint is resolved.

13. Mr A wrote to the Debt Management (DM) department of DWP in October 2019 and gave details about his financial and medical situation., He also told them he was worried about their ability to pay their mortgage, bills and food. He said in this letter that he believed that he might be entitled to benefits but was reluctant to follow this up as he wanted to ‘keep things simple’.

14. In November 2019, Mr A wrote to DWP again and said the only household income for a year had been his State Pension and nobody had told him if there were any benefits that he could claim. Dr A wrote in December and repeated their concerns. This letter was treated as a complaint and DWP sent its first response on 8 January 2020.

15. Mr A wrote to DWP again on 19 January and said that it had not taken any responsibility for its failures, it was responsible for him losing income he was entitled to, and it had failed in its duty of care to him.

16. DWP replied on 21 February and accepted that some of its responses to his correspondence fell below its usual standards and apologised for this. It also explained that the DM department was not responsible for dealing with benefits and he would have to apply to the relevant department for this to be considered.

17. Mr and Dr A sent several letters after this. DM provided a response on 10 June in which it acknowledged and apologised that it had not responded to all of their letters, and that points they had raised about their financial difficulties had been missed.

18. It advised Mr A to consider making a claim for Attendance Allowance, which is a benefit available to people above pension age who have health issues that mean they require assistance with daily living. It explained if he was found to be entitled, then Dr A could claim Carers Allowance, a benefit for those caring for someone who is entitled to Attendance Allowance.

19. It gave directions to Mr and Dr A to the online resources and phone number of the Attendance Allowance Unit (AA Unit).

20. Mr A replied to this and said he was not happy with its response. He said that DM should explain to the benefits departments that it had failed in its duty of care by not signposting them to it when he first told them about their financial situation. DM replied on 21 July and told Mr A that its reply was an honest apology and it wanted to explain the points it had made about benefits advice. It explained that it was the responsibility of the individual claimant to complete the relevant application for the correct part of DWP.

21. It said that it had made further enquiries with the relevant sections of DWP, and the AA Unit agreed to send a claim pack to Mr A. It also explained that due to changes made in 2019, the complainants would no longer be eligible to have their Pension Credit claim restored, as Dr A was below State Pension age.

22. Mr A replied to this letter and acknowledged the efforts that had been made by DM to speak with other departments. He asked that it go further and tell the AA Unit that their delay in claiming was because of its failures. He expressed concern that by signing the form he would lose the right to claim any entitlement before 8 July 2020.

23. The AA Unit contacted Mr A on 9 December. It said it was sorry that he was not previously aware of Attendance Allowance and acknowledged his frustration that he felt he had the opportunity to claim earlier. It explained that by law, no payment of Attendance Allowance can be considered before the date on which a claim is made, and it therefore could not consider backdating to 2018 as they had asked. It could not consider entitlement until it received the completed application form.

24. Mr and Dr A continued corresponding with the AA Unit and it repeated the above explanation in its replies. On 18 May 2021, Dr A said that DWP must take responsibility for their financial losses due its failures. She asked that DWP agree that signing the form would not prevent them from claiming the losses that had arisen due to not being signposted to the AA Unit sooner.

25. Mr and Dr A asked their MP to help, and they emailed DWP on 5 May. It responded on 5 July and said it could not uphold their complaint about benefit entitlement. It set out its previous explanations that it could not backdate benefits to dates before the claim was made and it had not yet received a claim for Attendance Allowance.

26. The MP contacted the Secretary of State on 7 July, and on 9 November the Customer Experience Director of DWP replied. They repeated the previous response and said that as an application for Attendance Allowance had not been received there was nothing more that he could add and he could not uphold their complaint.

27. Mr and Dr A took their complaint to the Independent Case Examiner (ICE), which is the next stage in the complaint process. It gave its response on 20 April 2023 saying it did not find DWP had done anything wrong.

Carer’s Allowance and Attendance Allowance

30. We have looked at why Mr and Dr A are still unhappy after ICE’s final response. They tell us that DWP did not do enough to make sure they were receiving their full entitlement to benefits, and think that it should agree to compensate them for their missed period of entitlement.

31. The DM apologised in June 2020 for not acknowledging all their letters and overlooking what they had told it about their financial difficulties. It signposted them to the AA Unit so their entitlement to Attendance Allowance could be decided and explained that was all it could do.

32. DWP says it cannot consider backdating awards for benefits or make a decision on entitlement without a claim being received.

33. We have looked at DWP’s responses to Mr and Dr A carefully and considered if it has acted in line with its own standards and legislation. While we understand why Mr and Dr A wanted DWP to have done more, we can only make a decision based on its standards and legislation.

34. We can see DWP acknowledged its service failure in not dealing with all Mr and Dr A’s correspondence fully. It accepted that this meant it had overlooked what they had told it about their financial difficulties, and this is different to ‘DWP Debt Management customer service standards’ which says it will ‘explain where you can get further help and advice’. We agree that this is a sign of service failure on DWP’s part.

35. It provided a full apology to Mr and Dr A for this and confirmed it had fed back to the teams involved to make sure that they understand the importance of looking at customer’s needs and finding out what could be done to help them.

36. It explained what benefits might be available to them, based on the circumstances they described, and signposted them to the appropriate resources to make an application. After receiving further correspondence from them, the DM communicated with the AA Unit and arranged for a claim form to be issued.

37. While Mr and Dr A tell us they were grateful for these steps, they were concerned that they would not be able to claim before receiving the form and asked for guarantees that signing the form would not affect their ability to claim the losses they believe arose from DWP’s failures.

38. We understand they wanted a guarantee that making a claim would not prevent them from getting financial compensation for any DWP mistakes that had occurred previously. As such, they tell us that the full extent of DWP’s error has not yet been recognised.

39. As Mr and Dr A have agreed, the Attendance Allowance claim form says that it can only consider paying the benefit from the date that it receives the form.

40. DWP’s online guidance on Attendance Allowance says that a payment can be backdated to the date that a claim is made, ‘which is usually the date your form is received or the date you call the enquiry line’.

41. DWP has repeated this in its replies and explained that it could not make any benefits decision until it had received an application, nor could it backdate payments before receipt of the claim form.

42. We have looked at the Social Security Administration Act 1992 which says that:

‘(1) Except in such cases as may be prescribed, and subject to the following provisions of this section and to section 3 below, no person shall be entitled to any benefit unless, in addition to any other conditions relating to that benefit being satisfied—

(a)he makes a claim for it in the manner, and within the time, prescribed in relation to that benefit by regulations under this Part of this Act; or

(b)he is treated by virtue of such regulations as making a claim for it.’

43. We can see this means that DWP could not comment on any sort of decision about Mr and Dr A’s entitlement to benefits until they made a claim for it, and that it is the responsibility of the individual to make an application. As they had not made a claim, DWP could not consider if they were eligible.

44. We are satisfied that in telling them that it could not give a decision or an agreement to backdate their payments to a time before the application, DWP has acted in line with its guidance and legislation. This also meets our ‘Principles of Good Administration’ that say organisations should act ‘according to their statutory powers and duties and any other rules governing the service they provide’.

45. We understand that Mr and Dr A have said what they were asking was different from requesting backdated payments., They wanted DWP to confirm that returning the form would not prejudice any legal claim for financial loss that they might make.

46. If Mr and Dr A were considering making a legal claim against DWP, or were worried about the legal implications of making a benefits claim, the correct step would be to take independent legal advice. DWP could only advise that it could not reflect on any benefits entitlement or any legal implications of something that had not yet happened.

47. We consider the explanations that DWP provided were appropriate and accurate. We do understand that Mr and Dr A were caused some frustration when DWP delayed in signposting them to the relevant department.

48. Mr and Dr A tell us that DWP’s failures meant that they lost out on entitlement to benefits, and we have considered this carefully. They tell us if DWP had proactively considered the benefits they may have been entitled to and advised them of that, they could have applied earlier.

49. DWP’s legislation sets out that it is the responsibility of the claimant to make an application for a benefit. The responsibility is not on DWP to provide the proactive service that Mr A describes.

50. Mr A did tell DWP in October 2019 that he believed he may have some entitlement to benefits but was reluctant to apply. This shows us that he did not need to rely on DWP to make him aware of what he might be able to claim.

51. We can see that Mr and Dr A believe DWP should identify the full range of assistance that it could provide to an individual without any application having to be made. We can understand why they believe such a system would be beneficial.

52. The fact that Mr and Dr A may find such a system helpful does not mean that the current system is failing to provide its services.

53. While we agree that there was a service failure in how it handled Mr and Dr A’s communications, we cannot say that it led to the unfairness they describe, as DWP is not responsible for deciding or identifying benefit entitlement without an application being made.

54. We cannot say that Mr and Dr A would have made an earlier successful application or that they lost out financially as a result.

55. We are satisfied that DWP has put right the short-term frustration that its failures caused by issuing an apology and providing assurances that it had learned from this complaint, as well as going further to help Mr and Dr A identify what options might be available to them.

Support for Mortgage Interest (SMI)

56. Mr and Dr A tell us DWP ignored requests for them to be considered for SMI. DWP’s ’Support for Mortgage Interest’ guidance explains how it can help if the claimant is receiving one of the qualifying benefits:

• income support • income-based Jobseeker’s Allowance (JSA) • income-related Employment and Support Allowance (ESA) • Universal Credit • Pension Credit.

57. Mr and Dr A’s concerns started because they were no longer receiving any Pensions Credit payments after their joint income started to reach above the limit for eligibility.

58. When explaining what benefits they might be entitled to, DWP explained that due to changes in 2019 Mr and Dr A would no longer be entitled to claim for Pension Credit as Dr A was below pension age. Their correspondence shows that they accepted this explanation.

59. As Mr and Dr A were not eligible for Pension Credit and they were not receiving any other eligible benefit, they would not have been able to ask for SMI, nor would DWP be able to consider their eligibility. We are satisfied that it has acted in line with our ‘Principles of Good Administration’, that organisations should be acting in line with its own policies.

60. We have considered if there was a missed opportunity to explain this to Mr and Dr A by reviewing the correspondence between them.

61. DWP did signpost Mr and Dr A to the appropriate resources to help them apply for benefits. While we have seen some references to SMI in the correspondence, we have not seen Mr and Dr A directly asked DWP to provide an answer about whether they were eligible for it.

62. We cannot say that not providing information on SMI was a service failure or that DWP ignored any direct request. We are satisfied that it has acted in line with its ‘Customer Charter’ by providing them with the correct information.

63. While DWP did make a mistake in its service at an earlier stage, it has already taken action to put things right. On the other parts of the complaint, we cannot say that DWP did anything wrong.

64. We hope that Mr and Dr A understand our explanation for our decision to take no further action, and we wish them well.

1. The Parliamentary and Health Service Ombudsman has carefully considered the complaint that Mr and Dr A have made about the Department for Work and Pensions (DWP). We are sorry to hear of the stress they experienced in their contact with DWP and that they are unhappy with the outcome of their complaint so far. We are also very sorry to learn of their ongoing health problems.

2. We have seen that DWP made some mistakes in how it dealt with correspondence that it received from Mr and Dr A and it failed to deal with what they were telling it about their difficulties.

3. We have seen this mistake caused Mr and Dr A frustration. We think DWP has done enough to put this right.

4. We have not seen that it did anything wrong with their complaint about not doing enough to help them get Support for Mortgage Interest (SMI is a loan that can help with mortgage costs if an individual is also receiving certain benefits).

5. We have decided to take no further action. We will explain our decision below.