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Department for Work and Pensions

P-004712 · Statement · Decision date: 28 January 2026 · View Department for Work and Pensions scorecard
Employment and low income benefits Complaint handling DWP policy impact assessment
Complaint (AI summary)
Ms L complained the DWP delayed processing her ESA claim, leading to a loss of housing benefit, and that the ICE review failed to acknowledge this financial impact.
Outcome (AI summary)
The ombudsman acknowledged a DWP delay but couldn't confirm it caused housing benefit loss, concluding DWP had already remedied the impact and ICE acted appropriately.

Full decision details

The Complaint

3. Ms L complains the Department for Work & Pensions (DWP) failed to process her claim for Employment and Support Allowance (ESA) in a timely and appropriate manner after she reported a change in circumstances in November 2020.

4. Ms L says because of the delay by the DWP, she lost the right to claim housing benefit, which has had a financial impact. Ms L also says this caused her distress.

5. Ms L complains about the review by the Independent Case Examiner (ICE). She complains that while ICE found the delay by the DWP amounted to maladministration, it did not find she lost the right to claim housing benefit as a result.

6. Ms L says because ICE did not find the delay by DWP meant she lost the right to claim housing benefit, the financial impact has not been remedied.

7. Ms L is seeking a financial remedy.

Background

8. Employment Support Allowance (ESA) is a benefit for people who cannot work due to a disability or illness. There were two types of ESA: contributions based (ESAC) and income related (ESAIR). ESAIR was determined by a person’s capital and household circumstances.

9. Those entitled to ESAIR may have been entitled to additional amounts for premiums, including Severe Disability Premium (SDP). Claimants who had ESA with SDP were entitled to claim housing benefit.

10. Several benefits including ESAIR and housing benefit are in the process of being replaced by Universal Credit (UC).

11. A gateway was introduced from 16 January 2019 to 27 January 2021 to protect those claimants already entitled to SDP (the SDP Gateway). The aim was to stop severely disabled claimants from losing money during the transition to UC.

12. If a claimant did not successfully apply through the SDP gateway, the only way for them to get help with housing costs was through UC.

13. Ms L previously received ESAIR and housing benefit which ended in 2017 after she reported receiving some inheritance. On 11 November 2020 Ms L notified DWP of a reduction in her capital and asked for a review of her ESAIR entitlement. The DWP received this request on 24 November 2020.

14. The DWP reviewed Ms L’s entitlement to ESAIR and shared the entitlement decision on 1 October 2021, confirming she was entitled to the award.

15. Ms L complained to the DWP about the delay receiving an entitlement decision while she was still waiting to receive it. She later complained to ICE, which is the next stage of the complaints process, and said the delay in processing her notification meant she had lost out on the opportunity to apply for SDP and housing benefit.

16. ICE considered Ms L’s complaint about the DWP and completed a report of its findings on 5 April 2024.

17. On 19 April 2024 the DWP wrote to Ms L’s representative accepting the findings of the ICE investigation.

Findings

20. When we consider a complaint, we look at whether there are signs the organisation has got something wrong which had a negative effect. Where we find this to be the case, we consider whether the organisation has done enough to put this right.

21. In its report of 5 April 2024, ICE set out what happened between the DWP receiving Ms L’s request on 24 November 2020 and sending its decision on 1 October 2021. We will not repeat this here, as all parties are aware of the background, but note ICE highlighted delays by the DWP requesting further evidence from Ms L and reviewing that evidence before making a decision.

22. ICE explained the DWP does not have service standards for the completion of capital decisions as the complexity and evidence required can vary. This means there is nothing to indicate it needed to provide Ms L with a decision by a particular date, as each decision is provided on a ‘case by case’ basis. However, ICE considered the delays by DWP in following its process were not reasonable in Ms L’s case.

23. Following the ICE report, the DWP wrote to Ms L’s representative acknowledging that the delay reviewing her entitlement was unacceptable. The DWP apologised for any inconvenience or distress caused. Ms L remains unhappy as she tells us this does not put right the lost opportunity to apply for SDP and the housing benefit she would have received, had DWP made its decision before the closure of the gateway on 27 January 2021.

24. After considering all the information available, we have found indications that something went wrong. Our ‘Principles of Good Administration’ explain public bodies should give people information that is timely. While the DWP does not have service standards for reviewing a person’s entitlement to ESAIR, it should aim to provide decisions in a timely manner. Its ‘Customer Charter’ says DWP will ‘deal with your request the first time you contact us, or as soon as we can’. The evidence available to us suggests DWP did not request and review evidence in a timely manner, and so we have seen indications it did not act in line with applicable standards of service.

25. Ms L believes it would have been reasonable for the DWP to assess her entitlement within nine weeks and make a decision before the SDP gateway closed on 27 January 2021. She says because the DWP did not provide its decision before this time, this meant she lost the right to claim housing benefit.

26. ICE considered the impact claimed by Ms L but did not make recommendations in relation to a loss of entitlement to housing benefit.

27. ICE said the assessment of Ms L’s capital was particularly complex and that led to the DWP requiring additional evidence, which contributed to the time taken to make the decision. ICE noted the DWP did not receive Ms L’s request to review her capital until 24 November 2020. It said, having regard to the intervening Christmas period, it could not conclude with any certainty that the DWP would have completed the decision within nine weeks before the SDP gateway closed, even if no delays had taken place. ICE explained that from the date the SDP gateway closed on 27 January 2021, Ms L would have to claim UC to get help with housing costs.

28. After careful consideration, we cannot say the delay by the DWP meant Ms L lost the right to claim housing benefit. We have taken into account the views expressed by Ms L and her representative as to why the decision should have been made before the SDP gateway closed. Ms L’s representative said the DWP should have been better prepared to deal with entitlement decisions more efficiently, knowing the SDP gateway was closing and the potential impact this would have on claimants. Ms L’s representative also suggested her case was not particularly complex.

29. As explained above, there are no service standards for how long the DWP should take when reviewing entitlement to ESAIR. The DWP would need a reasonable period of time to consider such claims, but it is not our role to say what this should be, nor to set timeframes of our own for DWP’s work. We have not seen any guidelines or standards that indicate DWP should have made any staffing changes in the way Ms L describes.

30. We make findings on the balance of probabilities, which means we must consider whether it is more likely than not that the delay by the DWP led to the impact claimed by Ms L. While there clearly was a delay, we cannot say the DWP would have been in a position to provide Ms L with a decision before 27 January 2021 even if it had acted promptly at every stage of its process.

31. We consider ICE reviewed Ms L’s complaint appropriately, referring to the relevant evidence and providing a clear explanation for why it could not say the delay by the DWP had the impact Ms L claimed. This was in line with our ‘Principles of Good Administration’ which say ‘Good administration by public bodies means…Taking reasonable decisions, based on all relevant considerations’. We know that Ms L strongly disagrees with this view, which we fully recognise, and we should explain that disagreement alone is not an indication that ICE failed to consider the complaint in line with standards and guidelines.

32. We consider that the DWP has already taken sufficient steps to put right the impact of the delay, which caused Ms L stress, by providing an acknowledgement of this and an apology. This is in line with our ‘Principles of Good Administration’ which say ‘Good administration by public bodies means…Acknowledging mistakes and apologising where appropriate’. In addition, our ‘Guidance on Financial Remedy’, says an apology is an appropriate remedy for similar instances of ‘injustice such as annoyance, frustration, worry or inconvenience’. The DWP’s response is also in line with its own ‘Financial redress for maladministration: staff guide’, which says it should ‘accept responsibility’ and provide ‘a sincere and meaningful apology’.

33. After careful consideration, we have decided to take no further action in relation to Ms L’s complaint. We appreciate she did experience a delay by the DWP which caused her distress, but that the DWP has taken sufficient steps to put this right and ICE has provided a reasonable response to her complaint.

Our Decision

1. We have carefully considered Ms L’s complaint about the DWP and ICE. We have seen there was a delay by the DWP in reviewing Ms L’s claim. We have decided we cannot say this delay led to Ms L being unable to claim housing benefit. We are sorry to hear Ms L found her experience stressful. We consider the DWP has already done enough to put right the impact on Ms L and that ICE acted in line with applicable standards and guidelines when it reviewed her complaint.

2. We recognise how important this complaint is to Ms L. Having considered everything very carefully, we have decided to take no further action. We hope our explanations below allow Ms L to understand the reasons for our decision and help her find some closure.

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