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Chapter A4: Supersession, suspension and termination

Contents
A4001:Introduction
A4002:Introduction to supersession
A4003:Types of decisions that can be superseded
A4006:Circumstances when a decision can be superseded
Applications
A4012:Introduction
A4014:Hopeless applications
A4017:Admitting an application
A4018:Making a decision to supersede
A4021:Making a decision not to supersede
A4023:Treating as an application for supersession
A4024:Providing information
A4025:Further information needed
A4026:Information provided late
A4027:Issues for decision by HM Revenue and Customs
A4040:Decision to be superseded is set aside on appeal
A4050:The process of supersession
A4055:Recording the decision
Change of circumstances
A4100:Relevant change of circumstances

Decisions that can be superseded on the ground of change
A4101:of circumstances
A4102:Relevant change of circumstance
A4106:When a change has the potential to be relevant
A4108:Is a change of opinion a relevant change of circumstances
A4109:Can a change in law be a relevant change of circumstance
Can a decision be superseded because of a future change
A4110:of circumstance
A4115:Supersession of advance awards
A4117:Supersession for closed period
A4120:Relinquishment of benefit
A4122:Effectiveness of the relinquishment
A4129:Ending entitlement
A4132:Death of claimant
Notification of changes
A4150:Introduction
A4151:Notification of a change of circumstances
A4153:Categories of people who can notify the change
A4154:Method of notification
A4155:Where to notify a change of circumstances
A4158:UC Childcare Costs
A4159:UC - Severely Disabled Person Caring Responsibility
Supersession on a change of circumstances - effective dates
A4200:Introduction
A4201:Time limits
A4204:Late notification of change of circumstances
A4211:Meaning of special circumstances
A4212:Deciding whether it is reasonable to grant the extension of time
A4214:Decisions advantageous to the claimant
A4215:Effective dates when changes notified within the time limits
A4216:Change notified outside the time limits
A4218:Award of other benefits
A4219:UC
A4221:DM's own initiative
Decisions not advantageous to the claimant
A4223:Effective dates

ESA Decisions
A4224:Meaning of ESA Decision
A4225:Meaning of LCW determination
A4227:ESA Terminally ill Claimants
A4228:Ending entitlement
A4230:PIP Decisions
UC Decisions
A4232:Meaning of UC decision
A4233:Meaning of LCW determination
A4236:Meaning of "reasonably have been expected to know"
A4238:UC claimant reaches the qualifying age for SPC
A4239:UC Hardship Payments
A4240:UC Terminally ill Claimants
A4241:Changes in legislation
Error of law
What decisions can be superseded on the grounds of
A4243:error of law
Circumstances when a decision be superseded on the grounds of error of law....
A4244:
A4245:Meaning of error of law
A4246:Effective date
A4250:Reinterpretation of the law
A4253:Appeal against a relevant determination
A4254:Effective date
A4255:Superseding a first-tier Tribunal or upper Tribunal's decision
A4258:No outcome decision made
A4262:Stayed appeals
Ignorance of or mistake as to a material fact
What decisions can be superseded on the grounds of
A4264:ignorance of or mistake as to a material fact
A4265:Material facts
A4270:Ignorance of a material fact
A4273:Mistake as to a material fact
A4275:Opinions and material facts
A4278:Supersession of a decision of a DM on grounds of ignorance or mistake
A4280:Effective date
A4281:Supersession of a decision of the FtT or the UT

Effective date
A4282:Advantageous
A4283:Disadvantageous
Decisions which cannot be appealed to a First-tier tribunal
A4284:Introduction
A4285:Effective date
A4286:Sanction Cases
A4289:Reduction in benefit ceases to apply
A4290:Effective date
Loss of benefit following benefit fraud offences
A4294:Sanctionable benefit
A4295:Effective date
A4296:Special rules - uprating
A4297:Special rules - late or unpaid contributions
A4298:Special rules - UC Housing Costs
Special rules - PIP
A4299:Terminally ill
A4301:Special rules - ESA
A4304:Special rules - UC
A4306:Determinations on incomplete evidence
A4309:Determinations as to limited capability for work
A4311:Alterations affecting UC
A4312:Claimant fails to attend for or participate in a consultation - PIP
A4314:Change from JSA to ESA or ESA to JSA
Suspension and termination of benefit
A4317:Hardship
A4319:Loss of contact with claimant
A4320:Immediate suspension

Suspension where a question arises as to whether benefit should
A4322:be revised or superseded
A4323:Suspension where an appeal is pending
A4326:Notification
A4327:When benefit suspended must be paid - appeal no longer pending

Suspension where an appeal is pending against a decision in a
A4328:different case
A4330:What happens if the suspension is lifted
A4331:Suspension where information has been requested
A4337:Termination following suspension
A4339:Extension of the time limit
A4340:Date from which benefit is terminated

Chapter A4: Supersession, suspension and termination

A4001 Introduction

This chapter is about decision making on claims for
1. UC
2. PIP
3. new style JSA (hereafter referred to as JSA)
4. new style ESA (hereafter referred to as ESA).
Note
1: ADM Chapter M1 contains guidance on the meaning of new style JSA and
new style ESA.
Note
2: Guidance on supersession for benefits not listed above is in DMG Chapter
04.
Note
3: The guidance comes into effect (1) from 8.4.13 for PIP and from 29.4.13 for
UC, JSA and ESA.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 1(2) & 1(3)

A4002 Introduction to supersession

Supersession means changing a decision of the DM, the FtT or the UT and
replacing it, from a later date than the original decision. Certain conditions have to be
satisfied before a decision can be superseded. There is no time limit for making an
application for supersession.

A4003 Types of decisions that can be superseded A4004

The following decisions may be superseded by a decision made by the Secretary of
State (1)
1. a decision on any claim for a relevant benefit (2)
2. any decision of the Secretary of State that falls to be made under relevant
Acts (3)
3. any decision described in 1. & 2. as revised
but this is subject to regulations.

1 SS Act 98, s 10; 2 s 8(1)(a) & (3); 3 s 8(1)(c) & (4)

A4004

The decisions under relevant Acts described in A4003 2. include
1. a decision to "disqualify a claimant for receiving benefit" on imprisonment (1)
2. a decision to "adjust" benefit where the claimant is receiving treatment as an
in-patient in a hospital (2)
3. a decision whether an overpayment of benefit is recoverable under specific
provisions (3).
This list is not exhaustive. See also Annex D. A decision that can be appealed can
also generally be superseded.
Note: See ADM Chapter D1 for guidance on overpayment decision making.

1 SS CB Act 92, s 113(3); 2 SS A Act 92, s 73(1); 3 s 71

A4005

A decision of the FtT or UT can also be superseded
1. where there has been a change of circumstances since that decision had
effect (1) or
2. where the DM is satisfied that the decision was made in ignorance of a
material fact or was based on a mistake as to a material fact (2) or
3. where the DM is required to supersede the FtT or UT decision made under
the stayed appeals procedures (3) (see A4262 and ADM Chapter A5).
Note: A decision of the FtT or UT cannot be superseded by a DM on the grounds of
error of law.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 23(1)(a); 2 reg 31(a); 3 reg 31(b)

A4006 Circumstances when a decision can be superseded A4008

[See memo ADM 10 13 [not found]] A decision (referred to below as the "original decision") can
be superseded either when an application has been made by the claimant or on the
DM's own initiative where
1. there has been a relevant change of circumstances since the original decision
1.1 had effect
or
1.2 in the case of an advance award, was made (1)
2. a relevant change of circumstances is anticipated (2)
3. the original decision was
3.1 erroneous in law (DMs' decisions only) or
3.2 made in ignorance of a material fact or was based on a mistake as to a
material fact
and the application period for revision has expired (3)
4. the original decision is a decision without a right of appeal (see Annex D)4
5. a sanction has been imposed in accordance with specified legislation (5)
6. medical evidence has been received from a HCP or HP (other than a JSA
decision)6
7. a determination has been made that the claimant is to be treated as having
LCW or LCW and LCWRA (7)
8. on or after the original decision was made a late or unpaid contribution is
treated as paid under specified legislation (8)
9. a decision (9) which reduces the housing costs element of UC has been made
10. a negative determination decision has been made on an existing award of
PIP (10)
11. a decision has been made in loss of benefit cases (11)
1 UC, PIP, JSA & ESA (D&A) Regs, reg 23(1)(a); 2 reg 23(1)(b); 3 reg 24; 4 reg 25;
5 reg 27; WR Act 07, s 11J(1); JS Act, s 6J(1) & 6K(1); WR Act 12, s 26(1) & 27(1);
6 UC, PIP, JSA & ESA Regs, reg 26(1)(a); 7 reg 26(1)(b), ESA Regs, reg 16, 21, 22 & 29;
UC Regs, part 5; 8 UC, PIP, JSA & ESA (D&A) Regs, reg 29; SS (Crediting etc) Regs, regs 5&6;
SS (Conts) Regs 01, reg 60; 9 UC, PIP, JSA & ESA Regs, reg 30 & Rent Officers Order 2013;
10 UC, PIP, JSA & ESA (D&A) Regs, reg 26(2); 11 reg 28; SS Fraud Act 2001, s 6B, 7 & 9

A4007

To supersede a DM's decision on the ground that it was erroneous in law or made in
ignorance or mistake as to fact, the application for supersession or the decision to
initiate supersession must be made after the period in A4010 has ended (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 24(b)

A4008

If the application is made on any of the grounds listed in A4006, other than a change
of circumstances, during the period in A4010, the decision should be changed by
revision (1).
Note: A negative determination for PIP has the same effect as a change of
circumstances.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 20(1)

A4009

If during the period in A4010 a claimant reports a relevant change of circumstances
or information or evidence is received which indicates that a future relevant change
will occur, or is expected to occur, the DM should supersede the original decision (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 5(2) & reg 23

A4010 A4007 A4008 A4009 A4267

The application period for revision is either (1)
1. one month from the date of notification of the original decision or
2. a longer period (but not more than 13 months) allowed for a late application
for revision.
The one month period can be extended by 14 days in certain circumstances, for
example where reasons for the decision were not included in the decision notification
and the claimant asks for a written statement of reasons. See ADM Chapter A3 for
detailed guidance.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 5 & 6

A4011 A4107

A decision which can be revised should not be superseded except where there are
grounds allowing revision and further grounds arise allowing supersession (1). This
allows a decision to be revised and then superseded as part of one process.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 32

Example 1

A claimant has an award of the enhanced rate of the mobility component of PIP. He
disputes the decision, as he feels the period of the award is too short. He also
notifies that his condition has deteriorated and applies for the daily living component.
The DM revises the decision and extends the period of the award of the mobility
component and supersedes the decision as revised to award the standard rate of
the daily living component from a later date.

Example 2

A UC claimant disputes the amount of their award on the basis that their capital has
been determined incorrectly. He also says that he started having caring responsibility
for a severely disabled person. The DM revises the award of UC to alter the amount
payable and supersedes the decision as revised to include the carer element.
Applications

A4012 Introduction

When an application for supersession is received, the DM should consider whether
or not to admit it in order to establish whether an application is hopeless. See A4017
for guidance on admitting applications.

A4013

If the application is admitted, the DM should
1. make a decision to supersede where the outcome is changed (see A4018
A4020) or
2. make a decision not to supersede where the outcome is not changed (see

A4021 A4020

- A4022).

A4014 Hopeless applications

If the application is not admitted because it is hopeless, the DM should notify the
claimant that no decision has been made and there is no right of appeal (1). DMs
should note that this is not a "decision not to supersede". The existing award
remains in place. The claimant should be notified why no action has been taken on
the matters raised by the application.

1 Wood v Secretary of State for Work and Pensions [2003] EWCA Civ 53; R (DLA) 1/03

A4015

A communication from the claimant should not be admitted as an application for
supersession if no further investigation of fact or law could possibly produce a
different decision from the one that has been made. This means that a
communication will not be an application if
1. it only contains abuse or
2. it contains only material that is not relevant to the benefit the claimant has
been awarded (e.g. the claimant has requested extra benefit because of an
increase in the price of cat food) or
3. the amount or period to which the claimant's communication relates is already
the maximum the law allows (1).

1 R(DLA) 1/03

A4016

DMs should note that it will be exceptional to reject an application for supersession
as hopeless.

A4017 Admitting an application A4012 A4124

Where there is a possibility that one or more of the conditions for supersession may
be satisfied, the DM should admit a communication as an application for
supersession.

A4018 Making a decision to supersede A4013

The DM should make a decision to supersede where
1. one or more of the conditions (grounds) are satisfied, for example where
1.1 there has been a relevant change of circumstances
1.2 it is anticipated that a relevant change of circumstances will occur
1.3 a decision was made based on ignorance of or mistake as to a material fact
1.4 there has been an error of law and
2. the outcome is changed (1).

1 R(DLA) 1/03

A4019 A4124

An outcome is changed where
1. the rate or period of entitlement to benefit is altered or
2. the rate or period for which benefit is payable is altered or
3. the period, amount or recoverability of an overpayment is altered.

A4020 A4013 A4267

Where the DM supersedes the previous decision, that decision is replaced from the
effective date of the new decision which carries the right of appeal.
A4021 Making a decision not to supersede The DM makes a decision not to supersede where the outcome is not changed
whether or not the conditions (grounds) to supersede a decision are satisfied. The
decision not to supersede carries the right of appeal (1).
1 R(DLA) 1/03

Example 1

A claimant in receipt of an award of PIP notifies that their condition has worsened.
The DM considers the report of the change, together with medical reports and
advice, and decides that the earlier decision should not be superseded.

Example 2

The claimant's appointee notifies that the claimant, who is entitled to PIP, has
transferred from hospital to a care home. The appointee asks for payment of PIP to
be reinstated as the claimant has left hospital. The DM establishes that the care
home is a similar institution to a hospital. Although there has been a relevant change
of circumstances, PIP still cannot be paid. The outcome is not changed, and the DM
decides not to supersede the earlier decision given on the claim to PIP made whilst
the claimant was in hospital.

Example 3

A claimant returns to work after being in receipt of ESA for 20 weeks. The WCA has
not been carried out. The claimant asks for arrears of a component to be paid from
week 14. The DM should make a decision not to supersede the decision which
awarded entitlement on the grounds that the conditions allowing supersession are
not satisfied.

Example 4

A UC claimant asks for an increase in benefit as they allege that they are caring for a
severely disabled person. The DM determines that this is not the case and decides
that the UC award should not be superseded.

A4022 A4021

A decision not to supersede has no effective date. It does not replace the earlier
decision (1). If it is revised or overturned on appeal, it then becomes a decision to
supersede with the effective date calculated in the normal way. DMs should ensure that
1. the original decision and
2. the evidence on which it was based and
3. the application for supersession including the date on which it was made are
retained.
1 R(DLA) 1/03

A4023 Treating as an application for supersession

A DM may treat an application for revision or a notification of a change of
circumstances as an application for supersession (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 33(1)

A4024 Providing information

Where claimants apply for supersession, the onus is on them to prove (on the
balance of probabilities) the facts upon which that application is based. They should
supply information to support their application.

A4025 Further information needed A4026

Where a DM requires further information or evidence in order to consider all the
issues raised by an application for supersession the applicant should be notified that
more information or evidence is required and the decision may be superseded (1)
1. where the applicant provides the further evidence or information within one
month of the notification (or such longer period as the DM may allow) on the
basis of all the evidence and
2. where the applicant does not provide the further evidence or information within
one month (or such longer period as the DM may allow) on the basis of the
original application.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 33(2) & (3)

Example

John has income of 55 a week taken into account in relation to his claim for JSA
(profit from his P/T window cleaning business). In April he asks the DM to look again
at the decision as he says he now has expenses of 25 a week. He says he pays
someone to help him - 20 a week, and has to buy replacement cloths, cleaning
foam etc. for 5 a week. He sends in receipts for the cloths etc. At the beginning of
May the DM asks him to supply copies of wage slips or pay packets for the 20 a
week, but John doesn't reply. At the beginning of June the DM supersedes the
decision from the date of the application in April and takes income of 50 a week
into account.

A4026 Information provided late

Where the information is provided after the time limit allowed by the DM in A4025
and
1. a decision has not been made, the decision should be based on all the
evidence including the late information
2. a decision has been made, the DM should consider whether the decision
needs to be revised or superseded in the light of the late information.

A4027 Issues for decision by HM Revenue and Customs

HMRC are responsible for making decisions on SS contributions issues previously
determined by the Secretary of State (1). See Annex C for a list of these decisions.

1 Social Security Contributions (Transfer of Functions) Act 99, s 8(1)

A4028 A4029

Entitlement to SS contributory benefits depends on the contribution conditions being
satisfied. In practice the NI contribution record is usually obtained and any decision
is based on the assumption that the record is factually correct. See ADM Chapter A1
for further guidance about making assumptions. However, where there is a dispute
about the record, the matter must be referred by the Secretary of State to HMRC for
a formal decision.

A4029

Where the Secretary of State has decided a claim or another matter on an
assumption of facts about which
1. it appeared to him there was no dispute but
2. had an issue arisen, that issue would have fallen to be decided by HMRC as
in A4028
then the provisions of A4030 - A4034 may apply (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 42(2)

A4030 A4029

Where an application is made for supersession and the DM considers that an issue
arises about some question that should be decided by HMRC, that matter should be
referred to HMRC (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 42(1)

A4031

While a decision of HMRC is awaited, the DM can (1)
1. determine any other issue arising from the application for supersession
2. make a supersession decision on the basis of a preliminary opinion of HMRC
or
3. defer making a supersession decision.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 42(3)

A4032

Once the final decision of HMRC is received, the action to take depends on whether
the DM has made a supersession decision or has deferred that decision.

A4033

If the DM has made a decision on the basis of a preliminary opinion, he should
consider whether the decision should be revised or superseded (1) in accordance with
HMRC's final decision.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 42(4)(a)

A4034 A4029

Where the DM has decided to defer making the supersession decision, a decision
should be made in accordance with HMRC's final decision (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 42(4)(b)

A4035

A final decision of HMRC includes a decision on an appeal against a decision of
HMRC (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 42(5)

[A4036-A4039]

A4040 Decision to be superseded is set aside on appeal

Where
1. a decision is or is not superseded following an application and
2. the original decision is set aside on appeal to the FtT or UT
the decision to supersede or not may be of no effect (1).

1 R(DLA) 2/04

A4041

An application for supersession on the basis that the original decision was made in
ignorance of a material fact lapses where the original decision is set aside on
appeal.

Example

The claimant is awarded the standard rate of the daily living component of PIP
following a further claim. Following a mandatory reconsideration he lodges an appeal
against this decision with HMCTS. Before the appeal is heard, the claimant also
applies for the decision to be superseded on the grounds that the DM was ignorant
of material facts. The DM decides not to supersede the original decision. On appeal,
the FtT sets aside the DM's original decision and awards the enhanced rate of the
daily living component. The DM's decision not to supersede is of no effect, and there
is no requirement to consider whether the FtT decision should be superseded,
because they were deciding the further claim afresh.

A4042

An application for supersession for a relevant change of circumstances may need to
be processed again, including treating it as an application for supersession of a
different decision, or as a new claim.

Example

The claimant's award of PIP came to an end, and was disallowed when a further
claim was made. On appeal, the FtT awarded the standard rate of the mobility
component. The claimant made a further appeal to the UT who set aside the FtT
decision, and remitted the appeal for rehearing. While the UT appeal was pending,
but before the decision had been set aside, the claimant had applied by telephone
for supersession of the FtT decision so as to award the daily living component on the
grounds of a change of circumstances. The DM made a decision not to supersede,
and the claimant made a further appeal. Both appeals were heard together. The FtT
upheld the disallowance of the further claim, and held that the second appeal lapsed
as there was no awarding decision to supersede. The DM treats the application as a
claim, and makes a decision accordingly.

[A4043-A4049]

A4050 The process of supersession

Once it has been decided that there are grounds for supersession, the DM should
1. identify the decision to be superseded
2. investigate and determine the relevant facts
3. decide whether the facts mean that the terms of the award should change
4. make a decision accordingly. That may be either a decision which is different
from the decision superseded or a decision not to supersede
5. determine the date from which the supersession decision should take effect
6. decide what, if any, overpayment has occurred.

A4051

The DM need not consider any issue (1) that
1. in the case of an application, was not raised by the application or
2. in the case of a supersession at the DM's own initiative, did not cause the DM
to supersede.
1 SS Act 98, s 10(2)

[A4052-A4054]

A4055 Recording the decision

It is important that a record be made of the supersession decision. That record
needs to
1. identify the person to whom it relates
2. specify clearly that the decision is supersession
3. precisely identify the decision that is being superseded and
4. state the grounds allowing supersession to be undertaken.

[A4056-A4099]

Change of circumstances

A4100 Relevant change of circumstances

Where
1. there has been a relevant change of circumstances since the decision
1.1 had effect
or
1.2 was made in the case of an advance award (1) or
2. it is expected that a change will occur
the DM may supersede the decision which is currently in force (2). The application
period for revision is irrelevant in these cases. See also A4115 - A4116.
1 UC, PIP, JSA & ESA (C&P) Regs, regs 32-34; 2 UC, PIP, JSA & ESA (D&A) Regs, reg 23

A4101 Decisions that can be superseded on the grounds of change of circumstances

The following decisions can be superseded on the grounds of a change of circumstances
1. any decision on a claim for a relevant benefit (1)
2. any decision made under relevant Acts (2)
3. any decision in A4101 1. or A4101 2. which has been revised by a DM (3)
4. any decision made by the FtT or UT (4).
1 SS Act 98, s 8(1)(a); 2 s 8(1)(c); 3 s 10(1)(a); 4 s 10(1)(b)

A4102 Relevant change of circumstances

For the purposes of supersession a relevant change of circumstance is a change
which happens after the original decision had effect and which has a relevance to
the award of benefit. A decision disallowing a benefit cannot be superseded if there
is a change of circumstances from a date after the decision had effect. The claimant
must make a fresh claim (1). But see A4103 for an exception to this general rule.

1 SS Act 98, s 8(2)(b); R(A) 4/81

A4103 A4102

The claim continues to exist until it is decided (1). A new claim may not be required where
1. a claim is disallowed and
2. a change occurs after the date of claim but before the claim was decided and
3. the claimant notifies the change within the time limits (see A4201 - A4213).
Where the effect of the change is that entitlement would begin before the date of the
disallowance (or for PIP, the qualifying period would begin before the date of the
disallowance), the decision can be superseded for a relevant change of
circumstances. The effective date rules apply in the normal way.
1 SS Act 98, s 8(2)(a)

Example 1

A claim to JSA is made on 20.12.17. The claimant is working P/T in a high street
store for 20 hours a week, and the claim is disallowed on 10.1.18. On 22.1.18 she
notifies that her employment, which was a temporary job over Christmas, had ended
on 5.1.18. The change has been reported within one month, so the DM supersedes
the disallowance and awards entitlement to JSA from 6.1.18.

Example 2

A claim to UC is made on 20.12.15. The claim is disallowed on 17.1.16 because the
claimant has capital in excess of 16,000. On 22.1.16 the claimant reports that their
capital fell below 16,000 on 5.1.16. The DM determines that no deprivation has
occurred. The disallowance is superseded and an award of UC is made from
20.12.15.

A4104

To be relevant a change does not have to be a change in the claimant's own
circumstances. The phrase "relevant change of circumstances" should be given a
broad meaning. A relevant change must
1. be of sufficient substance to give serious consideration to supersession
2. have the potential effect of altering some component part of the award of
benefit even if the end result does not actually change the amount of the
award (see A4106).

A4105

The following are examples of a relevant change of circumstances.

Example 1

A jobseeker decides to go on holiday outside the UK. This is a relevant change
because the jobseeker is absent from GB.

Example 2

In PIP cases a person with an existing award of the standard rate of daily living
component whose needs increase on a regular basis is a relevant change because it
may give entitlement to the enhanced rate of the component.

Example 3

A person in receipt of UC starts to live with their partner.

A4106 When a change has the potential to be relevant A4104

There will be situations where a change has the potential to affect an award of
benefit but the DM ultimately decides that the change does not affect the amount of
benefit awarded. This could happen, for example, because a claimant in receipt of
ESA maintains that their medical condition has deteriorated. The DM may, having
considered the evidence, decide that the change does not affect the existing award.

A4107

The DM should make a decision not to supersede. See A4011 et seq for further
guidance.
Is a change of opinion a relevant change of circumstances

A4108

A change of opinion is not in itself a relevant change of circumstances. This should
be noted when a medical opinion has been obtained after a certificate has been
issued by a claimant's doctor. A report containing a further medical opinion may
however contain evidence of a change of circumstances, for example if a condition
has been wholly cured as a matter of medical fact (1).
Note:
Where new medical evidence is received following examination by a HCP or
HP or other person approved by the Secretary of State, the DM does not have to
identify a change of circumstances in order to supersede. This does not apply to
JSA.
1 R(DLA) 6/01

A4109 Can a change in law be a relevant change of circumstance

A change in the law can be a relevant change of circumstances. However, where a
claim has been disallowed before a change in legislation takes effect, it cannot be
superseded due to a change of circumstance. This is because the claim has already
been disposed of and the decision was correct under the law current at that time (1). A
fresh claim is needed.
1 R(I) 56/54 & R(A) 4/81

A4110 Can a decision be superseded because of a future change of circumstance

A decision may be superseded when it is expected that a relevant change of
circumstances will occur on a future date (1). The DM should be satisfied on the
balance of probabilities that it is likely that the expected change will actually take
place.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 23(1)(b)

A4111 A4112 A4112

Where a decision is given for an expected change of circumstances, the DM must
record that it might need to be revised (1) if the change
1. does not occur or
2. occurs on a date other than the one expected.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 5

A4112

Where
A4111 1. applies, the revised decision is that there are no grounds to
supersede. Where A4111 2. applies, the revised decision takes account of the fresh
information about the date of change and changes the effective date where
appropriate.

[A4113-A4114]

A4115 Supersession of advance awards A4100

An award on an advance claim is conditional on the claimant's circumstances on the
first day of entitlement (1). Changes of circumstances occurring and effective
1. after the date the claim is decided and
2. before the relevant or renewal date
can be dealt with by way of supersession where the circumstances in A4116 apply.
See also ADM Chapter A3 for revision of advance awards.

1 UC, PIP, JSA & ESA (C&P) Regs, regs 32-34; R(DLA) 4/05

A4116 A4100 A4115

Where
1. a change (either favourable or unfavourable) occurs and is notified before the
relevant or renewal date is reached or
2. a favourable change is notified after the relevant or renewal date is reached
the DM should consider whether the award should be superseded on the grounds of
a relevant change of circumstances since the decision was made (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 23(1)(a)

Example

PIP current award expires 1 August. Further claim decided 1 March, effective from
2 August. Award is for the standard rate of daily living component and standard rate
of mobility component.
On 1 April the claimant gets worse and his needs change, entitling him to the
enhanced rate of the daily living component. The change is reported 15 July. The
DM supersedes the decision made on 1 March awarding enhanced rate daily living
component from 2 August. The decision on the previous award is also superseded
with effect from 15 July.

A4117 Supersession for closed period

A decision awarding benefit may be superseded for a fixed period to take account of
a change of circumstances which has already come to an end. The supersession
only replaces the original decision for that period.

Example

A claimant is in receipt of JSA. Following a fraud investigation, it is established that
he was working on a building site for over a year. The work finished when he was
laid off. The DM supersedes the awarding decision to disallow JSA for the same
period. The conditions of entitlement should be determined from the first day of the
fresh period of entitlement.

[A4118-A4119]

A4120 Relinquishment of benefit

A claimant may decide that they do not want entitlement to benefit to continue for
example where the amount of benefit is small. The request should be treated as an
application for supersession.

A4121

The claimant may ask not to receive payment of benefit while underlying entitlement
continues. The DM should refuse to supersede following such a request. This is
because if entitlement exists, the Secretary of State has an obligation to pay benefit
in accordance with an award.

A4122 Effectiveness of the relinquishment

The DM should investigate to ensure that the claimant's relinquishment is a genuine
statement of intention, and the consequences explained where appropriate.

A4123 A4125 A4127

A request to surrender benefit might not be effective where
1. the claimant is vulnerable or incapable of deciding their affairs and there is no
appointee or
2. the withdrawal is made as a result of threatening or overbearing behaviour,
deception or similar improper behaviour.

A4124

Where the DM is not satisfied that the claimant
1. made the request freely and
2. is capable of fully understanding the implications
the request should be refused. The DM should make a decision that the awarding
decision is not superseded (see A4017 - A4019).

A4125

Where
1. the claimant has been advised of the consequences and
2. the request is genuine and
3. A4123 does not apply
the DM should end entitlement accordingly.

A4126

Once entitlement has been ended as in A4129 - A4131, a further claim is required if
the claimant wishes to receive the benefit again. A change of mind about
relinquishment is not grounds for revision, because it was not a fact in existence at
the time the original decision was made.

A4127

The decision ending entitlement can be revised within the application period if it is
established that the original request to surrender entitlement was not effective as in
A4123. Where the application is made outside the time limits, the DM should
consider whether to revise for official error. See ADM Chapter A3 for advice on
revision.

A4128

If ending entitlement was not in their best interests, and a further claim is made, the
DM has no authority to fix a date of claim to cover a period when the claimant was
not entitled. The normal rules about the prescribed time for claiming still apply (see
ADM Chapter A2). For example, a person who reclaims ESA two months after
surrendering an award can be entitled from the day following the end of that award.

A4129 Ending entitlement A4126

Where a claimant no longer wishes to receive a benefit, and the DM accepts that the
request is effective, the DM should supersede the awarding decision on a relevant
change of circumstances (1), and terminate the award. The claimant has the right of
appeal. The supersession ends entitlement to, as well as payability of, benefit,
because the award has come to an end with the withdrawal of consent.

1 SS Act 98, s 10; UC, PIP, JSA & ESA (D&A) Regs, reg 23(1)(a)

A4130

The relevant change is that the claimant no longer consents to be entitled to receive
the benefit, or no longer wishes it to be payable. The date of the change is
1. the date specified by the claimant where appropriate or
2. the first pay day following the date of the application or
3. the first pay day following the date the decision is made, where benefit
continues to be paid after the application is made and is not returned or
4. the first day in the assessment period for UC
Note: The claimant cannot surrender benefit for a past period.

Example

A claimant is in receipt of UC. They start work which has the effect of reducing the
amount of UC to 1 for each assessment period. The claimant writes to say that they
no longer wish to receive UC. The DM accepts that the relinquishment is genuine.
The decision awarding UC is superseded on a relevant change of circumstances to
end entitlement, effective from the first day of the assessment period in which the
request for relinquishment was made.

A4131 A4126

For guidance on the effective date of the supersession (1), see A4223 et seq. DMs
should note that although some changes of circumstances must be notified in
writing (2), an application for supersession can be made orally or in writing.
1 SS Act 98, s 10(5); UC, PIP, JSA & ESA (D&A) Regs, Sch 1; 2 UC, PIP, JSA & ESA (C&P) Regs, reg 38
Note: An award of benefit cannot be surrendered in part.

A4132 Death of claimant L3414

The death of the claimant is a relevant change of circumstances affecting
entitlement to benefit. In the majority of cases, there is no requirement for an
awarding decision to be superseded so as to end entitlement. However, where there
is an overpayment of benefit as a result of late notification of the death, the awarding
decision must be superseded before the DM can consider whether the overpayment
is recoverable (1).
Note 1: See ADM Chapter D1 for guidance on overpayment decision making.
Note
2: See ADM Chapter A2 regarding how death impacts awards of UC in certain
circumstances.
1 SS A Act 92, s 71(5A); SS Act 98, s 10(1)

[A4133-A4149]

Notification of changes

A4150 Introduction

The process of supersession on a change of circumstances is closely linked to the
legal requirement that certain changes be notified to the Secretary of State.

A4151 Notification of a change of circumstances A4154

Beneficiaries and every person by whom, or on whose behalf, sums by way of
benefit are receivable are required (1) to notify the Secretary of State of any change of
circumstance which they might reasonably be expected to know might affect
1. continuing entitlement to benefit or
2. the amount of benefit awarded or
3. the payment of benefit
as soon as reasonably practicable after the change occurs. In addition there may be
benefit specific rules requiring changes to be notified.
1 UC, PIP, JSA & ESA (C&P) Regs, reg 38

A4152

A4153 Categories of people who can notify the change

A change of circumstances can be notified by
1. the claimant
2. the appointee
3. any person who is an authorised representative for the claimant
4. a representative or agent of the Secretary of State
5. in overseas cases, social security authorities of EC countries, or other
countries that have reciprocal arrangements with the UK.
Note: This list is not exhaustive. The legislation does not specify who may apply for
supersession on a change of circumstances.

A4154 Method of notification

Notification of the changes set out in A4151 must be made (1) to an appropriate office
1. in writing (including electronic communications where appropriate) or by
telephone (unless it is determined that notice must be given in a particular way
or to accept notice other than in writing or telephone) or
2. in writing if in any class of case written notice is required (unless it is
determined to accept notice given otherwise than in writing).
Note:
this does not apply to JSA, which has its own rules (2) concerning reporting
changes.
1 UC, PIP, JSA & ESA (C&P) Regs, reg 38(5); 2 JSA Regs 13, reg 31

A4155 Where to notify a change of circumstances

A change of circumstances should be notified to an appropriate office (1). An
appropriate office is
1. in cases where a person is authorised or required to use electronic
communications, an address where electronic communications may be sent
2. a DWP office or
3. any other place as may be designated (including a postal address).
Note:
Where a notification is received in a different office of the DWP, and is
forwarded to and received by the appropriate office, it should be treated as received
in the appropriate office on the date of receipt in the different office. But see ADM
Chapter D1 in overpayment cases.

1 UC, PIP, JSA & ESA (C&P) Regs, reg 2 & Sch 2

A4156

In the case of a birth or death, the duty to notify (1) may be discharged by notifying the
Secretary of State, as soon as reasonably practicable, by personal attendance at an
office specified by
1. an LA or
2. a county council in England
that the Secretary of State has agreed may facilitate such notifications

1 UC, PIP, JSA & ESA (C&P) Regs, reg 39(a)

A4157

In the case of a death only, the duty to notify (1) may be alternatively discharged by
telephone to a telephone number specified for that purpose by the Secretary of
State.
1 UC, PIP, JSA & ESA (C&P) Regs, reg 39(b)

A4158 UC Childcare Costs

Where a claimant is in receipt of UC childcare costs then a person providing relevant
childcare (1) must provide such certificates, documents, information or evidence in
connection with the award, or any question arising out of it. This must be supplied
within a month or such longer period as may be considered reasonable (2). See ADM
Chapter F7 for when the childcare costs condition is satisfied.
1 UC Regs, reg 33 & 35; 2 UC, PIP, JSA & ESA (C&P) Regs, reg 38(7)

A4159 UC - Severely Disabled Person Caring Responsibility

Some UC claimants may be in receipt of a carer element (1) in respect of the fact that
they have regular and substantial caring responsibilities for a severely disabled
person. The severely disabled person may be required to furnish a signed
declaration to confirm the details which have been given by the claimant (2).
1 UC Regs, reg 29; 2 UC, PIP, JSA & ESA (C&P) Regs, reg 38(8)

[A4160-A4199]

Supersession on a change of circumstances -effective dates

A4200 Introduction L3414

The effective date of a supersession on a change of circumstances depends upon
whether the result of the supersession would be advantageous or disadvantageous
to the claimant and whether the change has been notified within certain time limits.

A4201 A4103 A4212

describes the general rule. However, these paragraphs should be read
together with any of the special rules relating to specific benefits.
A4201 Time limits The general rule is that an advantageous change of circumstances is to be notified
within one month of the date the change occurred. For UC it should be noted that the
change should be notified in the assessment period in which the change occurs.

A4202

The relevant notification period is, for UC the assessment period in which the
change occurs and for ESA, JSA and PIP a period of one month, beginning with the
date on which the change of circumstances occurred (1).
Note: The DM should exercise discretion in cases where a UC claimant notifies a
change promptly but it is received in the next assessment period.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(9)

Example

Cornelius has an assessment period that starts on the 13th of each month and ends
on the 12th of the following month. A change in his circumstances occurs on the
10th of January and he notifies the Department by post. The post is not received
until the 14th of January. The DM exercises discretion and supersedes the award of
UC from the 13th December.

[A4203]

A4204 Late notification of change of circumstances A4215 A4216

The time limit for notifying a change of circumstances can be extended provided all
of the five conditions at A4205 to A4209 are satisfied (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(1)

A4205 A4204

The first condition is that an application for an extension of time is made at an
appropriate office (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(2)

A4206

The second condition is that the application must (1)
1. contain details of the relevant change of circumstances and
2. include the reasons for the failure to notify the change on an earlier date and
3. be made within 13 months of the date the change occurred or
4. for PIP (2), be made within 13 months of the date on which the applicant first
satisfied the conditions of entitlement to the particular rate of benefit

1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(3); 2 Sch 1, part 2, para 14

A4207

The third condition is that it is reasonable to grant the application (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(4)

A4208

The fourth condition is that the notified change is relevant to the decision to be
superseded (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(5)

A4209 A4204

The fifth condition (1) is that
1. special circumstances are relevant to the application and
2. as a result of those special circumstances it was not practicable for the
applicant to notify the change of circumstances within the relevant notification
period.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(6)

A4210 A4215 A4216

A4211 Meaning of special circumstances

The phrase "special circumstances" is not defined in legislation. It can include
factors such as
1. the claimant, or the claimant's partner or dependant has died or suffered a
serious illness
2. the claimant is not resident in the UK
3. normal postal services have been disrupted
This list is not exhaustive and each application must be treated on its merits.

A4212 Deciding whether it is reasonable to grant the extension of time

The DM must have regard to the principle that the greater amount of time that has
lapsed between the time limit for notifying the change and the date of application the
more compelling should be the special circumstances on which the application is
based (1). The DM must take no account of the fact (2)
1. that the applicant or any person acting for them was ignorant of or
misunderstood the law applicable to their case (including the time limit for
reporting changes of circumstance as set out in A4201) or
2. that a UT or a court has taken a different view of the law from that which was
previously understood and applied.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(7)(a); 2 reg 36(7)(b) & 36(7)(c)

A4213 A4103

An application which has been refused cannot be renewed (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 36(8)

A4214 Decision advantageous to the claimant

Decisions which are advantageous to the claimant include those where
1. the amount of benefit is increased, or is awarded for a longer period (1) or
2. the amount of benefit in payment would be increased but for the application of
a provision in the law (2) restricting or suspending payment of a benefit or
disqualifying a claimant from receiving benefit or
3. a denial or disqualification for receiving benefit is lifted whether in whole or in
part (a partial lifting of a disqualification would include, for example, where the
period of a JSA sanction is reduced in length)3 or
4. a decision to pay benefit to a third party is reversed (4) or
5. an overpayment is not recoverable or the amount recoverable is reduced (5) or
6. the claimant gains financially (6).
Note:
See ADM Chapter D1 for guidance on overpayment decision making.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 52(5)(a); 2 reg 52(5)(b);
3 reg 52(5)(c); 4 reg 52(5)(d); 5 reg 52(5)(e); 6 reg 52(5)(f)

Example

Anna is in receipt of UC. Her assessment period runs from 16th of the month to 15th
of the following month. She rings up on Saturday 16th February to notify a change of
circumstances. The office is closed. She rings up again on Monday 18th February.
The DM supersedes the award of UC from 16th January.

A4215 Effective dates when changes notified within the time limits

Where an appropriate office is notified of an advantageous change of circumstances
within the relevant notification period or within such longer period as may be allowed
under A4204 - A4210, the effective date of the supersession will be
1. for ESA and JSA (1), the first day of the benefit week in which the change occurs
or is expected to occur
2. for PIP (2), the day on which the change occurs or is expected to occur
3. for UC (3) , the first day of the assessment period in which the change occurs or
is expected to occur
Note: See A4217 for PIP cases where the change relates to entitlement to a
particular rate.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, part 1, para 1; 2 Sch 1, part 2, para 12; 3 Sch 1, part 3, para 20

Example

David is in receipt of UC. His assessment period runs from the 17th of the month to
the 16th of the following month. He notifies the Department on the 1st of December
that from the 25th of November he started to care for his elderly mother. The DM
determines that David is caring for his mother on a regular and substantial basis.
The award of UC is superseded to include the carer element from the 17th of
November.

A4216 Change notified outside the time limits

Where an advantageous change of circumstances is notified later than one month
after it occurred, or for UC after the end of the assessment period in which the
change occurred (or such longer period as the DM may have allowed under A4204
A4210) then the effective date of the supersession will be
1. for ESA and JSA (1), from the beginning of the benefit week in which the
notification was made
2. for PIP (2), from the date of notification of the change (but see A4217)
3. for UC (3), from the first day of the AP in which the notification was made (but
see A4219 - A4220)

1 UC, PIP, JSA & ESA (D&A) Regs Sch 1, part 1, para 6; 2 Sch (1), part 2, para 14; 3 Sch 1, part 3, para 21

A4217 A4215 A4216

In the case of PIP (1),
1. where the change is relevant to entitlement to a particular rate and
2. the claimant notifies an appropriate office of the change
2.1 no later than one month after the date on which they first satisfied the
conditions of entitlement to that rate or
2.2 within such longer period as may be allowed
the superseding decision takes effect from the date on which the claimant first
satisfied those conditions.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 2, para 15

A4218 Award of other benefits

In the case of PIP where the claimant becomes entitled to another relevant benefit
under prescribed legislation (1) or ceases to be entitled or the rate of another such
benefit alters then the superseding decision takes effect (2) from the date on which
entitlement to the other benefit or an alteration in its rate arises or entitlement ends.
1 SS Act 98, s 8(3); 2 UC, PIP, JSA & ESA (D&A) Regs, Sch 1 part 4, para 31(1) & 31(2)(b)

A4219 UC A4216

In the case of a UC claimant where
1. the relevant change is that the person's employed earnings are reduced and
2. the claimant provides such information for calculating those earnings at such
times as may be required
the superseding decision takes effect (1) from the first day of the assessment period in
which that change occurred.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3, para 22

Example

Tony is in receipt of UC and works part time in a bingo hall. His assessment period
starts on the 15th of each month. His hours are reduced on 28 February. He informs
DWP of this change and is asked to provide details of his new earnings. Tony does
this and the DM supersedes the award of UC from 15 February to take into account
his reduced earnings.

A4220 A4216

In the case of UC where the claimant or a member of their family becomes entitled
to another relevant benefit, ceases to be entitled or the rate of another such benefit
alters then the superseding decision takes effect (1) from the first day of the
assessment period in which entitlement to the other benefit or an alteration in it's
rate arises or entitlement ends.
1 SS Act 98, s 8(3); UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 4, para 31(1) & 31(2)(a)

Example

Matt is in receipt of UC and JSA. He starts part time work and receives payment
from this employment in the final week of his assessment period. His award of JSA
is terminated. The DM supersedes the award of UC from the first day of the
assessment period so that JSA is no longer taken into account when determining the
amount of UC payable.

A4221 DM's own initiative

Where DMs supersede on their own initiative to deal with a change of circumstances
and the result is advantageous to the claimant the effective date of supersession
takes effect
1. for ESA and JSA, from the beginning of the benefit week in which action was
started with a view to supersession (1)
2. for PIP, the date on which action was started with a view to supersession (2)
3. for UC, the first day of the AP in which action was started with a view to
supersession (3).

1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1, para 10; 2 Part 2, para 18; 3 Part 3, para 29

A4222

It will often be useful for the DM to make a note of the date they first noticed that
action was needed to deal with a change so that there is evidence of the basis for
the effective date subsequently used.
Decisions not advantageous to the claimant

A4223 Effective dates A4131

A supersession for a change of circumstances that is not advantageous to the
claimant generally takes effect
1. for ESA and JSA
1.1 from the first day of the benefit week in which the change occurs or is
expected to occur (1) or
1.2 if not practicable as in 1.1, and the change has occurred, from the first
day of the benefit week following that in which the superseding decision
is made (2) or
1.3 if not practicable as in 1.1 and where the change is expected to occur,
from the first day of the benefit week following that in which the change
is expected to occur (3)
2. for PIP (4), from the date on which the change occurs or is expected to occur
(see A4231)
3. for
UC (5), the first day of the assessment period in which the change occurs or
is expected to occur.
Note:
See ADM Chapter D1 for overpayments.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1, para 1; 2 para 3(a);
3 para 3(b); 4 Part 2, para 12; 5 Part 3, para 20

Example 1

Norman is in receipt of UC. His assessment period runs from the 8th of the month to
the 7th of the following month. On the 12th January he notifies the Department that
he has inherited 25,000 from his father's estate and has received a cheque for that
day. The DM supersedes the award of UC to terminate the award from the 8th
January.

Example 2

Jeremy is in receipt of PIP. On 17 January he rings up to inform the Department that
he has moved to the USA permanently since 10 January. The DM supersedes the
award of PIP to end entitlement from 11 January.
ESA decisions

A4224 Meaning of ESA decision

An ESA decision (1) in this section of the guidance is a decision to award ESA that
embodies a determination that the person is or is to be treated as having LCW.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1, para 11

A4225 Meaning of LCW determination A4226

A LCW determination (1) is a determination whether
1. a person has LCW or
2. can be treated as having LCW.

1 WR Act 07, s 1(4) & s 8; ESA Regs 13, reg 15 & 16

A4226

In the case of an ESA decision where there has been a LCW determination as in A4225where the DM is satisfied that the claimant (1)
1. failed to notify the appropriate office of a change of circumstances which the
claimant is required to notify and
2. could reasonably have been expected to know that the change of
circumstances should have been notified
then the award of ESA is superseded from (2) either the date on which the claimant
ought to have notified the change of circumstances or if more than one change has
taken place between the date from which the decision to be superseded took effect
and the date of the superseding decision, the date the first change should have been
notified. See A4235 - A4236.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1 para 7; 2 para 8

A4227 ESA Terminally ill Claimants

When a claimant applies for a supersession which contains a statement that they
are terminally ill then the superseding decision takes effect from the date the
claimant became terminally ill (1).
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1, para 9

A4228 Ending entitlement

Where entitlement ends, or is expected to end as a result of a change of
circumstances the superseding decision takes effect from the day the change
occurs or is expected to occur (1).
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1, para 4

Example

David is in receipt of ESA. He starts work on 1.11.16. His award of ESA is
terminated from 1.11.16.

A4229

Where an ESA claimant has been detained in hospital under prescribed legislation (1)
and ceases or is expected to cease to be so detained for less than a week the
superseding decision takes effect from the day on which the change of
circumstances occurs or is expected to occur (2).
1 Mental Health Act, s 45A & s 47; 2 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 1, para 4

A4230 PIP Decisions

A PIP decision in this section of the guidance is a decision to award either or both
the daily living or mobility components of PIP (1).

1 WR Act 12, s 78(1) & (2) & s 79(1) & (2); UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 2, para 19

A4231 A4223

Where the DM is satisfied that the claimant (1)
1. failed to notify an appropriate office of a change of circumstances relating to
disability issue and
2. could reasonably have been expected to know that the change of
circumstances should have been notified
the award of PIP is superseded from (2) either the date on which the claimant ought to
have notified the change of circumstances or the date on which the first change
ought to have been notified if more than one change has taken place between the
date from which the decision to be superseded took effect and the date of the
superseding decision. See A4236. "Reasonably expected to know" only refers to
changes in a claimant's disability and their ability to carry out activities.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 2, para 16; 2 para 17
UC decisions

A4232 Meaning of UC decision

The UC decision in this section of the guidance means a decision to award UC
which embodies a determination that a person has, or is treated as having LCW (1).
1 WR Act 12, s 37; UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3, para 30

A4233 Meaning of LCW determination

A LCW determination (1) is a determination whether
1. a person has LCW or
2. can be treated as having LCW.

1 WR Act 12, s 37(1) & 37(6); UC Regs 13, reg 39

A4234

Where the DM is satisfied that the claimant
1. failed to notify an appropriate office of a change of circumstances which the
claimant is required to notify and
2. could reasonably have been expected to know that the change of
circumstances should have been notified then the award of UC is superseded
from (1)
either the first day of the assessment period in which the claimant ought to have
notified the change of circumstances or the first day of the assessment period in
which the first change ought to have been notified if more than one change has
taken place between the date from which the decision to be superseded took effect
and the date of the superseding decision (2) (see A4236).

1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3, para 23; 2 para 24

A4235 A4226

For ESA and PIP, if it is not reasonable for the claimant to know that the change
should have been notified then the supersession decision takes effect from the date
the decision is made (1). For UC the effective date is the first day of the assessment
period in which the DM makes the decision (2).
1 SS Act 98, s 10(5); 2 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3, para 25

A4236 Meaning of "reasonably have been expected to know" A4226 A4231 A4234

The test of reasonableness is not defined in law. It is similar to the test established
by case law for recoverable overpayments arising from failure to disclose material
facts (see ADM Chapter D1). When considering that guidance the DM should take
into account such matters as
1. the likely extent of the claimant or appointee's knowledge of the reasons for
awarding the benefit involved
2. the information given to the claimant about notification of changes of circumstances
3. the claimant's ability to recognise when a gradual improvement results in a
relevant change of circumstances.

A4237

A slight change in the claimant's ability to carry out activities would not normally be a
change that a person could reasonably be expected to notify. However, where the
change is gradual there may be a point at which the person could reasonably have
been expected to know that a change should be reported.

Example 1

A claimant has an award of the enhanced mobility and enhanced daily living
components of PIP because of the effects of progressive heart disease. On 8.11.19
the claimant undergoes a successful heart bypass operation, but does not report this
until 1.6.20. Further evidence is obtained from the hospital showing a significant
improvement in the claimant's walking ability and reduced care needs, within three
months of the operation.
The DM decides that the claimant is not entitled to either component from 9.2.20.
The claimant was aware of the basis of the award and could reasonably have been
expected to know that the improvement should have been notified. The
supersession decision takes effect from 9.2.20

Example 2

The claimant has a cataract. She satisfies the WCA because she cannot see well
enough to read 16 point print at a distance greater than 20 centimetres. The DM has
determined that she has LCW. She has an operation to remove the cataract. After a
period of recuperation her vision is improved to the extent that three weeks after the
operation she is able to read a newspaper without using her magnifying glass. The
DM decides that she could reasonably have been expected to know that the
improvement in her ability to see should have been notified. The supersession
decision takes effect three weeks after the operation, when the change should have
been notified.

Example 3

The claimant has a heart condition and is receiving out-patient treatment at a
hospital. He scores points for walking, and lifting, carrying and reaching, satisfying
the WCA. At first he was unable to walk further than 200 metres. But with exercise
this has improved and he can now walk more than 200 metres. The doctor reports
that he still has problems with lifting, carrying and reaching. The DM decides that it
was not reasonable for him to know that the change should be notified, because the
improvement was gradual and only affected one activity. The supersession decision
takes effect from the date it is made.

A4238 UC claimant reaches the qualifying age for SPC

When a claimant reaches the qualifying age for SPC in an assessment period and
makes an advance claim for SPC then a superseding decision made in
consequence of the person reaching that age takes effect on the date on which the
change occurs or is expected to occur (1).
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3, para 26

A4239 UC Hardship Payments

A decision to make or stop making hardship payments takes effect from the date
prescribed in legislation (1).
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3 para 27; UC Regs, reg 117

A4240 UC Terminally ill Claimants

Where a claimant makes an application for supersession which expressly states that
they are terminally ill the superseding decision takes effect from the first day of the
assessment period in which the claimant becomes terminally ill (1).
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 3 para 28

A4241 Changes in legislation

Changes to legislation can constitute a relevant change of circumstances. Where
there has been a change in legislation the superseding decision has effect from the
date the law changed. Where the change has not yet taken place the superseding
decision takes effect from the date the change in legislation takes effect (1).
Note: In some cases the effective date is not always the change in law. For example
if an ESA or UC claimant attends a WCA and the effect is that they are due a higher
rate of benefit the effective date is the date of the DMs decision. If the claimant
applies for a supersession in the light of the changes to legislation the effective date
will be the date of application.
1 UC, PIP, JSA & ESA (D&A) Regs, Sch 1, Part 4 para 32 & 33

Example

A PIP claimant is in receipt of the standard rate mobility component due to visual
impairment. A future change in legislation from 11.4.21 means that the claimant will
be entitled to the enhanced rate. The DM identifies that the claimant will become
entitled and supersedes the award in advance of the coming into force of the
legislation and awards the enhanced rate mobility component from 11.4.21.

A4242

Error of law

A4243 What decisions can be superseded on the grounds of error of law

Some decisions of a DM can be superseded when the decision was wrong in law.
The decision can be superseded either on an application or on the DM's own
initiative. These are any decision
1. on a claim for a relevant benefit (1)
2. under relevant acts (2)
3. as in
1. or 2. which has been revised (3)
Note:
A decision of the FtT or UT cannot be superseded by the DM on these
grounds.
1 SS Act 98, s 8(1)(a); 2 s 8(1)(c); 3 s 10(1)(a)

A4244 Circumstances when a decision can be superseded on the grounds of error of law

Supersession on the grounds of error of law only apply where (1)
1. an application was received more than one month (or such longer period as
might be allowed) after the date the original decision was notified or
2. the DM decided to act on their own initiative more than one month after the
date the original decision was notified.
Note: There will be cases where the DM is able to revise a decision which was
wrong in law on the grounds of official error. This route is available where the error is
solely the responsibility of the DM.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 24

A4245 Meaning of error of law

The Courts have set out (1) categories of circumstances in which errors of law may be
found. These are
1. making perverse or irrational findings on a matter or matters that were
material to the outcome ("material matters")
2. failing to give reasons or any adequate reasons for findings on material matters
3. failing to take into account and/or resolve conflicts of fact or opinion on
material matters
4. giving weight to immaterial matters
5. making a material misdirection of law on any material matter
6. committing or permitting a procedural or other irregularity capable of making a
material difference to the outcome or the fairness of the proceedings
7. making a mistake as to a material fact which could be established by objective
and uncontentious evidence, where the appellant and/or his advisers were not
responsible for the mistake, and where unfairness resulted from the fact that a
mistake was made
Note: As errors in law will usually also be official errors allowing revision, this
provision has limited use. See ADM Chapter A3 for guidance on the meaning of
official error.
1 R (Iran) & Ors v Secretary of State for the Home Department [2005] EWCA Civ 982

A4246 Effective date

Where a decision is superseded on the grounds of error of law the effective date is
1. for JSA or ESA the first day of the benefit week (1)
2. for UC the first day of the assessment period (2)
in which the superseding decision, or where applicable, the application for
supersession was made (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(3); 2 reg 35(4)

[A4247-A4249]

A4250 Reinterpretation of the law

Sometimes UTs and higher courts give decisions that change a previously held
interpretation of the law. These decisions will sometimes mean that earlier decisions
of DMs were wrong in law.

A4251 A4253

A decision by the UT or a court that the decision of the DM or the FtT out of which
the appeal arose was wrong in law is known as the "relevant determination".

A4252

Where
1. an application is made for a supersession decision relating to entitlement to
benefit (regardless of whether it is made before or after the relevant
determination) and
2. a decision on that application falls to be made in accordance with the relevant determination
then the effective date of that supersession will be the date of the relevant
determination (1).
Note: A judgement in an ECJ reference counts as a "relevant determination".
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(5)

A4253 Appeal against a relevant determination A4254

Where
1. a UT or court makes a relevant determination (see A4251) and
2. the Secretary of State appeals against that determination and does not stay
decisions and
3. an award of benefit made in consequence of the relevant determination is
suspended and
4. the relevant determination is reversed on appeal
the suspension is lifted and the decision made by the DM in 3. is superseded on the
ground of error of law (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 37(5)

A4254 Effective date

Where a DM's decision is superseded as in ADM A4253, the decision takes effect
from the date on which the earlier decision took effect (1). No arrears are paid when
the suspension is lifted.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 37(5) & 37(6)

Example

The claimant appeals against a DM's decision. The FtT dismisses the appeal,
upholding the DM's view of the law. The claimant appeals to the UT, but this is again
dismissed on the same point. The claimant then makes an appeal to the Court of
Appeal, which succeeds. The Secretary of State appeals this to the Supreme Court.
At the same time the Secretary of State receives applications in look-alike cases
seeking benefit on the basis of the Court's decision. The Secretary of State
supersedes existing decisions but suspends payment under these new awards
pending the outcome of the appeal of the Supreme Court. The Supreme Court then
upholds the Secretary of State's appeal. The Secretary of State then lifts the
suspensions and supersedes the decision made following the Court of Appeal's
decision, effective from the same date as those decisions. This ensures that no
benefit is paid in consequence of the Court of Appeal's (erroneous) decision.

A4255 Superseding a First-tier Tribunal or Upper Tribunal's decision A4256 A4257

An FtT's or UT's decision can be superseded where
1. the decision arose from ignorance of or mistake as to some material fact (1) and
as a result the decision to be superseded was more advantageous to the
claimant than it otherwise would have been or
2. it was made after the appeal was stayed (2)
3. there has been a relevant change of circumstances (3)

1 UC, PIP, JSA & ESA (D&A) Regs, reg 31(a) & 37(1); 2 reg 31(b) & 37(4); 3 reg 23

A4256

Where
A4255 1. applies the superseding decision takes effect for
1. JSA and PIP, the date the FtT's or UT's decision took or was to take effect
from (1)
2. ESA or UC, when the material fact does not relate to the LCW determination
or if it does and the DM is satisfied that at the time the decision was made the
claimant knew or could reasonably be expected to know of it and that it was
relevant - the first day of the benefit week or the assessment period in which
the Tribunal's decision took or was to take effect (2).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 37(2); 2 reg 37(3)

A4257 A4262

Where
A4255 2. applies the superseding decision takes effect for
1. PIP, from the date on which the decision of the FtT or UT would have taken
effect had it been decided in accordance with decision which was the subject
of the lead appeal (1)
2. JSA or ESA from the first day of the benefit week in which the Tribunal's
decision would have taken effect had it been so decided (2)
3. UC, from the first day of the assessment period in which the Tribunal's
decision would have taken effect had it been so decided (3).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 37(4)(a); 2 reg 37(4)(b); 3 reg 37(4)(c)

A4258 No outcome decision made

Where the FtT does not give an outcome decision after allowing an appeal, the DM
must follow the FtT's decision on the issues it has dealt with when dealing with the
matters referred back for subsequent decision unless
1. there are grounds to supersede the FtT's decision or
2. the DM considers it is erroneous in law and applies for leave to appeal (see
ADM Chapter A5)1.

1 R(IS) 2/08

A4259

Where
1. the DM incorporates the FtT's decision into a new decision
1.1 on a claim or
1.2 revising or superseding an earlier decision and
2. the facts have changed since the time of the decision under appeal
the DM should not supersede the FtT's decision in order to take account of the
change in the facts. This is because the DM must determine all the facts down to the
date of the new decision - see ADM Chapter A2. The FtT cannot take account of
circumstances which had not arisen at the time of the decision under appeal (1).

1 SS Act 98, s 12(8)(b)

A4260

Similarly, if the FtT's decision, other than an outcome decision, is incorporated into a
DM's decision, and there are grounds to supersede, it is the DM's decision which
must be superseded, not the FtT's decision.

A4261

Note that the claimant cannot ask for the DM's decision to be
1. revised (during the application period or for official error) or
2. superseded for error of law
where the only issue raised by the application relates to the incorporated FtT's
decision. The claimant should apply for leave to appeal to the UT against the FtT's
decision.

A4262 Stayed appeals A4005

ADM Chapter A5 describes the procedure where appeals are stayed at FtT or UT
level. Where
1. the tribunal or UT decides the appeal as if the lead appeal had been
determined in the most unfavourable terms for the appellant (1) and
2. the DM is required to supersede the tribunal or UT's decision once the lead
appeal is determined (2)
the effective date of the supersession is the date the FtT or UT's decision would
have taken effect if it had been decided in accordance with the decision which was
the subject of the lead appeal (3) (see A4257).
1 SS Act 98, s 26(4)(b); 2 s 26(5); UC, PIP, JSA & ESA (D&A) Regs, reg 31(b); 3 reg 37(4)

A4263

DMA Leeds will give guidance following the determination of lead cases on whether
supersession is required.
Ignorance of or mistake as to a material fact

A4264 What decisions can be superseded on the grounds of ignorance of or mistake as to a material fact

Supersession of
1. any decision on a claim for UC, PIP, ESA or JSA (1)
2. any decision made under relevant Acts (2)
3. any decision in A4264 1. or A4264 2. which has been revised by a DM (3)
4. any decision made by the FtT or UT (4).
can be made on the grounds of ignorance of or mistake as to a material fact.
1 SS Act 98, s 8(1)(a); 2 s 8(1)(c); 3 s 10(1)(a); 4 s 10(1)(b)

A4265 Material facts

A material fact is one which is relevant to a decision on a claim or application. Any
fact which has to be determined before a decision can be given is a material fact.

A4266

A fact which is itself not immediately relevant can be important to a decision if the
process of reaching a decision has been influenced by it.

Example

The FtT does not accept a claimant's evidence because they consider it not to be a
true statement of the facts. The claimant then produces evidence to prove the fact
was correct. The DM supersedes the decision because it is based on a mistake as
to a material fact.

A4267

An application for supersession because of ignorance of, or a mistake as to, a
material fact may not always result in a supersession decision. See A4010 - A4020
for further guidance.

A4268

There is a distinction between a primary fact and a secondary fact. A primary fact is
a fact established directly by evidence. A secondary fact is found by applying the
process of reasoning to evidence.

A4269

DMs often make an inference of fact by reasoning from the evidence before them. If,
however, they are wrong because the reasoning was wrong, the decision is not
based on a mistake as to a material fact. DMs cannot supersede decisions just
because they would have reached a different decision on the same evidence (1) (but
see A4273).
1 R(I) 3/75

A4270 Ignorance of a material fact

A decision may be superseded if the DM is satisfied that it was given in ignorance of
some material fact. A material fact is one which is relevant to
1. an award of benefit
2. a claimant commitment
3. a labour market question
4. an overpayment recoverability decision
and has to be identified before a decision is given. The fact must exist at the time the
original decision is given (1).

1 CAO v Combe (Court of Session 1999)

A4271

It is presumed that a DM is aware of the facts included in the papers available to
make a decision. This presumed knowledge prevents supersession because of the
ignorance, but supersession because of a mistake as to a material fact may be
possible.

A4272

Sometimes a question has to be decided by making an adverse assumption about a
relevant fact because the DM has been unable to obtain sufficient evidence (1). If
evidence is then provided which shows the DM's assumption is wrong the original
decision can be superseded because of ignorance of a material fact. If the evidence
is provided within the dispute period, revision would be appropriate.
1 R(SB) 18/81; R(SB) 29/83

Example

A jobseeker fails to provide evidence that he is actively seeking work after a request
from the Secretary of State. The DM decides that he is not actively seeking
employment, and disallows the claim for JSA. The claimant later produces his record
of job applications. The DM supersedes the original decision because it was made in
ignorance of the material fact that the claimant was actively seeking employment.

A4273 Mistake as to a material fact A4269

A DM may misinterpret the evidence and make a mistake as to a material fact (1). If
the mistake was wholly the responsibility of the DM, or of another official of the
DWP, it would be an official error and the decision would be revised (see ADM
Chapter A3). If the claimant had contributed to the mistake, it would not be an official
error and the decision would be superseded (2).

1 R(G) 8/55; UC, PIP, JSA & ESA (D&A) Regs, reg 9; 2 reg 22

A4274

The mistake may be made when dealing with the claim, for example by a DM
misreading information in a document. It may be made by another official, for
example by a receptionist recording an incorrect date. The revision provisions should
always be considered where the new decision would be advantageous to the
claimant.

Example 1

A claimant has an award of the standard rate of the daily living component of PIP.
Two years later the claimant reports that her daily living needs have increased. The
DM examines the case and finds that the evidence obtained at the time of the
original claim shows that the claimant needed more assistance with her daily living
activities. The DM revises the original decision for official error. The effective date is
the date of the original award.

Example 2

A claimant is awarded UC. The DM overlooked the fact that income of 290 a month
was in payment. Two years later on a routine case check the DM realises that the
income should have been taken into account. The DM supersedes the original
decision on a mistake as to a material fact. The effective date is the date the DM
started the routine check.

Example 3

The DM decides that the jobseeker was not available for work because he was in
prison for the period 3 July to 28 August. The jobseeker later realises that he got his
dates mixed up, and he was actually in prison for the period 28 July to 3 August. The
DM supersedes his decision because it was based on a mistake as to a material
fact.

A4275 Opinions and material facts

Opinions should be distinguished from facts. DMs often take into account opinions of
other persons, for example doctors, in making decisions. Medical opinion does not
form a material fact (1).

1 R v. Secretary for Social Services ex parte Loveday [15.2.83]

A4276

Because it is not a material fact, a change of medical opinion is not of itself a ground
for supersession. A DM's decision awarding benefit as a result of a medical opinion
cannot be superseded because it was based on a mistake as to a material fact, if
another doctor provides a different opinion based on the same facts. This is because
there is no specific or primary fact about which the DM was mistaken (1). For further
guidance on medical opinion/fact see benefit specific guidance.

1 R(S) 4/86

A4277

However, medical opinions are often expressed in reports which may contain
evidence, such as clinical findings or statements by the claimant, from which the DM
can infer facts. This may enable the DM to show that the original facts would not
have been found, or were found incorrectly, if the new facts had been known (1). A
change of opinion where there are different facts may be evidence that the original
decision was based on ignorance of or mistake as to some material fact (2).
1 R(I) 3/75; 2 R(DLA) 6/01

A4278 Supersession of a decision of a DM on grounds of ignorance or mistake A4280

Where the decision to be superseded is one made by a DM, it can be superseded
on the grounds of ignorance of or mistake as to a material fact where either (1)
1. an application is made more than one month after the original decision was
notified (or a late dispute is not admitted - see ADM Chapter A3)
2. the DM commenced action with a view to supersession more than one month
after the original decision was notified.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 24

A4279

A decision based on ignorance of, or mistake as to, a material fact may have arisen
because of official error. In that case revision may be appropriate (1). DMs should also
consider whether revision is appropriate where the decision was more advantageous
than it would have been if the material fact was known (see ADM Chapter A3).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 9

A4280 Effective date

The effective date of a supersession to which A4278 applies will be for
1. JSA or ESA, the first day of the benefit week in which the superseding
decision or application for supersession was made (1)
2. UC, the first day of the assessment period in which the superseding decision
or application for supersession was made (2)
3. PIP, on the date the decision is made (3).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(3); 2 reg 35(4); 3 SS Act 98, s 10(5)

A4281 Supersession of a decision of the FtT or the UT

A decision of the FtT or UT may be superseded at any time on the grounds of
ignorance or mistake as to a material fact (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 31(a)
Effective date

A4282 Advantageous

If the effect of the supersession would be advantageous to the claimant the effective
date is (1)
1. where the supersession is made as a result of an application, the date the
application was received or
2. where the supersession was undertaken at the DM's own initiative, the date
the decision was made.
1 SS Act 98, s 10(5)

A4283 Disadvantageous

Where the effect of the supersession of the FtT or UT decision would be to the
disadvantage of the claimant the effective date is for
1. JSA and PIP, from the date on which the decision of the FtT or UT took or
was to take effect (1)
2. ESA or UC (2) where the fact does not relate to the LCW determination or does
relate to it and the DM is satisfied that at the time the decision was made the
claimant knew or could reasonably be expected to know of it and that it was
relevant, from the first day of the benefit week or the first day in the
assessment period in which the decision of the FtT or UT took or was due to
take effect.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 37(2); 2 reg 37(3)
Decisions which cannot be appealed to a First-tier Tribunal

A4284 Introduction

Annex E lists decisions and determinations that are not appealable. Such decisions
can be superseded at any time either on an application or at the DM's own initiative (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 25

A4285 Effective date

The effective date will be (1)
1. the date of the application for supersession or
2. the date the decision was made when made on the DM's own initiative
1 SS Act 98, s 10(5)

A4286 Sanction Cases

ESA, JSA and UC claimants can be sanctioned under certain circumstances (1). A
superseding decision to apply a sanction takes effect for ESA (2)
1. where the claimant has not been paid ESA for the benefit week in which the
Secretary of State determines that the amount of the award of ESA is to be
reduced, the first day of that benefit week or
2. where the claimant has been paid ESA for the benefit week referred to in A42861. the first day of the first benefit week for which the claimant has not
been paid ESA or
3. where the amount of the award of ESA for the benefit week referred to in
paragraph A4286 1. or 2. is already subject to a reduction because of a
previous sanctionable failure, the first day in respect of which the amount of
the award is no longer subject to that reduction.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 27; 2 ESA Regs, reg 54 & reg 35(10)(a)

A4287

A superseding decision to apply a sanction takes effect for JSA (1)
1. where the claimant has not been paid JSA for the benefit week in which the
sanctionable failure occurred, the first day of that benefit week or
2. where the claimant has been paid JSA for the benefit week referred to in A42871. the first day of the first benefit week for which the claimant has not
been paid JSA or
3. where the amount of the award of JSA for the benefit week referred to in A42871. or A4287 2. is already subject to a reduction because of a previous
sanctionable failure, the first day of the first benefit week in respect of which
the amount of the award is no longer subject to that reduction.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(10)(c); JSA Regs 13, reg 22

A4288

A superseding decision to apply a sanction takes effect for UC (1) from
1. the first day of the assessment period in which the DM determines that the
amount is to be reduced or
2. if the amount of the award is not reduced as in A4288 1. the first day of the
next assessment period or
3. if the amount of the award for the assessment period as in A4288 1. or 2. is
already subject to a reduction because of a previous sanctionable failure, the
first day in respect of which the amount of the award is no longer subject to
that reduction
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(10)(e); UC Regs, reg 106

A4289 Reduction in benefit ceases to apply

Where a person has had an award of benefit sanctioned as above and the reduction
is suspended or terminated then the decision to impose the reduction can be
superseded (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 27(2)

A4290 Effective date

For ESA, JSA and UC the reduction is suspended for any period during which a
fraud sanction applies. The reduction ceases to have effect on the day that period
begins (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(11)(a), 35(11)(c) & 35(11)(e);

ESA Regs, reg 56; JSA Regs 13, reg 24; UC Regs, reg 108

A4291

The reduction is terminated where, since the date of the most recent sanctionable
failure, the claimant has been in paid work (1)
1. for a period of at least 26 weeks (ESA) or 182 days (JSA) or
2. for more than one period where the total of those periods amounts to at least
26 weeks (ESA) or 182 days (JSA).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(11)(b) & 35(11)(d); ESA Regs 13, reg 57; JSA Regs 13, reg 25

A4292 A4293

For UC claimants the reduction is terminated where since the date of the most
recent sanctionable failure, the claimant has been in paid work for a period of, or for
periods amounting to at least 26 weeks and the claimant's weekly earnings during
that period or periods were equal to or exceed their individual threshold or
prescribed legislation in relation to apprenticeships apply (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 11(f); UC Regs, reg 90(4) & reg 109(1)

A4293

The effective date is either the first day of the assessment period in which A4292 is
satisfied or where that date falls outside a period of entitlement to UC, from the
beginning of the first assessment period in relation to any subsequent award (1).
1 UC Regs, reg 109(2)
Loss of benefit following benefit fraud offences

A4294 Sanctionable benefit

A decision can be superseded (1) where
1. it is a decision that a sanctionable benefit is payable and
2. that benefit ceases to be payable or is reduced under the provisions allowing
restrictions on the payment of benefit following convictions for benefit fraud
offences.
Note: See ADM Chapter B2 for further guidance.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 28

A4295 Effective date

The effective date (1) will be the first day of the disqualification period as set out in
regulations (2).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(12); 2 SS (Loss of Benefit) Regs, reg 2

A4296 Special rules - uprating

The uprating of benefit will not normally require a supersession decision (1).
1 SS A Act 92, s 159A; s 159C; s 159D

A4297 Special rules - late or unpaid contributions

Where a late or unpaid contribution is treated as paid at an earlier date then the DM
can supersede (1) the original decision. The superseding decision takes effect from the
date on which the contribution is treated as paid (2). See ADM Chapter A3 where a late
paid contribution or credit is treated as paid on or before the date of the original
decision.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 29; 2 reg 35(13)

A4298 Special rules - UC Housing Costs

Where the housing costs element is reduced following a determination made under
specified legislation then the award of UC may be superseded (1).The effective date is
the first day of the assessment period following the day on which that determination
is received by DWP (2).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 30; 2 reg 35(14)
Special rules - PIP

A4299 Terminally ill

For the purpose of PIP, the fact that a person is terminally ill is not a relevant change
of circumstances, unless1 an application for supersession contains an express
statement that the person is terminally ill and is made by
1. the terminally ill person or
2. any other person claiming to act on that person's behalf whether or not that
other person is acting with the knowledge or authority of the terminally ill
person.
Note:
Where an application for supersession is made without an express statement
of terminal illness but evidence is received of terminal illness from either the
claimant or on behalf of the claimant then the application for supersession should be
treated as one made on the grounds of terminal illness.

1 UC, PIP, JSA & ESA (D&A) Regs, reg 23(2)

A4300

If the application for supersession is made expressly on the grounds of terminal
illness then this constitutes a relevant change of circumstances. The effective date
of the supersession is the date of the change (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(1)

A4301 Special rules - ESA

Where a claimant applies for supersession on the grounds that they have LCWRA
the effective date of the supersession is the date of the application (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(6)

A4302

Where a determination is made that the claimant has
1. LCW
or
2. LCWRA
or
3. LCW and LCWRA
and it is the first determination then the effective date of the supersession takes
effect from the beginning of the 14th week of entitlement (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(7)

A4303

Where
1. the claimant was previously entitled to ESA for no more than 13 weeks and
2. the assessment phase had not ended in the previous award and
3. the claimant's current PLCW is treated as a continuous PLCW
the supersession decision takes effect from the beginning of the 14th week of the
claimant's continuous PLCW (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(8)

A4304 Special rules UC

A decision that embodies a determination that the claimant has LCW or LCW and
LCWRA takes effect from the beginning of the assessment period in which the
decision is made (DMs own initiative) or the application for supersession was made (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(9)(b)

A4305

Some awards of UC are not to include the LCW or LCWRA elements until certain
circumstances are satisfied. In these cases the elements are not included until the
beginning of the assessment period that follows the assessment period in which the
relevant period ends (1). See ADM Chapter F5.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 35(9)(a)

A4306 Determinations on incomplete evidence

Where, for the purposes of deciding a claim or making a supersession decision, a
determination has to be made as to whether
1. a person is to be treated as receiving relevant education under specific
regulations (1) and
2. it appears to the DM that he is not in possession of all the evidence or
information needed to make that determination
the determination shall be made on the assumption that the missing evidence or
information is adverse to the claimant (2).

1 JSA Regs 13, reg 45; 2 UC, PIP, JSA & ESA (D&A) Regs, reg 39(3)

A4307

Where
1. a determination falls to be made as what housing costs are to be included in
an award of UC and
2. it appears to the DM that he is not in possession of all the evidence or
information needed to make that determination
the determination may be made on the assumption that the housing costs to be
included in the award are those that can be determined (1) using evidence or
information that is in the DM's posession (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 39(4)

A4308

Where
1. a determination falls to be made as to whether a PIP claimant meets the
condition in prescribed legislation regarding costs of qualifying services for
care home residents (1) and
2. it appears to the DM that he is not in possession of all the evidence or
information needed to make that determination after having made reasonable enquiries
the determination may be made on the basis of the information or evidence that is in
the DM's possession (2).
1 WR Act 12, s 85(2); 2 UC, PIP, JSA & ESA (D&A) Regs, reg 39(5)

A4309 Determination as to limited capability for work

When a DM determines (including after a change of circumstances) that for the
purposes of ESA or UC a claimant
1. has or does not have LCW or
2. is to be treated as having or not having LCW
then this determination is conclusive for any further decisions on ESA or UC (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 40(1) & reg 40(2)

A4310

Where an issue arises (1) whether a person is or is to be treated as having or not
having LCW or is terminally ill for the purposes of UC or ESA then that issue should
be determined by the DM. This is notwithstanding any other matters that fall to be
determined by another authority.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 40(3)

A4311 Alterations affecting Universal Credit

Where a person disputes the figure used to calculate earnings from employment for
any assessment period for UC then the Secretary of State must
1. inform the person that they may request a decision in relation to the amount of
UC payable in relation to that assessment period and
2. where such a decision is requested, provide it within 14 days of receiving the
request or as soon as practicable afterwards
In these cases the decision takes effect on the same date on which the alteration of
the person's employed earnings takes effect (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 41; SS A Act 92, s 159(D)(2) & (3)

A4312 Claimant fails to attend for or participate in a consultation - PIP

Where a PIP claimant fails without good reason to attend for or participate in a
consultation a negative determination shall be made (1). This only applies if written
notice of the date, time and place of the consultation was issued at least 7 days in
advance or unless the claimant agreed to accept a shorter period of notice. A
negative determination means that the claimant does not meet the requirements of
entitlement to the daily living component or the mobility component (2). A supersession
decision can be made to end entitlement to PIP (3). The effective date of the decision
is the date of the DM's decision (4).
Good reason includes the claimant's state of health at the relevant time and the
nature of their disability. The DM should exercise discretion when determining good
reason.
Note 1: A decision made in consequence of a negative determination may be
revised at any time if it contains an error to which the claimant did not materially
contribute (5).
Note 2: See Chapter P2 for guidance on PIP assessments.
1 PIP Regs, reg 9; 2 WR Act 12, s 80(6); 3 UC, PIP, JSA & ESA (D&A) Regs, reg 26(2);
4 SS Act 98, s 10(5); 5 UC, PIP, JSA & ESA (D&A) Regs, reg 18(3)

Example 1

Jackie is sent a written request to attend a consultation but does not attend. She tells
the DM that she did not attend because she was in hospital and did not receive the
letter. The DM accepts that Jackie has shown good reason for not attending.

Example 2

Kevin is sent a written request to attend a consultation but does not attend. He tells
the DM that he didn't go because he didn't want his award of PIP to be looked at
again. The DM decides that Kevin has not shown good reason for not attending and
makes a negative determination.

Example 3

Warren does not attend the consultation. He tells the DM that he didn't attend
because on the day of the consultation he suffered an epileptic seizure and was
admitted to hospital. The DM accepts that Warren has shown good reason.

A4313

An existing PIP claimant may be required to provide any information or evidence
required to determine if they have limited or severely limited ability to carry out daily
living or mobility activities, for example on the form "How your disability affects you".
In such cases the claimant must provide the information or evidence within one
month from the date of the request or within such longer period as is considered
reasonable.
Where the claimant fails without good reason to provide the information or evidence
then a negative determination must be made (1). The effective date is the date of the
DM's decision (2).
1 PIP Regs, reg 8; 2 SS Act 98, s 10(5)

A4314 Change from JSA to ESA or ESA to JSA A4315

Where
1. a person is awarded ESA or JSA ("the existing award") and if
2. that award did not exist, an award could be made for JSA or ESA ("the
alternative benefit") were a claim made for it
then when a claim is made for the alternative benefit, the DM may supersede the
existing award to bring it to an end (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 48(1), (2) & (3)

A4315

Where A4314 applies the existing award ends on the day immediately before the
first day on which the award of the alternative benefit takes effect (1).

1 UC, PIP, JSA & ESA (D&A) Regs, reg 48(4)

A4316

Waiting days do not have to be saved in where either an award of ESA or JSA is
made (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 48(5) & 48(6)
Suspension and termination of benefit

A4317 Hardship

DMs should always have regard to the question of whether hardship will result from
their decision when considering suspension of benefit, either wholly or in part. This
applies both to circumstances where the DM is considering an immediate
suspension or where the claimant has been asked to provide information.

A4318

For issues to be considered when deciding if hardship would result see benefit
specific guidance.

A4319 Loss of contact with claimant

If contact with the claimant is lost the DM should consider suspension and
termination to help prevent the accumulation of long periods of arrears.

A4320 Immediate suspension

The DM may suspend the payment of benefit immediately, either wholly or in part,
where a question has arisen about the claimant's entitlement to benefit or some
component part of it (1). Payment can also be suspended after 14 days, where there
has been a failure to satisfy information requirements (2).

1 SS Act 1998, s 21 & UC, PIP, JSA & ESA (D&A) Regs, reg 44; 2 reg 45

A4321 A4331

Suspension may be appropriate where a question has arisen during the currency of
an award
1. about whether the claimant satisfies the conditions of entitlement to benefit (1)
2. about whether an award of benefit should be revised or superseded (2)
3. about whether an overpayment of benefit is recoverable (3)
4. about whether the claimant is still residing at the last address notified to the
Secretary of State (4)
5. about the award of benefit because an appeal is pending against a decision
made by a FtT, UT or a court (5)
6. because an appeal is pending in a different case before a UT or a court, and it
appears to the DM that the outcome of that case might require the award to
be revised or superseded (6).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 44(2)(a)(i); 2 reg 44(2)(a)(ii);
3 reg 44(2)(a)(iii); 4 reg 44(2)(a)(iv); 5 reg 44(2)(b); 6 reg 44(2)(c)

A4322 Suspension where a question arises as to whether benefit should be revised or superseded

Where a question arises about whether a decision awarding benefit should be
revised (1) or superseded (2) the DM should consider whether a suspension of the
payment of benefit is appropriate. If it looks as though the revised or superseded
decision would result in
1. an increase in entitlement, there is no need to consider suspension
2. a decrease in entitlement, consider suspending payments of the amount in question
3. a loss of entitlement to benefit, consider suspending the whole of the
payment.
1 SS Act 1998, s 8; 2 s 10

Example

If a question arises about a claimant's entitlement to a UC housing element consider
suspending payment of the element pending enquiries to resolve the doubt.

A4323 Suspension where an appeal is pending

The DM may suspend payment of benefit, wholly or in part, where an appeal is
pending against the decision (1), if in the opinion of the DM the likely outcome of the
appeal is that there would be no entitlement to the benefit or part of the benefit in
question.

1 SS Act 1998, s 21(2)(c); UC, PIP, JSA & ESA (D&A) Regs, reg 44(3)

A4324

Appeal in this context means an appeal against a decision by the
1. FtT
2. UT or Three Judge Panels
3. High Court, the Court of Appeal, the Court of Session in Scotland and the
Supreme Court.

A4325

An appeal is pending (1) where a decision of the FtT, UT or a court has been made
and
1. the Secretary of State is waiting to receive that decision or
2. in the case of the FtT decision the Secretary of State
2.1 is considering whether to apply for a statement of reasons or
2.2 has applied for a statement of reasons and is waiting to receive it or
2.3 has received the statement of reasons and is considering whether to
apply for leave to appeal to the UT or
3. the Secretary of State has received the decision and is considering whether to
apply for permission to appeal against it or
4. an application for permission to appeal has been made but not determined or
5. permission to appeal has been granted and the Secretary of State is
considering whether to proceed with an appeal or
6. an appeal has been made but has not yet been determined.
1 SS Act 98, s 21 & UC, PIP, JSA & ESA (D&A) Regs, reg 44(4)

A4326 Notification

The Secretary of State must give written notice (1) to the claimant of his proposal to
1. in the case of the FtT decision, apply for a statement of reasons
2. apply for permission to appeal or
3. make an appeal
as soon as reasonably practicable.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 44(5)
Note:
As the regulations require the Secretary of State to notify his proposal to take
the actions listed above, he must send the notification before taking the action.

A4327 When benefit suspended must be paid - appeal no longer pending

Payment of benefit that has been suspended must be made if (1)
1. in the case of the FtT decision, the Secretary of State does not apply for a
statement of reasons within one month of the day he receives notice of the
FtT's decision
2. in the case of any decision, the Secretary of State does not
2.1 make an application for permission to appeal or
2.2
when permission is granted, make an appeal
within the relevant time limit
3. the Secretary of State withdraws his appeal or application for permission to appeal
4. the Secretary of State is refused permission to appeal where he cannot renew
his application or make a further application for permission to appeal.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 46(c) & 46(d)

A4328 Suspension where an appeal is pending against a decision in a different case

The DM may suspend benefit wholly or in part where (1)
1. an appeal is pending in another case (the lead case) before a UT or a court
and
2. it seems to the DM that, if the lead case were determined in a particular way
an issue would arise as to whether the award of benefit in the case before the
DM (the look-alike case) should be revised or superseded (2).

1 SS Act 98, s 21(2)(d); 2 UC, PIP, JSA & ESA (D&A) Regs, reg 44(2)(c)

A4329

The appeal in question does not have to involve the same benefit. But if it appears
the outcome of the appeal would have an effect on the award being considered by
the DM then suspension can still be considered.

A4330 What happens if the suspension is lifted

When the suspension is lifted the DM
1. reinstates all or part of the benefit where it is appropriate to do so
2. revises or supersedes the award of benefit
3. makes, revises or supersedes the award of benefit in accordance with the
directions of the FtT, UT or court
4. makes, refuses to make, revises or supersedes the award of benefit in
accordance with the directions of the UT or court given in the different case.

A4331 Suspension where information has been requested

The DM can suspend (1) payment of benefit when they are considering whether an
award of benefit should be revised or superseded. This applies to (2)
1. a person who has had benefit suspended as in A4321
2. a person who has applied for a decision to be revised or superseded
3. a person who is required to provide information or evidence
4. a JSA claimant who has been asked to provide documents, certificates or
other evidence
5. a person whose entitlement to ESA or UC is conditional on their having or
being treated as having LCW

1 SS Act 98, s 21(2)(b); 2 UC, PIP, JSA & ESA (D&A) Regs, reg 45(2)(a)-(e)

A4332

When the DM has asked the claimant to provide information (1) they must
1. supply that information (2) within a period of 14 days beginning with the date on
which the notification was sent or such longer period as the DM allows in that
notification or
2. supply that information (3) within such longer period as he satisfies the DM is
necessary in order to enable him to comply with the requirement
in default of which payment of benefit may be suspended.
1 UC, PIP, JSA & ESA (D&A) Regs, reg 45(1) & 45(3); 2 reg 45(4)(a)(i); 3 reg 45(4)(a)(ii)

Example

Matt is self employed and is in receipt of UC. He is asked to send in details of his
earnings within 14 days and told that if he doesn't his UC may be suspended. Matt
fails to do this and his award of UC is suspended.

A4333

Alternatively, the claimant must satisfy the DM within 14 days beginning with the date
on which the notification was sent that either (1)
1. the information does not exist or
2. it is not possible for him to obtain it

1 UC, PIP, JSA & ESA (D&A) Regs, reg 45(4)(b)

A4334

Where the DM requires documents, certificates or other evidence from a JSA
claimant under other legislation (1) then this must be supplied within 7 days beginning
with the date on which notification was sent in default of which payment of JSA may
be suspended (2).

1 JSA Regs 13, reg 31(3); 2 UC, PIP, JSA & ESA (D&A) Regs, reg 45(5)

A4335

The DM should impose the 14 day period where there is a serious doubt about the
claimant's award. Examples are where
1. information has been received indicating that there may be undeclared
income or capital or an undeclared non dependant or partner
2. a data match anomaly
3. the claimant has failed to co-operate with a Benefit Integrity Centre review by
failing to participate in a telephone review and subsequently fails to return a
fully completed postal review form.
4. BIC has no contact number and reverts immediately to the postal process
5. BIC has been unable to make contact by telephone and reverts to the postal process
6. BIC has conducted a telephone review but further information is required and
sends a letter requesting this information

A4336

When considering whether to extend the 14 day period the DM should take into
account all the circumstances including
1. the claimant's circumstances and the nature of the information requested
2. whether there are difficulties in obtaining the information (e.g. where
verification, which may not be readily available, has to be sought from a third
party such as a bank)
3. any difficulty the claimant may have in obtaining the information due to
disability, illness or family circumstances
4. circumstances beyond the claimant's control such as hospitalisation,
bereavement or postal disruption
5. whether the nature of the award causes difficulties e.g. overseas awards
This list is not exhaustive and each case should be considered on its merits.
Extension is at the discretion of the DM. Before making a decision to suspend the
DM must consider hardship.

Example 1

A claimant fails to comply with a Benefit Integrity Centre review by failing to
participate in a telephone review. The DM issues a letter asking them to provide
information relating to his award. This letter asks the claimant to provide the
information within 14 days of the day it was sent. The letter also states that failure to
provide the required information will result in suspension of benefit. The claimant
does not respond to the letter and the DM decides to suspend benefit.

Example 2

An allegation is received that the claimant has a large amount of capital in numerous
savings accounts. The DM issues a letter asking them to provide evidence of their
capital within 14 days of the date of issue of the letter. The claimant responds within
14 days, denying the allegation and says that they have only small amounts of
capital in several accounts. The claimant says that it will take a month to provide this
information. The DM considers this is reasonable and does not suspend benefit and
allows the claimant a month in total to provide the information.

A4337 Termination following suspension

The DM must consider terminating benefit where
1. the claimant has been required to provide information (this applies where
payment has been suspended both immediately and following failure to satisfy
information requirements) and
2. has failed to do so within one month or such longer period as appropriate and
3. payment of benefit has been suspended in full (1).
It should be noted that it is not possible to terminate benefit if the suspension is a
partial one. In this situation the suspension remains in place indefinitely.

1 SS Act 98, s 23; UC, PIP, JSA & ESA (D&A) Regs, reg 47

A4338

The time limit of one month may be extended where the DM considers in all the
circumstances it is reasonable to do so. A decision terminating benefit in these
circumstances will be a supersession decision. This decision carries the right of
appeal (1).
1 SS Act 98, s 23; SS CS (D&A) Regs, reg 47

A4339 Extension of the time limit

When considering whether to extend the time limit for providing information, the DM
should take into account all the circumstances including
1. the circumstances of the claimant and the nature of the information requested
2. whether there are difficulties in obtaining the information itself, for example
where verification, which may not be readily available, has to be sought from
another source such as a bank or a building society
3. any difficulty the claimant may have in obtaining the information due to
disability, illness or family circumstances
4. where the nature of the benefit itself, for example, overseas cases, creates its
own difficulties.
This list is not exhaustive. Each case must be based on its merits.

A4340 Date from which benefit is terminated

Benefit is terminated with effect from the date on which the payment of benefit was
suspended.

A4341

DMs should note that if it transpires that entitlement should have terminated from an
earlier date, then this termination provision cannot be used. Instead, the original
decision should be revised or superseded, with the effective date of termination
being determined as appropriate (1).
1 UC, PIP, JSA & ESA (D&A) Regs, reg 47(2)

Example

Original outcome decision 1.4.13. Benefit suspended 1.7.13. Because the claimant
does not respond to requests for information entitlement is terminated from 1.7.13.
On 1.10.13 the Secretary of State discovers that entitlement should have ended on
1.5.13 as a result of new information coming to light. He revises the decision to
terminate benefit and then supersedes the decision of 1.4.13, effective from 1.5.13.

[A4342-A4999]