Suspensions, terminations and withdrawals

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Deborah Cooper
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1 Suspensions, terminations and withdrawals Summary How to update and process a suspension, termination or withdrawal on a Universal Credit claim Content IMPORTANT When accessing the Payment Management system to enter any details, an agent must only access one claimant account at any one time. This is to avoid taking action on the incorrect account, as the claimant identifying details are not visible on the screen - for example, there is no name or National Insurance number (NINO) displayed. Suspension means stopping payment of one or more elements of a claim, or the whole claim, due to a doubt about entitlement. The suspension usually remains until the doubt is removed and payment can continue or the claim/element is disallowed. Claim admin suspending a claim (or elements of a claim) An account developer (AD) can suspend or lift a suspension in Claim admin. The AD uses Change claim status for full claim suspension, and Manual claim updates override or suspend elements to suspend one or more of the following elements: Child Disabled child addition Childcare costs Carer Health Housing costs The AD selects the reason for suspension from a drop-down list. A suspension is effective immediately and all payments related to the claim or the suspended elements stop. If a claim or particular element is already suspended the date of suspension is displayed. Where the claimant has failed to provide information and/or verification requested by Universal Credit, the element(s) associated with the request will be suspended until contact is made and the information and/or verification is received. If the information and/or verification is not received within 1 calendar month of the suspension date, the associated element(s) will be removed. Notification completion

2 When a claim has been suspended because a claimant has failed to respond to a request to provide documents or information, use the UC141 in Supporting document(s) for non-specific notifications. An immediate suspension may be required where information is received from a third party, for example an employer, bank, Local Authority, which strongly suggests that the information given by the claimant is inaccurate. In these circumstances where the claim has been suspended, without asking the claimant to provide documents or information, complete the UC142 in Supporting document(s) for nonspecific notifications. Fraud and error cases The AD completes the UC143 in Supporting document(s) for non-specific notifications to suspend Universal Credit following a referral from the Fraud and Error Service (FES) because: fraud is suspected the claimant has been asked to provide documents or information during an interview with a FES Officer, but has failed to do this The name of the FES Officer and their contact details must be included in the 'What you need to do now Contact us immediately' section of the letter. Suspension decisions The decision to suspend a claim or a particular element is unique to each case in line with suspensions guidance, but the Standard allowance cannot be suspended. This must be a full claim suspension. Suspensions can also be lifted using Claim admin. This is effective immediately and the suspension reason is removed automatically. AD action suspension lifted (establishing an under / overpayment) The AD checks the date of suspension and establishes how many assessment periods have elapsed since that date. If the start date of the suspension is in the current assessment period no further action is needed, the system will continue to pay as normal.

3 If the suspension occurred in a previous assessment period the AD must consider if any under or overpayments have occurred for each past assessment period the suspension was in place (the system will pay anything due in the current assessment period). The AD calculates the under or overpayment and notes a UC6 with: Type of suspension Notes included Whole claim unsuspended Amount due/owed for each past assessment period From and to dates for each past assessment period Full amount payable/recoverable (Amount due/recover x number of assessment periods) Date payment requested One or more elements unsuspended Which element(s) the ad-hoc payment is for in each assessment period Amount due/owed per element for each past assessment period From and to dates for each past assessment period Full amount payable (Amount due/owed x number of assessment periods) Date payment requested If there are any assessment periods of nil entitlement where: a sanctionable failure has occurred during that assessment period and a decision maker (DM) has determined that a sanction applies for that failure the sanction must be cancelled. This action does not apply if there was no entitlement in the assessment period because the award was reduced to zero by the application of this or a

4 previous sanction (in these cases the claimant is still entitled to Universal Credit therefore any sanction actions for failing to undertake work-related requirements may still apply). To establish if a sanctionable failure occurred during an assessment period of nil entitlement, the AD: 1. Navigates to the claimant record in the Universal Credit Agent Portal. 2. Selects the Payments: Sanctions screen. 3. Identifies any current sanctions with a decision date on or after the start date of the assessment period of nil entitlement. 4. Selects View to establish The Date of Conditionality Failure, the Date of Decision and the Reason for Sanction. The AD must make a note of these dates and the reason for the sanction. If a sanction hasn t been identified, the AD goes to Underpayment action below. If a sanction has been identified, it must be cancelled. The AD must also establish if any further sanctions have been applied to any subsequent assessment periods (including the current assessment period) where the claimant is entitled to Universal Credit. The AD: 1. Identifies any sanctions with a decision date after the end date of the assessment period of nil entitlement. 2. Selects View to establish The Date of conditionality failure, the Date of decision and the Reason for sanction. The AD must make a note of these dates and the reason for the sanction. If a sanctionable failure has been identified during an assessment period of nil entitlement, see Cancelling a sanction where a sanctionable failure has occurred in an assessment period with a nil or no entitlement. The AD then returns here to consider underpayment/overpayment action. Underpayment action

5 If there is an underpayment, the AD completes the Universal Credit payment instruction, prints and attaches the calculation and it is then checked by a checking AD. If correct, the checking AD stores the calculation in the Document Repository System (DRS) and arranges for the payment to be issued by Central Payment System (CPS). Overpayment action If an overpayment has taken place the AD follows the overpayment guidance. See Identifying and/or 'actioning' an underpayment or overpayment. Agent claim termination Following a change of circumstance that has led to: the claimant(s) not being entitled to Universal Credit a failure to meet the requirements of a claim the claimant relinquishes or withdraws the claim The Universal Credit claim is terminated. Before terminating the claim the AD must check to see if there are any assessment periods of nil or no entitlement when: a sanctionable failure has occurred during that assessment period and a decision maker (DM) has determined that a sanction applies for that failure To establish if a sanctionable failure occurred during an assessment period of nil or no entitlement the AD: 1. Navigates to the claimant record in the Universal Credit Agent Portal. 2. Selects the 'Payments: Sanctions' screen. 3. Identifies any current sanction(s) with a decision date on or after the start date of the assessment period of nil or no entitlement.

6 4. Selects 'View' and establishes 'The Date of conditionality failure', the 'Date of Decision' and the 'Reason for Sanction'. 5. Makes a note of these dates and the reason for the sanction(s). If no sanction(s) are identified, see 'Underpayment action' heading above.. If a sanction is identified the AD must cancel the sanction. The AD must then establish if any further sanctions have been applied to any subsequent assessment periods (including the current assessment period) where the claimant is entitled to Universal Credit. To complete this action the AD: 1. Identifies any sanctions with a failure date falling in the assessment period of nil or no entitlement. 2. Selects 'View' to establish 'The Date of conditionality failure', the 'Date of Decision' and the 'Reason for Sanction'. 3. Makes a note of these dates and the reason for the sanction. If a sanctionable failure has been identified during an assessment period of nil or no entitlement, the AD cancels the sanction see Cancelling a sanction where a sanctionable failure has occurred in an assessment period with a nil or no entitlement. The above action does not apply when there was no entitlement in the assessment period because the award was reduced to zero by the application of this or a previous sanction (in these cases the claimant is still entitled to Universal Credit therefore any sanctions for failing to undertake work-related requirements may still apply). To terminate a claim the AD: Accesses the Agent Portal. 1. Selects Claim admin. 2. Selects Change claim status. 3. Selects Terminate claim.

7 4. Selects the termination reason from the Reason for termination drop-down list within Claim admin. The options are: Reason for termination Used when: Claim withdrawn The claimant chooses to end their Universal Credit claim. Due to system restrictions this can be used after the claim is decided. Claimant Commitment unsigned The claimant refuses to sigh their Claimant Commitment Incorrect National Insurance number The wrong National Insurance number has been used for the claim Insufficient evidence The claimant has failed to provide appropriate evidence within required timescales for either a new claim or change of circumstance Failed to attend Work Services have informed Universal Credit that the claimant has failed to attend their interview as directed Moved abroad The claimant has moved abroad In prison The claimant is imprisoned In legal custody The claimant is in legal custody Deceased The claimant is dead Full time education The claimant is in full-time education Moved to Northern Ireland The claimant has moved to Northern Ireland

8 Ineligible - aged The claimant is ineligible as they are aged Fraud intervention SFIS has made a decision to terminate the claim Ineligible - state pension age The claimant has reached state pension age Ineligible - pension credit age The claimant has reached pension credit age Capital The claimant has more than 16,000 of capital when reporting a change of circumstance Other The reason for termination does n't fall into the categories above System claim termination This is where the Universal Credit system automatically closes a claim. When a claim has been terminated the AD will receive the following CAMLite task: Task Type: Termination/Suspension Sub Type: Clean-Up Action No CoC SLA: 3 Days To identify if the claim has been terminated as a result of a claimant failing to contact Universal Credit to confirm their circumstances regarding a potential re-award, the AD navigates to CAMLite Contact history to establish the reason for the claim termination. When a termination has taken place during a potential re-award period, the Contact history notes will read: RE-AWARD, outbound call to claimant regarding re-award unsuccessful, re-award info request notification issued, suppression marker must not be removed before day 33 (dd/mm/yyyy). If CAMLite Contact history shows that a Work Capability Assessment (WCA) referral has been made, the AD creates a CAMLite task with the following information: Task Type: Health Condition Sub Type: WCA Referral

9 Start Task From: Today s date SLA: 3 days Notes: Claim terminated (insert reason) on (dd/mm/yyyy) WCA action in progress, inform assessment provider Assigned to: UC WCA See CAMLite and Work Service Platform notes. Claim termination within potential re-award period The AD: 1. Accesses the Agent Portal. 2. Opens Claim Admin and identifies if the claimant is a single claimant or joint claimant. 3. Issues a UC448 to the claimant if they are single and a UC449 to both claimants if it is a joint claim. 4. Uploads a copy to DRS. 5. Updates CAMLite Contact history with all the actions taken. 6. Identifies if the claimant has an In Work Progression (IWP) status of Started or Excluded in the Work Services Platform (WSP). If so see: In Work Progression Completion. 7. Deactivates the claimants WSP record. See Work Services Platform guide (deactivating and reactivating claimant records). 8. Closes the originating CAMLite task. 9. Exits all claimant records. Termination not in potential re-award period If the termination is not in a potential re-award period, see Agent action terminating a claim below.

10 Agent action withdrawal or termination request received from the claimant A claimant may request to withdraw their claim for Universal Credit in writing either by letter or on a UC213 'Claim not pursued' form. When one these notifications is received one of the following CAMLite tasks will be received: If a letter is received the task details will be: Task Type: Scanned Correspondence. Sub Type: WHITE MAIL UN - STRUCTURED SLA: 3 Days If a UC213 is received the task details will be: Task Type: Scanned Correspondence. Sub Type: WHITE MAIL STRUCTURED SLA: 3 Days The agent accesses CAMLite, selects 'Tasks' and then the 'Post received' task. The agent then accesses DRS, retrieves and views the postal evidence received and determines whether the post is the Claim not pursued proforma which is uploaded in a previous process. Post received is not the 'Claim not pursued' proforma The agent: 1. Retrieves latest Universal Credit decision. 2. Checks the claimant's assessment period. 3. Determines the effective date of termination. The agent informs the claimant that the termination will take affect for the entire assessment period and therefore they will receive no payment for it. A termination post-payment is effective from the first day of the assessment period in which it is reported this reflects the change of circumstances work-stream approach. If a termination is reported 1 day before the assessment period ends, the claimant would receive no payment for the entirety of the assessment period. For this reason, the agent must inform the claimant of this before they confirm termination.

11 The agent navigates to CAMLite and makes an outbound call to the claimant. See Handling Calls. Claim withdrawal or termination is due to a change of circumstances The agent: 1. Informs the claimant that a change of circumstances is required. See the appropriate change of circumstances process. 2. Wraps-up the call. 3. Records outcome of discussion in CAMLite Contact history notes. 4. Closes the 'Post received' task. 5. Selects finish. Claim withdrawal or termination isn't due to a change of circumstances The agent informs the claimant of the termination date and the consequences of claim termination: if the claimant wishes to proceed the agent wraps-up the call and records the outcome of the discussion in CAMLite Contact history notes (the agent updates all fields, with the exception of the date, as this will be system generated and will default to today's date) if the claimant doesn't wish to proceed with termination, see 'Claimant doesn't wish to proceed with withdrawal/ termination' below Post received is the 'Claim not pursued' proforma The agent navigates to CAMLite and: 1. Selects 'Tasks'. 2. Selects the 'Post received' task.

12 3. Checks if there are any other open tasks. If 'Yes' the agent closes all open tasks. The agent should be aware that if there is a partner on the claim they will be required to close the tasks in CAMLite for both the claimant and partner. 4. Selects 'Finish'.. 5. Issues a manual Universal Credit decision prior to terminating the claim in the Agent Portal. This is to ensure that the Universal Credit decision is generated and issued on the same day as claim termination and will reach the claimant before the system generated claim termination letter. See Claims administration overview. 6. Records the claim termination. See Claims administration overview. 7. Closes the CAMLite case. The CAMLite case will need to be closed for both the claimant and partner. Claimant doesn't wish to proceed with the withdrawal or termination If the claimant doesn't wish to proceed the agent: 1. Wraps-up the call. 2. Records the outcome of discussion in CAMLite Contact history notes 3. Closes the 'Post received' task. Claimant has a partner 4. Selects 'Finish'. For Universal Credit Singles Expansion, either member of the partnership can terminate the claim. The agent clarifies that the termination is not because of a partnership ending and follows the standard termination process. Partnership has ended

13 When a couple separate, the member who reports the separation must be the one who makes a new claim to Universal Credit if they wish to continue claiming as a single person. The other member of the couple can continue claiming Universal Credit subject to them confirming their circumstances. The agent suspends the remaining live claim and creates a CAMLite task with the following details: Task Type: Generic Clerical Sub Type: Action Required Task Start From: 14 days from today's date SLA: 3 days Notes: 'To check if partner has made contact and they want to continue as a single person'. Assigned To: UC - Work Services See CAMLite and Work Service Platform notes. Agent action terminating a claim Before terminating a claim, an agent uses the claimant's CAMLite Contact history to check if a previous Universal Credit decision has been issued. This is because a manual Universal Credit decision notification is required to inform the claimant why they are not entitled to Universal Credit. The agent accesses DRS to view the claimant's current assessment period and to determine the claim termination date. The claim will be closed from the first day of the current assessment period. The exception to this is where a claimant reaches the qualifying age for Pension Credit part way through their assessment period. Any Universal Credit owed to the claimant must be paid manually. If Universal Credit has been awarded, the agent accesses Claim admin and opens 'View claim data' to check if the claimant has a partner. This is because both partners will require a Universal Credit decision notification. Work Capability Assessment referrals If CAMLite Contact history shows that a WCA referral has been made, the AD creates a CAMLite task with the following information: Task Type: Health Condition

14 Sub Type: WCA Referral Start Task From: Today's date SLA: 3 days Notes: 'Claim terminated (insert reason) on (dd/mm/yyyy) WCA action in progress, inform assessment provider Assigned To: UC WCA See CAMLite and Work Service Platform notes. If the claimant isn't sick, the agent accesses WSP and searches for the claimant record. If the claimant record has an IWP status as 'Started' or 'Excluded', see In Work Progression Completion. The agent selects 'Deactivate' from the toolbar which creates a warning message. By selecting 'OK' this will automatically cancel any outstanding appointments. CAMLite task notes are updated with any actions taken. Issuing a manual Universal Credit decision notification A Universal Credit decision notification is created clerically by the agent and sent to each claimant on the claim. The agent completes the UC373 manual Universal Credit decision template with the claimant's personal details, the reason for the claim ending and the date from this is effective. CAMLite Contact history is noted to record issue of the notification. There are circumstances when the notification is scanned and stored on DRS but not issued to the claimant, for example a termination due to an incorrect NINO or the claimant has moved abroad and their address is not known. Terminating a claim on the Universal Credit system The agent opens the 'Change claim status' screen to terminate the claim, selecting the appropriate reason from the drop-down list. If 'Other' is selected from the drop-down list, the reason for the termination is included in the manual Universal Credit decision notification. Claim termination notification

15 A claim termination notification is automatically sent to each claimant on the Universal Credit claim. This is a generic letter that states that the active claim has been closed on the system and doesn't give a reason for termination. A UC373 manual notification will also be issued giving the reason for termination. This notification is then scanned and stored on DRS. Query received about a claim termination notification If a claimant calls Universal Credit about a claim termination notification, the agent checks CAMLite Contact history notes for the reason. If the reason for termination isn't recorded in the notes, the agent checks 'Claim status' in Claim Admin or DRS and explains the reason to the claimant and advises them of the next steps. For example, a further claim may be appropriate if the claimant's circumstances have changed. Termination notifications Having terminated a claim there may be other interested parties that need to be notified, for example: healthcare providers to stop the WCA process interested third parties This is not a complete list.

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