Housing Benefit/Council Tax Benefit Security Guidance 2006/2007

Transcription

1 Address Maxine Leyland Local Authority Performance The Adelphi (5 th Floor) 1-11 John Adam Street London WC2N 6HT Telephone Fax To all LA Fraud and Benefit Managers Website Date Dear Fraud Manager/Benefit Manager Housing Benefit/Council Tax Benefit Security Guidance 2006/2007 I write to bring your attention to the new edition of the Housing Benefit /Council Tax Benefit Security Guidance (formerly the HB/CTB Security Manual) which has been fully revised and updated to reflect: changes to the subsidy distribution methodology announced in HB/CTB S4/2005 (Revised), changes to the Performance Measures announced in HB/CTB A7/2006, the abolition of the Security Against Fraud and Error scheme, the abolition of the Verification Framework and; the application of new Housing Benefit and Council Tax Benefit Regulations, including those applicable to persons who have attained the qualifying age for state pension credit. The document provides advice and guidance on securing the HB and CTB systems and achieving the performance measures and enablers defined in the Performance Standards. The introduction gives an explanation of the background to the changes relating to subsidy and the links with the Performance Standards. It also provides references to the statutory provisions and a glossary of abbreviations used. The introduction and overview to Part A reinforces our view of the importance of ensuring that the initial entitlement decision is correct and that effective caseload management represents the best method of reducing fraud and error. We have removed all references to previous funding arrangements, the voluntary aspect of the VF scheme, and VF - compliance status because they no longer apply. The New Claims procedures section has been amended to remove references to VF set up costs and ongoing funding.

2 For reviews/interventions, we have included references to the Performance Standards performance measures to make clear the requirement to have effective caseload management. We have also included the change to the definition of performance measure 10 which specifies reviews completed rather than commenced. Otherwise the definition of a risk-scored review remains unchanged and confirms that the purpose of the review is to ensure that potential incorrectness is rectified quickly and that LA Decision Makers are responsible for applying the suspension and termination requirements during the review. We have removed the requirement to carry out a number of reviews per month as it is not possible to specify in advance the number to be completed each month. We have also removed the 2 month break from the need to carry out reviews as it became clear during our discussions with the Local Authority Associations that the preferred option was that assessment should be on an annual basis so that LAs could continue to use their resources more flexibly. The Visiting section has been changed substantially to reflect the decision to use the definition of effective visits as applied to the Best Value Performance Indicator. This definition is considerably wider than that applied for VF purposes but better reflects the realities of a visiting regime. The Procedures for Administration section replaces Standards of Verification in the old Security Manual. The section on Verification done by other than LA staff has been relocated towards the beginning of this section. We have removed or revised as appropriate references to RATS, order books, CMS, hostel dwellers, evidence on capital, verification guidance, consolidated HB/CTB regulations and other associated regulations so they reflect the current position. Fraud and Error Strategy Division colleagues have provided the content in Part B (Identity). We will issue updates to this section as and when further amendments may be required to reflect changes in this area. Part C (Housing Benefit Matching Service) has been redrafted to reflect the new arrangements for data matching and reporting. We have also provided relevant appendices to reflect these changes and included the timetable for data collection. Part D on Royal Mail Do Not Redirect has been reviewed and the amended contents agreed with the Royal Mail. The appendices have been re-arranged; those appendices which refer back to Part A and Part C are grouped together; Part B is in the middle but comprises only 1 appendix, the extract from the SSAA 1992 relating to identity. The Part A appendices have been revised to include references concerning the importance of understanding the consequences of providing a signature and removing references to VF. The appendix on Fraud Awareness (Appendix 10) has been amended to reflect the need to emphasise importance of Error as a feature of the fraud and error strategy.

3 The guidance will be available on the website at Appendix 1 of the guidance contains contact details however if you wish to make enquiries please send them to SAFE-VF@dwp.gsi.gov.uk. Yours sincerely Maxine Leyland Local Authority Performance Division

4 Housing Benefit and Council Tax Benefit Security Guidance

5 Record of amendments Record of amendments 1 Amendments are serially numbered so that holders can check they have received the full series. 2 Incorporate amendments immediately and record that you have done so below. Serial number Initials Date Serial number Initials Date

6 About this guidance Contents About this guidance Introduction...1 Background...5 What this guidance does not contain and where to find that information...20 How to use this guidance...25 Finding the information you need...25 Contents...30 Language and layout of the guidance...40 Words and phrases used with a specific meaning in this guidance...40 Cross references...45 Statutory references...50

7 About this guidance 1-10 About this guidance Introduction 1 This guidance gives information about Department for Work and Pensions (DWP) advice and guidance on interventions and verification of claims for Housing Benefit (HB) and Council Tax Benefit (CTB) Section 1(1A) and 1(1B) of the Social Security (Administration) Act 1992 Housing Benefit Matching Service (HBMS) Royal Mail Do Not Redirect service 2-4 Background 5 Prior to April 2006 the DWP funded two additional subsidy schemes, the Verification Framework (VF) and Security Against Fraud and Error (SAFE), to drive down the amount of fraud and error in the HB system. 6 Compliance with the VF was voluntary. LAs that adopted one or more modules of the scheme were entitled to claim additional subsidy payments to assist with the cost of its administration. 7 The SAFE anti-fraud incentive scheme provided LAs with additional subsidy payments for identifying and correcting fraud and error in the administration of HB and CTB. 8 HB/CTB Circular S4/2005 (Revised) announced changes to the distribution of administration subsidy from April All LAs will receive all available VF funding that would have been paid if they were fully compliant with all three modules of the VF. Local Authorities (LAs) will also receive an amount of funding, based on the value of their claims made in accordance with the SAFE scheme in 2004/ Combining the funding elements previously paid as VF and SAFE subsidy, and distributing them with HB/CTB administration subsidy using a single formula, allows LAs the opportunity to know their funding level in advance of the financial year. This provides LAs with more financial stability and provides the first step towards more stable three year funding settlements. 10 This combined funding gives LAs the flexibility to fund their administration and security of benefits in accordance with local circumstances. However, as a guide, we expect LAs to direct around a third of their total allocation to security of benefits through effective new claim investigation, reviews, visits and counter-fraud investigations.

8 About this guidance As funding for programme protection activities will be combined with administration subsidy funding and issued much earlier than previously, DWP needs to ensure that LAs remain committed to resourcing and carrying out counter fraud activities. 12 We have therefore agreed with Local Authority Associations (LAA) representatives on revisions to the scoring methodology for the Security theme in the 2005 HB/CTB Performance Standards to ensure that the Standards encourage all LAs to become even more effective in minimising fraud and error. The security performance measures and enablers have been developed to enable the LAs and DWP to assess performance against guidance contained in the HB/CTB verification guidance, the 2005 HB/CTB Performance Standards Manual and the Fraud Procedures and Instruction (FPI) Manual 13 The DWP advice and guidance on verification represents best practice in support of the Performance Standards What this guidance does not contain and where to find that information 20 This guidance does not include advice about subsidy arrangements to LAs when they are payable and how to calculate, etc. For subsidy information, see HB/CTB Subsidy (S) Circulars and HB/CTB Subsidy Guidance the administrative procedures for dealing with benefit claims, such as gathering information. For more information, see Housing Benefit and Council Tax Benefit Guidance Manual the Adjudication and Operations Circulars, issued by the Department for Work and Pensions (DWP) 21-24

9 About this guidance How to use this guidance Finding the information you need 25 The information in this guidance is contained in separate parts. Some parts of this guidance are split into several chapters, eg DWP advice and guidance on verification has the following chapters Introduction New Claims procedures Reviews procedures Visiting Procedures for administration The Guidance and the law Security of administration and Performance Standards Contents 30 There is a main contents page at the front of this guidance that lists the main and sub headings within each Part of the guidance is a quick reference to the structure of the guidance and its subject 31 The guidance is divided into four Parts which are Part A Part B Part C Part D DWP advice and guidance on verification Guidance on Section 1(1A) & 1(1B) of the Social Security (Administration) Act 1992, ie identity Housing Benefit Matching Service Royal Mail Do Not Redirect service 32 Each chapter has its own contents showing a detailed list of all the headings within that chapter

10 About this guidance Language and layout of the guidance Words and phrases used with a specific meaning in this guidance 40 Some ordinary words and phrases have been used in this guidance with a specific meaning to aid ease of reading and understanding, eg you, used to mean the person within the LA making the decision or gathering information and evidence we, used to refer to HB Security Support Team, Local Authority Performance Division (LAPD) 41 In this guidance DWP should be taken to include Jobcentre Plus offices Jobcentres Social Security offices The Pension Service 42 Jobcentre Plus should be taken to include Jobcentre and Jobcentre Plus offices Social Security offices Cross references 45 Wherever possible all the main guidance for a particular issue is contained in the same part. Sometimes you will be referred to another part of the guidance, or to another document for further related information rather than repeating that same information

11 About this guidance Statutory references 50 Reference to the relevant statutory provisions are given in this guidance underneath the relevant paragraph. The abbreviations used are D&A reg S Sch Housing Benefit and Council Tax Benefit (Decision and Appeals) Regulations 2001 for regulation for section - refers to a Section of the Social Security Administration Act 1992 or the Social Security Contributions and Benefits Act 1992 for schedule SSAA Social Security Administration Act 1992 SSCBA Social Security Contributions and benefits Act

12 Abbreviations Abbreviations AA AIF AIP ALMO BB ChB CIS CMS CPS CTB Attendance Allowance Assessed Income Figure Assessed Income Period Arms Length Management Organisation Bereavement Benefit Child Benefit Customer Information Service Customer Management System Crown Prosecution Service Council Tax Benefit CTB Reg Council Tax Benefit Regulations 2006 CTB(SPC) Reg Council Tax Benefit (Persons who have attained the qualifying age for state pension credit) Regulations 2006 DCI DIT DLA Departmental Central Index Data Integrity Team Disability Living Allowance DPA Data Protection Act 1992 DTOPS DWP e-sef ETD FAQ FOG FPI HA HB Data Take-On and Processing Schedule Department for Work and Pensions External standard enquiry facility Electronic Transfer of Data Frequently Asked Questions Field Operations Group Fraud Procedures and Instructions Housing Association Housing Benefit

13 Abbreviations HB Reg Housing Benefit Regulations 2006 HB(SPC) Reg HBMS HMRC IAD IB IRL IS JSA(Cont) JSA(IB) LA LAA LAPD MA MIDAS MIS NFI NIFU NINO NIS PIN RATs RDT RMDNR RMS RP RSL Housing Benefit (Persons who have attained the qualifying age for state pension credit) Regulations 2006 Housing Benefit Matching Service Her Majesty s Revenue and Customs Information Analysis Division Incapacity Benefit Indicative Rent Level Income Support Contribution based Jobseeker s Allowance Income-based Jobseeker s Allowance Local Authority Local Authority Associations Local Authority Performance Division Maternity Allowance Matching Intelligence and Data Analysis Services Management Information System National Fraud Initiative National Identity Fraud Unit National Insurance Number New Incentive Scheme Personal Identification Number Remote Access Terminals Rule Development Team Royal Mail Do Not Redirect Referral Management System Retirement Pension Registered Social Landlord

14 Abbreviations SAFE SDA SLA TIC VO WB WTC Security Against Fraud and Error Severe Disablement Allowance Service Level Agreement Taken into Consideration Visiting Officer Widow s Benefit Working Tax Credit

15 Contents Contents Part A DWP advice and guidance on verification DWP advice and guidance on verification Introduction Queries New claims procedures Interventions and Reviews procedures Visiting New Claims procedures Introduction The claim form Reviews procedures Introduction Data-matches Risk-scored reviews Definition of a review Changes of circumstance Recording a completed review Frequency of reviews Volume of interventions Suspension of benefit Visiting Introduction Definition of an effective visit Notified/un-notified visits Procedures for administration Evidence and checks Security Evidence of residency and rent Evidence of household composition Evidence of earnings employed earners Evidence of earnings self employed Evidence of benefits Evidence of other income Evidence of capital Special rules for hostel dwellers

16 Contents The Guidance and the law Introduction Evidence Suspending payment of benefit Visiting Reasonableness Decisions and decision notices Case law Security of administration and the Performance Standards Introduction Management information requirements Training, fraud awareness and checks Part B Section 1(1A) and 1(1B) of the SSAA 1992 Evidence of identity Introduction LA s legal responsibility Recording evidence of identity Establishing identity Claimants without a NINO HB/CTB claims associated with certain DWP-administered benefits Recording the checks and evidence Part C Housing Benefit Matching Service Introduction Data Take-on and Processing Schedule HBMS data-matches Risk-scored reviews Data quality HBMS data scans DCI500 LA procedures Part D Royal Mail Do Not Re-Direct service Introduction Outline of service What LAs need to do Legislative requirements

17 Contents Appendices Contact list... Appendix 1 Interventions requirement 2006/07... Appendix 2 Security: Performance Measures and Enablers... Appendix 3 Risk-scoring methodology... Appendix 4 Reviews Form... Appendix 5 Visiting Officer s verification statement... Appendix 6 New claim checklist... Appendix 7 Certificate of Earned Income... Appendix 8 HB/CTB self-employed earnings information... Appendix 9 Fraud and error awareness... Appendix 10 Fair Processing Statement... Appendix 11 Management control sheet... Appendix 12 Management checklists... Appendix 13 Sections 1(1A) and 1(1B) of the SSAA Appendix 14 Data incidents... Appendix 15 Management information requirements 2006/07... Appendix 16 Form WIB4a Prosecution... Appendix 17a Form WIB4b Caution/Admin Pen... Appendix 17b Not used... Appendix 18 Not used... Appendix 19 DCI 500 LA DESK AID... Appendix 20 Word Solution/HBLite Desk Aid... Appendix 21 HBMS Data Take-On and Processing Schedule (DTOPS) Appendix 22 HBMS Rules Appendix 23 Completion of HBMS Results... Appendix 24a HBMS Results Sheet... Appendix 24b

18 Part A DWP advice and guidance on verification Contents Part A DWP advice and guidance on verification Introduction Key elements Queries New Claims procedures Interventions and Reviews procedures Visiting

19 Part A DWP advice and guidance on verification Part A DWP advice and guidance on verification Introduction 1.0 This guidance is produced by the Department for Work and Pensions (DWP) to provide Local Authorities (LAs) with minimum standards for the collection of evidence and ongoing checks in both Housing Benefit (HB) and Council Tax Benefit (CTB) cases. The intention is that when LAs adhere to the guidance, the amount of fraud and error entering the system will be reduced, and any that does enter will be detected more readily. This guidance represents best practice in support of the 2005 HB/CTB Performance Standards. 1.1 This guidance is not legislation but it is firmly based on the existing HB/CTB legislation. The guidance does not require, and does not imply, that LAs do anything contrary to the benefit legislation or any other existing statutory or legal requirement. At all times, LAs must decide HB/CTB entitlement in accordance with the law. 1.2 Fraud and error in HB/CTB can be reduced if the initial decision is correct, and any subsequent changes in circumstance are identified early and processed with speed and accuracy. This relies on LAs collecting appropriate information and evidence in support of benefit claims. The guidance helps to increase accuracy from the start of a claim and throughout its life by emphasising both the prevention and detection of fraud and error. 1.3 The guidance sets out the information that must be collected and verified before benefit is paid and specifies the minimum standards of evidence and checks that must be made during the life of the claim. The guidance represents the minimum standards to be applied by LAs in ensuring that the administration of HB/CTB is appropriate, secure and supports the Performance Standards. A link to the Performance Standards is provided in Appendix 1. The performance measures and enablers for the Security theme are provided in Appendix The guidance provides support to LAs working to achieve the Performance Standards by the implementation of a system of finding fraud and error in the live caseload by the use of data-matching and risk analysis. It enables LAs to review HB/CTB claims with targeted interventions; better targeting will enable fraud and error to be detected more quickly from fewer interventions.

20 Part A DWP advice and guidance on verification This part is divided into six chapters and gives details of the key elements and the action LAs must take when dealing with claims. There are also a number of supporting appendices. The six chapters are New Claims procedures Reviews procedures Visiting Procedures for administration The Guidance and the law Security of administration and the Performance Standards Key elements 1.10 The three key elements are New Claims Reviews Visiting 1.11 This chapter gives an overview of each of these elements. Full details of each key element are in the relevant chapters Queries 1.20 Further guidance on preventing fraud and error is contained in the 2005 HB/CTB Performance Standards manual and the Fraud Procedures and Instruction (FPI) Manual For any enquiries regarding the guidance that cannot be resolved by the Frequently Asked Questions (FAQs) page, contact HB Security Support Team, Local Authority Performance Division (LAPD), see Appendix 1 for details

21 New Claims procedures Part A DWP advice and guidance on verification The New Claims procedures recommend that LAs collect all information and evidence in respect of new claims in accordance with the guidance specified verify all new claims in accordance with the guidance specified in this guidance 1.31 All subsequent changes of circumstances to these cases must be verified to these standards, including change of address within an LA area, reported by the claimant or from any other source, either prompted or unprompted Interventions and Reviews procedures 1.35 The Reviews procedures recommend that LAs resolve, within two months, issues raised by all the data-matches carried out monthly for all LAs by Housing Benefit Matching Service (HBMS). A data-match will be resolved when the HBMS Results Sheet has been returned to HBMS indicating that one of the four criteria stated in paragraph 3.21 later in this part has been achieved carry out the balance of annual interventions by completing additional riskscored reviews to be carried out on live claims which are particularly at risk of fraud or error. A list of these cases will be provided monthly by HBMS. The reviews can be carried out by telephone postal check office interview visit 1.36 The total number of data-matches resolved and reviews completed should be in accordance with the numbers specified in Appendix LAs must, verify to the standards specified in this Guidance any changes of circumstances that have occurred since the last review or last updated information held for the claimant. Such changes may come to light either as part of the review process or fraud investigation when a full review is being carried out

22 Part A DWP advice and guidance on verification Visiting 1.40 The Visiting procedures explain that LAs should, in accordance with the Performance Standards carry out a number of visits per year, equivalent to a specified percentage of its caseload. For the number of visits to be carried out by individual LAs, see Appendix LAs who choose to visit a claimant to carry out a review should verify to the standards specified in this guidance any changes of circumstances that have occurred since the last review or last updated information held for the claimant. Such changes may come to light either as part of the review process or fraud investigation when a full review is being carried out

23 Part A New Claims procedures Contents Part A New Claims procedures Introduction The claim form

24 Part A New Claims procedures Part A New Claims procedures Introduction 2.0 A new claim means any HB/CTB claim when there is no current award of HB/CTB, not including cases which are backdated to link with a previous claim, or when a previous claim can be reviewed to create continuous entitlement to HB/CTB made following a change of address to a different LA area, or following extended payments of HB/CTB, or not covered by these points when there is a break in entitlement from a previous award 2.1 The New Claims procedures recommend that LAs collect all information and evidence in respect of new claims, and verify all new claims to the standards specified in Procedures for administration later in this part 2.2 This chapter contains information about the claim form

25 Part A New Claims procedures The claim form 2.10 The onus is on the claimant to provide all the information and evidence the LA needs to decide their entitlement. It is vital that the claim form is clear about the information and documentary evidence the claimant must supply in support of the claim The guidance does not require the use of a standard national claim form, however we strongly recommend that LAs refer to the DWP HCTB1 claim form when designing their own form Before a decision on a claim is made, a claim form should either collect all the information and evidence as specified in the DWP HCTB1 claim form, or contain trigger questions that identify areas that need to be followed up, so that all the information and evidence required is collected 2.13 LAs can design multiple claim forms designed to target different groups, such as pensioners claiming CTB only. These forms should clearly identify areas that need to be followed up for supplementary action

26 Part A Reviews procedures Contents Part A Reviews procedures Introduction Data-matches Numbers to be resolved Resolution of a data-match Recording completed data-matches Risk-scored reviews Definition of a review Action to take at the review stage Changes of circumstance Recording a completed review Frequency of reviews Volume of interventions Suspension of benefit

27 Part A Reviews procedures Part A Reviews procedures Introduction 3.0 This section contains information about data-matches risk-scored reviews changes of circumstance recording a completed review frequency of reviews volume of interventions suspension of benefits 3.1 The Reviews procedures comprise two elements data-matching and risk-scored reviews provide guidance to LAs to ensure that cases are reviewed in accordance with the targets and timescales specified in the Performance Standards.

28 Part A Reviews procedures Data-matches Numbers to be resolved 3.10 Every month, HBMS send all LAs a set of data-matches. LAs are encouraged to treat the resolution of a data match as a priority because there is a high chance that data matches will identify incorrectness that is likely to result in larger overpayments the longer they are undetected The Performance Standards indicate that LAs should aim to resolve all data-matches within two months of receipt. See Performance Measure PM11 in the 2005 HB/CTB Performance Standards manual Resolution of a data-match 3.20 The resolution of a data-match could involve as little as correcting data entries, or may involve a full review, including a fraud investigation. The sifting and management of the data-matches on receipt and who should resolve them is a matter for individual LAs to decide A data-match is considered to be resolved when the HBMS results sheet has been returned indicating that the reason for the apparent discrepancy has been identified and the LA have established that the amount in payment is correct, or any incorrectness that is uncovered has been rectified, ie the benefit has been re-assessed,or a fraud investigation has commenced, or action to suspend has commenced Recording completed data-matches 3.30 Because the resolution of a data-match counts towards the LA s annual target your annual target of interventions, the LA should notify the outcome of the resolution to HBMS, and only complete the last recorded review date field on your benefit system if a full review has also been carried out

29 Part A Reviews procedures Risk-scored reviews 3.40 HBMS provide all LAs with a monthly list of risk-scored cases. The content and effectiveness of the list is dependent on LAs providing accurate data extracts to HBMS and the HBSD/IAD scan to the Information Centre on the dates specified in the schedule The Reviews procedures do not require an LA to follow this DWP risk analysis if they have a local risk analysis that they consider more accurate. However, analysis of activity in 2005/06 demonstrates that DWP risk analysis-related activity is more effective than local risk analysis. The risk methodology used in deriving the DWP risk score is explained in Appendix If an LA does not provide the monthly extract or if HBMS is not able to provide the list, an LA should meet its quota of interventions using its own risk analysis The guidance does not specify a time limit for completing the review however it is advisable to complete it as soon as practicable to ensure that any potential incorrectness is rectified at the earliest opportunity The purpose of the review is to ensure that the claimant is entitled to the correct amount of HB/CTB. LA Decision Makers are responsible for deciding whether and when to use their powers of suspension and termination during the review process A risk-scored review is completed when the LA has established that the customer is entitled to their current rate of benefit, or the benefit award has been superseded following a change of circumstances, or the benefit award has been terminated, or a fraud investigation has commenced Definition of a review 3.50 For standard HB/CTB cases, including pensioners not in receipt of Pension Credit, a review of a selected case will require checking and confirmation of all the main elements of entitlement by whatever method the LA feels appropriate for that case For non-standard cases, including those in receipt of Pension Credit (both guarantee and savings credit), LAs are not required to review a claimant s income and capital. The LA must verify the claimant s ongoing entitlement to Income Support (IS), income-based Jobseeker s Allowance (JSA(IB)), or Pension Credit. All other HB-specific elements of the claim must be reviewed for these cases to confirm entitlement to HB/CTB

30 Part A Reviews procedures Action to take at the review stage 3.60 A risk-scored review should cover the main elements of entitlement. The LA can decide whether the risk-scored review is carried out by telephone, post, an office interview or a visit. Whichever method is used, the risk-scored review can be carried out on the basis of a shortened version of an initial claim form. For an example of the form see Appendix 5, LAs can use their own version provided it meets the minimum requirements A risk-scored review requires verification only of any information that has changed since the last review or the initial claim although LAs may wish to verify to a higher standard. Information must be verified in accordance with the guidance in Procedures for administration later in this part. Where claims for HB/CTB are made through the Jobcentre Plus Customer Management System (CMS) instead of a clerical HB/CTB claim form, LAs will need to use the LA Input Document from Jobcentre Plus as the base document for the purpose of carrying out a review Since the completion of the form over the telephone is simply a means of gathering information that may indicate a change of circumstance or other incorrectness in the claim, the guidance does not specify whether the form needs to be signed by the claimant If a change of circumstances is discovered, LAs should act as required by the HB/CTB regulations. LAs can decide if they want to obtain a signature for reasons beyond those stipulated in the regulations

31 Changes of circumstance Part A Reviews procedures Claimants and landlords who receive direct payments of HB for their tenants are responsible for reporting to the LA, in writing, changes of circumstances which they could reasonably be expected to know might affect their entitlement to HB or the amount received. HB Reg 88(1), HB(SPC) Reg 69(1); CTB Reg 74(1) CTB(SPC) Reg 59(1) 3.71 All changes of circumstance that come to light as part of the review process must be verified to the standards laid out in Procedures for administration later in this part. LAs should ensure that customers provide appropriate documentation to support the notification of change of circumstances and should ensure that their review form reflects this The guidance requires that only changes since the last review or initial claim must be verified, although LAs may wish to verify to a higher standard The same applies to obtaining a signature for a no change review. The guidance does not require this but LAs may want to obtain a signature for their own purposes In all cases when the LA takes action as a result of a telephone call, care must be taken to make sure both the caller and information are bona fide the information supplied is accurately and fully recorded

32 Part A Reviews procedures Recording a completed review 3.80 On completion of the review, enter the relevant date in the last recorded review date field on your benefit system. This will make sure the case does not reappear on the list of risk-scored cases until at least six months have elapsed for working-age claimants three years have elapsed for pensioner cases 3.81 You must resolve any data-match that is subsequently received before the next earliest possible review date, and can review more often in exceptional circumstances. Each LA decides what constitutes exceptional circumstances Some reviews may start as a telephone/postal review but require follow-up by a visit. This will count as one review on the basis that once a review is commenced, it has to be actively resolved by whatever means necessary Action on hotline fraud referral or resolving National Fraud Initiative (NFI) matches can be counted towards your reviews target only if a full review is undertaken. This list is not exhaustive

33 Part A Reviews procedures Frequency of reviews 3.90 A Working Age claim should not normally be reviewed more than every six months except where it is considered to be exceptionally risky. A Pensioner s claim should not be reviewed more than once every three years. Exceptionally a case can be reviewed more frequently if an LA chooses to do so If a claimant who has recently been reviewed subsequently nevertheless appears on a data-match, this must be followed up, as it is a positive indication that a potential incorrectness remains or has arisen since the review

34 Part A Reviews procedures Volume of interventions LAs have targets for the minimum number of interventions to be carried out each year, see Performance Measure PM 10 in the 2005 HB/CTB Performance Standards. The minimum number of interventions is set out in Appendix 2 to this guidance. The minimum number can be exceeded as all interventions may lead to the identification of fraud and error The total interventions target has been agreed with the Local Authority Associations (LAA). It is based on 50% of the LA s June 2005 caseload and was used to calculate the 2006/07 Administration subsidy HB/CTB Circular S4/2005 (Revised), paragraph 12 refers To achieve the interventions targets LAs must complete risk-scored reviews and resolve HBMS data-matches Data-matching and risk-scored reviews are most effective if done continuously. LAs should aim to complete a minimum number of risk-scored reviews throughout the year and resolve all data-matches within two months in accordance with the Performance Standards

35 Part A Reviews procedures Suspension of benefit LAs already have powers to suspend benefit in certain prescribed circumstances. Crucially, there is no right of appeal against decisions to suspend payment of benefit. The claimant can seek leave to bring judicial review proceedings against the decision in question. There is, therefore, an onus upon the Decision Maker to act reasonably, as well as in accordance with legislation An LA can suspend payment of benefit straight away, either in part or in whole, when an issue arises as to whether the conditions of entitlement are satisfied or the present award of benefit may be incorrect An LA can suspend the payment of benefit if a question arises about an award of benefit Request information or evidence from the claimant and give them one month to supply this information. If the claimant says they need more time, you can extend the period as you consider reasonable If the information has not been provided within that period, you can suspend benefit, in whole or in part as appropriate. You should then write to the claimant, explaining that they must provide the information within one month. Again, you can extend this period if it appears to be reasonable to do so If the claimant still does not comply, you can terminate the benefit award. The termination takes effect from the date of suspension or earlier if it is decided that entitlement ceased from an earlier date Before suspending benefit, you must be able to demonstrate you have taken account of all relevant considerations and not based your decision purely on the basis that the case has been identified on the risk-scored review list by DWP. The risk score is simply a piece of information which may trigger a review, and suspension comes later if it comes at all If you suspect there is no entitlement to IS, JSA(IB) or Pension Credit, and as a result, a question arises over whether the person is entitled to HB/CTB or whether the existing award should be revised or superseded, refer the matter to the DWP for its decision. For Pension Credit cases, pass the information to The Pension Service.

36 Part A Reviews procedures LAs must bear in mind that the decision to suspend is for the LA to take in accordance with the legislation the LA must take account of all relevant considerations in making its decision. It must not exclude any relevant consideration, and it must not take account of irrelevant considerations the decision whether to review the person s case precedes any decision to suspend when DWP supply the LA with information, including a risk score, they are not requiring the LA to review any particular case or to suspend benefit it would be unlawful to suspend simply on the basis of a risk score. The score is based on statistical analysis of how the chance of overpayment tends to vary according to a claimant s characteristics. It does not indicate any reason to suspect that a particular individual who has a risky score is being dishonest. It means that, in general, people who have similar characteristics to that individual are more likely to have a change of circumstance than those with a lower score

37 Part A Visiting Contents Part A Visiting Introduction Definition of an effective visit Notified/un-notified visits

38 Part A Visiting Part A Visiting Introduction 4.0 Visiting is an effective method in preventing and detecting fraud and error in HB/CTB by assisting in confirming residency, ensuring that the initial decision is correct, and any subsequent changes in circumstance are identified early and processed with speed and accuracy. Visits can be carried out by fraud and non-fraud staff. 4.1 LAs are required to provide details of the number of effective visits to claimants for the purpose of detecting or preventing fraud or error and their performance is reported through the Best Value Performance Indicator (BV76) (Wales: NS 20) and the HB/CTB Performance Standards (PM 12) Definition of an effective visit 4.10 Since April 2005 PM 12 has included all visits carried out by fraud and non-fraud staff where the purpose was to prevent or detect fraud or error. The count includes pre-payment visits. A visit is classed as effective if the information gained assists in confirming that the claim is correct, in the detection or prevention of an incorrect benefit payment or in a referral for a fraud investigation Where a series of visits are made on the same case in order to establish the same piece/pieces of information and more than one of these are effective, this will be counted as only one effective visit. The count will include notified and un-notified visits Examples of visits that can be included in the count are pre award visits visits to confirm residency visits to conduct an intervention 4.13 The count of such visits will be included in the HB and CTB Management Information System guide for 2006/07 produced by DWP For the Best Value Performance Indicator the number of effective visits will continue to be measured by 1,000 caseload For the PM 12 the number of effective visits will be assessed against an annual target representing 20% of the LAs live load at June 2005 as used for the Administration subsidy for 2006/07, see HB/CTB Circular S4/2005 (Revised) para 12.

39 Part A Visiting The data used for volumes has been taken from the HBMS extracts submitted by each LA using the extract that was closest to 30 June Requirements for 2006/07 are given in Appendix Visiting can be used as a method of conducting reviews. See Reviews procedures earlier in this chapter Notified/un-notified visits 4.30 It is for the LA to decide if visits should be notified or un-notified. In most cases DWP recommends that visits should be notified but there will be occasions where an un-notified is appropriate Different LAs will carry out un-notified visits in different circumstances, depending on their own risk analysis and local knowledge. Some examples of when un-notified visits may be appropriate are when a claimant has previously failed to inform the LA of a change of address whilst claiming HB the LA has concerns about the landlord, eg has previously accepted direct payments of HB for tenants who are no longer resident the address is known to have a high turnover of occupants the claimant has previously failed to declare they are cohabiting or working, and the claimant is not currently declaring a partner or earnings

40 Part A Procedures for administration Contents Part A Procedures for administration Evidence and checks Introduction Verification done by other than LA staff Collecting and recording evidence Exceptions Crosschecking Security Evidence of residency and rent Rent Rebate cases Rent Allowance cases Landlord s/agent s name and address Registered Social Landlords Council Tax Benefit cases Crosschecking residency and rent Council Tax records Handwriting Dependants Rent books Recording the evidence and checks Evidence of household composition Partners Dependants Non-dependants Second adult rebates Crosschecking information Single person and lone parent claims Electoral Register and housing lists Rent Officers Recording the evidence and checks Evidence of earnings employed earners Crosschecking earnings Bank statements Wage slips Letter from employer Certificate of earnings Handwriting Other benefits

41 Part A Procedures for administration Contents Expenses Severance pay or redundancy Recording the evidence and checks Evidence of earnings self-employed Recording the evidence and checks Evidence of benefits IS and JSA(IB) Pension Credit cases Guarantee credit or guarantee and savings credit payment Savings credit in only in payment Unsuccessful claims for Pension Credit HB/CTB Rapid Reclaim claims HB/CTB claims made through the Customer Management System Post Office card account Crosschecking benefits Recording the evidence and checks Evidence of other income Internet banking Disregarded income Crosschecking income Recording the evidence and checks Evidence of capital Additional information from CMS Evidence specified not available Premium Bonds Land and buildings Crosschecking capital Recording the evidence and checks Special rules for hostel dwellers

42 Part A Procedures for administration Part A Procedures for administration Evidence and checks Introduction 5.0 This chapter explains the standards of evidence needed and the crosschecks that must be carried out for each claim to ensure that LA activity is focused on delivering an effective HB/CTB system in accordance with the Performance Standards. It provides checks to filter out fraud and error. The requirements in this chapter apply to all aspects of standard new claims HB aspects only of non-standard new claims all changes of circumstance that have occurred since the initial claim to benefit and/or last review 5.1 Verification beyond the requirement is a matter for the LA to decide. Different rules apply for hostel dwellers, see Special Rules for hostel dwellers later in this chapter. 5.2 This chapter also explains some verification procedures which may be different under the CMS process such as in verifying handwriting, see Handwriting and Evidence of benefits later in this chapter. 5.3 National Insurance number (NINO) and identity must be verified for all new claims to HB/CTB as per specified by Section 1 (1A) and 1 (1B) of the Social Security (Administration) Act 1992, see Part B, Guidance on Section 1 (1A) and 1 (1B) of the SSAA 1992 later in this guidance.

43 Part A Procedures for administration This chapter contains information about evidence and checks security evidence of residency and rent household composition earnings - employed earners earnings - self-employed benefits other income capital special rules for hostel dwellers 5.5 Each section specifies the standards of evidence required and details what is acceptable evidence what to do if the prescribed evidence is not available what checks are required for new claims, reviews and visits why checks are necessary what to do if checking reveals inconsistencies Verification done by other than LA staff 5.10 Where verification activity has been contracted out to a third party, eg Arms Length Management Organisations (ALMOs), Registered Social Landlords (RSLs) or any such organisation, either under contractual or partnership agreements, the legal duty to administer HB remains with the LA.

44 Part A Procedures for administration The LA is required to make all decisions and decisions on individual HB/CTB claim entitlement. Claimants should be offered the choice of having their claims verified by the LA or by the third party organisation remains responsible for maintaining and making sure verification standards are met, including data protection requirements will develop quality checking procedures that make sure the verification activity is accurate, and that standards are maintained must make sure that fraud and error is prevented and does not enter the system retains responsibility for any errors and/or omissions that occur during the verification process investigating fraud and error compliance with intervention targets, data quality and management information 5.12 Any overpayment which results from error and/or omission by the LA will be designated an LA error overpayment, with all the recovery and subsidy implications connected with these cases LAs could introduce a checking regime that might include visiting the claimant, checking evidence/documents at the point of contact and build a review of the processes, performance and standards into the internal audit programme. This would reassure the LA that verification by the other organisation is being done accurately and to the required standard Collecting and recording evidence 5.20 Documents can only be accepted and certified as originals by LA staff contractor staff, if the LA has contracted out HB/CTB administration DWP third parties, eg RSLs ALMOs others with whom the LA may have contracted.

45 Part A Procedures for administration The LA remains accountable for the standard of verification carried out by the third party. For HB/CTB claims made through the Jobcentre Plus CMS, see HB/CTB claims made through the Customer Management System later in this chapter for details of what is acceptable to satisfy the guidance requirements Agency staff are also able to take decisions on HB/CTB claims, but the ultimate responsibility for the administration of these benefits remains with the LA The evidence collected and checks made must be clearly and accurately recorded. The checklist proforma at Appendix 7 can be used as an example. How this is done depends on the LA s processing procedures. However the LA, in recording this information, must show any documents that were seen and accepted by an appropriately trained officer as being original the identity of that officer the date the officer saw the document or made the decision the relevant details in the document, or the reason for the decision 5.24 A record must be completed to show the appropriate checks have been made. These records can be either clerical or system based. The LA must make sure all the relevant details are recorded. For example it is not sufficient to record that a bank statement has been seen. The record must show the current balance and any regular deposits or withdrawals made. This information will be used for crosschecking purposes Taking copies of documents provides the most comprehensive information and enables further referral, if necessary. Copies should be clear and, in the case of passports and ID cards, the face of the customer should be visible LAs can choose to either copy documents, eg photocopying or scanning, or record the relevant information contained in the documents, eg on a clerical form, or a system notepad facility. The LA, when recording the information must ensure that the record meets the criteria set out in paragraph 5.23 above For an example of a Visiting Officer s (VO) verification statement, see Appendix 6. This can be used by VOs to record details of evidence obtained during a visit. A similar form could be used by office-based staff. LAs do not need to use this particular form but must record the information it contains When evidence is documented, as opposed to copied, the appropriate chapters of this part show the minimum details that must be recorded It is important to record all the appropriate information, even when the evidence is incomplete and further evidence will be sought.

46 Part A Procedures for administration When seeking evidence, the LA should only request what is reasonably required in order to make a decision on the HB/CTB claim. See The Guidance and the law later in this part Exceptions 5.40 DWP recognises there may be individual cases when full compliance with the guidance is not possible. In such cases, the LA must be able to demonstrate it has made all reasonable efforts to establish that the facts are more likely than not to be as stated by the claimant on their claim form record its reasons for accepting the lower standard of evidence consider each case on an individual basis and not apply blanket exemptions 5.41 If evidence to support the claim is not supplied and the claimant does not supply a reasonable explanation for the failure to provide the information, LAs should consider whether a decision that the claim has not been made in the prescribed manner or a decision based on an adverse inference would be appropriate, see Decisions and decision notices later in this part Crosschecking 5.50 Crosschecking may identify inconsistencies in the information given by the claimant. It is important to crosscheck a number of areas within the claim. For example a claimant declares they do not have a bank account, but the evidence provided to confirm their income shows the income is paid directly into a bank account In such cases ask the claimant to provide details to explain this apparent discrepancy. This may highlight further discrepancies or disclose undeclared capital or income. By crosschecking against previous claims, similar inconsistencies may be discovered

47 Part A Procedures for administration Security 5.60 Security is of prime concern when dealing with all documents but particularly those with value attached or that are difficult to replace Secure procedures should be established to handle the documents and for arranging their safe return after the evidence has been recorded. See 2005 HB/CTB Performance Standards, Resource management for more information

48 Part A Procedures for administration Evidence of residency and rent HB is only payable to claimants who have a liability to pay rent on the dwelling they occupy as their home. Regulations define who is, or is not, to be treated as having such a liability occupying the dwelling as their home 5.71 In all cases the key to deciding if a liability exists, and whether the claimant and their family occupy the dwelling as their home, will be the evidence of residency and rent. This will normally be in the form of proof of liability to pay rent CTB is only payable to claimants who are liable for the Council Tax on the dwelling in which they reside Rent Rebate cases 5.80 In all Rent Rebate cases the LA should be able to establish all necessary proof of the claimant s tenancy, rent and residency from its own records Rent Allowance cases 5.90 In all Rent Allowance cases the LA should, in the first instance, seek proof of the liability to pay rent and proof of residency from the claimant. When possible, original documents should be accepted as evidence. If, for example, the claimant does not have an original agreement, they should provide some other form of original documentation Evidence of a claimant s liability to pay rent could be provided in a number of forms. Acceptable as evidence of tenancy are in-date tenancy agreement rent book letter from the landlord landlord s agent 5.92 The most secure way to verify residency is to visit the claimant at their dwelling. However, other methods may be useful, such as seeing a utility bill.

49 Part A Procedures for administration The evidence must provide the following information the full name and business address of the landlord, but see Landlord s/agent s names and addresses later in this chapter managing agent the date the agreement started the amount of rent payable what is included in the rent, eg fuel water meals other support services, in particular personal care general counselling support cleaning of rooms and windows emergency alarms the payment period or frequency, eg weekly, monthly, four weekly, etc details of documents used to verify residency 5.94 For new agreements, confirm the date the claimant moved in. If, at the time the claim was made, the claimant had not yet moved in, verify the date of occupation; the claimant should sign a statement stating the date they occupied the accommodation Tenancy agreements should come in two identical parts, one is kept by the landlord, the other by the tenant. Usually both parties sign both parts. However, following changes in stamp duty, some landlords sign only the claimant s part and the claimant signs only the landlord s. The LA should bear in mind that a claimant does not need a tenancy agreement in order to claim HB but if they have one, it should be checked for authenticity

50 Part A Procedures for administration Landlord s/agent s name and address Record the landlord s full name. This should be available to the claimant as it is usually included on a tenancy agreement. By full name we mean a name by which they can be identified, eg, neither John nor Mr Smith would be sufficient on their own, but John Smith or John A Smith would be acceptable The intention is that landlords and agents are clearly identified. The LA should not ask the claimant to produce evidence to verify his landlord s name, because it is not reasonable to expect claimants to provide such evidence Both landlords and agents can be companies. When they are, record the company s details In many cases, when an agent manages the property, the claimant will not know the landlord s address. In such cases, it is sufficient for the LA to record just the landlord s name together with the name and address of the managing agent Registered Social Landlords Some tenants of RSLs, ALMOs and Housing Associations (HAs) may have difficulty in providing tenancy agreements. Additionally, these organisations may wish to avoid having to write letters for individual tenants to confirm tenancy details. In such cases the LA can use information from up-to-date schedules provided by the organisation to crosscheck the information given by the claimant. If the claimant s details match those on the schedule, accept this as proof of rent and tenancy Council Tax Benefit cases In all CTB cases liability must be confirmed by reference to the LA s Council Tax records Crosschecking residency and rent In all cases crosscheck rent and residency details against benefit records. This may indicate if anyone else is claiming from the same accommodation Council Tax records, see Council Tax records later in this chapter make other checks as appropriate

51 Part A Procedures for administration All these crosschecks are designed to build up the evidence supporting genuine claims and identify inconsistencies that point to fraud or error in others. If inconsistencies are identified they must be recorded clearly on the claim, explained, and the outcome recorded. In many cases it will be both appropriate and sufficient to ask the claimant to explain any discrepancies. In other cases, or when suspicions still remain, refer the case to a fraud investigator to follow up Council Tax records Council Tax records must be checked for both HB and CTB cases. These records may provide the date of occupancy and are useful to confirm some of the information supplied by the claimant. Checks may reveal inconsistencies that need to be followed up. For example, a lone parent who has declared no other adults in the dwelling but has not claimed the single person discount The information supplied by the claimant may imply a liability for Council Tax on the accommodation, but Council Tax records may show that another person eg the landlord is responsible for payment. Any differences that are discovered must be pursued, explained, and recorded. If appropriate, update the records Handwriting The handwriting on the claim form can be crosschecked against handwriting on the evidence of rent. If it appears similar, it may indicate the evidence is suspect. Follow-up any suspicion with the claimant and refer to a fraud investigator if appropriate There may be some cases when the handwriting is similar and a valid explanation is provided. For example if the landlord helped the claimant complete the claim form. This should be apparent from the declaration on the claim form. If not, clearly record information on the case following the appropriate checks If HB/CTB claims are made through the Jobcentre Plus CMS process there will not be a claim form. Details regarding the customer s claim will be collected by Jobcentre Plus and are passed to the LA by way of an LA Input Document The LA Input Document will not be signed by the customer but the customer s claim statement is signed and retained by Jobcentre Plus. When undertaking fraud prosecutions, dealing with appeals and/or overpayments you may wish to consider the need to obtain the original statement or an extract or copy of the original statement. If necessary, you can request the statement from Jobcentre Plus.

52 Part A Procedures for administration For comprehensive information on the CMS processes and procedures, refer to Customer Management System - A Guide for Local Authorities, which can be found on the DWP website: Dependants The surnames of dependent children must be checked against the name of the landlord and any non-dependants in the household. If the surnames are the same, make further inquiries to establish if there is any relationship between the children and landlord/non-dependant that has not been declared. If, following such checks, a suspicion of fraud remains, refer the claim to a fraud investigator Rent books Careful inspection of rent books may indicate that entries have all been made at the same time. For example, the same ink is always used and the initials are exactly the same. It is usual for initials or signatures written at different times to vary slightly. If there is a suspicion of fraud, refer the claim to a fraud investigator Recording the evidence and checks It is generally preferable to make copies of documents rather than document relevant information. However, when evidence is documented, as opposed to copied, make sure the details shown at paragraphs earlier in this chapter are the minimum recorded

53 Part A Procedures for administration Evidence of household composition In order for a correct HB decision to be made, you need to know who are members of the claimant s household and who occupies the accommodation as their home. HB Reg 21, HB(SPC) Reg 21; CTB Reg 9, CTB(SPC) Reg This information is needed in order for you to decide such things as who to include as occupiers on referrals to the Rent Officer appropriate applicable amounts non-dependant deductions rent restrictions Partners The claimant is obliged to provide full evidence of identity for their partner. SSAA S 1(1A) & S1(1B) Dependants Documentary evidence to confirm household composition is limited. In most cases the main source of information about dependants will be other social security benefits. Evidence of benefits later in this chapter gives guidance on obtaining and recording evidence of other benefits The amount of Child Benefit (ChB) in payment will be an indication of the number of children in the claimant s household. ChB may be paid four-weekly at the Post Office, or Direct Payment paid four-weekly into the claimant s bank or building society account The number and age group of the children may be ascertained from the details given on the award notice Other benefits may include amounts for dependant children. The number and age group of the children may be ascertained from the details given on award notices

54 Part A Procedures for administration Non-dependants Documentary evidence of non-dependants is limited. Some crosschecks must be made against other records held by the LA, eg the electoral register, housing records, Council Tax records, etc Details can also be checked with benefit records when the claimant is in receipt of IS JSA(IB) Pension Credit Bereavement Benefit (BB) Widow s Benefit (WB) Incapacity Benefit (IB) Severe Disablement Allowance (SDA) Retirement Pension (RP), and Maternity Allowance (MA) If a non-dependant is present in the claimant s household, obtain evidence of their income in order to make the appropriate deduction. If the non-dependant is in receipt of benefit, access DWP records relating to the non-dependant in specific circumstances and within the boundaries of the Data Protection Act (DPA) In order to comply with the first principle of the DPA fair and lawful the Information Commissioner has advised that a fair processing statement is required when the personal information about the non-dependant is supplied by a third party, ie the benefit claimant. The fair processing statement should give details of the data controller; why they need the information, what they will do with it and who they will pass it to, see Appendix Information gathered must be necessary. LAs should liaise with their own legal advisors when drawing up the relevant guidance for staff to ensure compliance with the data protection requirements When the non-dependant is stated to have a low income, this will need to be fully verified before low-level deductions are made Remember the claimant may not be able to provide evidence of a non-dependant s income, see Evidence of earnings employed earners later in this chapter. If the claimant cannot verify the non-dependant s income, make the higher deduction

55 Part A Procedures for administration Second adult rebates In a second adult rebate case, you need to establish the claimant s identity and circumstances in the usual way. However, as with a non-dependant, the amount of evidence the claimant will be able to furnish about the second adult may be limited Ask the claimant for all the relevant information about the second adult, but accept it may not meet the standards contained in this guidance. You do not need to establish the second adult s NINO Crosschecking information Single person and lone parent claims All claims from single people and lone parents must be checked against Council Tax records. A check of these records may reveal a single person or a lone parent has not claimed the single-person discount. This may indicate that someone else is living in the household and has not been declared on the claim form Electoral Register and housing lists These records may provide additional evidence about household composition. The LA should use these records for crosschecking if appropriate. For example, it is not necessary to check the Electoral Register if the claimant has occupied the dwelling since the register was compiled Rent Officers Rent Officers and the records they produce can assist you in identifying anomalies in evidence on household composition provided by the claimant

56 Recording the evidence and checks Part A Procedures for administration Record evidence and checks as in Collecting and recording evidence earlier in this chapter. The minimum details to be recorded are the type of evidence provided, eg award notice, bank statement, etc appropriate reference numbers relevant dates, these should help you take account of foreseeable changes details of non-dependants gross income

57 Part A Procedures for administration Evidence of earnings - employed earners HB and CTB legislation requires the LA to decide the average earned income of employees who claim benefit The legislation is quite precise as to the period over which the average is decided. In most cases the period for which the evidence is required is immediately prior to the benefit week in which the claim is made When the claimant or their partner declares they have earnings from employment, you need to see the appropriate evidence before HB/CTB are decided. The evidence should cover the period immediately prior to the claim being made. For weeklypaid employees, you will need evidence of the last five weeks pay For monthly-paid employees, you need evidence of the last two months pay. In all other cases you need evidence to cover at least the previous five weeks pay. For example, in the case of a fortnightly-paid employee, you need evidence of the last three payments. HB Reg 29, HB(SPC) Reg 33; CTB Reg 19, CTB(SPC) Reg When the claimant cannot provide evidence for the relevant period you need other evidence to accurately determine the claimant s average weekly income. For example when a claimant has recently started a job, details of expected earnings provided by the employer might be used It is important to collect all the necessary evidence of employment, this may involve more than one type of evidence Only ask claimants for evidence which they can reasonably be expected to obtain, see Evidence later in this part. When a claimant is unable to produce a particular piece of evidence, ask for alternative evidence. The guidance should not be used to penalise claimants who do not have certain pieces of evidence The following are all acceptable as evidence of employment and income wage slips, but see Wage slips later in this chapter certificate of earnings from employer. This must have a declaration, signed by the employer, stating that the information contained in the statement is true and complete. For an example, see Appendix 8 letter from employer, which must show the same details as a certificate of earnings Working Tax Credit (WTC) award notification with details of earnings on it. The earnings on the notification must be for the appropriate period. WTC is awarded for fixed periods and earnings can increase during the award without WTC being affected

58 Part A Procedures for administration Whatever form the evidence takes, record the following on the case the employer s name and address the number of hours worked, and the period gross income for the year to date period covered income tax deducted for the period covered year to date National Insurance contributions deducted for the period covered year to date occupational pension or personal pension contributions made by the employee, and method of payment, eg cash, cheque, or directly into bank

59 Part A Procedures for administration Crosschecking earnings Bank statements When the evidence shows wages or salaries are paid by cheque or directly into a bank or building society, make sure evidence of the relevant bank accounts is collected as detailed in Evidence of capital, and Recording the evidence and checks in this chapter. Follow up any discrepancies and record on the case Wage slips Check wage slips to make sure they relate to the claimant or partner, as appropriate cover the relevant period as required by the legislation have not been altered Follow up any discrepancies and record on the case If the claimant produces computer-generated pay-slips which are clearly identifiable as from the claimant s employer, eg they have the company s logo on them, and the LA is aware of the employer s address through local knowledge, there is no need to seek further evidence of the employer s address If the claimant produces handwritten or brown envelope pay-slips, ask for further evidence of the claimant s income, for example by obtaining a certificate or letter from the employer, see Appendix Once you have established the name and address of the employer, and recorded it on the case, there is no need to see further evidence on renewal claims unless the claim form shows a change in employment Make sure the hours worked, the type of work being done, and the earnings are consistent with local conditions Make further inquiries if wages are low in relation to the number of hours worked and the type of work, particularly low pay could be a sign of collusion between the claimant and employer.

60 Part A Procedures for administration Refer such cases to a fraud officer for investigation. The LA might also wish to use its powers under HB Regs, regulation 42 (9) CTB Regs, regulation 32(9) to apply a notional income in such cases Make checks of the average earnings on the pay-slips against the average suggested by the year-to-date figure. Any discrepancies must be followed up and recorded on the case If you have any doubts about the authenticity of the pay-slips or the information they contain, ask the claimant for additional evidence such as a certificate or letter, see Appendix Letter from employer This form of evidence is only acceptable when it contains the name and address of the employer. Greater credence could be given to letters authenticated by an employer s stamp Look out for obvious anomalies, such as handwritten letters on plain paper from large organisations which on the whole tend to use headed paper. Also poor spelling, grammar or layout might indicate that a letter is not what it purports to be. Further inquiries may be necessary, either by phone or in writing, to validate a letter Certificate of earnings For an example of a Certificate of Earned Income, see Appendix 8. As with all other evidence, make sure all reasonable checks are made as to the authenticity of completed certificates If any doubts are raised, make further inquiries and record the outcome. Make similar checks on the figures given on a certificate as for wage slips. See Wage slips earlier in this chapter

61 Part A Procedures for administration Handwriting Check all handwritten evidence against the claimant s handwriting. In most cases when handwritten evidence is provided, make further checks with the employer to authenticate the document LAs should be aware that with modern IT equipment it is possible to make realistic copies of headed paper, etc. If you doubt the authenticity of a document, make further checks Other benefits If a claimant declares receipt of another benefit, such as WTC, which would indicate that there are earnings to be declared, but none have been declared, make further checks to establish why this is Expenses If a claimant has requested that an allowance be made for the expenses of a child minder, the appropriate authority s records must be checked to confirm that the child minder is registered before expenses can be allowed. Ask the claimant to provide evidence that fees are paid to the child minder for regular child care. A copy of the contract should suffice. HB Reg 28, HB(SPC) Reg 31; CTB Reg 18, CTB(SPC) Reg Severance pay or redundancy When a claimant has recently left employment, obtain evidence of any redundancy or severance pay they received. When it is likely that such payments were substantial, make crosschecks with the evidence of capital provided by the claimant. Follow up any discrepancies and record details on the case Recording the evidence and checks Record evidence and checks as in Collecting and recording evidence earlier in this chapter, and the minimum to be recorded for wages as in paragraph

62 Part A Procedures for administration Evidence of earnings self-employed HB and CTB legislation require the LA to calculate the average earned income of claimants, or their partners, who are self-employed. HB Reg 30, HB(SPC) Reg 37, CTB Reg 20, CTB(SPC) The legislation allows the LA to decide the appropriate period over which the average earnings are calculated. In all cases, the period for which the evidence is required cannot exceed one year The legislation is quite detailed as to how a self-employed claimant s income is calculated. The LA should have regard to what the legislation requires when deciding what evidence is needed for the average earnings of a self-employed claimant to be decided correctly. HB Reg 37, 38, 39, HB(SPC) Reg 38, 39, 40; CTB Reg 27, 28, 29, CTB(SPC) Reg 28, 29, Verifying income from self-employed earnings can present a number of problems. The most significant is often a lack of information or little confidence in the evidence provided This makes it difficult to specify minimum standards of evidence that can be applied universally to all self-employed claimants. Consider individual claims based on the evidence presented Each claim will need to be treated on its own merit, the aim being to achieve a satisfactory level of confidence in the information being provided. The onus is on the claimant to demonstrate their self-employed status and the level of earnings for the relevant period You must be reasonable in making requests for evidence, and only ask the claimant for evidence which they can reasonably be expected to have or obtain, see Reasonableness later in this part Ask all non-is/jsa(ib)/pension Credit self-employed claimants to provide some form of accounts. For those who have been trading for a complete financial year, or longer, it is reasonable to assume that some form of accounts would have been drawn up for tax purposes. In such cases, ask the claimant to provide a copy of these accounts For those that have only just commenced self-employment or whose accounts are unavailable or unacceptable, calculate estimated earnings based on alternative information and evidence. In such cases, the claimant must complete a selfemployed earnings information proforma, see Appendix 9.

63 Part A Procedures for administration The proforma can be adapted to suit the LA s style and requirements. The information given by the claimant on the proforma needs to be substantiated. This can be gathered from a variety of sources, including bank or building society statements, both business and personal cheque books latest income tax assessment invoices and receipts other appropriate records A combination of items, rather than one piece of evidence, is likely to be needed to provide enough detail to establish the level of earnings Check the details provided by the claimant on the proforma to make sure the income declared is consistent with the type of work being done, the number of hours being declared and local rates for the job Follow up any discrepancies and record details, and if appropriate ask the claimant for more information to resolve such discrepancies For non-standard cases only, the LA is not required to do a full review on the selfemployed element of the benefit claim Recording the evidence and checks Record evidence and checks as in Collecting and recording evidence earlier on this chapter. Make sure the following details are the minimum recorded details of the evidence seen and confirmation documents were originals gross receipts for period expenses for period full details of the calculation of net income

64 Evidence of benefits Part A Procedures for administration HB and CTB legislation requires the LA to decide the average income of all benefit claimants. This requirement includes many of the benefits paid by the DWP and other Government Departments. HB Reg 25, HB(SPC) Reg 23, CTB Reg 15, CTB(SPC) Reg The legislation is quite precise as to the period over which benefits are taken into account IS and JSA(IB) Confirm whether the claimant is in receipt of IS/JSA(IB). Whilst the onus is on the claimant to prove this, it is acceptable for the LA to check. This can be done using the Customer Information System (CIS) via the External Standard Enquiry Facility (e- SEF). LAs may continue to use Electronic Transfer of Data (ETD) until its integration with the CIS. It is expected that some clerical notification, using NHB forms may still be required You may need to confirm entitlement to Attendance Allowance (AA) or Disability Living Allowance (DLA) (care component) in order to decide whether or not a nondependant deduction is appropriate If the claimant, or their partner, is in receipt of any social security benefit other than IS/JSA(IB)/Pension Credit, it must be verified before a decision on HB/CTB is made. Acceptable evidence for this purpose is a current award notification detailing the current rates of benefit current bank or building society statement showing payments of benefit paid by Direct Payment telephone, fax, electronic or written confirmation provided by the DWP. Written or faxed evidence must be on official stationery and contain the office address and the identity and contact details of the officer completing it. Record evidence taken by telephone on the case together with the identity and contact details of the DWP member of staff. Note: some staff may be reluctant to give their full names. If this occurs accept the details they give usually a first name and, if you have any doubts, check the details by telephoning the liaison officer at the DWP

65 Part A Procedures for administration Pension Credit cases Guarantee credit or guarantee and savings credit in payment When the claimant has been awarded guarantee credit or savings and guarantee credit together, the claimant has linked entitlement to full HB/CTB Savings credit only in payment Take savings credit into account in full in the HB/CTB assessment for claimants in receipt of savings credit only The Pension Service must provide LAs with an Assessed Income Figure (AIF) detailing the income and capital used in the Pension Credit calculation, and the amount of savings credit in payment. Use the AIF when calculating HB/CTB Unsuccessful claims for Pension Credit For those pensioners who claimed for Pension Credit but are not entitled to it, The Pension Service will still pass on details of the claimant s income and capital to the LA You may use the information in the assessment for standard HB/CTB, but there is no obligation to do so. For further information, see Housing Benefit and Council Tax Benefit Guidance Manual

66 Part A Procedures for administration HB/CTB Rapid Reclaim claims HB Rapid Reclaim will be appropriate when all the following conditions are met. The claimant is reclaiming either IS or JSA at the same time as HB/CTB reclaiming benefit within 12 weeks of their last entitlement to benefit, and entitled to IS/JSA(IB) and there have been no changes of circumstance since their last entitlement to HB/CTB When you receive form HBRR1, check that the form is properly completed. If the form is not properly completed it will not be possible to process the claim without getting back to the claimant. You can either return the form or send a full-length form the details against details of previous HB/CTB claim held on the system. If the details are not the same, it will not be safe to process the claim without further information from the claimant. Depending on the individual circumstances of the claim, you can either send a full-length form or get back to the claimant about the specific change that the claimant has declared there are no changes of circumstance since their last entitlement to benefit. If the claimant has declared a change, it will not be appropriate to process the claim without getting further information. Depending on the individual circumstances of the claim, you can either send a full-length form or get back to the claimant about the specific change whether the claimant is entitled to IS or JSA(IB). Jobcentre Plus or the social security office will send notifications of IS/JSA(IB) entitlement to the LA. LA staff can also use their RATs. If the claimant is not entitled to IS/JSA(IB), send the claimant a full-length claim form that it is not more than 12 weeks since the claimant s previous entitlement to HB/CTB ceased. Although issue of form HBRR1 is linked to IS/JSA last entitlement dates, there should be no circumstances when the last previous date of HB/CTB entitlement is more than 12 weeks from the date of the HB Rapid Reclaim. In rare cases, when the previous entitlement to HB/CTB is more than 12 weeks before, or if there is no previous claim to HB/CTB, the claimant may have been incorrectly issued with form HBRR1. Send a full-length form Process the claim and restore HB/CTB to the previous level of entitlement. For further information, see Housing Benefit and Council Tax Benefit Guidance Manual

67 Part A Procedures for administration HB/CTB claims made through the Customer Management System Regardless of the primary benefit(s) being claimed (IS, JSA(Cont), JSA(IB) or IB) all HB/CTB information is gathered by Jobcentre Plus through the CMS scripts. However, Jobcentre Plus will only verify evidence required for the primary benefit claim. They will not request or verify HB/CTB only evidence You need to contact claimants for further evidence to support their HB/CTB claim, eg for proof of rent and verify it in the normal manner. Part B, Guidance on Section 1(1A) and 1(1B) of the Social Security (Administration) Act 1992 later in this guidance contains guidance on Identity and National Insurance Numbers Jobcentre Plus will record any evidence of income and capital accepted and verified in support of the primary benefit claim on the LA Input Document, you can accept this as sufficient to satisfy the requirements of the guidance. The LA Input Document provides details of all the evidence the customer has been asked to provide, see Section 11 of the Customer Management System A Guide for Local Authorities, which can be found on the DWP website The LA Input Document shows any state benefits in payment to the claimant/partner/children, eg the amount, frequency, and the system used to verify the information, again see Customer Management System - A Guide for Local Authorities, Verification Details for further information You may also accept, for the purposes of assessing HB/CTB entitlement, any information contained in the LA Input Document showing, for example, a calculation of the value of shares or of average earnings. However, check details for any obvious errors and remember you will probably only need to use this information if the primary benefit fails Remember, all decisions regarding HB/CTB entitlement rest with the LA, not Jobcentre Plus. For further information, see Customer Management System A Guide for Local Authorities

68 Post Office card account Part A Procedures for administration The Post Office card account is a simple account operated by the Post Office and designed for receiving most benefits (but not including HB/CTB) state pensions war pensions tax credits Other payments, for example wages, cannot be paid into this account. These accounts do not pay interest Almost anyone can open a Post Office card account and customers cannot go overdrawn. Customers can get their cash over the counter at any Post Office branch but not from a bank, building society or cash machine The account comes with a card and a Personal Identification Number (PIN). Customers will receive a quarterly statement of their account. This will detail all credits and debits on the account and will show the current balance of the account For all claims, you need to verify the amount declared on the claim form. You may take evidence of capital into account if the amount exceeds a prescribed amount, see Evidence of capital later in this chapter Crosschecking benefits Refer to the claim history, if one exists, which gives details of previous information to substantiate the current claim. If previously declared benefit is missing from the current claim form, and all other circumstances appear the same, establish if the benefit is still in payment. If further enquiries are necessary record them, with the outcome, on the case If benefit is paid into a bank or building society account, make sure you see the appropriate statements. As with all statements, they should be examined for evidence of other income, which may not have been declared

69 Part A Procedures for administration Recording the evidence and checks Record evidence and checks as in Collecting and recording evidence earlier in this chapter. Make sure the following details are the minimum recorded type of evidence provided, and when documents were seen, confirmation that they were original, eg award notice, etc types of benefit being paid gross amount payable and how often it is paid who the benefit is payable for, eg ChB details the names and dates of birth of the children for whom it is paid

70 Evidence of other income Part A Procedures for administration Verify all the claimant s income before making a decision on the claim, subject to disregarded income, see Disregarded income later in this chapter. If possible, establish if the income is subject to regular increases and if so, when, eg an occupational pension that increases annually in April The following are acceptable as evidence of income recent payment slips recent full bank statement that shows the amount being paid and its source. See also Internet banking and Evidence of capital later in this chapter appropriate award notification, eg a benefit award notice, court order notice, notification of tax credit award, or Child Support Agency notification. You must be satisfied the notification shows the current amount being paid to the claimant telephone confirmation from the source of income, eg a former employer paying an occupational pension. Record details of any call, include details of the contact name and their position in the organisation. In the case of tax credit, confirmation of the award can be obtained by telephoning the Inland Revenue fax confirmation from the source of income, eg a former employer paying an occupational pension. You must be satisfied the fax originated from the appropriate source, eg the fax might contain an official logo, address, contact name and phone number, etc letter from a non-resident parent confirming maintenance payments they are making Note: This list is not exhaustive In all cases, you must be satisfied the evidence provided is sufficiently robust to verify the declared income. If it is not, or any doubt arises, seek further evidence and/or make appropriate enquiries When seeking evidence, bear in mind that claimants can only be asked to supply evidence that they have, or could reasonably be expected to obtain, see Reasonableness later in this part

71 Part A Procedures for administration Internet banking If a claimant holds an account with a financial services company that provides the service via the Internet, you need to ask the claimant for screen prints of their account details The prints should contain details covering at least the previous two months transactions. As the financial institutions concerned have quite rigid security, the claimant would not be able to manipulate the account details without some difficulty In most cases it should be clear that the prints are screen prints because of the layout, logos, etc. You should not accept prints that have been altered or that appear to have been manipulated in any way Remember claimants may have to pay to get copies of their account details from the financial institution, and that these are likely to be in the form of screen prints anyway Disregarded income HB and CTB regulations provide for the full disregard of certain types of income. When a claimant states they are in receipt of an income that is fully disregarded, do not seek verification of the amount of income. However, if receipt of that income gives rise to an increase in applicable amounts, you must verify that the claimant is in receipt of the income in question. HB Sch 5, HB(SPC) Reg 29 & Sch 5; CTB Sch 4, CTB(SPC) Reg 19 & Sch The regulations specifically state that claimants shall not be required to produce information or evidence relating to certain types of payment, including payments made under the Macfarlane Trust, the Eileen Trust, the Independent Living Funds, The Skipton Fund and the London Bombings Relief Charitable Fund. HB Reg 56(1)&(4), HB(SPC) Reg 67(1)&(4); CTB Reg 72(1)&(4), CTB(SPC) 67(1)&(4) If it is unclear whether an income is to be disregarded, because, for example, you are unsure of the exact nature of the income, ask for the necessary evidence to establish what the income is. As soon as it becomes apparent that it is income to be disregarded, stop asking for further evidence, it is not needed for a decision to be made Fully verify income subject to a partial disregard in line with paragraph above. This is needed for the appropriate amounts to be taken into account

72 Part A Procedures for administration Crosschecking income Whenever a claim is received, check it against any previous claim. This helps to highlight discrepancies between the claims, or substantiate the current claim. Significant differences in income, which have not been satisfactorily explained, must be followed up with relevant enquiries. If further enquiries are made, record details of on the case Recording the evidence and checks Record evidence and checks as in Collection and recording evidence earlier in this chapter. Make sure the following details are the minimum recorded the type of income being paid the type of evidence provided, eg payment slip award notice bank statement benefit order book appropriate reference or account numbers the amount and frequency of payments any foreseeable changes to the amount or frequency of payments

73 Part A Procedures for administration Evidence of capital HB and CTB legislation requires the LA to make a decision on the amount of capital belonging to a claimant and their family. When the capital exceeds a prescribed amount, no HB or CTB is payable. HB Reg 43, HB(SPC) Reg 43, CTB Reg 33, CTB(SPC) Reg The legislation requires the LA to calculate tariff income for amounts less than the prescribed limit, currently 16,000, but greater than a second prescribed figure currently 6,000, or 10,000, if the claimant is permanently in residential accommodation HB Reg 52, HB(SPC) Reg 29(f); CTB Reg 42, CTB(SPC) Reg 19(2) In Pension Credit cases, the 16,000 capital limit continues to apply in HB/CTB except if the claimant is entitled to guarantee credit, when all the income and capital is disregarded. Capital of 6,000 and below is completely ignored along with any income from that capital For Working Age claimants, assume an income, of 1 per week for each block, or part thereof, of 250, based on the total value of the claimant s capital assets over 6,000 people aged 60 or over, assume an income, of 1 per week for each block, or part thereof, of 500. For further information see Housing Benefit and Council Tax Benefit Guidance Manual In non-standard cases, notify Jobcentre Plus/DWP if the claimant/partner has declared capital of 5,500 or more There are separate rules regarding the treatment of different types of capital, and capital belonging to children or young persons HB Regs 44 to 49 &51, HB(SPC) Regs 44 to 47 & 49; CTB Regs 34 to 41, CTB(SPC) Regs 34 to 39

74 Part A Procedures for administration Capital can take a variety of different forms, eg bank accounts building society accounts deposit account with other financial organisations, such as insurance companies cash National Savings Certificates The Post Office Card Account Premium Bonds shares unit trusts Personal Equity Plans (PEPs) Individual Savings Accounts (ISAs), Tax Exempt Special Savings Accounts (TESSAs) Tessa-only Individual Savings Accounts (TOISAs), and land and buildings, but see Land and buildings later in this chapter Note: This list is not exhaustive Generally, capital falls into savings and investments, but also includes property, eg land and buildings. Only capital that belongs to the claimant and their family, and is available to them, is taken into account The guidance on verification indicates that you need to fully verify all the capital declared on the claim form for all claims. You must always see the originals of the documents appropriate for verifying each type of capital.

75 Part A Procedures for administration Claimants can provide appropriate evidence to verify their capital. Listed below are some of the main types of evidence a claimant might provide are current bank or building society statements, see Internet Banking. A slip showing the outstanding balance is not acceptable. Statements, which show all credits and debits and the outstanding balance for a period of at least two months are required a letter from the organisation that holds the capital, eg bank, building society or insurance company. The letter should detail the type of account the balance outstanding any transactions occurring in the last two months the account number original documents showing proof of ownership, eg share certificates, Premium Bonds, statements showing dividends, building society passbooks, etc Note: This list is not exhaustive Additional information from CMS You may also accept, for the purpose of assessing HB/CTB entitlement, any information contained in the LA Input Document showing, for example, a calculation of the value of shares or average earnings. However, check details for any obvious errors and remember you will probably only need to use this information if the primary benefit fails Evidence specified not available Ask claimants to provide the evidence as previously specified in the guidance. Exceptionally, the claimant may not possess a current statement and the financial institution concerned might levy a charge for copies. In these exceptional cases confirmation of the balance is acceptable, as the claimant may not be in a financial position to pay for a copy statement. Ask the claimant when the next statement is due and ask them to forward the evidence then. Follow up such cases to make sure the appropriate evidence is supplied

76 Part A Procedures for administration Premium Bonds When the claimant has a large number of Premium Bonds there is no need to copy them or record all the individual identification numbers, etc. It is acceptable to record the total value of the bonds, together with details of the number and denomination of the certificates Land and buildings The property occupied by the claimant and their family as their home does not count as capital. This includes owner-occupiers for CTB purposes. Obtain details of all other property or land owned by the claimant/partner or dependants, whether in this country or abroad. Request details of its value and current status, eg if it is let out, occupied by relatives, subject to repossession, etc If you are not satisfied by the valuation evidence provided by the claimant, you can seek a valuation of the property from the District Valuers Services, see Housing Benefit and Council Tax Benefit Guidance Manual, Valuing the property Crosschecking capital The LA s ability to crosscheck information about capital is limited. Local knowledge and the experience of staff will play a major role in identifying fraud and error. Refer to the claim history, which gives details of previous circumstances, eg types of capital and account details, etc and may provide information to help substantiate the current claim. Follow up significant differences in capital, which have not been adequately explained. If further enquiries are necessary, record details on the case, together with details of the outcome If the claimant is receiving wages or other income paid directly into a bank account, check the bank account has been declared as capital. If it has not, check with the claimant and record details on the case Any large or frequent withdrawals from an account must be queried to see if there is a deliberate disposal of capital to claim benefit, or if money has been transferred to another account that has not been declared

77 Part A Procedures for administration Recording the evidence and checks Record evidence and checks as in Collecting and recording evidence earlier in this chapter. Make sure the following details are the minimum recorded the type of evidence provided and when documents were seen confirmation the originals were seen, eg bank statements building society book Premium Bonds, etc the type of capital held, eg current account savings account bonds shares, etc individual account references and certificate numbers, etc the value of each type of capital. If the LA has calculated the value of a capital asset, it should record on the case how the valuation was made the total value of all capital held

78 Special rules for hostel dwellers Part A Procedures for administration The legislation requiring claimants to provide details of their NINO, or sufficient details for one to be traced or allocated does not apply to people who live in hostels. HB Reg 4(a), HB(SPC) Reg 4(a) This change applies only to hostel dwellers. Hostel is defined in legislation as a building - (a) in which there is provided for persons generally or for a class of persons, domestic accommodation, otherwise than in separate and self-contained premises, and either board or facilities for the preparation of food adequate to the needs of those persons, or both and (b) which is (i) managed or owned by a registered housing association, or (ii) operated other than on a commercial basis and in respect of which funds are provided wholly or in part by a Government Department or agency or an LA, or (iii) managed by a voluntary organisation or charity and provides care, support or supervision with a view to assisting those persons to be rehabilitated or resettled within the community other than a residential care home, a nursing home or residential accommodation within the meaning of regulation 21(3) of the Income Support (General) Regulations HB Reg 2, HB(SPC) Reg As well as the NINO requirement not applying, you do not need to apply the guidance to these claims for the first 13 weeks of any claim. This only applies to residents of hostels within the definition shown in the previous paragraph You do not need to seek evidence to the standards specified by the guidance at the beginning of a claim or before paying HB for hostel dwellers. You must apply the requirements of HB legislation in deciding entitlement in such cases Calculate the thirteen weeks from the date the claimant moves into the hostel or from the date HB is claimed, if later. In the majority of cases, at the end of 13 weeks, claimants will be able to supply the appropriate evidence to support their claim. LAs must bear in mind that some vulnerable claimants will not be able to meet this requirement. However, the LA is obliged to consider all the requirements of the legislation before suspending payment of benefit or terminating benefit, see Suspending payment of benefit later in this part.

79 Part A Procedures for administration The thirteen-week period is not cumulative. Give the claimant up to thirteen weeks to provide the evidence on each separate claim, eq if the claimant moves into a hostel for four nights then moves out only to reclaim from the hostel a week later, the thirteen weeks for the second claim starts on the day the second claim is made When a claimant moves from one hostel to another every few days, the LA can treat each change as a new claim. As such, the claimant will not be required to provide evidence whilst on the move DWP is satisfied that the special rules for hostel dwellers will not lead to any increase in HB fraud. However, if you become aware at any time the claimant may not be entitled to HB, make appropriate enquires For guidance in using a shortened claim form, in prescribed circumstances, for rough sleepers on initially entering a hostel, see Housing Benefit and Council Tax Benefit Guidance Manual, Chapter A9, Using a shortened claim form for a claimant entering a hostel

80 Part A - The Guidance and the law Contents Part A The Guidance and the law Introduction Evidence Suspending payment of benefit Visiting Reasonableness Decisions and decision notices Case law

81 Part A - The Guidance and the law Part A The Guidance and the law Introduction DWP provides guidance to LAs showing the minimum standards for the collection of evidence and ongoing checks in both HB and CTB cases. The intention is that where LAs adhere to the guidance, the amount of fraud and error entering the system will be reduced, and any that does enter will be detected more readily. 6.1 The guidance is not legislation, however, it is firmly based on the existing HB/CTB legislation. As far as the Department is aware, the guidance does not require, and does not imply, that LAs do anything contrary to the benefit legislation or any other existing statutory or legal requirement. At all times LAs must decide HB/CTB entitlement in accordance with the law. 6.2 When appropriate, this guidance contains references within its chapters to the key parts of the legislation. Below is a brief outline of how the guidance sits within the legislation generally. 6.3 This chapter contains information about evidence suspending payment of benefit visiting reasonableness decisions and decision notices case law

82 Part A The Guidance and the law Evidence 6.10 LAs are required to make decisions on entitlement to HB/CTB based on the facts of the particular case in question. So, before any decision can be made, the LA needs to establish the facts from the evidence available. Certain types of evidence are more valuable at supporting the declared facts than others The claimant s statement is evidence. However, to simply accept as the truth all statements made by claimants would leave the benefit system vulnerable to abuse by less honest claimants In both HB and CTB legislation there are key regulations that allow the LA to require evidence before deciding the claim. For HB, these are regulations 83 and 86 of the HB Regs and regulations 64 and 67 of the HB(SPC) Regs CTB, these are regulations 69 and 72 of the CTB Regs and regulations 53 and 57 of the CTB (SPC) Regs. All parts of the guidance dealing with the collection of evidence are based on these regulations It is important that the LA only requires evidence that is reasonable this is a specific requirement of the legislation. See Reasonableness later in this chapter

83 Part A - The Guidance and the law Suspending payment of benefit Where an award of benefit has been made, suspension of payment of benefit may be an appropriate course of action in certain cases. If the LA suspends payment of benefit, it must do so within the provisions of the relevant legislation The relevant legislation is in the HB and CTB (Decisions and Appeals) Regulations 2001, SI Specifically regulation 11 allows a relevant LA to suspend payment of benefit where an issue arises in connection with the conditions of entitlement or whether a decision should be revised or superseded regulation 13 provides for suspension where there is a failure to furnish information, and regulation 14 provides for the termination of benefit where regulation 11 and or regulation 13 is not complied with 6.22 The LA must act reasonably both in suspending payment of benefit and in the information or evidence it seeks. See Reasonableness later in this chapter. Nothing contained in the guidance is intended to imply that LAs should, in any way, contravene the requirements of the relevant regulations A claim should not be suspended purely on the basis that it appears on a risk-scored review list from HBMS. An LA must adhere to the guidance in the paragraph above

84 Part A The Guidance and the law Visiting 6.30 The legislation does not contain any direct references to visiting. Visiting is one method of collecting the necessary evidence to make sure the correct amount of benefit is in payment LAs do not need legislation to carry out visits. Although LA benefit staff have the right to visit private dwellings, they do not have the right of entry If the VO is refused entry to a claimant s dwelling they should consider whether there is any other way of obtaining the necessary evidence. See Case law later in this chapter

85 Part A - The Guidance and the law Reasonableness 6.40 It is a general principle of the legislation, and the law in general, that when seeking evidence or interpreting information, the LA acts reasonably The LA cannot ask a claimant to provide evidence or information that they cannot reasonably obtain, or be expected to obtain. For example, the LA cannot insist that a claimant provide wage slips for a non-dependant Nothing in the guidance should be taken to imply that this general rule of reasonableness should be overlooked The Data Protection Act 1998 requires that all the information or evidence collected by the LA for a benefit claim must be adequate, relevant to that claim and not excessive. The collection and/or retention of extraneous information may put the LA at risk of breaching the Act

86 Part A The Guidance and the law Decisions and decision notices 6.50 Whenever the LA receives a claim form, it is required to decide whether there is an entitlement to benefit. This requirement is contained in regulation 89 of the HB Regs regulation 70 of the HB (SPC) Regulations regulation 75 of the CTB Regs, and regulation 60 of the CTB (SPC) Regulations 6.51 Having made a decision, the LA is required to notify the claimant in writing of its decision. This is in accordance with regulation 90 of the HB Regulations regulation 71 of the HB (SPC) regulations regulation 76 of the CTB Regulations regulation 61 of the CTB (SPC) Regulations, and regulation 10 of the HB and CTB (Decisions and Appeals) Regulations These regulations prescribe certain information that must be included in the decision notice. The claimant will have the right to dispute and appeal such decisions in the normal manner From 21 December 2004 regulations were amended to confirm that an LA will no longer be able to refuse to make a decision on a claim. As such a decision must always be given on a claim, whether that claim is defective or effective If the LA decides that a claim is defective (as the claimant has failed to fully complete the claim form in accordance with the instructions on the claim form and/or supply the evidence and information requested on that form) the LA should make a decision that there is no entitlement to benefit as the claim has not been made within the prescribed time or in the prescribed manner Where a claim is effective, but further information and/or evidence requested under Regulation 86(1) of the HB Regulations, Regulation 67(1) of the HB(SPC) Regulations and/or regulation 72(1) of the CTB Regulations and regulation 57(1) of the CTB (SPC) Regulations has not been supplied to allow the correct entitlement to be calculated, the LA should consider making a decision based on an adverse inference drawn from that failure to supply information and/or evidence Depending on the nature of the missing evidence, this adverse inference may either nullify the benefit claim or allow for a reduction in the amount awarded as appropriate.

87 Part A - The Guidance and the law In both circumstances an LA must give the claimant sufficient time to provide the necessary information and evidence before making a decision. The LA should also consider whether it is reasonable to expect the claimant provide the information and/or evidence requested, considering the circumstances of the case Whatever decision is made, the claimant will be able to appeal against the decision made A decision is not needed when a claim is withdrawn, as the claim no longer exists Nothing contained in the guidance should be interpreted to imply that the LA could refuse to decide a claim or revise such a decision, other than in accordance with the legislation

88 Part A The Guidance and the law Case law 6.70 There is much case law relating to specific parts of the HB/CTB legislation and it is not appropriate to detail it all here. However, LAs must have regard to appropriate case law when making benefit decisions. Decision Makers should also be aware of relevant other benefit case law that might apply to HB/CTB In so far as it affects the collection of information and evidence, the most obvious piece of case law affecting the way the claim should be verified and administered is R v Liverpool CC, ex p Johnson (No 2)[1995] COD 200, QBD. This case was specifically about whether an LA could insist that a claimant attend an interview In its judgment, the Court held that the LA was not empowered to insist that a claimant attend for an interview. Neither could the LA decline to make a decision on the claim if the claimant did not attend. However, in the absence of such an interview, the LA may decide, having considered all the evidence, that it is not satisfied that the claimant has established their entitlement to HB, in which case the claim will be refused and the claimant left to their remedy of dispute and appeal Although this case was about interviews, the same principles must be applied to visiting. If a claimant refuses the LA entry to their property, or is not in when visited, the LA cannot simply refuse to pay benefit on this basis. Any decision as to entitlement must be made on the evidence available to the LA If there is insufficient evidence to demonstrate a claimant s entitlement to benefit, the LA must make reasonable efforts to inform the claimant what evidence is required, and give the claimant reasonable time to provide it

89 Part A Security of administration and the Performance Standards Contents Part A Security of administration and the Performance Standards Introduction Management information requirements Training, fraud awareness and checks

90 Part A Security of administration and the Performance Standards Part A Security of administration and the Performance Standards Introduction This chapter contains information about reporting performance against the Performance Standards and details of internal management checks associated with security and administration as specified in the Performance Standards Management information requirements 7.10 To enable DWP to monitor LA performance throughout the year, LAs are required to supply data and management information in the appropriate format. These are specified in the HB/CTB MIS Guide 2006/07 Stats 121 Return Stats 122 Return Stats 124 Return Stats 124A Return Stats 128 Return WIB In addition, DWP will continue to require forms WIB 4a and WIB4b, the HBSD/IAD scan and the monthly data extract to HBMS Appendix 16 contains details of these requirements; Appendix 17a contains the WIB4a and Appendix 17b the WIB4b LAs should also submit an annual self-assessment against the Performance Standards. Timing of the self assessment will be announced when it is required

91 Part A Security of Administration and the Performance Standards Training, fraud awareness and checks 7.20 LAs are responsible for making sure staff are adequately trained, and that they meet the standards of verification It is important that staff are made aware of the types of fraud and error that can occur and understand the need to be vigilant when dealing with benefit claims. Good fraud awareness can reduce the amount of fraud that enters the system and produce a high number of good quality fraud referrals for investigation. Appendix 10 gives some guidance on fraud awareness The guidance contains a number of checklists to assist managers in making sure their LA is meeting the Performance Standards, see Appendix 3, Security: Performance Measures and Appendix 13 Management checklists In addition to compliance checks, management must make sure staff are conducting their own checks accurately and effectively, and that payments are correct Records must be kept of all checks made. The record must show the nature, frequency and outcome of checks, including those where discrepancies were identified, and the follow-up action that was taken An example of a management control sheet is shown at Appendix 12. Whilst the LA is required to complete a record of the management checks made, they do not have to be in the exact format shown in the example but must contain the same information and may be kept either clerically or on the LA s computer system Completion of the new claim checklist, see Appendix 7, is not mandatory. It is provided as an aide-memoire to be used to make sure all the appropriate checks have been made

92 Part B Section 1(1A) and 1(1B) of the SSAA 1992 Part B Guidance on Section 1(1A) and 1(1B) of the Social Security (Administration) Act 1992 Contents Evidence of identity Introduction LA s legal responsibility Recording evidence of identity Establishing identity Using documents to support identity Interviewing to establish identity Claimants without a NINO HB/CTB claims associated with certain DWP-administered benefits Background HB/CTB claims associated with Pension Credit HB/CTB claims made at Jobcentre Plus via CMS HB/CTB claims made at Jobcentre Plus not via CMS JSA(Cont) and IB cases when no dependant s benefit claimed Recording the checks and evidence

93 Part B Section 1(1A) and 1(1B) of the SSAA 1992 Part B Guidance on Section 1(1A) and 1(1B) of the Social Security (Administration) Act 1992 Evidence of identity Introduction Since 6 September 1999 there has been a legislative requirement for anybody making a claim for HB or CTB to either state their National Insurance Number (NINO) or to provide sufficient information or evidence for one to be traced, confirmed or allocated. Where a claimant states their NINO they are also required to provide evidence or information that the NINO was allocated to them. This requirement is sometimes referred to as Section 19, after Section 19 of the Social Security Administration (Fraud) Act 1997 which inserted the provision. The legislation is included at Appendix If the claimant has a partner, the legislation also requires the claimant to state their partner s NINO or to provide sufficient information or evidence for their NINO to be traced, confirmed or allocated. Where a claimant states their partner s NINO they are also required to provide evidence or information that the NINO was allocated to their partner. There is no requirement for the claimant to provide this information for any other member of their household. 1.2 Special rules apply to claimants who live in hostels (as defined in regulation 2 of the Housing Benefit (General) Regulations 1987). In brief, the requirements of Section 1(1A) of the Social Security Administration Act 1992 do not apply to claimants living in hostels. Hostel dwellers do not have to produce a NINO but do have to prove identity. For further guidance, see Procedures for administration, Special rules for hostel dwellers earlier in this guidance. 1.3 The LA does not need to establish the NINO of a second adult in a second adult rebate case as they are not a member of the claimant s household

94 Part B Section 1(1A) and 1(1B) of the SSAA LA s legal responsibility 1.10 The legislation concerning the establishment of a NINO when a claimant makes a claim for HB/CTB is the same whether or not the claimant has also claimed an associated DWP benefit. Only an LA can make a decision as to whether or not the evidence of a NINO and identity is sufficient for the purpose of meeting the relevant legislation for HB/CTB. The evidence an LA is prepared to accept is a matter for the LA LAs will need to consider each case on an individual basis and maintain an audit trail to document how they have arrived at their decision that the legislative requirements have been satisfactorily met for the HB/CTB claim. External auditors will want to satisfy themselves that the LA has met the requirements of establishing NINO and identity for the purpose of the HB/CTB claim DWP staff carry out checks to confirm whether or not the claimant has satisfied the legislative requirements for the purpose of DWP benefit claim(s) JSA(IB) JSA(Cont) IS Incapacity Benefit (IB), and Pension Credit Subject to LA s legal responsibility, as described in paragraphs 1.10 and 1.11 above, LAs can choose to accept the DWP s checks as sufficient for HB/CTB purposes in all cases where the HB/CTB claim is associated with a claim for a DWP benefit It is for LAs to decide whether or not to take account of the verification of identity and NINO checks carried out by DWP, for the purposes of deciding entitlement to DWP benefits, when deciding HB/CTB claims. Paragraphs later in this chapter give more information about the processes in place within Jobcentre Plus and The Pension Service in relation to notifying LAs and confirming whether or not the relevant legislative requirements have been satisfied for the purpose of DWP benefits Recording evidence of identity 1.20 When the initial identity check is completed the LA should record on the case how identity was established together with details of any evidence or information provided, eg French passport number together with the identity of the officer who carried out the check. It is not sufficient merely to show that identity has been established. The LA must record how it was established in each case for audit purposes.

95 Part B Section 1(1A) and 1(1B) of the SSAA In addition to complying with the statutory requirements applying to new claims, it is the duty of the LA to seek sufficient evidence or information to establish or confirm the claimant s identity at any time it has dealings with them. This helps to avoid error and ensures the claimant s right to confidentiality is maintained Establishing identity 1.30 When establishing the identity of a claimant or their partner, efforts should be concentrated on the whole picture the individual has presented rather than just one piece of evidence, or one aspect of the process. The amount and range of information which is required to establish identity will depend on the claimant s circumstances and whether they have a NINO already, or if one needs to be allocated There are many sources of information that can be used to help build up a picture of the claimant and, where appropriate their partner. These include the claim form documentation interview previous claims/records Council Tax records, housing records, etc using the CIS via e-sef or ETD other organizations and third parties, eg DWP, Home Office, Social Services, Probation Service, GP, etc employers LA Input Document, for HB/CTB claims made via CMS Note: This list is not exhaustive, but provides examples of the sources of information that may be available to help establish the identity of a claimant. Each case should be considered in the context of the individual s personal circumstances. The LA must be reasonable in its requests for additional evidence The aim is that the LA should be satisfied about the claimant s identity by collecting a sufficient amount of information and evidence about the claimant and their circumstances

96 Part B Section 1(1A) and 1(1B) of the SSAA Using documents to support identity 1.40 Many of the documents that a claimant may produce to validate other aspects of their claim can be used to help establish identity. For example, they may produce current bank statements, or benefit details as evidence of income and capital When using documents to help establish identity, the LA should only accept original documents. The LA should record that original documentation has been seen and that it has been checked for authenticity and alterations. If the claimant does not have access to the original documents because, for example, a government department has retained them, then the LA should establish the reason why the original document is not available and record that original documentation was not provided and state the reason for this Some documents are more secure than others because they are subject to checks and controls before they are issued. If staff have any doubts about the validity of a document they should contact the Department s National Identity Fraud Unit (NIFU) for advice, see paragraphs below. NIFU can advise but cannot make decisions for LAs as to what is sufficient evidence to satisfy the LA The NIFU provides free telephone advice and guidance about the validity of documents. They also issue information bulletins bi-monthly. If you wish to be placed on their mailing list please fax full contact details to the number below. They also deliver training and awareness sessions relating to document abuse and identity fraud on request (and part cost) of the LA asking for these sessions LAs will wish to decide how to treat suspicious documents and make referrals to the NIFU. For example, LAs could choose to make referrals via their Fraud section or to nominate a single officer as a liaison point The contact details for the National Identity Fraud Unit can be found in the hard copy of this guidance manual To help authenticate documents, the Department has provided LAs with ultra-violet lamps and training for staff in their use. It is possible, for those who are determined to defraud the system, to produce false documentation that is difficult to spot. Some documents have built-in security features that can be checked with a lamp. The lamps will help LA staff to detect forged documents, but not alterations to genuine documents. Vigilant checks of the evidence presented and other crosschecks will help prevent many fraudulent claims from entering the system.

97 Part B Section 1(1A) and 1(1B) of the SSAA Most claimants should be able to produce some documentation to help establish their identity. If the claimant is unable to provide any documents, the LA should establish why none is available and record the reason on the claimant s case Not all claimants will be able to produce the same, or in some cases any, documentation, as their individual circumstances will affect their ability to supply such evidence. For example a victim of domestic violence who has fled the marital home without prior planning may not have taken any documents with them. It may not be reasonable to expect them to retrieve documentation in such circumstances In cases such as this, it may be that the LA chooses to rely on evidence from a third party, such as a social worker or other responsible person, who can provide a statement to help support the claimant s identity For further guidance you could refer to the Fraud Procedures and Instructions Manual Interviewing to establish identity 1.60 There may be occasions when the LA decides that it needs to interview the claimant in order to establish their identity, for example if the claimant is unable to supply the documentary evidence required to establish their identity, or where the evidence they have provided contains inconsistencies. The aim of the interview should be to establish identity by building an overall picture of the person There may be occasions when the LA decides to obtain a signed statement of the information they provide during the interview. Permission should be sought for the LA to make appropriate inquiries of third parties for confirmation of these details The LA should ensure that appropriate account is always taken of a claimant s circumstances when they are being interviewed. Some claimants may be vulnerable or suffering considerable stress. Such claimants should be treated sensitively and fairly. They should be given reasonable opportunity to provide relevant information about their background and circumstances in order to establish their identity and the validity of their claim Claimants without a NINO 1.70 If a claimant has not been issued with a NINO, does not know what their NINO is or if the LA is not satisfied that the NINO given belongs to the claimant, a form DCI 1(LA) should be completed and passed to the appropriate DWP Area Central Control Unit, who will carry out the necessary checks and advise the LA of the outcome.

98 Part B Section 1(1A) and 1(1B) of the SSAA All NINO enquiries including the issue of NINO cards must be referred to the local Jobcentre Plus office, Jobcentre or Social Security office that has responsibility for the allocation of NINOs, including NINOs for pensioners HB/CTB claims associated with certain DWP-administered benefits Background 1.80 The introduction of The Pension Service and roll-out of the Customer Management System (CMS) has prompted DWP to provide guidance to LAs on the discretion they have when discharging their responsibility to ensure that relevant legislative requirements are met for HB/CTB cases associated with Pension Credit and with IS, IB, JSA(IB) and JSA(Cont) made through CMS Subject to LAs legal responsibility, as described in paragraphs 1.10 and 1.11 earlier in this chapter, DWP s view is that such discretion also applies to other HB/CTB cases made via Jobcentre Plus (as mentioned in paragraph below), but not made via CMS HB/CTB claims associated with Pension Credit 1.90 Where a claim for HB/CTB is made in association with Pension Credit, The Pension Service will satisfy itself that the relevant legislation has been met. The award of Pension Credit and the AIF will be notified to the LA by The Pension Service. The LA must use the AIF to assess the HB/CTB claim. In these cases, LAs can choose to accept the evidence of identity and NINO requirement carried out by The Pension Service as having been satisfied for HB/CTB claims also. The Housing Benefit and Council Tax Benefit Guidance Manual, available on the DWP website, details the process of notification to LAs HB/CTB claims made at Jobcentre Plus via CMS Where CMS has been implemented, Jobcentre Plus will gather HB/CTB claim details when a claimant makes a new or repeat claim for IS, JSA(IB), JSA(Cont) or IB. Jobcentre Plus staff will satisfy themselves that relevant legislative requirements have been met for the claimant, and the partner where appropriate, for the purpose of IS, JSA(IB), JSA(Cont) and IB.

99 Part B Section 1(1A) and 1(1B) of the SSAA The LA Input Document from CMS sent to the LA will indicate whether legislative requirements have been met in respect of the claimant and if appropriate, any partner. LAs can choose to accept the Department s verification of the claimant s NINO and identity as sufficient for HB/CTB purposes. Full details of the CMS claim process are given in the LA Guide to CMS, available at HB/CTB claims made at Jobcentre Plus not via CMS Unlike CMS cases, there is no LA Input document sent to LAs. They may wish to keep any appropriate documentation, eg a screen print of a Remote Access Terminal (RAT) check, information supplied under ETD, or clerically using NHB forms, as proof that the primary benefit has been awarded and ensure that the legislative requirements have been fully met JSA(Cont) and IB cases when no dependant s benefit claimed In JSA(Cont) and IB cases where no dependant s allowance has been claimed, Jobcentre Plus will not have verified the identity of any partner as this is not necessary for the award of the primary benefit. Therefore, in these cases, LAs will need to carry out their own checks to verify the partner s NINO and identity, where a partner has been declared on the HB/CTB claim Recording the checks and evidence It is essential for the member of staff responsible for deciding whether or not the claimant has complied with HB/CTB legislation to record their decision on the claimant s case. This decision must be signed and dated It is generally preferable to make and authenticate copies of documents rather than document relevant information. However, where evidence is documented, as opposed to copied, the LA should ensure that the following details are the minimum that is recorded the claimant s/partner s full name, including previous or known as names and date of birth the claimant s/partner s NINO the type of information and evidence provided, for example passport, driving licence, letter from social worker, etc continued

100 Part B Section 1(1A) and 1(1B) of the SSAA 1992 (1.131) (1.131) serial or reference numbers on documents, and when evidence contained a photograph of the claimant/partner, whether the photograph was checked against the document s owner whilst they were present The documentation for audit trail purposes should include, as appropriate, at least one of the following notifications the LA Input Document from Jobcentre Plus a clerical LA Input Document from Jobcentre Plus notification of the AIF from The Pension Service Pension Credit award ETD notification a clerical notification relating to Pension Credit from The Pension Service Jobcentre Plus clerical notification to the claimant of primary benefit entitlement Jobcentre Plus notification of primary benefit entitlement via the CIS, e-sef or ETD Jobcentre Plus clerical notification to the LA of primary benefit entitlement

101 Part C Housing Benefit Matching Service Contents Part C Housing Benefit Matching Service Introduction Data Take-On and Processing Schedule Data collections HBMS data-matches Referrals Results Risk-scored reviews Data quality HBMS Data Specification file Data incidents HBMS data scans Accuracy DCI500 LA Procedures

102 Part C Housing Benefit Matching Service Part C Housing Benefit Matching Service Introduction Housing Benefit Matching Service (HBMS) was established in 1996 to provide a DWP data-matching service for LAs. HBMS referrals identify potential HB and CTB payment incorrectness fraud customer error official error 1.1 The legal gateway for HBMS data-matching lies in the Social Security Administration Act (1992) and Social Security (Fraud) Act (1997). Section 122C of the 1997 Fraud Act provides that the information held by DWP and other Government Departments can be supplied to LAs for the purpose of preventing, detecting, investigating and prosecuting offences relating to fraudulent claims for HB/CTB. 1.2 HBMS is based in Lytham St Annes and is part of the Matching Intelligence and Data Analysis Services (MIDAS) which, since 1 October 2005 has been within the DWP Information Directorate. For a full list of HBMS contacts, see Appendix Following the abolition of benefit periods for pensioners from October 2003 and working-age customers from April 2004, the role of HBMS has become more significant. Increased data-matching has been identified as a key tool to assist LAs achieve targets for reducing fraud and error within HB/CTB. In addition, the role has been widened to include running a risk analysis of LAs live loads, in order to provide LAs with lists of risk-scored cases to review. 1.4 This part contains information about Data Take-On and Processing Schedule (DTOPS) HBMS data-matches Risk-scored reviews Data quality HBMS data scans Accuracy DCI500 LA procedures

103 Part C Housing Benefit Matching Service Data Take-On and Processing Schedule 1.10 LAs are regionally grouped into the Data Take-On and Processing Schedule (DTOPS) to manage the flow of data to HBMS and the output of referrals to LAs. The schedule for data-matching is a four weekly schedule, to enable monthly matching to take place Data collections 1.20 Each LA is allocated a specific date for data collection, see Appendix 22. Collections that fall on bank holidays will normally be collected on the next working day The person responsible for producing the HBMS data extract will be contacted by telephone approximately four weeks prior to the data collection date. Data collection arrangements will also be confirmed in writing. LAs not able to submit data should inform HBMS as soon as possible. Note: LAs not submitting data will not receive the risk-scored reviews list, see Riskscored reviews later in this part The HBMS data extract is a key element the performance measures. Full details of the performance measures and the associated enablers are provided in Appendix Blue data boxes will be supplied for the physical transfer of HBMS data. These will be collected by DHL courier on the collection date and returned, together with the original data following data load at HBMS HBMS extracts that fail to load will be returned to the LA and data-matching for that month will be missed

104 HBMS data-matches Part C Housing Benefit Matching Service HBMS rules match HB/CTB data against other data sources to identify inconsistencies that may indicate the existence of incorrectness on an HB/CTB award. Data sources currently available to HBMS include Attendance Allowance (AA) Carer s Allowance (CA) Child Benefit (ChB) Departmental Central Index (DCI) Disability Living Allowance (DLA) Incapacity Benefit (IB) Income Support (IS) Industrial Injuries Disablement Benefit (IIDB) Her Majesty s Revenues and Customs (HMRC) P46 HMRC Construction Industry Scheme HMRC Interest from Savings HMRC forms P45/P46 HMRC Tax Credits Jobseeker s Allowance (JSA) Pension Credit Retirement Pension (RP) Royal Mail Do Not Redirect (RMDNR) 1.31 HBMS rules are identified by the data sources involved in creating the match, followed by a numeric value. For example HBMS rule HBIS105 identifies failure to declare cessation of IS to HB. HBMS provides full details of all rules within the HBMS Rule Guides folders that have been distributed to all LAs. For additional copies, please contact HBMS Rule Development Team (RDT) A full list of the rules available to HBMS which can be run from April 2006 is included in Appendix 23. HBMS RDT identifies and designs rules that address key risks to the accurate payment of HB/CTB.

105 Part C Housing Benefit Matching Service HBMS develop new rules to identify incorrectness in HB/CTB payments. A protocol for managing the release of new rules into the data matching schedule has been agreed with the Field Operations Group (FOG). Where significant numbers of matches result from a new rule, ie 5,000-plus nationally, the overall number of referrals issued by HBMS per month was capped at 26,000 during 2005/06. The cap on referrals will be reviewed and FOG consulted should this be necessary It is worth emphasising that any increase in data-matching will lead to an equivalent decrease in the number of risk-scored reviews LAs will have to undertake Following the automated rule running process, HBMS Referrals Team carry out a manual sift on all rules, using DWP live systems. The sift identifies additional information not available at the rule-running stage, which may undermine the quality of the data-match. Such cases may be deselected and not issued to LAs for investigation The sifting process may also identify additional details of relevance to the LA investigation. Such details will be manually included on the data-match, together with information automatically brought forward from the data sources in use Referrals 1.40 HBMS referrals were originally issued in paper format. A significant increase in volumes over recent years has prompted the development of a more efficient procedure. During 2005, HBMS devised and tested a new process to allow datamatching referrals to be issued electronically. The successful conclusion of this pilot has resulted in the withdrawal of paper referrals from January The new 'HB Lite' process, see Appendix 21, Word Solution/HBLite Desk Aid, involves LAs receiving either a floppy disc or CD containing their data-matches in a user-friendly Word format that mirrors the previous paper layout. The disc also creates a 'PSV' file which allows referrals to be automatically uploaded into the LA's Fraud Management or Interventions system. A built in decompression tool allows the compressed file to be opened without the need for additional software. LAs therefore have the option to load their referrals electronically or print paper copies - or both

106 Part C Housing Benefit Matching Service Results 1.50 A result is required for every HBMS data-match referral. An 'Electronic Results Spreadsheet' is included on the referrals disc. The spreadsheet can be returned via to HBMS at HBMS@dwp.gsi.gov.uk 1.51 Results from the completed spreadsheet are automatically uploaded into HBMS' referral management system. LAs can therefore return the part-completed spreadsheet as soon as new results become available. A desk-aid to assist LAs return result sheets is included at Appendix 24a, Completion of HBMS Results and Appendix 24b, HBMS Results Sheet The performance measures require all data-matches to be resolved within two months. In cases where a HBMS referral leads to a potentially lengthy fraud investigation, LAs should initially return a result of 4z LA/DWP investigation ongoing and the date the investigation commenced. When the investigation has been completed, LAs should return a further results sheet informing HBMS of the outcome of the investigation The result sheet captures basic details on the outcome of the referral and is used to produce management information on specific rules, as well as LA and HBMS generic performance statistics

107 Part C Housing Benefit Matching Service Risk-scored reviews 1.60 Following the receipt of an LA s data extract, HBMS will generate and issue a list of the most risky cases. The risk methodology devised by the Information Analysis Division (IAD) identifies characteristics within both working-age and pensioner claims that are more likely to result in the existence of fraud or error, see Appendix A risk score is assigned to each case, together with the probability of further investigation identifying fraud or error. The highest scoring 32% of caseload are included on the list Risk-scored cases are issued on CD in MS Excel format. The CD will be included in the courier package with the HBMS data-matches The risk-scored review layout was amended and improved in April The format includes first name surname date of birth address post code National Insurance Number HB reference number rank and priority possible causes of error Risk Scoring Specification last case review date receipt for caseload review scan 1.64 A risk-scored review should be carried out, see Reviews module earlier in this manual Risk-scored review lists will only be produced from fresh data extracts. LAs that do not submit data to HBMS or where the data fails to load (see Data collections earlier in this chapter) will not receive data-matches or a risk-scored review list for that month.

108 Part C Housing Benefit Matching Service To prevent the reissue of duplicate cases already referred on a recent risk-scored review list, the Last Recorded Review Date will be used to identify cases recently reviewed by LAs. This process will prevent the reissue of working-age cases within six months and three years for pensioner cases with a review date after October Unlike data-matches, risk-scored review lists issued by HBMS do not require a result sheet to be returned for each case. Instead, Management Information (MI) on reviews should be provided direct to the Information Centre, see Appendix

109 Part C Housing Benefit Matching Service Data quality 1.70 HBMS data-matching and the output of accurate risk-scored review lists are dependent on the receipt of quality data. Poor quality data limits the potential for the issue of data-matches and may also corrupt the risk-scoring process HBMS Data Specification file 1.80 The HBMS Data Specification file standardises the format of HB/CTB data The HBMS Data Specification file outlines the expected format for all data extracts. The file consists of 146 fields, capturing information about HB/CTB customers, partners, dependants and non-dependants. Population of the majority of these fields is mandatory, with a small number being essential for a record to load Records that are rejected at data load will not be made available for data-matching or risk scoring Electronic copies of the latest HBMS Data Specification file are available from HBMS Data Integrity Team (DIT) on request Data incidents 1.90 HBMS DIT analyses each LA s data extract following data load. Data incidents are raised when a key field used to produce data-matches or risk-scored review lists is inadequately populated Incidents are graded from 1 to 3 depending on the severity of impact, 1 being highest. Incidents are also graded according to the area of impact, ie data-matching referrals or risk-scored review lists Each LA will receive a letter identifying any outstanding data incidents following data load. LAs will also receive details of any records rejected at data load or cases when anomalies exist within field population. LAs can contact DIT for further advice to make sure their data is fully supporting the issue of HBMS data-matches and riskscored review lists With effect from April 2005, incidents graded as Category 1 and 2 must be cleared within three months. This requirement must be achieved as it forms part of the performance measures Category 1, 2 and 3 incidents are defined in Appendix

110 Part C Housing Benefit Matching Service HBMS data scans HBMS provides a dedicated data scans service to LAs to further identify fraud error improve data quality Risks not already addressed by HBMS rules may be identified through a specific data scan on request, eg HB claims with IS mortgage interest payments being paid dependants aged 19 and above on HB/CTB awards single HB/CTB claimants with a joint bank account (using TC data) undeclared AA/DLA (possibly identifying underpayments) Local Poverty Index scans (identifying areas of deprivation to inform local policies) HBMS also provides scans to LAs using 'local' data sources obtained by the LA. For example, scans have been issued identifying undeclared earnings from local employer data bases, eg supermarket and agency payrolls Scan delivery depends on the availability of data sources, policy approval and technical possibility. LAs will be informed if a scan request is unsuccessful HBMS reserve the right to charge for the delivery of a data scan if there is technical complexity or in cases where the purpose of the scan is not to identify fraud or error. LAs will be fully advised if a charge is likely to be incurred Accuracy HBMS rules are increasingly reliant upon accurate population of NINOs and dates of birth (DOB) details on HB/CTB extracts. Incorrect details will, in most cases, prevent the issue of referrals and allow the continuation of fraud and error. Customer NINO accuracy forms part of the performance measures HBMS run quarterly NINO/DOB Accuracy Scans, comparing HB/CTB details with DWP data held on Departmental Central Index (DCI). HB/CTB records are allocated a rating depending on how the details compare to those held on DCI HBMS issues each LA with a summary of their results following the scan and invites LAs to request a detailed (free) scan to identify the actual cases requiring further verification.

111 Part C Housing Benefit Matching Service LAs requesting the detailed NINO/DOB Accuracy Scan will also receive information from DCI of the personal details held by DWP HBMS statistics show that those LAs with the most accurate NINO/DOB details have usually requested and acted upon a recent data scan To request a data scan application form, or to discuss scan requirements LAs should contact the HBMS Data Scans Team, see Appendix

112 DCI500 LA Procedures Part C Housing Benefit Matching Service A new process was implemented in February 2005, allowing LAs to notify DWP directly when errors were identified within the personal details held on DWP systems HBMS include a form DCI 500 LA with all individual NINO verification scans requested by LAs. The DCI 500 LA should be completed and returned when verification is obtained that shows personal details, eg NINO, date of birth, surname, held on DWP systems is incorrect. Forms should be returned directly to DCI Frontline Services at the address given on the form, see Appendix 20, DCI 500 LA DESK AID

113 Part D Royal Mail Do Not Redirect service Contents Part D Royal Mail Do Not Redirect service Introduction Data-matching Outline of the service What LAs need to do Obtaining further information about redirected post Legislative requirements

114 Part D Royal Mail Do Not Redirect service Part D Royal Mail Do Not Redirect service Introduction This part explains the operation of the Royal Mail Do Not Redirect service. This service has been available to all LAs since 1 February This version of the guidance replaces all previous guidance issued. Make sure all previous guidance is destroyed as confidential waste. 1.1 The Do Not Redirect service is intended to combat fraud if a person claims benefit from an address where they do not reside. Redirection facilities allow for postal items to be redirected to an address that the fraudster may more conveniently collect mail from. 1.2 There are two methods of postal redirection a claimant can misuse to commit benefit fraud official redirection of post using Royal Mail s redirection service unofficial redirection of post by placing the postal item back into the mail system for redelivery. This is generally achieved in collusion with the occupier of the property, or a person with access to it Data-matching 1.10 Effective data-matching is important for detecting benefit fraud HBMS compare the Royal Mail redirection database with LA and DWP benefit records HBMS will issue data-match referrals for investigation, see Part C Housing Benefit Matching Service earlier in this guidance This part contains an outline of the service information about what LAs need to do legislative requirements

115 Part D Royal Mail Do Not Redirect service Outline of the service 1.20 The Do Not Redirect service will prevent both official and unofficial redirections of mail occurring by identifying LA benefit post within the delivery office intercepting the postal item if it would otherwise be subject to either an official or unofficial redirect (including items that would otherwise have been redirected to the Mail Collect service) showing the address the item would otherwise have been redirected to returning the item to the nominated point within the LA 1.21 The three key components to the Do Not Redirect service are Royal Mail intercept and return to LAs any HB/CTB post which would otherwise have been redirected Royal Mail provides LAs with details of official redirections by affixing the official redirection label to the front of the postal item. Items that would otherwise have been unofficially redirected will already have had the redirect address written on the front of the postal packet Royal Mail Corporate Security Criminal Intelligence provide a service where LAs may obtain further details about the person who requested a redirect, such as the length of time a redirect has been in place

116 What LAs need to do Part D Royal Mail Do Not Redirect service LAs who want to adopt the scheme can get a Royal Mail s Sales Pack from Royal Mail Business Customer Services, see Appendix 1, Contact list We recommend that LAs who adopt the scheme send all HB/CTB related post in an envelope that complies with the specification in Royal Mail s Sales Pack, ie an envelope with green hatchings clearly marked Do Not Redirect. It is vital that a Do Not Redirect envelope is used for all post and not just, for example, post that contains a payment cheque LAs that send payments-only by Do Not Redirect envelopes increase the risk that such payments may be identified and stolen within the postal system. LAs should therefore make sure all sections that issue benefit-related post have access to sufficient quantities of approved envelopes. LAs will need to meet the cost of printing compliant envelopes from their own budgets LAs need to have robust procedures in place to handle postal items intercepted and returned under the contract. In particular, staff involved in post opening duties should be aware of how to identify returned Do Not Redirect items and to whom they should be referred for further action A returned item of post is likely to indicate that the customer has recently changed address a relevant change in circumstances may have occurred there are reasonable grounds to suspect fraud 1.35 The individual circumstances of the case will decide whether it should be dealt with administratively, eg by contacting the customer for clarification referring for a formal fraud investigation 1.36 It is vital that action is taken on each referral as soon as possible so that the benefit overpayments can be minimised Obtaining further information about redirected post 1.40 Royal Mail informs LAs about the redirect address by placing the redirection label on the front of postal items that would otherwise have been officially redirected.

117 Part D Royal Mail Do Not Redirect service If further information is needed during the course of a fraud investigation, LAs may obtain this from Royal Mail Corporate Security Criminal Intelligence using an appropriate legal gateway Both the DWP and Royal Mail take the view that, in this respect, the Royal Mail is a person from whom information may be obtained within the meaning of Section 109B (2A) of the Social Security Administration Act 1992 (as inserted by Section 1 of the Social Security Fraud Act 2001) Requests for further information should be made by Fraud Act Authorised Officers working in either an LA the National Anti-Fraud Network a DWP Operational Intelligence Unit 1.44 Requests will only be accepted from Fraud Act Authorised Officers when the request is made in accordance with the Statutory Code of Practice Royal Mail Corporate Security Criminal Intelligence have access to a secure DWP website listing the contact details of Authorised Officers and their managers Make requests to the nominated central point of contact shown on the secure DWP website. All requests should include a copy of the officer s certificate of authorisation. The Royal Mail will send the relevant information back to the Authorised Officer

118 Legislative requirements Part D Royal Mail Do Not Redirect service Sections 182A of the Social Security Administration Act 1992 (SSAA 1992), as inserted by section 20 of the Social Security Administration (Fraud) Act 1997, places a requirement on Royal Mail, and any other mail carrier, not to redirect social security post when the LA has endorsed the envelopes that it should not be redirected Redirected mail should be returned to the issuing office, along with details of where the mail was to be redirected, for further investigation, rather than being sent on to another address Under section 182B of the SSAA 1992, Royal Mail can be required to provide details of the address to which the post would have been redirected had it not been intercepted. However, as this section predates the Human Rights Act 1998, both DWP and Royal Mail take the view that it should no longer be used to request information relating to postal redirections

119 Appendices Contents Appendices Contact list... Appendix 1 Intervention requirement 2006/07... Appendix 2 Security: Performance Measures and Enablers... Appendix 3 Risk scoring methodology... Appendix 4 Reviews Form... Appendix 5 Visiting Officer s verification statement... Appendix 6 New claim checklist... Appendix 7 Certificate of Earned Income... Appendix 8 HB/CTB Self-employed earnings information... Appendix 9 Fraud and error awareness... Appendix 10 Fair Processing Statement... Appendix 11 Management control sheet... Appendix 12 Management checklists... Appendix 13 Sections 1(1A) and 1(1B) of the SSAA Appendix 14 Data Incidents... Appendix 15 Management information requirements 2006/07... Appendix 16 Form WIB4a/Prosecution... Appendix 17a Form WIB4b Caution/Admin Pen... Appendix 17b Not used... Appendix 18 Not used... Appendix 19 DCI 500 LA DESK AID... Appendix 20 Word Solution/HB Lite Desk Aid... Appendix 21 HBMS Data Take-On and Processing Schedule (DTOPS) Appendix 22 Housing Benefit Matching Service rules - April Appendix 23 Completion of HBMS Results... Appendix 24a HBMS Results Sheet... Appendix 24b

120 Appendix 1 Contact list Contact list Note: Full contact details can be found in the hard copy of the HB/CTB security Guidance.

121 Appendix 2 Interventions requirement 2006/07 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Aberdeen Aberdeenshire Adur Allerdale Alnwick Amber Valley Angus Argyll and Bute Arun Ashfield Ashford Aylesbury Vale Babergh Barking Barnet Barnsley Barrow in Furness Basildon Basingstoke and Deane Bassetlaw Bath and N E Somerset Bedford Berwick upon Tweed Bexley Birmingham Blaby Blackburn with Darwen Blackpool Blaenau Gwent Blyth Valley Bolsover Bolton Boston Bournemouth Bracknell Forest Bradford Braintree Breckland Brent Brentwood

122 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Bridgend Bridgnorth Brighton and Hove Bristol Broadland Bromley Bromsgrove Broxbourne Broxtowe Burnley Bury Caerphilly Calderdale Cambridge Camden Cannock Chase Canterbury Caradon Cardiff Carlisle Carmarthenshire Carrick Castle Morpeth Castle Point Ceredigion Charnwood Chelmsford Cheltenham Cherwell Chester Chester le Street Chesterfield Chichester Chiltern Chorley Christchurch City of London Clackmannanshire Colchester Congleton Conwy Copeland Corby

123 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Cotswold Coventry Craven Crawley Crewe and Nantwich Croydon Dacorum Darlington Dartford Daventry Denbighshire Derby Derbyshire Dales Derwentside Doncaster Dover Dudley Dumfries and Galloway Dundee Durham Ealing Easington East Ayrshire East Cambridgeshire East Devon East Dorset East Dunbartonshire East Hampshire East Hertfordshire East Lindsey East Lothian East Northamptonshire East Renfrewshire East Riding of Yorkshire East Staffordshire Eastbourne Eastleigh Eden Edinburgh Ellesmere Port and Neston Elmbridge Enfield Epping Forest

124 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Epsom and Ewell Erewash Exeter Falkirk Fareham Fenland Fife Flintshire Forest Heath Forest of Dean Fylde Gateshead Gedling Glasgow Gloucester Gosport Gravesham Great Yarmouth Greenwich Guildford Gwynedd Hackney Halton Hambleton Hammersmith and Fulham Harborough Haringey Harlow Harrogate Harrow Hart Hartlepool Hastings Havant Havering Herefordshire Hertsmere High Peak Highland Hillingdon Hinckley and Bosworth Horsham Hounslow

125 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Huntingdonshire Hyndburn Inverclyde Ipswich Isle of Anglesey Isle of Wight Isles of Scilly Islington Kennet Kensington and Chelsea Kerrier Kettering Kings Lynn and West Norfolk Kingston upon Hull Kingston upon Thames Kirklees Knowsley Lambeth Lancaster Leeds Leicester Lewes Lewisham Lichfield Lincoln Liverpool Luton Macclesfield Maidstone Maldon Malvern Hills Manchester Mansfield Medway Melton Mendip Merthyr Tydfil Merton Mid Bedfordshire Mid Devon Mid Suffolk Mid Sussex Middlesbrough

126 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Midlothian Milton Keynes Mole Valley Monmouthshire Moray Neath and Port Talbot New Forest Newark and Sherwood Newbury/W Berkshire Newcastle under Lyme Newcastle upon Tyne Newham Newport North Ayrshire North Cornwall North Devon North Dorset North East Derby North East Lincoln North Hertfordshire North Kesteven North Lanarkshire North Lincolnshire North Norfolk North Shropshire North Somerset North Tyneside North Warwickshire North West Leicester North Wiltshire Northampton Norwich Nottingham Nuneaton and Bedworth Oadby and Wigston Oldham Orkney Oswestry Oxford Pembrokeshire Pendle Penwith Perth and Kinross

127 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Peterborough Plymouth Poole Portsmouth Powys Preston Purbeck Reading Redbridge Redcar and Cleveland Redditch Reigate and Banstead Renfrewshire Restormel Rhondda Cynon Taff Ribble Valley Richmond upon Thames Richmondshire Rochdale Rochford Rossendale Rother Rotherham Rugby Runnymede Rushcliffe Rushmoor Rutland Ryedale Salford Salisbury Sandwell Scarborough Scottish Borders Sedgefield Sedgemoor Sefton Selby Sevenoaks Sheffield Shepway Shetland Shrewsbury and Atcham

128 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Slough Solihull South Ayrshire South Bedfordshire South Bucks South Cambridgeshire South Derbyshire South Gloucestershire South Hams South Holland South Kesteven South Lakeland South Lanarkshire South Norfolk South Northants South Oxfordshire South Ribble South Shropshire South Somerset South Staffordshire South Tyneside Southampton Southend on Sea Southwark Spelthorne St Albans St Edmundsbury St Helens Stafford Staffordshire Moorlands Stevenage Stirling Stockport Stockton on Tees Stoke on Trent Stratford on Avon Stroud Suffolk Coastal Sunderland Surrey Heath Sutton Swale Swansea

129 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits Swindon Tameside Tamworth Tandridge Taunton Deane Teesdale Teignbridge Telford and Wrekin Tendring Test Valley Tewkesbury Thanet Three Rivers Thurrock Tonbridge and Malling Torbay Torfaen Torridge Tower Hamlets Trafford Tunbridge Wells Tynedale Uttlesford Vale of Glamorgan Vale of White Horse Vale Royal Wakefield Walsall Waltham Forest Wandsworth Wansbeck Warrington Warwick Watford Waveney Waverley Wealden Wear Valley Wellingborough Welwyn Hatfield West Devon West Dorset West Dunbartonshire

130 Appendix 2 Interventions requirement 2006/07 Local Authority Annual Interventions (data-matches & reviews) Annual Visits West Lancashire West Lindsey West Lothian West Oxfordshire West Somerset West Wiltshire Western Isles Westminster Weymouth and Portland Wigan Winchester Windsor and Maidenhead Wirral Woking Wokingham Wolverhampton Worcester Worthing Wrexham Wychavon Wycombe Wyre Wyre Forest York

131 Appendix 3 Security: Performance Measures and Enablers Security: Performance Measures and Enablers Security of administration PM 10 PM 11 PM 12 Number of interventions where review actions completed since 1 April. Percentage of data matches resolved in 2 months. Number of claimants visited. Compliance with guidance E 17 E 18 The LA ensures a person making a claim or notifying a change of circumstance provides all the certificates, documents information and other evidence in its original form to support the claim as they may reasonably require. All employees responsible for receiving and verifying documents are trained on the latest evidence requirements including identifying false documents and following up discrepancies and apply this in order to comply with the relevant legislation. Compliance with data integrity E 19 The LA provides data (the HBMS extract) in loadable state for all 12 months on specified dates, ensuring the accuracy of customer National Insurance Numbers recorded on their benefits systems, 98% to match with DWP records. All incidents rated 1 and 2 by HBMS to be resolved within a maximum of three months unless otherwise agreed with HBMS. Counter-fraud activities PM 13 PM 14 PM 15 Number of fraud referrals per thousand caseload. Performance Indicator: Number of fraud investigators employed per 1,000 caseload. Performance Indicator: Number of fraud investigations per 1,000 caseload.

132 Appendix 3 Security: Performance Measures and Enablers Fraud referrals E 20 E 21 The LA publicises guidance on making a referral to all employees working for the LA. It provides fraud awareness sessions at induction and supports this with an ongoing programme of fraud awareness to employees who are involved in HB/CTB benefit administration, housing and council tax collection, external employees to whom such work is outsourced and any employees working for a third party who are involved in the verification of HB/CTB claims. The LA provides a publicised dedicated telephone service (or National Benefit Fraud Hotline), which is staffed during office hours, for the public or employees to report suspicions. An answerphone service is available outside working hours. Risk profiling referrals E 22 E 23 Referrals are risk assessed, with priority given to medium to high-risk cases, with the results of investigations informing regular review of the risk assessment process. In relevant cases the LA gathers intelligence through a discrete intelligence function within the LA or through National Anti-Fraud Network (NAFN), London Team Against Fraud (LTAF) or through the DWP Intelligence structure. Action on referrals E 24 The LA sifts referrals within an average of 10 working days* of receipt and uses a management information system to track all fraud referrals that are allocated to a named investigator and the progress made on them. *This excludes bulk data referrals such as the National Fraud Initiative (NFI) and HBMS data matches. These types of bulk-referrals should be managed and sifted as a source of potential investigation cases. E 25 The LA commences investigations within an average of 10 working days of referrals being sifted. Fraud Investigators Code of conduct E 26 The LA complies with the appropriate legislation and ensures that its fraud investigation officers understand that under section 67(9) of the Police And Criminal Evidence (PACE) Act 1984 they are persons charged with the investigation of crime and are, therefore, subject to the same restraints as the police, especially those contained in PACE Act In Scotland fraud investigation officers adhere to the test of fairness.

133 Appendix 3 Security: Performance Measures and Enablers E 27 E 28 E 29 The LA maintains a separate fraud file with restricted access for all investigations, and such records as are needed for the purposes of disclosure, under Criminal Procedure and Investigations Act (CPIA) 1996, Regulation of Investigatory Powers Act (RIPA)2000, or Regulation of Investigatory Powers (Scotland) Act (RIP(S)A) 2000 are kept in accordance with PACE Act Fraud investigators keep a proper record of what they do for their own personal use so that it can, if necessary, be used as an aide memoire when giving evidence. Interviews are conducted under caution in accordance with PACE or the test of fairness (Scotland) when there are reasonable grounds based on known facts or information which are relevant to the offence. LA fraud policy E 30 E 31 E 32 E 33 E 34 There is a Member approved anti-fraud policy supported by a fraud business plan against which the progress, outcome and quality of investigations are monitored. The LA makes all appointments of authorised officers in accordance with the law and monitors the use of these powers or uses a centralised intelligence resource such as NAFN or a DWP Operational Intelligence Unit (OIU) or in conjunction with neighbouring LAs. The LA has chosen to use and operate the Do Not Redirect (DNR) service in accordance with the legislation and procedural guidance, see HB/CTB Security Guidance, Do Not Redirect service. The LA has signed, and adheres to, the Fraud Partnership Agreement with Counterfraud Investigation Service (CFIS) at Operational Board level and has underpinned this with locally agreed service standards with the CFIS Sector, which meet at least the minimum requirements set out in the Partnership Agreement. The LA has in place systems to ensure that only lawful requests are sent to DWP for Inland Revenue information. Sanctions PM 16 Performance Indicator: Number of successful sanctions per 1,000 caseload. A balanced sanctions policy E 35 The LA provides clear guidelines to employees to consider and administer the appropriate sanctions and ensures they are applied strictly in accordance with the law.

134 Appendix 3 Security: Performance Measures and Enablers E 36 E 37 The LA always checks the DWP s database and Police National Computer (PNC) or SOL P (as per ) for previous benefit fraud sanctions and convictions before issuing a caution or penalty. If a caution or penalty is given the LA records the penalty details clearly, including sending notification for recording on the DWP database, to ensure further attempts to defraud by the same person are considered for prosecution as a first option. If a caution or penalty is refused the LA ensures all cases are referred for prosecution.

135 Risk scoring methodology Introduction Appendix 4 Risk scoring methodology 1.0 Each month, on a scheduled date, Housing Benefit Matching Service (HBMS) extract data from a Local Authority (LA). HBMS run these data scans against a risk scoring methodology developed by Department for Work and Pensions (DWP) analysts to identify and prioritise Housing Benefit (HB)/Council Tax Benefit (CTB) claims that appear to be more risky. 1.1 This risk-scored list of cases is issued to LAs for use in carrying out the risk-scored reviews described in the Reviews procedures and Visiting. The risk-scored list for reviews is issued alongside data-matching referrals by HBMS to each LA. 1.2 The lists of risk-scored cases, in order of priority for review, will be issued to LAs on CD-ROM as the files will be too large to send in paper form. These files can be opened in Microsoft Excel. 1.3 At present the CD Rom will contain two, one with the new style presentation of the risk list, one with the old style. Both formats will contain the same risk scoring. The new style is described below. It is for LAs and their software providers to decide when to adopt the new format. Risk-scored caseload lists 1.4 Cases are listed in decreasing order of risk. The following fields give extra information about each case that we hope will be useful Priority and Rank Possible Causes of Error

136 Appendix 4 Risk scoring methodology Priority and Rank 1.5 This replaces the old risk score and is made up of two components. The first indicates priority and is a number in the range 1 to 6. The second is the remaining number once the leading digit has been excluded. The second component gives the individual rank of the case. 1.6 Cases with priority 1 should be reviewed first, then cases with priority 2, then 3 and then 4. Cases with priority 5 or 6 should not ordinarily be reviewed. The table below shows the likelihood of finding an overpayment across the six priority classifications. Priority Detected overpayments 1 47% 2 33% 3 22% 4 16% 5 9% 6 7% 1.7 This table shows that cases with priority 1 have a 47% chance of having an overpayment on them, priority 2 cases have a 33% chance having an overpayment, and so on. 1.8 Because the risk score list is in descending error order of risk, the riskiest case is at the top and has rank 1, the second riskiest case is second and has rank 2, and so. Even within a priority group you should review the riskiest cases first, ie review the cases with lower numerical value of rank first. Possible Causes of Error 1.9 This replaces the old probability rating and consists of a three digit number where each digit is between 1-6. The three digits represent the three most likely errors, where: 1 = Amount of eligible rent/tenancy details/liability to pay rent 2 = Claimants/partners/non-dependants earned income 3 = Capital/other income 4 = LTAHW/number of dependants/number of non-dependants 5 = Non-residence 6 = Income from other benefits 1.10 The first digit represents the most likely reason for an error, the second digit is the next most likely reason for an error, and the third digit the third most likely reason for an overpayment.

137 Appendix 4 Risk scoring methodology 1.11 Below is an example of what the old risk score looked like. It is populated with some test data. Note: For the purposes of this example, some address fields have been removed. Forename Surname D.O.B ADDRESS NINO HB REF NO SCORE LAST RECORDED REVIEW DATE ESTIMATED PROBABILITY SCORE % % % % 1.12 In the new format, the risk score for the same test data (above) will look like: Forename Surname D.O.B ADDRESS NINO HB REF NO Priority & Rank LAST RECORDED REVIEW DATE Possible causes of error

138 Appendix 5 Reviews Form Reviews Form Please ensure that the LA s Review Form complies with the guidance in Part A, para 3.71.

139 Appendix 5 Reviews Form

140 Appendix 5 Reviews Form

141 Appendix 6 Visiting Officer s verification statement Visiting Officer s verification statement

142 Appendix 6 Visiting Officer s verification statement

143 Appendix 7 New claim checklist New claim checklist

144 Appendix 8 Certificate of Earned Income Certificate of Earned Income

145 Appendix 9 HB/CTB Self-employed earnings information HB/CTB Self-employed earnings information

146 Appendix 9 HB/CTB Self-employed earnings information

147 Appendix 9 HB/CTB Self-employed earnings information

148 Appendix 9 HB/CTB Self-employed earnings information

149 Fraud and error awareness Introduction Appendix 10 Fraud and error awareness 1 LAs are committed to paying HB/CTB promptly and accurately to genuine claimants, making sure they receive the full benefit they are entitled to. 2 It is important that staff are made aware of the types of fraud that can occur and understand the need to be vigilant when dealing with benefit claims. 3 Fraud awareness should be part of each new member of staff s induction. New members of staff should spend time with the claim administration and fraud sections to get to know the staff and their work. It is also important that staff are aware of the importance of reducing errors and preventing overpayments occurring. 4 There should be regular liaison between fraud staff, benefit processing staff and others who have contact with them. 5 The following is a checklist of issues that fraud officers should consider covering in all talks to benefits staff. The list should be tailored to suit non-benefit staff. As the list is extensive, it may be more appropriate to split the areas covered between a number of sessions, for example structure chart of the fraud section, showing contact names and telephone numbers talk-through of the LA s policy on benefit fraud, the work of the fraud unit and the processes involved in a typical investigation examples of what needs to be referred to the fraud section and how the referral should be made the information that needs to be collected from a caller if an allegation is being made that a claimant is claiming benefit fraudulently what to do if a claimant starts to admit to claiming benefit fraudulently during the course of an interview or telephone call what to do if a claimant calls, either in person or by telephone, as a result of benefit being suspended because of a fraud investigation types of fraud and how they are perpetrated, for example, non-declaration of earnings, non-declaration of partner, false claim for dependants, undeclared capital, Instrument of Payment (IOP) fraud, non-residence, landlord fraud, contrived tenancy and identity fraud continued

150 Appendix 10 Fraud and error awareness 5 (continued) anonymous examples of actual investigations. How the fraud was identified and the result of the investigation, with details of the court hearing, if there was one what the staff need to specifically look for whilst doing their jobs examples of false and forged documentation and how forgeries can be spotted managing expectations. For example, all referrals may not get investigated but all information will be put to some use and may be beneficial if a subsequent referral is made how losses due to fraud and errors could have been prevented or identified The LA s policy 6 Staff at all levels need to be clear that the LA is committed to preventing and detecting fraud and reducing losses due to error. All staff should be made aware of the LA s policy and approach to tackling fraud and error. The policy must be written down and made available to all staff, preferably individual copies provided and explained to all new staff within four weeks of appointment included in refresher training, at least annually. 7 LAs are encouraged to develop a policy that demonstrates a clear commitment to preventing, detecting and punishing fraud. Communicating the results of fraud investigations 8 Feedback from fraud sections on the progress of referrals and fraud drives gives benefit sections a greater understanding of the types of fraud being perpetrated. News of successful prosecutions or the withdrawal of benefit encourages staff to continue to be vigilant. 9 General progress reports must be issued at least on a quarterly basis to keep all benefit staff informed about the progress of fraud investigations. The reports must (subject to security considerations) include information on how frauds were detected which claim types are affected patterns and themes of fraud detected new types of fraud identified, and how some frauds could more easily be prevented

151 Appendix 10 Fraud and error awareness 10 In addition, when a fraud referral is made, the following information should ideally be provided on the referred case to the member of staff making the referral. Information can be given in writing or in person and should cover the following on receipt of referral, inform the member of staff whether it is to be investigated or not, and if not, give the reason why if it is to be investigated, give details of who will be investigating and to whom any additional information should be given. Advise on the expected date when the investigation will be complete keep the member of staff informed of developments if the above date passes without conclusion to the investigation 11 Advise the member of staff what the result of the investigation is, this is in addition to informing benefit staff, as appropriate, of any changes to the benefit

152 Fair Processing Statement Appendix 11 Fair Processing Statement 1 The Department for Work and Pensions (DWP) collects information for social security benefit purposes. The information we collect depends on the nature of our customer s business with us. 2 Under the Department s legislation, customers making a claim to an income-related benefit, eg Income Support, Pension Credit, Jobseeker s Allowance, Housing Benefit, are required to give us information on any children or other adults living with them, as this may affect the amount of benefit that is paid to them. This is because other adults (non-dependants) are expected to make a financial contribution towards housing costs, depending on their personal circumstances. 3 Local Authorities (LAs) administer Housing Benefit/Council Tax Benefit on behalf of DWP and the law permits DWP to share information about non-dependants with LAs for Housing Benefit/Council Tax Benefit purposes. Information will be passed to the relevant LA so that they can calculate the correct amount of Housing Benefit/Council Tax Benefit to pay to our customer. 4 The DWP customer making the claim for benefit has provided us with the information we hold about you. If you would like to check the information, and if you live in a house that is rented by our customer, please contact your local council. In all other cases, please contact your local DWP office. 5 We may check information that we have been given about you, which has been provided by the person making the claim for benefit, with other information, held by us. 6 We will not disclose information about you to anyone outside DWP unless the law permits us to. DWP is the Data Controller for the purposes of the Data Protection Act. If you want to know more about what information we have about you, or the way we use your information, you can contact any of the Department s offices and ask for the leaflet GL33. Or you can find a copy of the leaflet on our website. The address is For further information, see LA RAT Bulletin 10/03.

153 Management control sheet Appendix 12 Management control sheet

154 Appendix 13 Management checklists Management checklists

155 Appendix 13 Management checklists

156 Appendix 13 Management checklists

157 Appendix 13 Management checklists

158 Appendix 13 Management checklists

159 Appendix 13 Management checklists

160 Appendix 13 Management checklists

161 Appendix 14 Sections 1(1A) and 1(1B) of the SSAA 1992 Sections 1(1A) and 1(1B) of the Social Security (Administration) Act 1992 Extract from the Social Security (Administration) Act 1992 (1A) (1B) No person whose entitlement to any benefit depends on his making a claim shall be entitled to the benefit unless subsection (1B) below is satisfied in relation both to the person making the claim and to any other person in respect of whom he is claiming benefit. This subsection is satisfied in relation to a person if (a) the claim is accompanied by (i) a statement of the person s national insurance number and information or evidence establishing that that number has been allocated to the person, or (ii) information or evidence enabling the national insurance number that has been allocated to the person to be ascertained, or (b) the person makes an application for a national insurance number to be allocated to him, which is accompanied by information or evidence enabling such a number to be so allocated (1C) Regulations may make provision disapplying subsection (1A) above in the case of (a) prescribed benefits (b) prescribed descriptions of persons making claims, or (c) prescribed descriptions of persons in respect of whom benefit is claimed, or in other prescribed circumstances.

162 Appendix 15 Data incidents Data incidents Area of Impact Referrals Rules High Risk Review Scans Status Incident Description Impact R1 R2 R3 S1 S2 S3 Nil population of a key field Low population of a key field Limited population of a key field Nil population of a key field Low population of a key field Limited population of a key field Developme D1 Nil population of a key field nt Rules D2 Low population of a key field Rejected Records 1 >10% rejected records Rule deselected No matches produced Rule deselected Very limited number of matches produced Mismatches requiring extra sifting Issue of incorrect referrals Limited number of referrals issued Major impact on accuracy of risk scores Major impact on accuracy of risk scores Limited impact on accuracy of risk scores HBMS development rule will fail to work HBMS development rule will fail to work Reduction in caseload for data matching

163 Appendix 16 Management information requirement 2006/07 Management information requirement 2006/07 1 LAs must return the management information required on the HBSD/IAD data extract scan, completing the fields covering Case Review Records (fields ). Note: The HBSD/IAD data extract scan should not be confused with the HBMS extraction file (also known as first data extraction file). This is used purely for running the monthly data-matching rules and risk analysis. It has no role in the provision of MI. 2 The HBSD/IAD MI scan should be extracted according to the same schedule as the LA s HBMS scan, ie in a four-week cycle. A courier from TNT will arrive on the designated date and collect the data for return to IAD Information Centre, Longbenton, Newcastle-upon-Tyne. Please ensure that the data is clearly labeled HBSD/IAD scan and that they are returned in the plastic envelopes which have been provided by TNT. 3 Requests for a copy of the specification of the HBSD/IAD MI scan, or for any other queries regarding return of the MI data, please contact the Information Centre, see below. 4 The basic information being collected in the six fields for MI under the HBSD/IAD scan includes the following details date case review/check started or fraud investigation commenced type of case review/check reason for case review/source of referral review indicator Y will indicate a full review, N a partial review date of outcome of case review or fraud investigation outcome of case review or fraud investigation 5 HBMS data-matches require the completion and return of a result sheet for each referral issued. LAs should make sure a process exists to co-ordinate the direct return to HBMS of correctly completed HBMS result sheets.

164 Appendix 16 Management information requirement 2006/07 6 If you have any queries regarding the management information requirement, contact the DWP Information Centre Information Centre Information Directorate Department for Work and Pensions Room BP5201 Benton Park view Benton Park Road Longbenton Newcastle-upon-Tyne NE98 1YX 7 Electronic Management Information (form WIB 1) should be sent quarterly on disk. The WIB1 records case level data on all cases of incorrect benefit. The disk should be clearly labelled WIB 1 and include your LA number and an contact address. The disk should then be sent to Information Centre Benton Park View Longbenton Newcastle-upon-Tyne NE98 1YX 8 Electronic returns should not be sent by although the following address may be used for contacting the Information Centre querying data returns Note: see hard copy of the for contact details. 9 The WIB4a records case level information on prosecutions. Completed WIB4a and enquiries about completion of WIB4a should be addressed to Technical Support 5th Floor West Trevelyan Square Leeds LS1 6EB 10 The WIB4b records case level information on cautions and administrative penalties. Completed WIB4b should be sent to WIB4b HRAD2 Dept. for Work & Pensions 4 th floor, The Adelphi 1-11 John Adam Street London WC2N 6HT

165 Appendix 16 Management information requirement 2006/07 11 For enquires regarding submissions or amendments to final subsidy claim forms (MPF720A/B), please refer to the latest HB/CTB Subsidy Guidance Manual. To obtain a copy of this, contact Corporate Document Services Ltd Orderline Tel: Fax: orderline@cds.co.uk 12 Other MI returns are listed below Stats 121 Stats 122 Stats 124 Stats 124A Stats 128

166 Appendix 17a Form WIB4a/Prosecution Form WIB4a/Prosecution DEPARTMENT FOR WORK & PENSIONS Form WIB4a/Prosecution PROSECUTION INCENTIVE/TWO STRIKES FORM 1. Customer name 2. LA reference number 8 digit reference number quoted on subsidy claim form 3. Date of birth 4. Claimant s NINO 5. HB reference number 6. Address 7. Rent rebate HB Rent allowance HB Council tax benefit Income support Jobseekers allowance Other benefits Which benefits were in receipt before investigation? Total value of overpayment identified ( ) Which benefits were considered in the Prosecution? 8. Type of fraud Non-resident at address/property ineligible for HB Amount of earnings or number of hours worked Amount of other Social Security benefits Amount of capital Other, please specify Amount of other income Composition of household Amount of rent Internal fraud

167 Appendix 17a Form WIB4a/Prosecution 9. Benefits convicted against Period of conviction Amount From To Rent rebate HB Rent allowance HB Council tax benefit Income support Jobseekers allowance Other benefits 10. Who initiated the prosecution? LA / Jobcentre Plus / Joint Initiative 11. Date of referral for investigation: 12. Date of referral for prosecution: 13. Date of conviction: 14. Court of hearing: 15. Was a check of previous convictions carried out? Yes / No If yes, by whom? Jobcentre Plus / Police 16. Prosecution authority used Police (CPS) Own legal Department Procurators Fiscal (Scotland) High Street Solicitors DWP solicitors 17. Under which of the following legislative provisions was the case prosecuted? Theft Act Social Security Admin Act Section 112 Section 111A Section 112 (1A) Other (please specify) 18. Was the case successfully prosecuted? Yes / No 19. Penalty incurred by defendant: Custodial Sentence mths Suspended Sentence mths Community Service hrs Conditional Sentence mths Fine Costs Other (please specify) 20. Current Benefit Awarded (please state): Start date Benefit Paying Office

168 Appendix 17a Form WIB4a/Prosecution 21. Partner s details (if applicable) Name National Insurance No D.O.B. Partner s address Local Authority contact: Tel Number: Signed: Date: When complete, please send this form to: Technical Support, 5th Floor West, Trevelyan Square, Leeds LS1 6EB

169 Appendix 17b Form WIB4b Caution/Admin Pen Wib4b Caution/Admin Pen DEPARTMENT FOR WORK & PENSIONS Form WIB 4b Caution/Admin Pen CAUTION / ADMINISTRATIVE PENALTY INCENTIVE FORM 1. LA name 2. LA reference number 8 digit reference number quoted on subsidy claim form 3. Claimant s HB reference number 4. Claimant s NINo 5. Benefit entitlement overpayment identified: Rent rebate HB Rent allowance HB Council tax benefit Income support Jobseekers allowance Other benefits Which benefits were in receipt before investigation? Total value of overpayment identified ( ) Which benefits were considered in the Sanction? 6. Type of fraud: Non-resident at address or property ineligible for HB Composition of household Amount of earnings or number of hours worked Amount of other Social Security benefits Amount of other income Amount of rent Amount of capital Internal fraud Other, please specify 7. Who initiated the sanction? LA / Jobcentre Plus / Joint Initiative 8. Was a check of previous convictions carried out? Yes / No If yes, by whom? Jobcentre Plus / Police 9. Which sanction is administered? Caution / Administrative Penalty 10. With whom is the Caution/Admin Penalty registered? Jobcentre Plus / Police / LA only

170 Appendix 17b Form WIB4b Caution/Admin Pen 11. Finally, if the check for previous convictions had instead recommended prosecution, which prosecution authority would your LA use? Police (CPS) Own legal Department Procurators Fiscal (Scotland) High Street Solicitors DWP solicitors Local Authority contact: Tel Number: Signed: Date: When complete, please send this form to: WIB 4b, HRAD2 at DWP, 5th Floor, The Adelphi, 1-11 John Adam Street, London WC2N 6HT

171 Appendix 18 Appendix 18 This appendix is not used.

172 Appendix 19 Appendix 19 This appendix is not used.

173 Appendix 20 DCI 500 LA DESK AID

174 Appendix 20 DCI 500 LA DESK AID

175 Appendix 21 Word Solution/HBLite Desk Aid Word Solution/HBLite Desk Aid Load the floppy disc into the PCs A Drive and view the contents Select the HBLITECL (icon displayed looks like a tap) and double click. (An egg timer may not be displayed. This may take a few minutes). The Enter filename to save box will appear. In the Save in field select an appropriate folder or your desktop to save the information into (do not change the file name at this stage as this may affect the opening process) and click the Save button. Once the above steps have been followed check the destination into which you selected to save the information and there will be two files. File 1: Word Document This file is displayed as a white box with the blue word icon at the top left hand corner. When the file is opened a mirror image of the referrals you previously received on paper will be displayed (3 pages per referral). File 2: PSV File This file is displayed as a white box with a coloured icon in the centre. This can now be uploaded through your fraud management system.

176 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Barrow in Furness Week 1 Blackburn Monday Blackpool Bolton Expected Dates Burnley Of Data Pick Up Bury /04/2006 Carlisle /05/2006 Chester /06/2006 Chorley /07/2006 Congleton /07/2006 Crewe & Nantwich /09/2006 Ellesmere Port & Neston /10/2006 Fylde /10/2006 Halton /11/2006 Hyndburn /01/2007 Knowsley /02/2007 Lancaster /03/2007 Liverpool Macclesfield LAs

177 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Manchester Week 1 Oldham Tuesday Pendle Preston Expected Dates Ribble Valley Of Data Pick Up Rochdale /04/2006 Rossendale /05/2006 Salford /06/2006 Sefton /07/2006 South Ribble /08/2006 St Helens /09/2006 Stockport /10/2006 Tameside /10/2006 Trafford /11/2006 Vale Royal /01/2007 Warrington /02/2007 West Lancashire /03/2007 Wigan Wirral Wyre LAs

178 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Barking & Dagenham Week 1 Barnet Wednesday Bexley Brent Expected Dates Bromley Of Data Pick Up Broxbourne /04/2006 Camden /05/2006 Corporation of London /06/2006 Croydon /07/2006 Ealing /08/2006 East Cambridgeshire /09/2006 Enfield /10/2006 Greenwich /11/2006 Hackney /11/2006 Hammersmith & Fulham /01/2007 Havering /02/2007 Islington /03/2007 Lambeth Mid Sussex Sheffield Southwark Westminster LAs

179 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Haringey Week 1 Harrow Thursday Hillingdon Hounslow Expected Dates Kensington & Chelsea Of Data Pick Up Kingston-Upon Thames /04/2006 Lewisham /05/2006 Merton /06/2006 Newham /07/2006 Redbridge /08/2006 Richmond Upon Thames /09/2006 Sutton /10/2006 Tower Hamlets /11/2006 Waltham Forest /11/2006 Wandsworth /01/ /02/ /03/ LAs

180 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Allerdale Week 2 Alnwick Monday Barnsley Berwick on Tweed Expected Dates Blyth Valley Of Data Pick Up Bradford Tue 18/04/06 Calderdale /05/2006 Castle Morpeth /06/2006 Chester Le Street /07/2006 Copeland /08/2006 Craven /09/2006 Derwentside /10/2006 Doncaster /11/2006 Durham /12/2006 Easington /01/2007 East Riding of Yorkshire /02/2007 Eden /03/2007 Gateshead Kingston Upon Hull Kirklees Rotherham South Lakeland South Tyneside Sunderland Teesdale LAs

181 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Darlington Week 2 Hambleton Tuesday Harrogate Hartlepool Expected Dates Leeds Of Data Pick Up Middlesbrough /04/2006 Newcastle-upon-Tyne /05/2006 North East Lincolnshire /06/2006 North Lincolnshire /07/2006 North Tyneside /08/2006 Redcar & Cleveland /09/2006 Richmondshire /10/2006 Ryedale /11/2006 Scarborough /12/2006 Sedgefield /01/2007 Selby /02/2007 Stockton-On-Tees /03/2007 Tynedale Wakefield Wansbeck Wear Valley York LAs

182 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Aylesbury Vale Week 2 Bedford Wednesday Cheltenham Cherwell Expected Dates Chiltern Of Data Pick Up Cotswold /04/2006 Dacorum /05/2006 Forest of Dean /06/2006 Gloucester /07/2006 Hertsmere /08/2006 Luton /09/2006 Mid Bedfordshire /10/2006 Milton Keynes /11/2006 North Wiltshire /12/2006 Oxford /01/2007 South Bedfordshire /02/2007 South Buckinghamshire /03/2007 South Oxfordshire St Albans Stevenage Stroud Swindon Tewkesbury Three Rivers Vale of White Horse Watford Welwyn Hatfield West Oxfordshire West Wiltshire Wycombe LAs

183 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Basingstoke & Deane Week 2 Bracknell Forest Thursday East Hampshire Eastleigh Expected Dates Elmbridge Of Data Pick Up Epsom & Ewell /04/2006 Fareham /05/2006 Gosport /06/2006 Guildford /07/2006 Hart /08/2006 Havant /09/2006 Isle of Wight /10/2006 Kennet /11/2006 Mole Valley /12/2006 New Forest /01/2007 Newbury (West Berkshire) /02/2007 North Dorset /03/2007 Portsmouth Reading Reigate & Banstead Runnymede Rushmoor Salisbury Slough Southampton Spelthorne Surrey Heath Tandridge Test Valley Waverley Winchester Windsor Woking LAs Wokingham

184 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Aberdeenshire Week 2 Argyll & Bute Friday Orkney Islands Shetland Islands Expected Dates Western Isles Of Data Pick Up 21/04/ /05/ /06/ /07/ /08/ /09/ /10/ /11/ /12/ /01/ /02/ /03/ LAs

185 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Bath & North East Somerset Week 3 Bournemouth Monday Bristol Caradon Expected Dates Carrick Of Data Pick Up Christchurch /04/2006 East Devon /05/2006 East Dorset /06/2006 Exeter /07/2006 Kerrier /08/2006 Mendip /09/2006 Mid Devon /10/2006 North Cornwall /11/2006 North Devon /12/2006 North Somerset /01/2007 Penwith /02/2007 Plymouth /03/2007 Poole Purbeck LAs Restormel

186 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Bridgnorth Week 3 Bromsgrove Tuesday Coventry Dudley Expected Dates East Hertfordshire Of Data Pick Up Herefordshire (Hereford City) /04/2006 Malvern Hills /05/2006 Sedgemoor /06/2006 South Gloucestershire /07/2006 South Hams /08/2006 South Somerset /09/2006 Taunton Deane /10/2006 Teignbridge /11/2006 Torbay /12/2006 Torridge /01/2007 West Devon /02/2007 West Dorset /03/2007 West Somerset LAs Weymouth & Portland

187 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Birmingham Week 3 North Hertfordshire Wednesday North Shropshire North Warwickshire Expected Dates Nuneaton & Bedworth Of Data Pick Up Oswestry /04/2006 Redditch /05/2006 Rugby /06/2006 Sandwell /07/2006 Shrewsbury & Atcham /08/2006 Solihull /09/2006 South Shropshire /10/2006 South Staffordshire /11/2006 Stratford upon Avon /12/2006 Walsall /01/2007 Warwick /02/2007 Wolverhampton /03/2007 Worcester Wrekin Wychavon LAs Wyre Forest

188 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Aberdeen Week 3 Angus Thursday Clackmannanshire Dumfries & Galloway Expected Dates Dundee Of Data Pick Up East Ayrshire /04/2006 East Dunbartonshire /05/2006 East Lothian /06/2006 East Renfrewshire /07/2006 Edinburgh /08/2006 Falkirk /09/2006 Fife /10/2006 Glasgow /11/2006 Highland /12/2006 Inverclyde /01/2007 Midlothian /02/2007 Moray /03/2007 North Ayrshire North Lanarkshire Perth & Kinross Renfrewshire Scottish Borders South Ayrshire South Lanarkshire Stirling West Dunbartonshire LAs West Lothian

189 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Adur Week 4 Arun Monday Ashford Blaenau Gwent Expected Dates Bridgend Of Data Pick Up Brighton & Hove Tue 02/05/06 Caerphilly Tue 30/05/06 Canterbury /06/2006 Cardiff /07/2006 Carmarthenshire /08/2006 Ceredigion /09/2006 Chichester /10/2006 Conwy /11/2006 Crawley /12/2006 Dartford /01/2007 Denbighshire /02/2007 Dover /03/2007 Eastbourne Flintshire Gwynedd Merthyr Tydfil Monmouthshire Neath Port Talbot Newport Pembrokeshire Powys Rhondda Cynon Taff Swansea Torfaen Vale of Glamorgan LAs Ynys Mon (Isle of Anglesey)

190 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Amber Valley Week 4 Ashfield Tuesday Bassetlaw Blaby Expected Date Bolsover Of Data Pick Up Broxtowe /05/2006 Cannock Chase /05/2006 Charnwood /06/2006 Chesterfield /07/2006 Corby /08/2006 Daventry /09/2006 Derby /10/2006 Derbyshire Dales /11/2006 East Northamptonshire /12/2006 East Staffordshire /01/2007 Erewash /02/2007 Gravesham /03/2007 Hastings Horsham Lewes Maidstone Medway (Medway Town) Rother Sevenoaks Shepway Swale Thanet Tonbridge & Malling Tunbridge Wells Wealden LAs Worthing

191 Appendix 22 HBMS Data Take-On Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Babergh Week 4 Basildon Wednesday Boston Braintree Expected Dates Breckland Of Data Pick Up Brentwood /05/2006 Broadland /05/2006 Forest Heath /06/2006 Gedling /07/2006 Harborough /08/2006 High Peak /09/2006 Hinckley & Bosworth /10/2006 Kettering /11/2006 Leicester /12/2006 Lichfield /01/2007 Mansfield /02/2007 Melton /03/2007 Newark & Sherwood Newcastle-under-Lyme North East Derbyshire North West Leicester Northampton Nottingham Oadby & Wigston Rushcliffe Rutland South Derbyshire South Northamptonshire Stafford Staffordshire Moorlands Stoke on Trent Tamworth Wellingborough LAs Wrexham

192 Appendix 22 HBMS Data Take-On and Processing Schedule (DTOPS) 28 Schedule Week Local Authority LA ID Cambridge Week 4 Castle Point Thursday Chelmsford Colchester East Lindsey Expected Dates Epping Forest Of Data Pick Up Fenland /05/2006 Great Yarmouth /06/2006 Harlow /06/2006 Huntingdonshire /07/2006 Ipswich /08/2006 Lincoln /09/2006 Maldon /10/2006 Mid Suffolk /11/2006 North Kesteven /12/2006 North Norfolk /02/2007 Northern Ireland (All 5 Executives) /03/2007 Norwich /03/2007 Peterborough Rochford South Cambridge South Holland South Kesteven South Norfolk Southend-on-Sea St Edmundsbury Suffolk Coastal Tendring Thurrock Uttlesford Waveney West Lindsey West Norfolk & Kings Lynn LAs

193 Appendix 23 Housing Benefit Matching Service rules April 2006 Housing Benefit Matching Service rules April 2006 Rule Description CTBB001 CTBB002 CTCI101 CTCT801 CTCT911 CTDB101 CTDC004 CTIB012 CTIB114 CTIC201 CTIR101 CTIR102 CTIR215 CTIS005 CTIS105 CTJS055 CTJS105 CTJS212 CTPD001 CTRM101 CTRP004 CTRP103 Failure to declare payment of a Bereavement Benefit Failure to declare Occupational Pension (using Bereavement Benefit data) Failure to declare income from earnings (using HMRC Construction Industry data) Concurrent CT claims by the same person within one LA Concurrent CT claims by the same customer, cross-boundary matching Failure to declare Industrial Injuries Disability Benefit Failure to declare the death of a customer (using DCI data) Incorrect rate of Incapacity Benefit declared Failure to declare receipt of Incapacity Benefit by customer or partner Failure of customer or partner to declare receipt of Carers Allowance. Failure of customer or partner aged under 60 to declare capital of 3000 and above Failure of customer or partner to declare capital of 6000 and above Incorrect rate of capital declared Failure to notify change of address (using IS data) False declaration by customer or partner of receipt of Income Support Failure to notify change of address (using JSA data) False declaration by customer or partner of receipt of JSA (IB) Fraudulent HB claim on the basis that JSA (C) is in payment Failure to declare customer in an English or Welsh prison for +13 weeks Failure to declare a change of address (using Royal Mail Re-direct data) Identifies a foreign address recorded on PSCS Failure to declare receipt of State Retirement Pension by customer or partner

194 Appendix 23 Housing Benefit Matching Service rules April 2006 Rule CTRP107 CTTC001 CTTC003 HBBB001 HBBB002 HBCI101 HBDB101 HBDC004 HBHB001 HBHB911 HBIB012 HBIB114 HBIC201 HBIR101 HBIR102 HBIR215 HBIS005 HBIS105 HBJS055 HBJS105 HBJS212 HBPD001 HBRM101 HBRP004 HBRP103 Description Failure to declare Occupational Pension (using Retirement Pension data) Failure to declare receipt of Tax Credits (using HMRC Tax Credits data) Failure to declare partner in household (using HMRC Tax Credits data) Failure to declare payment of a Bereavement Benefit Failure to declare Occupational Pension (using Bereavement Benefit data) Failure to declare income from earnings (using HMRC Construction Industry data) Failure to declare Industrial Injuries Disability Benefit Failure to declare the death of a customer (using DCI data) Concurrent HB claims by the same person Concurrent claims by the same customer, cross-boundary matching Incorrect rate of Incapacity Benefit declared Failure to declare receipt of Incapacity Benefit by customer or partner Failure of customer or partner to declare receipt of Carers Allowance Failure of customer or partner aged under 60 to declare capital of 3000 and above Failure of customer or partner to declare capital of 6000 and above Incorrect rate of capital declared Failure to notify change of address (using IS data) False declaration by customer or partner of receipt of Income Support Failure to notify change of address (using JSA data) False declaration by customer or partner of receipt of JSA (IB) Fraudulent HB claim on the basis that JSA (C) is in payment Failure to declare customer in an English or Welsh prison for +13 weeks Failure to declare a change of address (using Royal Mail Re-direct data) Identifies a foreign address recorded on PSCS Failure to declare receipt of State Retirement Pension by customer or partner

195 Appendix 23 Housing Benefit Matching Service rules April 2006 Rule HBRP107 HBTC001 HBTC003 Description Failure to declare Occupational Pension (using Retirement Pension data) Failure to declare receipt of Tax Credits (Using HMRC Tax Credits data) Failure to declare partner in household (using HMRC Tax Credits data) Abbreviations used DCI HMRC JSA(C) JSA(IB) PSCS TC Departmental Central Index Her Majesty s Revenues and Customs (formerly IR Inland Revenue) Jobseeker s Allowance (Contributions Based) Jobseeker s Allowance (Income Based) Pension Service Computer System Tax Credits

196 Appendix 24a Completion of HBMS Results COMPLETION OF HBMS RESULTS The HBMS referrals disc contains an electronic result sheet that should be returned to HBMS via to at the end of each working day or week. The new HBMS system in place to manage the electronic result sheets is designed to ignore duplicates, therefore the same result sheet can be returned as often as necessary until all the results have been returned. PLEASE FOLLOW THESE RULES WHEN ENTERING RESULTS ON SPREADSHEETS All dates must be entered in the format dd/mm/yyyy No zeros, nil, n/a, 0 or signs to be entered. Columns should be formatted to 2 decimal places ERROR TYPE should be chosen from the drop down box as follows:- Fraud Claimant Error Local Authority Government Department Other NEGATIVE CODES should be entered from the drop down box as follows:- Code (then the number) Code 4z (with the date) SANCTION column should be entered from the drop down box as follows:- Prosecution Admin Penalty Caution An overpayment and underpayment cannot be used for the same referral. In this case provide the overpayment details. Where there is a positive result, an error type must be entered. No additional information is required. Your name and contact number may be added to your if you so wish. Please do not send more than one per day, however you may send more than one spreadsheet attached to that , if necessary. Failure to return a spreadsheet in the correct format may result in it being returned to you for correction. PLEASE CIRCULATE THESE INSTRUCTIONS TO ALL USERS

197 Appendix 24b HBMS Results Sheet HBMS Results Sheet