[1995] NISSCSC C12-95(IS) (7 August 1995)
Decision No: C12/95(IS)
"(a) Claimant was in receipt of Supplementary Benefit from 18 May 1983to 10 April 1988 and thereafter in receipt of Income Support and
during the periods from 30 August 1985 to 9 January 1986 and
14 July 1988 to 28 September 1988 the weekly amounts paid to
him were those set out in the third column in the Breakdown of
Revised Overpayment attached to the submission at Tab 7.
(b) While these weekly amounts were being paid the Supplementary
Benefit and Income Support branches were not aware of the
material fact that Claimant's wife was in receipt of maternity
allowance from 26 August 1985 to 28 December 1985, Sickness
Benefit from 18 July 1988 to 5 August 1988 and Invalidity
Benefit from 6 August 1988 to 26 September 1988 and Income
Support branch only became aware of these benefits on and
following the receipt of a memo dated 9 November 1988 which it
received from Central Benefits Branch in reply to an enquiry.
(c) Had the Supplementary Benefit and Income Support branches been
aware of these benefits during the whole of the periods in
question the weekly amounts of benefit paid to claimant would
have been those set out in the fourth column of Tab 7.
(d) We are satisfied that claimant knew of his wife's benefits (he
has not denied knowledge) and that he did not disclose directly
to Supplementary Benefit or Income Support Branches that his
wife was in receipt of these benefits (and he does not allege
that he did so) and in consequence he received a total
overpayment of £968.04 (as calculated in Tab 7) in respect of
the periods 30 August 1985 to 9 January 1986 and 14 July 1988
to 28 September 1988.
(e) We are also satisfied that, although Supplementary Benefit and
Income Support Branches were not aware of Mrs McC...'s benefits
Central Benefits Branch was aware of them as were various
counter clerks in the unemployment section of the local office
were Mrs McC... signed the unemployment register and that it was
stated by Mrs McC... in her application form for maternity
allowance (which would have been received by Central Benefits
Branch) that her husband was in receipt of Income Support.
However, we do not accept that claimant himself made a report
to the desk clerk in the unemployment section as stated by
him and that he was referred to Income Support section were
he again reported the circumstances. There is no record that
he did so and we find, on the balance of probabilities that
he did not do so.
(f) For the reasons set out at part 4 hereof we find that such
reports as were made to various branches and offices of the
Department did not satisfy claimant's obligation to disclose
the material fact to the relevant branches i.e. Supplementary
Benefit and Income Support branches.
(g) As to whether or not the amount of the overpayment is
recoverable we find that claimant did not have good cause
for his continuing failure to disclose his wife's benefits
to the Income Support branch and therefore the amount is
recoverable."
It also recorded reasons for its decision as:-
"Claimant has argued that since at least one branch of the Departmentwas aware of his wife's benefits then the amount of benefit paid to
him was paid in that knowledge and must have been correct so there
could not have been an overpayment. We cannot accept that argument
because in R(SB) 15/87 the Commissioners spell out exactly to whom
disclosure should be made as follows, "his duty is best fulfilled
by disclosure to the local office where his claim is being handled
whether in the claim form or otherwise in terms that make sufficient
reference to his claim to enable the matter disclosed to be referred
to the proper person". In claimant's case the contacts were between
his wife and the Central Benefits branch, which is not in the local
office or between his wife and the unemployment benefits counter
clerk at the local office. We do not accept that the latter contact,
which was in connection with her own benefit would have been "in
terms that made sufficient reference" to claimant's Income Support
claim. Further we do not accept that it would be logical for
claimant himself to have reported his wife's benefit to the
unemployment benefits clerk. In any event, even if it was to be
accepted (and we do not accept it) that claimant could have been
of the opinion that his wife's contacts were sufficient disclosure
R(SB) 54.83 recognises a continuing obligation to ensure that the
Adjudication Officer is in possession of all information relevant to
the benefit claimed. Claimant is an intelligent man and he could
not have been unaware that Supplementary Benefit and Income Support
are means-tested benefits which would be affected by family income.
If he had thought that sufficient disclosure had been made then
when there was no reduction in the level of his benefit the
continuing obligation would have applied.
We accept Mrs B…'s evidence that she prepared the figures in
Tab 7 and that they are correct and we accept the forms UB80.ES
(Tax) and T.B.8. as establishing the amounts actually paid to
claimant.
The legislation relating to recovery of overpayment is fully quoted
in the submission and it is drafted in such a way that it does not
matter whether a failure to disclose is fraudulent or innocent. Once
it is found that there has been such a failure without good cause
then recovery must follow. Claimant has taken exception to the
premature action of the recovery section of the Department in making
deductions from his benefit but that is of no relevance to this
appeal which is only concerned with whether there has been an
overpayment and whether it is recoverable."
"In our judgment disclosure must be made, in connection with theclaimant's own benefit, by the claimant himself or, on his behalf,
by someone else. In this context we would consider that disclosure
could fall within the ambit of having been made "on behalf" of the
claimant if someone else were to give information concerning the
claimant in the course of some entirely separate transaction (for
example, in connection with the informant's own claim for benefit),
provided that:-
(a) the information was given to the relevant benefit office;(b) the claimant was aware that the information had been so given;
and
(c) in the circumstances it was reasonable for the claimant to
believe that it was unnecessary for him to take any action
himself."
This view has been reinforced by the Court of Sessions in Scotland in the recent case of Riches -v- Secretary of State for Social Security.
The Commissioners went on to say:- "Whether or not a claimant has made disclosure will therefore be a question of fact to be decided upon the evidence before the tribunal ..."
"Part 1, paragraph 7 - There is no dispute that Mrs McC... statedon her form MA1 claim for maternity allowance that her husband was
in receipt of Income Support, and even though it was completed and handed
to the receptionist at the Social Security Office it would not have
been passed to the Supplementary Benefit/Income Support Section but
would have been forwarded directly to Central Benefits Branch.
As a result Mr McC... may have felt he had discharged his
responsibility to disclose the fact. It appears departmental
procedure was not followed in this case to notify the Social
Security Office of the claim to Maternity Allowance and in
accordance with Commissioners decision R(SB) 18/87 paragraph 17
Mr McC... would have been under a continuing obligation to
disclose, as the disclosure was not made to the appropriate office."
(Signed): C.C.G. McNally
COMMISSIONER
7 August 1995