IN THE UPPER TRIBUNAL Appeal No. CH/3570/2014
ADMINISTRATIVE APPEALS CHAMBER
Before: Upper Tribunal Judge K Markus QC
The decision of the Upper Tribunal is to allow the appeal.
The decision of the First-tier Tribunal made on 27 January 2014 under number SC010/13/01603 was made in error of law. Under section 12(2)(a) and (b)(ii) of the Tribunals, Courts and Enforcement Act 2007 I set that decision aside and re-make the decision.
The decision that I make is that the overpayment of housing benefit for the period 3 November 2011 to 4 November 2012 is not recoverable.
REASONS FOR DECISION
Introduction
1. This appeal concerns a decision by the respondent to recover overpaid housing benefit of Ł343.12 in respect of the period 3 November 2011 to 4 November 2012. On 27 January 2014 the First-tier Tribunal confirmed the decision of the respondent and the appellant appealed to the Upper Tribunal. I gave permission to appeal on 6 October 2014. The respondent has sent written submissions in which it opposes the appeal. The respondent has not requested a hearing. The appellant’s mother, who is the appellant’s representative in this appeal, has written to say that due to her own ill-health she is unable to attend a hearing and asks that the appeal is considered on the papers.
2. I have decided that I am able to determine this appeal without an oral hearing. I have had full written submissions from both parties and I would not be assisted by those submissions being supplemented by oral submissions. On the basis of their written submissions I consider that the parties have been able to participate fully in the appeal.
Background
3. Up to and including 2 November 2011 housing benefit had been paid to the appellant on the basis that he was in receipt of long term incapacity benefit. In March 2012 the appellant’s landlord notified the respondent that the appellant’s incapacity benefit had ended on 2 November 2011 and that he was in receipt of employment and support allowance (ESA) from 3 November 2011, this being much less than the previous incapacity benefit. As a result the respondent recalculated the appellant’s housing benefit with effect from 3 November 2011. As his income had decreased, the housing benefit increased. There was an underpayment from 3 November 2011 which was paid to the appellant’s landlord.
4. In the meantime the appellant had appealed against the ESA decision. The First-tier Tribunal (“Tribunal 1”) allowed his appeal on 22 August 2012. This meant that the appellant was entitled to a larger award of ESA. The Secretary of State did not implement that decision until 24 October 2012 when, on the basis of the adjustment to his entitlement, the appellant was paid arrears of ESA in respect of the period from 3 November 2011. On 25 October 2012 the Secretary of State wrote to the appellant notifying him that he would receive the higher rate from 3 November 2011.
5. Although the respondent was aware that the appellant was appealing the ESA decision the respondent did not become aware of the outcome of that appeal nor the revised award of ESA until a CIS check on 18 March 2013. As a result, the respondent recalculated the appellant’s entitlement to housing benefit from 3 November 2011 to 1 November 2012 taking into account the arrears which he had been paid and the increase in his ESA entitlement. On 19 March 2013 the respondent decided that the appellant had been overpaid housing benefit of Ł343.12 and that the overpayment was recoverable from him.
The decision of the First-tier Tribunal
6. The appellant appealed against the overpayment decision to the First-tier Tribunal (“Tribunal 2”). The appellant chose not to have a hearing and, having considered rules 2 and 27 of the Tribunal Procedure (First-tier Tribunal) (Social Entitlement Chamber) Rules of Procedure 2008, the tribunal proceeded to consider the appeal on the papers. The tribunal confirmed the decision. The decision notice continued as follows:
“4. The overpayment was caused because [the appellant] successfully appealed a DWP decision about his claim to Employment and Support Allowance and received an increased award back dated to 03.11.11.
5. [The appellant] did not inform the local authority that his appeal had been allowed.
6. The overpayment was not caused as a result of official error and the overpayment is, therefore, recoverable from him.”
Proceedings in the Upper Tribunal
7. I gave the appellant permission to appeal on 6 October 2014, for the following reasons:
“a. The tribunal appears to have erred in its approach to official error under regulation 100(2) and (3) of the Housing Benefit Regulations 2006 as it may not have considered whether the overpayment was caused by official error of the Department for Work and Pensions in respect of ESA and/or incapacity benefit decisions. The statement of reasons appears only to consider whether there was any error by the local authority. But where a tribunal on appeal finds that a decision on benefits has been wrongly made by the DWP, that is an error or mistake for the purposes of regulation 100(3): CH/943/2003.
b. The tribunal does not appear to have addressed the question of when the appellant or any other relevant person as set out in regulation 100(2) became aware of the tribunal decision as to his ESA/incapacity benefit. The appellant says that he was not aware of it until 25 October 2012.
c. In any event, was there a recoverable overpayment prior to the date of the tribunal decision? On any basis, it seems that neither the appellant nor any other relevant person could reasonably have known that there was an overpayment prior to that date.
d. I also give the appellant permission to the appeal as to the calculation of any overpayment. If the appellant’s calculations are correct then there has been no overpayment at all.”
The legal framework
8. Section 130 of the Social Security Contribution and Benefits Act 1992 and the Housing Benefit Regulations 2006 (“the regulations”) make provision for entitlement to and the calculation of housing benefit, and for recovery of overpayments. The rules for the calculation of housing benefit are complex but for present purposes it is sufficient to explain that if the claimant’s income is below a prescribed amount then entitlement is to the maximum housing benefit and, where the claimant’s income exceeds a prescribed amount, entitlement is subject to a taper. The higher the income, the lower the entitlement, until entitlement is eventually extinguished.
9. Regulation 79 provides for the date on which a change of circumstances which affects entitlement to or the amount of housing benefit is to take effect. Regulation 79(7) provides:
“(7) … where the change of circumstances is the payment of income, or arrears of income, in respect of a past period, the change of circumstances shall take effect from the first day on which such income, had it been timeously paid in that period at intervals appropriate to that income, would have fallen to be taken into account for the purposes of these Regulations.”
10. An overpayment of housing benefit is defined in regulation 99 as:
“any amount which has been paid by way of housing benefit and to which there was no entitlement under these Regulations …”
11. Under regulation 100, any overpayment is recoverable unless it arose in consequence of official error and at the time of receipt of the payment the claimant could not reasonably have been expected to realise that it was an overpayment. The relevant provisions are:
“100 (1) Any overpayment, except one to which paragraph (2) applies, shall be recoverable.
(2) Subject to paragraph (4) this paragraph applies to an overpayment which arose in consequence of an official error where the claimant or a person acting on his behalf or any other person to whom the payment is made could not, at the time of receipt of the payment or of any notice relating to that payment, reasonably have been expected to realise that it was an overpayment.
(3) In paragraph (2), “overpayment which arose in consequence of an official error” means an overpayment caused by a mistake made whether in the form of an act or omission by—
(a) the relevant authority;
(b) an officer or person acting for that authority;
(c) an officer of—
(i) the Department for Work and Pensions; or
(ii) Revenue and Customs,
acting as such; or
(d) a person providing services to the Department for Work and Pensions or to the Commissioners for Her Majesty's Revenue and Customs,
where the claimant, a person acting on his behalf or any other person to whom the payment is made, did not cause or materially contribute to that mistake, act or omission.”
12. In R (Sier) v Cambridge City Council Housing Benefit Review Board [2001] EWCA Civ 1523 Latham LJ said:
“25. … one has to have regard to the general legislative purpose, which seems to me to be clear. Parliament has laid down in the Regulations that a person is to be relieved of the obligation to repay an overpayment when that has been occasioned by an administrative mistake and not by any fault on the part of the recipient. That seems to me to be the basic thrust of the Regulation and one should approach the meaning of the word “cause” and its application to the facts on that basis.
13. Simon Brown LJ agreed, adding at paragraph [30] that a single composite question falls to be asked under what was then regulation 99(3) and is now regulation 100(3):
“was the overpayment the result of a wholly uninduced official error, or was it rather the result of the claimant’s own failing, here his failure in breach of duty to report a change of circumstance?”
14. The Court held in that case that an administrative failure by what was then the Department of Social Security to notify the housing benefit authority of a change in benefit entitlement was not the cause of the overpayment, even if it was an official error. The overpayment occurred because the claimant continued to claim housing benefit when he was not entitled to do so and failed to notify the authority of what was plainly a relevant change in circumstances and of which he was aware.
15. In SN v London Borough of Hounslow (HB) [2010] UKUT 57 (AAC); [2010] ACR 27, Judge Howell QC further explained the approach under regulation 100 as follows:
“7. The terms of the regulation thus require that for an amount overpaid to get within the exception, there are four aspects of the facts that potentially have to be examined:
(1) what caused the amount in question to be overpaid?
(2) was that cause a mistake by the authority or a person within regulation 100(3)?
(3) if yes to (2), did the claimant cause or materially contribute to that mistake?
(4) if no to (3), could he or she nevertheless reasonably have been expected to have realised, at the relevant time in regulation 100(2) in relation to that amount, that it was an amount to which there was no true entitlement?
8. …
9. In relation to any particular amount overpaid the causative part of the inquiry (aspects (1)–(3) in paragraph 7) requires a practical and substantive, not a philosophical and abstract, approach. It is the substantial cause of that amount being overpaid that matters: R (Sier) v Cambridge CC HBRB (unreported 8 October 2001) [2001] EWCA Civ 1523. As Simon Brown LJ said in a short concurring judgment in that case, that part of the inquiry really amounts to asking the single composite question whether the overpayment in question was the result of a wholly uninduced official error, as distinct from the kind of case where the claimant himself is substantially responsible for the overpayment: that is a question to be answered in a common sense way and if put in those terms it is usually easy to see the answer on the facts.
10. Thus if an authority provided with all the right information makes a complete mess of its own calculations it cannot of course stop the resultant overpayment being one of “official error” by saying that if only the claim had not been made in the first place its errors would never have taken place, even though in one sense that is causally true. Conversely if incorrect or incomplete information is given in a claim form and benefit is overpaid in reliance on that, the claimant cannot turn those overpayments into ones “caused by official error” by pointing out that if only the authority had done better detective work among other information it had, or if only there had not been a failure to match or transmit information between it and the DWP, it could have realised that what he was telling them was wrong. Such arguments deserve and get short shrift in the pragmatic causal inquiry needed for regulation 100. In each case what matters is the real or substantial cause that triggers the overpayment of the amount in question, not anything more remote, recondite or speculative in the facts before or after that might be said to have a connection with it, or that might have operated to stop it but did not.”
Discussion
16. There is no doubt that the appellant was overpaid housing benefit during the period in question. Although his housing benefit had been correctly calculated and paid to him on the basis of the lower award of ESA which he had received prior to 24 October 2012, when the amount of ESA increased he was no longer entitled to the amount of housing benefit previously awarded. The arrears of ESA which were paid to the appellant in respect of the period from 3 November 2011 were, by reason of regulation 79(7), treated as income during that period with the effect that the amount of housing benefit to which he was entitled during the whole of that period decreased. The difference between the amount to which he was entitled and that which he was paid was an overpayment in accordance with regulation 99. For the same reason, the effect of the increased ongoing payments of ESA from 24 October 2012 had the effect that the appellant’s housing benefit up to 4 November 2012 (when the appellant’s entitlement to contribution-based ESA ceased, and he was awarded income-based ESA) was also overpaid.
17. However, I conclude that Tribunal 2 erred in deciding that the whole of the overpayment was recoverable under regulation 100 for the reasons which I now explain.
18. The tribunal found that the overpayment was not caused by official error but by the appellant failing to inform the respondent of his successful appeal. In the statement of reasons the tribunal said:
“19. The overpayment was caused by the appellant’s failure to notify the Local Authority of his successful ESA appeal as soon as he became aware of it. He did not.”
(emphasis added by me)
19. There are three principal errors in this conclusion.
20. First, the tribunal did not have regard to the fact that a substantial portion of the total overpayment related to a period prior to the decision of Tribunal 1 and it made no finding as to what caused that part of the overpayment.
21. Second, having found that the appellant’s duty was to notify the outcome of his appeal when he became aware of it, the tribunal failed to make a finding of when that was. The appeal was decided by Tribunal 1 on 22 August 2012. It does not appear that there was any evidence before Tribunal 2 as to whether the appellant attended that tribunal hearing. If he did not attend, he would not have been aware of the decision on that day. His case in his appeal to Tribunal 2 was that he was not aware of the decision of Tribunal 1 until the DWP notified him of the outcome by letter dated 25 October 2012. Although the respondent now says that all parties would have been notified of the tribunal’s decision immediately after it was made, it does not appear that they made that submission to Tribunal 2. The tribunal made no finding that the appellant knew about the outcome of the appeal before he received the letter of 25 October 2012.
22. Third, had the tribunal approached the above two matters correctly, it would have had to go on to identify the cause of the overpayment in respect of both the period prior to the decision of Tribunal 1 and, if relevant, during any period after that decision when the appellant was not aware of it. It would have been bound to conclude that the overpayment arose because the appellant’s ESA was recalculated following the decision of Tribunal 1. Did that meant that the overpayment arose in consequence of official error? The respondent submits that there was no official error, relying on CH/38/2008. The key facts in that case were similar to those of this case. The claimant had been in receipt of housing benefit calculated on the basis that he was not receiving incapacity benefit. An appeal tribunal allowed the claimant’s appeal against the refusal of incapacity benefit, resulting in arrears of such benefit being awarded to him. That was taken into account as income during the period for which the arrears were paid under regulation 79(7), resulting in an overpayment of benefit. The local authority decided that the overpayment in respect of the period prior to the claimant notifying the change of circumstances was recoverable. The Deputy Commissioner decided that the overpayment was not caused by official error, as follows:
“10. The local authority correctly superseded the claimant’s entitlement to housing benefit and council tax benefit having been notified that he had lost his entitlement to incapacity benefit. The loss of his incapacity benefit was not caused by official error. His entitlement was reinstated by a tribunal following an appeal. The fact that a tribunal came to a different conclusion on whether the claimant satisfied the personal capability assessment to that which was reached by the Secretary of State does not show that the Secretary of State’s decision amounted to “official error”. In the first place, assessment of disability inevitably involves a degree of subjectivity, and it might be that the tribunal which allowed the claimant’s appeal heard additional evidence which was not available to the original decision maker. Secondly, it is not an error which relates to the award of HB or CTB. It is not “a mistake made whether in the form of an act or omission” and therefore the definition of “official error” in regulation 100(3) HB Regulations is not satisfied. Once the award had been re‑instated, by reason of the provisions set out at paragraphs (3) and (4) above, the local authority must treat the claimant’s income as increased throughout each of the relevant weeks. The local authority’s error was in failing to supersede timeously. But that itself did not create the overpayment for the period 27 October 2003 to 26 March 2005. That was created by the effects of the successful appeal on incapacity. Even if the local authority had acted immediately when given notice of the reinstatement of his incapacity benefit, the claimant would still have been overpaid for the period 27 October 2003 – 26 March 2005.”
23. With the greatest respect to the Deputy Commissioner, I do not agree with that analysis. The Deputy Commissioner did not consider the detailed analysis of Commissioner Williams in CH/943/2003 as to this very point. Commissioner Williams addressed essentially the same factual situation as arises in this case and arose in CH/38/2008. The Inland Revenue had refused the claimant’s claim for working families tax credit (WFTC) and her housing benefit was calculated accordingly for the period in question. Eleven months later an appeal tribunal decided that the claim was entitled to WFTC for the whole of that period. This had the effect of retrospectively reducing her entitlement to housing benefit which the council sought to recover. The issue in the appeal was whether the overpayment was caused by official error, and that in turn involved deciding whether the Revenue’s decision refusing WFTC was a “mistake”. The Commissioner decided that it was. He said:
“31 The focus of this appeal is on how the Council (or any similarly placed public body) must handle the Revenue decision on WFTC (or any similar decision) in the light of the first tribunal decision (or any similar tribunal decision) that found the Revenue (or any similar) decision appealed to it to be wrong. To add the extra dimension of the second tribunal to that focus is in my view to blur it. What matters is how the Council must deal with the problem of a successful appeal against an official decision on which it has previously properly relied.
32 My starting point is, as noted above, the comprehensive analysis of the jurisdiction and powers of appeal tribunals in CIB 4751 2002[1] by the recent Tribunal of Commissioners. The core issue is how that approach is to be applied here, alongside the overriding principles of judicial finality as endorsed by the House of Lords in Thrasyvoulou, when viewed from the standpoint of the Council.
33 The importance of giving due weight to a tribunal decision, combined with the fact that the claimant in this case in no way caused or contributed to the Revenue decision being wrong, separate this case from the issues considered by Commissioner Howell QC in CH 5485 2002 or the other cases cited to me. The first tribunal decided that the Revenue decision was wrong. The Tribunal of Commissioners in CIB 4751 2002 put renewed emphasis on the role of the appeal tribunal as a superior decision maker. Any doubts that it did not do its job properly were ended when the appeal period ran out without anyone seeking permission to appeal. At that point the weighty principles of judicial finality must come into play. The claimant cannot be expected to show all over again to the Council that the Revenue was wrong or, for it amounts in substance to the same thing, why it was wrong.
34 Had this case come forward without the first tribunal’s decision in the claimant’s favour, then I would have adopted the approach in CH 5485 2002 and I would have wanted to see why it was that Miss C contended that the Revenue decision was wrong and how she based her arguments. But she has done that. She persuaded the superior decision maker that the Revenue decision needed changing. If there was an evidential burden on Miss C, then she discharged it in winning that appeal. And in persuading the tribunal as she did, she established that there was something clearly wrong with the Revenue’s decision. It may not have been clear before the appeal, but it is clear in the light of the tribunal decision. As compared with the situation in CH 5485 2002, things have gone a further stage here, and that stage cannot be ignored.
35 Without the benefit of the statement of facts or reasons for the first tribunal decision I agree with the Revenue view that it is impossible to say whether the tribunal found that the Revenue decision was wrong on a factual basis, or a basis of law, or by exercise of some discretion on which the tribunal could rightly take a different view of the overall situation. So I cannot decide, or direct another tribunal how to decide, whether the Revenue decision was “right” or “wrong” in the secondary sense argued by the official parties to this case. Further, even if there were a statement of reasons, it would be wrong to use it to speculate whether the tribunal thought that the Revenue decision was an “official error” in the regulation 99 sense. That is an impossible approach in this case. Even if it were possible in other cases it is wrong. There was no appeal against the tribunal decision. It must stand, and the Revenue decision must go. To engage in speculation about the first tribunal decision is to go behind that decision in an unacceptable manner. To expect the Council to go behind it in this way offends judicial certainty and imposes a double jeopardy on the claimant. Further, if this approach allowed the Council to ignore the tribunal decision then issues of Article 6 independence and equality of arms arise.
36 The only answer to this problem consistent with the principles set out above is that the Council must accept the first tribunal decision. And it must accept that the first tribunal decision shows that the Revenue decision was an “error” or “mistake”.
37 As there is in this case no question on the facts of Miss C being in any way causative of or contributory to the Revenue decision, then the error or mistake, or incorrect or wrong decision, of the Revenue (all those terms can be used interchangeably in my view) must be an official error for the purposes of regulation 99(2), regardless of the reason – fact, law or discretion – why the tribunal disagreed with the Revenue. This is of course subject to any appeal against that tribunal decision.
38 Arguments in support of the approach of the official parties to this case were based on the tribunal’s remarks to the effect that Miss C was unjustly enriched by this decision. I do not agree that the tribunal’s remarks on that issue are appropriate, nor do I find much help in the “public money” policy arguments deployed by the official parties to the case. Regulation 99 provides a small but important safeguard to claimants against being required to repay overpaid benefits. But, as the Court of Appeal emphasised in Sier, regulation 99 also includes safeguards for those official bodies against abuse of this safeguard. A claimant can only rely on regulation 99(2) if, first, she or he (or any agent) did not cause or materially contribute to the mistake and, second, she or he (or any agent) could not reasonably be expected to realise that there was an overpayment at the time the payment was received.
39 The answer to arguments about tribunals reaching decisions on new facts lies not in narrowing the meaning of “official error” but in asking why the official did not have access to the facts that were before the tribunal. Whose fault was that? If a claimant failed to put something in evidence to the official when that should have been done, but then persuaded the tribunal of the relevance of the evidence, it is open for consideration whether the failure of the claimant to produce the evidence earlier contributed to the official error. Similarly, if the claimant knew that there was a “clear and obvious” official error that gave rise to the overpayment, and appealed on that ground, it would be difficult for the claimant also to argue that he or she could not reasonably have been expected to realise that there was an error at the time of the payment.”
24. I cannot improve on this reasoning and I adopt it entirely. The difference between the two decisions cannot be explained by the element of subjectivity involved in assessment of disability which is not involved in a determination of the number of hours worked. For the reasons given by Commissioner Williams at paragraph 35 of his decision, his analysis applies regardless of such considerations.
25. It follows that the effect of the decision of Tribunal 1 was that the Secretary of State had made a mistake in his determination of the appellant’s entitlement to ESA. It was that determination which led to the appellant being overpaid housing benefit, at least for the period prior to the date of the decision of Tribunal 1 and, depending on the facts of the case, possibly afterwards.
26. Had the tribunal addressed this issue correctly, it would have had to consider whether the appellant caused or materially contributed to the Secretary of State’s error and whether, at the time that he received the overpayments or notice relating to them, he could reasonably have been expected to realise that they were overpayments. Considerations such as those discussed by Commissioner Williams at paragraph 39 may have been relevant to either or both of those issues. There was no evidence to suggest that either of those issues applied to the appellant in this case.
27. In addition Tribunal 2 found (at paragraph 20) that the appellant could reasonably have been expected to realise that he was being overpaid. On the tribunal’s own reasoning this was irrelevant, because having found that there was no official error the question of what the appellant could be expected to have realised did not arise under regulation 100(2). In any event, the tribunal failed to address whether the appellant could reasonably have been expected to realise it was an overpayment at the relevant time. Plainly he could not during the period prior to Tribunal 1’s decision and, thereafter, whether he could have done so would depend on a variety of potentially relevant factors, taking a subjective approach, including what the appellant knew and what he could reasonably have found out. On any analysis, the tribunal did not approach this issue correctly. Paragraph 20 of the statement of reasons does not make sense: receipt of the back-payment could not have alerted the appellant earlier than the date of receipt to there having previously been an overpayment.
28. In the light of the above errors of law, I set aside the decision of Tribunal 2.
29. I must then consider whether to remit the appeal to another First-tier Tribunal for reconsideration or whether I should re-make the decision.
30. In the light of my conclusions on the law, as set out above it inevitably follows that prior to the date of the decision of Tribunal 1 the overpayment was caused by official error and the appellant could not have realised at that time that there was an overpayment. The only outstanding issue therefore is whether the overpayment in respect of any of the period after the decision of Tribunal 1 is recoverable. I have decided that I should not remit the appeal to another tribunal but that I should re-make the decision. In doing so I take into account the following considerations. The issue to be determined is narrow. The amount of any possibly recoverable overpayment is limited to the period after the first day of the benefit week after 22 August 2012, that is a period of just over two months, and so the maximum amount would be in the region of Ł60. It is not proportionate to remit the appeal for reconsideration in the light of the sum involved. I have sufficient evidence to determine the appeal.
31. I conclude that the appellant was not aware of the decision of Tribunal 1 at the time. The respondent submits that all parties are notified immediately following a decision. However, things do not always go as they should and letters do not always arrive at their destination. The appellant has been consistent throughout this appeal that he was not aware of the decision of Tribunal 1 until he received the DWP’s letter of 25 October. The respondent did not submit otherwise to Tribunal 2. I note that in a letter dated 13 October 2013 (page 30) the appellant’s mother said that the appellant had said that “his appeal had been awarded” but this could be a reference to the letter of 25 October 2012.
32. In the light of the foregoing, I conclude that after 22 August 2012 the continuing cause of the overpayment was the erroneous decision as to ESA by the Secretary of State coupled with the failure by the Secretary of State to correct that decision or notify it to the appellant until the letter of 25 October 2012. The appellant did not cause or contribute to that error. In the light of my findings above I conclude that until he received the letter of 25 October the appellant could not reasonably have been expected to realise that he was being overpaid.
33. It is unlikely that the appellant would have received the letter of 25 October on the following day. On balance of probabilities, he would not have received it until early the following week and so, had he notified the respondent immediately on receipt, regulation 79(7) would not have permitted the change of circumstances to take effect prior to 4 November.
34. It follows that the whole of the overpayment arose in consequence of official error. Accordingly I re-make the decision by making the decision which the First-tier Tribunal should have made. The overpayment is not recoverable.
Signed on the original Kate Markus QC
On 23 April 2015 Judge of the Upper Tribunal