Correcting an official error that causes an underpayment
A case manager must conduct an unscheduled review (legally known as a determination without application) to correct an official error that results in an underpayment (PADP Regs, reg. 41(1))
Before correcting an error, case managers must make sure that there has not been any of the following:
- request for a re-determination (PADP Regs, reg. 41(1)(c))
- request for an appeal (PADP Regs, reg. 41(1)(d))
- fraud investigation started
The case manager should contact the appropriate team to establish this. This includes the:
- re-determinations team
- appeals team
- fraud team.
If the re-determination or appeal has been requested, but not yet been determined, then the case manager cannot make a determination without application.
Completing a determination without application involves correcting previous errors in order to work out the individual’s correct entitlement to PADP. This involves:
- considering all the entitlement criteria, including applying the backwards test. The chapter on the backwards test explains the tests in more detail
- working out when the change in entitlement should begin.
The case manager may use any or all of the following when making completing the determination without application:
- information provided in the application that led to the original determination (PADP Regs, reg. 41(2)(a)(i))
- any other information obtained with that application (PADP Regs, reg. 41(2)(a)(ii))
- any other information that they have obtained in connection with the individual’s entitlement to PADP (PADP Regs, reg. 41(2)(b)).