CCM14105 - Closing the enquiry: adjustment needed to the claim but a penalty is not appropriate: are adjustments needed for other years?

Your enquiry might have an impact on earlier or later years. Before you take any action regarding the enquiry year you must consider if there is an impact for any other year.

  1. Impact for Current Year - any adjustment for this year will be made under S16. If the adjustment relates to child care costs you will need to revise the current year award. In all other cases the revision to the enquiry year will automatically lead to a revision for the current year.
  2. Impact for an earlier year - the enquiry might have established a similar adjustment is needed for an earlier year. Where the enquiry window is still open you must open the enquiry before taking any further action regarding the existing enquiry. You should issue the letter at CCM14106 and allow 7 days for the new enquiry letter to reach the customer(s) before you take any further action.
  3. If the enquiry window has already closed you will only be able to revise the earlier year if you can make a discovery decision (see CCM13200). You can only make a discovery decision if there is clear neglect for that year. You should not extend your intervention into the PY-1 year without the documented approval of your manager. Managers should only approve the opening of PY-1 and earlier years where, firstly, they believe there is clear evidence that the customer could afford to pay any resulting overpayment, and secondly, the criteria for making a Discovery Decision are met where the normal enquiry window has closed for the year in question. Once your manager has approved the opening of PY-1you should issue the letter at CCM14106 and allow 7 days for the letter to reach the customer(s) before you take any further action.
  4. Impact for a later year which is not the Current Year - where an adjustment is needed for a later year which is not the current year how you proceed depends on whether the award has been finalised.
  • Award finalised - you will need to open an enquiry before you take any further action regarding the existing enquiry. You should issue the letter at CCM14106 and allow 7 days for the new enquiry letter to reach the customer(s) before taking any further action.
  • Award not finalised - you will need to inhibit finalisation and ask the customer to return their S17 notice to you. Once this has been returned you can make the amendment under S19 for the enquiry year and finalise the later year by making a S18 decision. If there is a continuing claim you will also have to make the S14 decision for the current year using ‘finalise and renew’. If there is no continuing claim you will use ‘finalise only’.

If the customer fails to return the S17 notice, you will have to wait until the first specified date (see CCM11040) before making your amendments using ‘finalise only’

You should not need to consider making a discovery decision. It will be very unusual for an enquiry to have been opened and closed for the later year. If you encounter this situation you must consult your manager.

(This content has been withheld because of exemptions in the Freedom of Information Act 2000)