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Help from the Independent Case Examiner (ICE) can have dramatic results and the service is free. Their annual report released last week details a case in which they helped a claimant get £17,000 in backdated PIP payments, but they only take on a limited range of cases. Find out if you could use their service.

ICE is a body set up to look at failings by the DWP, amongst others. It can investigate complaints, requiring the DWP to respond to its questions. It can instruct the DWP to take actions, such as carrying out a mandatory reconsideration and it can tell the department to make ‘consolatory payments’ which can total thousands of pounds where people have suffered distress as a result of DWP failings.

Elsewhere we have detailed two investigations by ICE that feature in their annual report.

One involved a claimant who died after their ESA and PIP were wrongly stopped.

Another involved a pensioner who took their own life after their state pension was wrongly stopped.

But ICE don’t only investigate complaints where the claimant has died.

In their latest annual report, ICE give an example of how effective their service can be:

“One of our case managers took a call one Sunday last June, from a distressed complainant who was adamant his benefit claims had been mismanaged. By January when I completed our full report addressing all his issues, the case manager’s investigation had already identified an overlooked mandatory reconsideration, prompted its completion, and the complainant had been paid the PIP and Disability Premiums he was owed totalling £17k.”

However, not everyone can go to ICE for help. There are a number of conditions that have to be met first and we should stress that going to ICE is never a substitute for appealing a decision where that is possible.

ICE deal with complaints made by users of DWP and DfC (Northern Ireland) services and organisations contracted to carry services on behalf of DWP and DfC, for example, HAAS, IAS and Capita.

You must have already made your complaint through the organisation’s own internal procedure and have received the organisation’s final response before contacting ICE, otherwise they will not accept or investigate your complaint.

Issues you can complain to ICE about

You can complain to ICE about:

  • failure to follow proper procedures
  • excessive delays
  • poor customer service
  • original complaint not dealt with satisfactorily by DWP or contracted organisation

It’s important to understand that you can’t successfully complain just because you are unhappy with a decision. Instead, you generally need to show that the DWP or an assessment provider, for example, didn’t follow their own procedures.

You could complain to ICE if, for example, you have been advised by the DWP to claim the wrong benefit and lost out as a result.

Or if the DWP failed to make a reasonable adjustment for you that their policies say that should make, such as providing information in an alternative format.

If the DWP simply ignored your request for a mandatory reconsideration, which has happened many times to people requesting a LEAP review, then you can complain to ICE once you have complained to the DWP. You would also want to try to lodge an appeal even without a mandatory reconsideration notice.

If an assessment provider refuses to allow your relative, friend or carer to help you give evidence at your PIP assessment or WCA, and this makes it hard for you to give the information that is needed for a correct decision, you could complain to ICE if you do not get a satisfactory response from the assessment company.

You can also raise the issue at appeal if you are unhappy with your award.

Remedies ICE can provide
If ICE decide that there is evidence of maladministration by government departments or contracted organisations, they can make recommendations which must be implemented.

This can include explanations, apologies and financial awards.

The first stage of the complaints procedure
You can contact ICE by phone, email or in writing and send a copy of the final response to your complaint from the DWP or health assessors. You should explain all the relevant facts, simply and clearly. You can appoint a representative to act on your behalf if you want to, although you must provide ICE with your written consent for us to discuss matters with your chosen representative.

Additional stages
ICE will look at both sides of a complaint and, if necessary, recommend how things can be put right. They will tell you within 2 weeks whether they can accept your complaint or not. Then, if they accept it, they will agree with you what your complaint covers.

If you and the organisation you are complaining about can agree what needs to be done, ICE will set out the agreed action in writing and send a copy to you and the organisation. They will also check that the organisation does what they have agreed to do. If they can deal with complaints this way, they aim to do so within 8 weeks of accepting them.

If you and the organisation are not able to agree what needs to be done, the matter will be referred to an investigation case manager, who will ask the organisation for papers about your case. Once they have reviewed all the evidence, they may contact all parties to try to settle the complaint and they will aim to do this in 15 weeks. If this is not possible, the investigation case manager will request a report from the Independent Case Examiner, and this may increase the time for resolution to 20 weeks from initial complaint.

When the report is ready, ICE will decide if there is any evidence of maladministration. If there is no evidence of maladministration, the complaint will not be upheld. If there is evidence of maladministration, the ICE will look at what the organisation did before the complaint was made to them.

If the organisation offered appropriate redress before the complaint was made to the ICE, the complaint will not be upheld. If they did not, the complaint will be upheld.

The organisation will implement the ICE’s recommendations unless they are prevented from doing so by legislation or policy. If the recommendations cannot be implemented, the organisation will explain why.

Deadlines
You need to refer your complaint to ICE within 6 months of receiving the final response from the DWP or health assessors.

If you are unhappy with ICE decision, and you have new evidence that you think would materially affect it or which shows that it contained a factual error, you need to complain within 3 months of their decision. They will consider the new evidence and change their findings, if appropriate.

If you are still unhappy with the outcome, or if you have no new evidence, you can ask your Member of Parliament to refer your complaint to the Parliamentary and Health Services Ombudsman

More information on ICE’s services are available on their website.

 

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