Claim Maintenance Policy and Strategy

5.1 The following main primary and secondary legislation govern the maintenance of benefit claims

• Social Security Contributions and Benefits Act 1992
• Social Security Administration Act 1992
• Housing Benefit Regulations 2006
• Housing Benefit (State Pension Credit) Regulations 2006
• Local Government Finance Act 2012
• Local Government Act 1992

5.2 Council Tax Reduction is a discount from Council Tax available to all residents within the District on a low income including those in receipt of benefits. View full details of the scheme for the 2025/26 financial year

The details of the scheme are contained in:-
The Council Tax Reduction Schemes (Prescribed Requirements) (England) Regulations 2012 (SI 2012/2885) and The Council Tax Reduction Schemes (Default Scheme) (England) Regulations 2012 (SI 2012/2886) were made on 16 November 2012, and laid before Parliament on 22 and 23 of November 2012 respectively.

This instrument, the Council Tax Reduction Schemes (Prescribed Requirements and Default Scheme) (England) (Amendment) Regulations 2012 (SI 2012:3085) has now been laid before Parliament. This follows through on the government’s stated intention to increase some of the allowances in the Prescribed Requirements and Default Scheme in line with the Department for Work and Pensions’ up-rating of Housing Benefit following the Autumn Statement.

The Prescribed Requirements regulations prescribe requirements for all local Council Tax reduction schemes and came into force on 27 November 2012.
Please note for Prescribed Requirements:

• Schedules 1 to 6 apply to pensioners (as defined) only
• Schedules 7 to 8 apply to all applicants (ie working age and pensioners)

The Default Scheme Regulations contain provisions about applicants in receipt of an award of universal credit, and we will be publishing a further guidance note on this approach, with worked examples.

5.3 The HB/CTR Regulations cover the following specific aspects of maintaining claims

• General
• Provisions affecting entitlement to HB/CTR
• Payments in respect of a dwelling
• Membership of a family
• Applicable Amounts
• Assessment of income and capital
• Students
• Amount of benefit
• Calculation of Weekly Amounts and changes in circumstances
• Claims
• Decisions on questions
• Payments
• Overpayments
• Information

5.4 In summary, LA’s maintaining claims are under a legal duty to;

• establish if a claimant is liable to pay rent or council tax
• decide the value of rent or council tax liability for benefit purposes
• identify all members of a claimant’s family and household
• calculate the claimant’s Applicable Amount
• assess the value of income and capital for benefit purposes
• ensure that claims are legally made
• respond to requests for reviews or appeals of benefit decisions
• pay the correct amount to the payee nominated by the claimant
• accurately identify and calculate overpayments of benefit

5.5 In addition, LA’s maintaining claims are encouraged to adopt best practice published by the DWP and/or CLG.

5.6 Operational procedures provide for each legal duty to be implemented. Various internal and external auditors inspect the procedures and processes to ensure claims are maintained in accordance with each legal duty.

Provide a comprehensive Claim Form to request all relevant information and documentary evidence to support claims

6.1 HB is a state benefit, entitlement to which is means-tested. There are over 100 HB Regulations applying conditions relating to housing costs liability, treatment of income and capital, impact of dependants and non-dependants in the household, payee and payment frequencies, notification, and requests for review and appeal of benefit decisions.

6.2 CTR is a Discount from Council Tax. It is not a state benefit but there are a number of locally approved rules relating to council tax liability, treatment of income and capital, impact of dependants and non-dependants in the household, payee and payment frequencies, notification, and requests for review and appeal of council tax reduction decisions.

6.3 The Online Claim form asks questions clearly and provides explanations of why certain documents must be provided before any assessment can take place. This can be found at http://www.wealden.gov.uk/benefits/make-a-benefit-claim/

6.4 The paper Claim Form is reviewed when a re-print is required. The current claim form was jointly designed and produced by all East Sussex benefits services. This ensures maximum continuity across the local area. The form is also discussed with senior staff and decision makers and includes or excludes questions depending on HB/CTR Regulations changes for the forthcoming year.

6.5 The paper Claim Form is made available to the public in the Council’s reception areas, from Housing Association offices, Citizens Advice Bureau, parish council offices, Local Taxation and from the Housing Department where it forms part of the tenancy sign-up pack. It is also issued by post on demand via letter, telephone, minicom or e-mail enquiry.

6.6 The Claim Form (whether the paper copy or online) is written in plain-English and has been certified to that effect by the Word Centre. It complies with best practice with regard to readability, especially important to those with partial sight or to those with reading difficulties.

6.7 The paper Claim form is available at Council Offices, all Citizens Advice Bureau in the Wealden area, other voluntary organisations, some parish councils and registered social landlords. It forms part of the tenant sign-up pack for Council tenants.

6.8 Online Claim Form  

Apply the guidance to each claim

7.1 The guidance on standard verification is used to verify the information provided in support of benefit claims. The Council adopted the Standard Verification Framework in April 2025 which states the items of evidence based on circumstances that can be accepted for different incomes, capital, tenancy, rent liability and identity; and how to verify their authenticity. The Standard Verification Framework should be reviewed each year.

7.2 The aim of the standard verification guidance, is to prevent fraud and error entering the benefits system, and to provide assurances that claimants receive their maximum entitlement to benefit – see Counter-Fraud Policy and Strategy.

7.3 Compliance with the guidance is secured through refresher training sessions, when reviewing procedures by Senior Benefits Officers, and when errors are discovered through the Management Checking Procedures.

Correctly record claim data into Academy Benefits

8.1 The HB/CTR Regulations are so complex that the Council uses a large IT software program (Academy Benefits) to maintain claims.

8.2 As with all IT systems the effectiveness of the programming depends totally on accurate input of data. Decision makers are trained to use Academy Benefits by experienced staff.

Accurately assess benefit entitlement using Academy Benefits

8.4 Due to the complexity of the Academy Benefits programs the accuracy of benefit and Council Tax Reduction entitlement is tested every time a new release of software is applied. It is occasionally the case that new software provided for specific purposes detrimentally affects the operation of previously accurate software. Testing of new software is undertaken on the Test System before it is applied to the ‘live’ system.

8.5 The Council’s IT Section manage Academy Benefits by ensuring its availability during working hours, and by maintaining those technical aspects that provide security and continuity of service. Access to Academy Benefits is tightly controlled to prevent unauthorised use.

8.6 The Council is a member of the Academy Benefits User Group who consider requirement specifications before software is written. The User Group meets to discuss claim maintenance software strengths and weaknesses together with development requests. The User Group will discuss these requests, agree on the priorities and Academy will allocate resources according to the priorities. As a member of this Group the Council contributes to ensuring that Academy Benefits remains user friendly, and therefore less prone to assessment error. The Council may also contribute to specialist sub groups of this User Group.

Allocate the correct subsidy classification to each benefit payment

9.1 HB is a state benefit that is funded by the government. LA’s act as agents for the government to administer the HB scheme, and they receive subsidies to contribute towards the costs of administration and each benefit payment. HB Subsidy is claimed annually.

9.2 Each time a payment is made an IT record is created that identifies the precise subsidy value that is claimable for that payment. The values range from 100% to nil depending on the circumstances governing the payment of that benefit. A combination of system parameters and decision maker input routines create these records, which are externally audited following the submission of each annual HB Subsidy Claim in May. If the Subsidy Claim is incorrect the Council can be financially penalised.

9.3 Decision makers receive training and refresher training throughout the year in response to Circulars issued by the DWP, best practice guidance issued by any government department, benchmarking intelligence that suggests good practice, responses to complaints, errors found through the Management Checking Procedure and changes in the HB Regulations.

9.4 Operational procedures provide for the regular quality control of work undertaken within the Benefits Service. Errors made by decision makers are brought to their attention, and amendments are made to their decisions when the reason for the error has been understood. Decision makers are provided with the opportunity to discuss any error identified to reinforce their knowledge.

Pay the right claimants the right amount, the right amount, at the right time

The right claimants

9.5 Operational procedures provide for extensive checking of claimants’ identity, in accordance with s19 Social Security Administration (Fraud) Act 1997. Claimants provide evidence of their identity that includes their National Insurance number, which can be validated using a government database.

9.6 The IT system reports on claims where a person with the same National Insurance number appears to be a member of more than one household claiming benefit. There are prescribed circumstances when this is lawful. These claims are checked to ensure that the circumstances are prescribed.

The right amount

9.7 The right amount of benefit depends on the claimant providing accurate data, decision makers interpreting and treating that data correctly for benefit purposes, and Academy Benefits accurately applying the appropriate parameters to claimants’ circumstances.

9.8 Customers applying are encouraged to provide accurate data on the Claim Form. If no evidence of information is provided decision makers write to each claimant listing, in detail, the documents required before their claim can be assessed.

9.9 The Corporate Fraud Unit respond to referrals of alleged fraud from several sources, including decision makers, members of the public and other government agencies. Housing Benefit Fraud is referred to the DWP’s Single Fraud Investigation Unit (SFIS).

9.10 Decision makers are trained extensively on HB/CTR Regulations and internal procedures, taking around 2 years to become fully experienced. Throughout the year decision makers receive update training and refresher training in response to Circulars issued by the DWP, best practice guidance issued by any government department, benchmarking intelligence that suggests good practice, responses to complaints, errors found through the Management Checking Procedure and changes in the HB/CTR Regulations.

9.11 Due to the complexity of Academy Benefits the accuracy of benefit and Council Tax Reduction entitlement is tested every time a new release of software is applied. It is occasionally the case that new software provided for specific purposes detrimentally affects the operation of previously accurate software. Testing of new software is undertaken on the Test System before it is applied to the ‘live’ system. Bugs or failures are reported to Academy Benefits.

The right manner at the right time

9.12 HB for Council tenants and CTR for all claimants is paid as a rebate to their rent and Council Tax accounts held by the Council, by law. Council tenant rent accounts are updated weekly with their rebate and any adjustments made during the week to reflect any changes in their circumstances or in the HB/CTR Regulations. The first payment of CTR made each year is paid to next 31st March, and any changes in claimant circumstances are reflected in adjustments made thereafter.

9.13 Private tenants or their landlords are paid by BACS transfer. HB Regulations govern whether or not payments are made in advance or arrears.

9.14 Only in one circumstance can landlords request payment be made direct to them, which is actioned in accordance with the HB Regulations.

9.15 The Benefits Service Safeguard Policy describes in which circumstances Local Housing Allowance payments can be made to landlords of private tenants. This policy was produced by East Sussex benefits services and is published on the Council’s website.

Notify claimants and landlords about benefit decisions, in accordance with HB/CTR Regulations Schedule 9 (Schedule 8 of the State Pension Credit Regulations) prescriptions

10.1 The HB/CTR Regulations prescribe those information items that must comprise each Decision Notice relating to benefit entitlement. These are the following where applicable;

• a statement as to the right of any ‘person affected’ to request a written statement that explains how the decision was reached
• a statement as to the right of any ‘person affected’ to apply for the decision to be revised, or to appeal against the decision
• where the original decision has been changed, a statement as to the right of any ‘person affected’ to apply for the new decision to be further revised, or to appeal against the new decision
• where the original decision has not been changed, the reasons why the decision has not been revised
• weekly eligible rent/Council Tax
• amount of any fuel deductions
• amount and category of any non-dependent deductions
• weekly amount of benefit
• 1st day of payment for private tenants
• 1st day of entitlement to benefit
• last day of entitlement to benefit, if not ended earlier
• claimants duty to notify the Council about changes in circumstances, and the kinds of changes to notify
• the claimant’s Applicable Amount, and how it is calculated
• the value of any earnings used to decide entitlement
• the value of any other income used to decide entitlement
• where the claimant has requested direct payment to landlord, the value and date from which the payment will be made
• where the income/capital of a non-dependent has been used to decide entitlement, that fact and the reasons why the decision has been made thus
• where no benefit entitlement is assessed, that fact and the reasons why
• where the notification is about an overpayment of HB the items in Overpayment Policy and Strategy

10.2 Operational procedures ensure that the above information items are included in relevant notifications to claimants and landlords, where applicable.

10.3 Correspondence from the Benefits Service is written in plain English, unless the letter templates prevent amendments from being made.

Make claimants aware of their rights to request a review or appeal against decisions

11.1 Operational procedures ensure that the Council

• examines the circumstances of each case and makes decisions in accordance with the HB/CTR Regulations
• advises claimants and landlords of their rights – See 9 Notification of an overpayment above

11.2 DWP guidance states that “it is important to recognise that there is a right under the law to appeal and LA’s should not filter or obstruct the process in any way”.

11.3 Operation procedures make claimants and other ‘persons affected’ aware of their rights to request a revision or appeal against benefit decisions. These rights are contained in all decision notices relating to benefit decisions. Operational procedures provide for requests for a revision or appeal to be actioned according to the DMA Regulations.

11.4 Operational procedures aim to reply to requests for an explanation, review or appeal against overpayment decisions within 14 days. As well as the appropriate response depending on the request, all replies contain the following information;

• the right to appeal further, how and when to do this
• a simple and clear form for submitting a further appeal
• direct telephone numbers to contact the Benefits team

11.5 Claimants and ‘persons affected’ may appeal outright when receiving a decision. If the Council does not revise or supersede its original decision in favour of the claimant or landlord the appeal is automatically submitted, by law, to The Tribunal Service for a tribunal hearing.

11.6 Tribunal hearings are judicial, though less formal than court hearings. A legally qualified Chairman hears the appeal. All tribunal members are independent of the Council.

11.7 Operation procedures ensure that any decision by the tribunal is actioned on the same or following working day, unless the Council intends to appeal against the tribunal’s decision. If the Council intends to appeal the prescribed procedures and time-limits are strictly observed.

11.8 Council Tax Reduction Appeals are dealt with through the Independent Valuation Tribunal like other Council Tax appeals. Customers have no time limit to appeal to the Local Authority. Once the customer has appealed to the Council, the Council has 2 months to act on the Appeal. Should the Local Authority not respond within these 2 months or do it negatively the customer has a further 2 months to refer the appeal to the Independent Valuation Tribunal.

Ensure the Council makes accurate decisions

12.1 The Council has sound and comprehensive mechanisms to ensure the quality of claim maintenance decision making through regular training of staff, and through the Management Checking Procedure.

12.2 Decision makers receive training and refresher training throughout the year in response to Circulars issued by the DWP, best practice guidance issued by any government department, benchmarking intelligence that suggests good practice, responding to complaints, errors found through the Management Checking Procedure and changes in the HB/CTR Regulations.

12.3 Training is provided via dedicated subject training courses and refresher training sessions

12.4 Operational procedures provide for the regular quality control of work undertaken within the Benefits Service. Errors made by decision makers are brought to their attention, and amendments are made to their decisions when the reason for the error has been understood. Decision makers are provided with the opportunity to discuss any error identified to reinforce their knowledge.

12.5 The overall work of the Benefits Service is independently monitored by Internal Audit to provide assurance to the Council that procedures are adequate, appropriate and can be audited for financial probity.

12.6 Internal Audit has an annual plan to monitor the work of the Benefits Service. Any recommendations made in their reports are actioned within timetables accepted by them.

Set challenging and realistic performance targets

13.1 The Service measures its performance against a range of national and local performance indicators shown in the Corporate Plan. The Benefits Service reviews all targets annually to ensure they remain relevant to service users.

13.2 Each year a target is based on previous years’ performance and known issues affecting potential performance in the following year, such as the implementation of Universal Credit. Previous years’ performance and the new targets are discussed as part of the annual staff appraisal process and in regular 1:1’s and team meetings. This ensures all staff are aware about how their work contributes to the Council’s overall objectives. This is commonly known as the ‘Golden Thread’.

Monitor performance and report to Members

13.3 Performance is monitored regularly and will be analysed to explain deviation from expected outcomes. Performance monitoring methods and procedures are to be reviewed regularly.

13.4 Performance is monitored monthly and reported on the Council’s Corporate Performance System.

13.5 Quarterly reports on performance against national indicators are provided for Cabinet and Internal Scrutiny Committee in Quarterly Performance Management reports.