MK v Secretary of State for Work and Pensions (DLA)

Factual and Procedural Background

The case concerns an appeal against a decision of the First-tier Tribunal (Social Entitlement Chamber) made on 12 November 2008 at Manchester, which found that the Appellant had been overpaid Disability Living Allowance (DLA) from 6 April 1992 to 22 November 2005, with recovery sought on grounds of misrepresentation of material fact. The overpayment amount initially exceeded £42,697.15. However, the Department for Work and Pensions (DWP) revised this to an overpayment from 5 April 2000 to 22 November 2005, totaling £22,793.25, with recovery sought on the basis of failure to disclose.

The appeal was allowed on the basis that the First-tier Tribunal made an error of law. The matter was referred back for rehearing before a differently constituted tribunal with directions for reconsideration of the recoverability and amount of overpayment.

The claimant’s DLA awards spanned several decisions made in 1993, 1995, 2000, and 2004, each based on various claim forms and medical evidence, with differing rates and grounds for care and mobility components. Subsequent decisions in 2006 by the DWP removed entitlement and sought recovery of overpayment based on evidence including home videos showing the claimant participating in activities inconsistent with claimed disability.

Medical evidence indicated the claimant suffered from severe psoriasis, psoriatic arthropathy, depression, anxiety, and type 2 diabetes, with conflicting views on the claimant’s need for supervision or care over the relevant period. The tribunal’s approach heavily relied on video evidence to conclude the claimant was not entitled to DLA at any time during the period.

Legal Issues Presented

1. Whether the First-tier Tribunal erred in law in concluding that the claimant had misrepresented material facts justifying recovery of the entire overpayment from 1992 to 2005.
2. Whether the tribunal sufficiently identified and explained misrepresentations in relation to each operative decision awarding benefit.
3. Whether the evidence supported the conclusion that the claimant was never entitled to any award of DLA during the relevant period.
4. Whether the tribunal properly applied the statutory requirements under section 71 of the Social Security Administration Act 1992 regarding recovery of overpayments based on misrepresentation or failure to disclose.

Arguments of the Parties

The opinion does not contain a detailed account of the parties' legal arguments.

Table of Precedents Cited

No precedents were cited in the provided opinion.

Court's Reasoning and Analysis

The court found that the First-tier Tribunal erred in law by failing to properly identify or explain the misrepresentations that justified recovery of the overpayment in relation to each benefit award decision. The tribunal had relied heavily on video evidence depicting the claimant engaging in activities inconsistent with claimed disability but did not adequately reconcile this with extensive medical evidence indicating severe mental and physical health conditions requiring supervision and care.

The tribunal also failed to properly consider or explain the significance of medical reports, including those from a Community Psychiatric Nurse, General Practitioner, and an Examining Medical Practitioner, which provided professional assessments of the claimant’s condition. This lack of sufficient reasoning and failure to identify operative misrepresentations undermined the tribunal's conclusions.

Specifically, for the 1992 and 1995 awards, the tribunal had no claim forms or evidence of representations and thus could not establish misrepresentation on the balance of probabilities. The tribunal’s reliance on a previous case for this point was misplaced. For the later awards, the tribunal needed to examine the terms of claim forms and medical evidence more closely to determine if misrepresentations occurred and whether payments were made as a consequence.

The court emphasized that the burden of proof remained on the Secretary of State to prove misrepresentation or failure to disclose on the balance of probabilities and that the tribunal must give sufficient reasons for its findings. The court directed a full rehearing to address these issues properly.

Holding and Implications

The appeal was ALLOWED. The decision of the First-tier Tribunal was set aside due to an error of law, and the case was referred back for a rehearing before a differently constituted tribunal.

The rehearing is to reconsider the amount and recoverability of the overpayment in accordance with the legislation and the directions set out by the court. The Secretary of State is required to notify the tribunal and claimant in writing of the overpayment amount alleged recoverable, the relevant dates, and the grounds for recovery.

This decision carries no implication as to the outcome of the rehearing, which remains a matter for the tribunal conducting it. No new precedent was established by this ruling; it primarily addresses procedural and evidential deficiencies in the original tribunal’s decision.