[2025] UKUT 020 (AAC)

Mr Edwards submitted that there was a valid second claim to PIP made by the Appellant by telephone on 29 July 2022. It was validly made and registered by the Respondent irrespective of whether the PIP2 questionnaire was returned. Therefore, there was a valid decision by Respondent to close and disallow that claim on 25 September 2022. Therefore, the FTT made no error of law in finding this to be the case at [44] of the SOR and thus limiting the award under the first claim to PIP to the time up until the second claim to PIP.

He submitted that regulation 11(1) requires that a claim to PIP be made by certain methods including by telephone (11(1)(b)). Regulation 11(4) only provides that a telephone claim is not completed and defective when information required to determine the claim is not provided but the absence of a PIP2 questionnaire return being returned does not render the invalid, incomplete or not properly made.

In effect, although he did not directly refer to it, Mr Edwards appeared to rely upon the obiter observations and reasoning in GG at [19] as to how Regulation 11(4) should be interpreted. He impliedly argued that a claim is valid and properly completed by satisfying the ‘lay conditions’ for a claim in the telephone call, as observed in GG, rather than on return of the information in the PIP2 questionnaire.

His express submission was that the second claim to PIP made on the telephone call on 29 July 2022 was properly made and completed, and the later absence of the return of a PIP2 questionnaire did not render it a defective claim. Therefore, the negative determination on 25 September 2022 regarding the second PIP claim (based upon the failure to progress the claim or file a PIP2 questionnaire) was an effective and valid decision refusing PIP entitlement from 29 July 2022.

Mr Edwards contended that the second PIP claim was not defective for failure to provide the information contained in the PIP2 questionnaire. He argued that the provision of the PIP2 questionnaire, the requested information, only goes to the existence and level of entitlement to PIP (whether sufficient points can be awarded) but the provision of information does not determine the fact of a valid claim being made. A person makes a valid claim to PIP on initiating the telephone call which claims it. There can be a valid claim made to PIP by telephone without the need for provision of the PIP2 questionnaire – it simply means that the details of the level of the benefit cannot be assessed so the claim is not closed. It does not make the claim defective.

He argued that the absence of the provision of the information required to determine the extent of the entitlement to the benefit does not undermine the validity of the claim. In other words, the initial telephone call became the valid claim to PIP which brought the claim into the existence and the provision of the PIP2 questionnaire only went to the determination of the benefit and not the validity of the benefit. The evidence in support of a claim only goes to the entitlement to the benefit and the level of the award and not the validity of the claim.

Further, he argued that the reason in this case for the second PIP claim not being progressed (or negatively determined) on 25 September 2022 was the non-responsiveness of the Appellant and this could not be used to his advantage to submit that there was no valid claim to PIP made by telephone on 29 July 2022 (albeit Mr Edwards had to accept that the Respondent had decided in October 2023 that the Appellant had a reasonable excuse for not providing the PIP2 questionnaire back in 2022).

Mr Edwards did not address me on the effect of Regulation 12(1) but likewise he impliedly argued that the fact that Regulation 12(1)(b) provides that the date on which the claim is made by telephone is the date on which a claim is properly completed does not prevent a valid claim having been made or even properly completed when it is initiated by telephone.

I address the remainder of the parties’ submissions below in the discussion and analysis section.