PIP appeal or Change of Circumstances.

nicey1958

I gained PIP high mob in January with 12+ points, but scored only 6 on Daily. I have severe Peripheral Neuropathy in both Upper and lower limbs, but at the time only diagnosed lower limb by the Diabetic foot clinic I attended for 8 years. I did specify on the original form things I could and couldn't do on a daily basis and got the award. I Sent in a mandatory reconsideration on the Daily living part and added to the New medical information as to why it affects my arms and legs, A new Doctors report/referral that confirmed I have PN in upper limbs as sent in as well.  Anyway, It seems and I was told over the phone that the MR had failed. Now I don't no whether to do a Change of Circum or Appeal. I will do one of these but need advice as to which one because I have read many post's of success and fails as to on the day, it depends who reads the new PIP application. I did say on the MR, that I would welcome any examination by any appointed neurologist by the DWP but seems the MR Case manager was better qualified than any consultant or DR to make judgement on my condition and what I can and can't do.
thank you.

poppy123456

In my opinion, it's always better to proceed to Tribunal. Reporting a change of circumstances does risk your current award being reduced or even stopped completely. Of course it could also increase or remain the same. 

nicey1958 said:

 I would welcome any examination by any appointed neurologist by the DWP but seems the MR Case manager was better qualified than any consultant or DR to make judgement on my condition and what I can and can't do.
thank you.

That really wouldn't help anyway because PIP isn't awarded based on any diagnosis. Everyone is affected differently by these conditions and you never get 2 people the same. 

nicey1958

poppy123456 said:

In my opinion, it's always better to proceed to Tribunal. Reporting a change of circumstances does risk your current award being reduced or even stopped completely. Of course it could also increase or remain the same. 

nicey1958 said:

 I would welcome any examination by any appointed neurologist by the DWP but seems the MR Case manager was better qualified than any consultant or DR to make judgement on my condition and what I can and can't do.
thank you.

That really wouldn't help anyway because PIP isn't awarded based on any diagnosis. Everyone is affected differently by these conditions and you never get 2 people the same. 

I just think it was wishful thinking seeing someone else. Anyway, by pure coincidence, the Consultant who treated me for diabetes and PN, phoned me less than 30 mins ago, to take part in trials for PN. Will be the 3rd time I've done trials for them.  1st time I've spoke in 7 months to him :-)  Maybe something is written in the stars for me to get full PIP as he said he would write me a letter..

nicey1958

So I got the PIP MR decision letter today. I think the must have just photocopied the original decision on Daily award.. same points/same places.. Seems they didn't even contact my own GP or read the supplied new medical evidence re-affirming  my condition in my hands and arms and the DR's advice not to use any appliances that are hot or movable.  Anyway, as you said in your post above, I will probably go down the appeal route. One question is, If you start an appeal, is the PIP you receive currently , in my case, High Mobility, stopped or suspended till the appeal is heard and decided?

chiarieds

Your current award of PIP will continue until a decision is made by the tribunal.

poppy123456

They very rarely contact anyone for any evidence and you shouldn't rely on this. The onus is on you to prove you qualify, not their's. 

nicey1958

poppy123456 said:

They very rarely contact anyone for any evidence and you shouldn't rely on this. The onus is on you to prove you qualify, not their's. 

maybe i'll just have a nasty accident one day and say  ' I told you so'  .. I don't know on what else to do or say.

poppy123456

If it was a GP letter you sent then this isn't the best evidence to send anyway. A GP doesn't spend anytime with you to know how you manage the activities related to the PIP descriptors. They don't see you wash, dress, undress, cook etc etc. If they know it's because you've told them and then it becomes "hearsay"

nicey1958

poppy123456 said:

If it was a GP letter you sent then this isn't the best evidence to send anyway. A GP doesn't spend anytime with you to know how you manage the activities related to the PIP descriptors. They don't see you wash, dress, undress, cook etc etc. If they know it's because you've told them and then it becomes "hearsay"

yeah but If the problem diagnosed by the Dr means I'm not going to win any  marathon anytime, and if that was one of the descriptors surely that must count towards reason I can and can't do this. I can get my wife to write a letter stating the same but does that give any more reason to approve the claim. other than that, I just don't know what else to do.

honestjon

nicey1958 said:

poppy123456 said:

If it was a GP letter you sent then this isn't the best evidence to send anyway. A GP doesn't spend anytime with you to know how you manage the activities related to the PIP descriptors. They don't see you wash, dress, undress, cook etc etc. If they know it's because you've told them and then it becomes "hearsay"

yeah but If the problem diagnosed by the Dr means I'm not going to win any  marathon anytime, and if that was one of the descriptors surely that must count towards reason I can and can't do this. I can get my wife to write a letter stating the same but does that give any more reason to approve the claim. other than that, I just don't know what else to do.

I think your wife's letter saying how your illness makes your days hard is stronger evidence than a letter from your doctor and the dwp agree because as Poppy says they don't seem to respect the doctors opinion that much for some reason.

poppy123456

The only person that really knows how your conditions affect you is yourself. For this reason the best evidence you can send is your real world examples of exactly what happened the last time you attempted each descriptor that applies to you. At least 2 per descriptor you think applies to you, which should be at least half an A4 side of paper per descriptor that applies.

Adding detailed information such as where you were, what exactly happened, did anyone see it and what the consequences were.

Yes, you can also ask your wife to write a supporting letter.  

Jimm_Scope

As other's have said, you provide the best evidence as you know best how your day to day living is affected.

Your wife can also provide a supporting letter to confirm how your day to day living is affected too. 

In regards to medical evidence, it is not needed but can be useful at a tribunal. However, evidence that just says what your condition is (just "X has asthma" as an example) is much less helpful than evidence that says how your life is affected.

nicey1958

Jimm_Scope said:

As other's have said, you provide the best evidence as you know best how your day to day living is affected.

Your wife can also provide a supporting letter to confirm how your day to day living is affected too. 

In regards to medical evidence, it is not needed but can be useful at a tribunal. However, evidence that just says what your condition is (just "X has asthma" as an example) is much less helpful than evidence that says how your life is affected.

It would be better that they  understand the actual illness you have , they will might understand why you 'can and can't' physically. Anyway, appeal applied for, fingers crossed. 

chiarieds

I think sometimes there's a misconception that the assessors don't understand many, many medical conditions. The assessors are mainly nurses, but also physios & paramedics. With our training (I speak as a long-retired physio) we are taught about many disabilities, & also gain experience through rotating through different wards. Once qualified, one hopes such experience increases, & I believe as an assessor you need to have been qualified for at least 2 years. You therefore have an understanding as to the difficulties some claimants face. 

However, as you could have a couple of dozen people all with say peripheral neuropathy, they will not all be affected exactly the same as each other. This is why assessors are used that have some understanding about varying medical conditions, but why the claimant has to literally say how their disability affects them; it's totally individual, which is why your own testimony matters so much.

Jimm_Scope

Indeed, same with my Crohn's disease. There's a wide degree to how much Crohn's can affect someone, so some sort of assessment is needed. Also why evidence that just says I have Crohn's disease, without saying how it affects me, is not very helpful.

nicey1958

chiarieds said:

I think sometimes there's a misconception that the assessors don't understand many, many medical conditions. The assessors are mainly nurses, but also physios & paramedics. With our training (I speak as a long-retired physio) we are taught about many disabilities, & also gain experience through rotating through different wards. Once qualified, one hopes such experience increases, & I believe as an assessor you need to have been qualified for at least 2 years. You therefore have an understanding as to the difficulties some claimants face. 

However, as you could have a couple of dozen people all with say peripheral neuropathy, they will not all be affected exactly the same as each other. This is why assessors are used that have some understanding about varying medical conditions, but why the claimant has to literally say how their disability affects them; it's totally individual, which is why your own testimony matters so much.

I agree, different levels of disability from the disease will affect you abilities in everyday living, but when you actually have certified diagnosis by not one, but a few consultants, and that a level of disability is severe, they should take that is how that will affect the patient in real situations. I can only tell the assessor what it is and how it affects life. There's so many horror stories out there about about how the DWP have got it so wrong, They only need to do a medical that will prove the 99% of claim to be true or false. That's why I think an appeal hearing is going to be better in a face to face situation.  Anyway, talking about being qualified, even face to face, I attended hospital with a swollen ankle, informing A&E that I had Diabetes and Peripheral Neuropathy. Was told I had a sprained ankle, said go home rest up. I went back following day after worsening, turned out it was Charcot, broken  in 3 places, and displaced. ended up with a surgeon who saved my foot with a nail and ankle fusion after a long spell in hospital. Nobody knows everything and everything. I have to say tho, It was a sports physio who did send me to x-ray that day.

poppy123456

nicey1958 said:

chiarieds said:

I think sometimes there's a misconception that the assessors don't understand many, many medical conditions. The assessors are mainly nurses, but also physios & paramedics. With our training (I speak as a long-retired physio) we are taught about many disabilities, & also gain experience through rotating through different wards. Once qualified, one hopes such experience increases, & I believe as an assessor you need to have been qualified for at least 2 years. You therefore have an understanding as to the difficulties some claimants face. 

However, as you could have a couple of dozen people all with say peripheral neuropathy, they will not all be affected exactly the same as each other. This is why assessors are used that have some understanding about varying medical conditions, but why the claimant has to literally say how their disability affects them; it's totally individual, which is why your own testimony matters so much.

I agree, different levels of disability from the disease will affect you abilities in everyday living, but when you actually have certified diagnosis by not one, but a few consultants, and that a level of disability is severe, they should take that is how that will affect the patient in real situations. 

That still isn't going to help because as advised PIP isn't awarded based on any diagnosis. You can have a disability, regardless of how severe but there maybe no entitlement to PIP.

If you don't meet the descriptors, you won't score the points needed for an award. There are some people with disabilities that don't qualify. (I'm not saying you don't)

No one is automatically entitled to PIP (unless you have a terminal diagnosis, with a life expectancy of 12 months or less)

nicey1958

Ok, So thank you for all the comments on my original post.
I am going to Appeal the MR decision. 
1/.  Am I right in thinking that the DWP will or should send to the Tribunal  everything that I sent to them, including letters, evidence, etc. in fact every contact and information even via telephone calls I made to them, and then the Tribunal will then send me a pack containing all that as well for me to read through and check its all correct.?? 
2/  I can submit/upload any 'new' evidence to the Tribunal with the online appeal form, that might substantiate my claim as to why I think the DWP MR decisions were wrong.
3/ In the online appeal, I only have to put the 'activities' I disagree with what they think I can do, and put what I can actually do?    Won't that be on MR consideration I sent back to the DWP  that they should forward to the Tribunal  or do I have to say it all again?
4/Can my wife come and sit as a silent companion in the same room?
Thank you.

poppy123456

1/ Yes, DWP will send everything to HMCTS, which will include your PIP2 form, assessment report, any additional evidence you sent, MR request letter, assuming you sent one and DWPs response. The phone calls, if you requested the MR over the phone then the notes that were typed by the call handler should be sent. As for any other phone call then no. 

You will then receive a copy of everything in the bundle. 

2/ Yes you can send additional evidence anytime. Please note that a worsening of condition since the assessment took place will not be considered. What you need to concentrate on is the weakness in your evidence, not the strength of theirs.

3/ For now you just need to give a brief reason why you disagree with the decision. Don’t focus too much on the reasons why you were refused. 

4/ If it’s a face to face hearing yes your wife can attend with you but you will be expected to speak for yourself. Though most hearings are by telephone/video anyway. 

nicey1958

poppy123456 said:

1/ Yes, DWP will send everything to HMCTS, which will include your PIP2 form, assessment report, any additional evidence you sent, MR request letter, assuming you sent one and DWPs response. The phone calls, if you requested the MR over the phone then the notes that were typed by the call handler should be sent. As for any other phone call then no. 

You will then receive a copy of everything in the bundle. 

2/ Yes you can send additional evidence anytime. Please note that a worsening of condition since the assessment took place will not be considered. What you need to concentrate on is the weakness in your evidence, not the strength of theirs.

3/ For now you just need to give a brief reason why you disagree with the decision. Don’t focus too much on the reasons why you were refused. 

4/ If it’s a face to face hearing yes your wife can attend with you but you will be expected to speak for yourself. Though most hearings are by telephone/video anyway. 

Thank you very much for your answers. reassuring.  That's exactly what I have done and saved ready for sending.
TY

nicey1958

Like to say DWP got back to me 5 days before they were supposed to respond to the appeal board and offered me Standard award backdated to my original claim. Rather than go through all the appeal process, after talking to the missus decided I will accept it and as I did say to the 'CASE' reviewer who phoned, it may be Change of circumstances in the future because waiting for the Neurologist final say so on how he thinks or knows how this polyneuropathy will go, I could be much worse so its  some weight off my mind with out having to wait 18 months or so for a hearing.  cheers anyway.